NEWS: Democrats Blowing It On Health Care

Ah, so if a Doctor feels he might be under-compensenated by "the public option", he'll be free not to accept that insurance?

Please explain how that situation would come up. Use the REAL proposed health plan, not the made-up monster of talk radio.

Or he can charge above the 'scheduled fee' which is what they are allowed to do here in Oz with Medicare. There is nothing in the current proposals about trying to impose national price controls on doctors or medical operators as i suspect you know full well.

So what happens is that doctors servings in wealthier areas charge more and those serving in poorer areas charge less.

Why do some doctors choose to work in poorer areas i hear you ask? Well some do so out of altruism (i.e. they became doctors to help people not become wealthy), some do so because they aren't very good doctors (which sucks for the poor, but then no one ever said being poor was a great thing and some medical care is better than none) and some do so because the poor are a vast market and even at the scheduled fee you can make a good living if you can achieve economies of scale (i.e. you chain doc in a box operation)

Well, I'm basing it off of someone else's personal experience.

This is because you have too many systems and too many layers of bureaucracy. Done properly a national scheme will actually make everything easier.

The national medical insurance scheme here is Oz is called Medicare; this has differing levels of cover for citizens, pensioners, veterans etc. All handled by the same system.

We have a national medical payments system that operates over the EFTPOS network for both medicare and all the health insurance firms. I go to the doctor they ask for my medicare card they swipe it through the EFTPOS terminal and it deducts the money from the government to the health care provider. If the charge is above the schedule fee (or not covered) then they swipe my health insurance card and it deducts money from the health insurer to the health care provider. If there is still money left to pay i put that in.

I haven't had to fill out any paperwork for medical care for years, unless I have forgotten to take the necessary cards with me. I have mates who are doctors and they tell me that their reporting requirements under Medicare can all be handled automatically by all the various practice management programs they use.

This is not to say that the paperwork isn't a pain; bureaucracy always is. However; the issue in the US now is the plethora of systems. You need to have just one national system rather than the rats nest of state, federal and individual corporate systems.

Given how closely involved they are with so many aspects of life and how clearly they manipulate those aspects of life to their own benefit i wonder why Sarge isn't as concerned about insurance companies as he is about the government?

Dr. Helen is mostly talking about being frustrated because she took too much on her own shoulders. It was her choice. She could have worked with a practice and had a staff, but she didn't. Which makes it her own problem.

But don't you think, just maybe, if everybody is using the same insurance, that would simplify things for those who choose to do their own paperwork? And isn't it possible that they are trying to fix some of the problems that have haunted Medicare?

It's possible. Of course it's possible I could shit gold bricks. It's far more likely, however, that the problems haunting Medicare will be propagated to public insurance. If you have reason to believe otherwise, then by all means let's hear it.

You brought up the possibility. It is up to you to prove that the problems within Medicare will be propagated to public insurance.

But, since you asked, the simple fact that the problems within Medicare ARE so well known makes me think that they might use this opportunity to fine tune things to eliminate problems, instead of blindly doing the same thing and expecting a different result.

Medicare has problems, but compare those problems to what the Health Insurance system we have now. Honestly, which is worse?

Actually, that is not at all possible.

If I swallowed some gold nuggets, it could happen...

Medicare, because while we can opt of health insurance, or choose a different policy, we're forced to pay for Medicare whether we use it or not in the form of taxes.

Oddly enough, I end up paying for a bunch of roads that I never use. How about you?

Yeah, but you pay for the roads you do use, right? You're using the road system.

If you were smarter, you would have gotten my point. Oh well.

Gotcha, so since I wasn't able to decode your cleverly obfuscated point, it must be the result of some mental failing of mine. How about coming out and saying it for this confused, blundering idiot?

It's basic cost-benefit analysis under economies of scale.

I contribute taxes which pay for national roads, most of which I don't use. An alternative system that somehow tried to get me simply to contribute only to roads that I use would not yield significant benefits to me relative to the costs of implementing such a system. It's simply more efficient -- in terms of the ends trying to be achieved -- to collect taxes to fund the road system as an overall asset.

There are failry compelling reasons to argue that it becomes more efficient -- in terms of the ends trying to be achieved -- to fund an overall health system that covers the basic services. Individuals in large numbers cannot afford their (expected) health expenses on an up-front basis, so the only private alternative is insurance, which leads to the domination of the health system by insurance companies, with all the principal-agent problems that this implies.

It's an efficiency-based argument. I would have thought that was obvious.

YOU PAY FOR ALL OF THE ROADS BECAUSE YOU DO NOT KNOW WHICH ROADS YOU MAY END UP USING!

In my town the locals avoid a certain through way like the plague. Since living here for 6 years I have done the same. I recently found out that road is the fastest way to get my wife to work. I used to work at the same building. So for 3 years I was taking the long way to work because I was dumb and stubborn. I am glad I was paying for that road. I am also glad I stopped being dumb and stubborn.

Someday you'll be glad to have stopped being dumb and stubborn.


TFOK: I know you were making a different point, but I thought spinning it in the way I did would make more sense to Sarge.

You honestly don't think he would listen to something like reason do you?

Of course not knowing the specifics means you DO get praise the plan to high heaven.

I think perhaps I should offer an alternative solution to high health care costs. Obama sort of got it right when he said this country needs to produce more doctors. Unfortunatly doctors are trained, not built, but he was right there's a supply problem. Here's my solution:

Import more Doctors! Think about it. There a lot of smart people just waiting to get into the US. Why not find out which ones are in the medical profession and fast track them in the country? Also, find some way of incentivizing foriegn doctors to come to the US. That way you increase the supply of medical professional, lowering costs.

Yes, then we'll have even more doctors running around that people who can't afford health insurance aren't going to go see.

Maybe you don't get this. People don't skip health insurance for something stupid like political disagreements. We (yes, I am one) don't get insurance because we can't afford it. Let me repeat: We cannot afford it.

Now, I know your next answer will be "Go get a different job". Which would be great if there were jobs to be had.

Health insurance companies have proven that they cannot be trusted. They overcharge, then pull insurance when a high cost comes up. We need an alternative way to get insurance. Not some goal-shifting bullshit about importing doctors from around the world.

I'm not inclined to play the "Get a different job" card this time, for the reasons you just described (and I've been socked some high health care costs since the last time I weighed in on this, leaving me more empathetic), but if we have more doctors, the price of health care WILL go down, by extension, so will Health Insurance Premiums (if not, at least your ability to pay out of pocket will improve significantly). There's notihng about a public option that will increase the over all supply of health care, and it'll be just like the 1970's when we enacted price controls in response to OPEC's oil embargo, where people where waiting for gas. Except this time, the wait could cost you your life.