Mitts Pick

[erfalf]

What planet are you living on?  It sure ain't planet Earth.  In actual fact, we are right about #38 on THIS planet! 

As for non-insurance doctors being cheaper...well, that isn't the United States of America.  And certainly isn't Oklahoma.

You related to Gaspar??

Well, the non-insurance Dr. in town here charges significantly less. And I've seen similar tales on the television in other cities.

The WHO (where we were #38 in 2000, last time published) believes that universal health coverage should be the goal of every country. I imagine we would not finish toward the top of that list...EVER!

[heironymouspasparagus]

The WHO (where we were #38 in 2000, last time published) believes that universal health coverage should be the goal of every country. I imagine we would not finish toward the top of that list...EVER!

And that is the sad part - you actually believe that coverage for everyone is a bad thing.  Just wait until you hit 26 and aren't on Mommy and Daddy's insurance anymore, and Burger King won't have a plan you can afford.  And then there is that pesky broken arm from the skateboarding incident at Woodland Hills.  Also does damage to your rotator cuff, requiring a $50,000 surgery that you just can't quite afford.  So they put a couple stitches in it and send you home, telling you that you will be ok in a few months - do some exercises - nothing to worry about - you really don't need to move your arm up more than even with your shoulder anyway... it's just one of those evolutionary artifacts that you will never miss.

BIG surprise time...Huge!!

[heironymouspasparagus]

To pay for the civil war, yes. And now Republican's can claim Lincoln? I thought he was too non-racial for that.

But it was the socialist & Populist parties that were pushing for an income tax the most.

So, are you saying it was better NOT to pay for the wars we are just emerging from??  Leave the trillions in debt due to unfunded wars?

[Hoss]

To pay for the civil war, yes. And now Republican's can claim Lincoln? I thought he was too non-racial for that.

But it was the socialist & Populist parties that were pushing for an income tax the most.

My point exactly.  Progressive THEN and progressive NOW aren't necessarily the same thing.

[erfalf]

Weren't you just saying that Medicare squeezes doctors? You can't have it both ways. Either Medicare is too stingy or it's not.

I said Medicare sets the prices, doctors price accordingly. No squeezing, just unreal prices. The natural price discovery is never allowed to happen.

I suppose if you define fairness as rationing access based on one's financial means, then yes, it is quite fair. (Emergency care isn't generally rationed, but that's the most expensive time to treat a problem)

Yes I do define it that way, since health care services are not a right, nor should they be. I'm sure you disagree, but why should a service that another provides be considered a right? You have no right to have your car fixed by a mechanic that doesn't want to.

I'm not arguing for single payer healthcare. I'm arguing against the dismantling of Medicare when the only alternative is a system we both agree is dysfunctional.

I think what we are saying is that Medicare is already dysfunctional. The head honchos have already put a due date on the whole thing, 2033 I believe. Some parts are already underwater. While that is over 20 years away, I don't think sitting on our hands waiting is a solution.

Yes. I'm saying that Medicare beneficiaries are on average happier with their package than the average beneficiary of private health insurance. Look it up. You want satisfaction surveys. Even within Medicare, traditional Medicare rates more highly than Advantage, despite Advantage costing more. Satisfaction is not complete, but it is not by any means that in the private market, either.

Um, yes, a program where the premium is withheld from your SS check and costs little more out of pocket for most of the users is probably going to be pretty popular. Let's see the comparison between Medicare and a private insurance firm that has infinite resources and let's see how it turns out.

It's mathematically impossible that our system is the most efficient. It costs more to do any procedure here than it does anywhere else in the world and our outcomes are no better than our (economic) near neighbors. The most efficient system would have the lowest prices for a given quality. Simple economics.

Um, no. Low cost does not equal efficiency. When I say efficiency, I mean that patients can go to doctors and get procedures with little to no dictation from any other entities besides the patient and doctor.

Freedom of choice is a matter of opinion. Many insurance plans have woefully small networks and have no coverage for non-emergency out of network services. The individual gets to pick their doctor even over in NHS-land. The difference there is that they're all covered the same. Only the source of the rationing changes. But that's irrelevant, I'm not arguing for an NHS-style system here.

You keep mixing insurance and health care choices. People in the U.S. have ultimate choice in what health care provider they choose. Insurance only comes in to the payment for said services. Don't mix the two up.

I wanted a public option. That is a GSE that sells health insurance. What better to liven up the market than a little competition, after all?

Out of curiosity, do you want a public option that is solvent, or like Medicare?

The health care system is already run mainly by capitalists. You keep repeating this mantra, not realizing that is what we already have. If you have the solution, have at it. Reform the insurance industry. When it's been declared a raging success by all because it reduced costs and increased efficiency, forever (or at least for a while) banishing the drag on our economy that is the present healthcare system, I'll be right with you in turning the insurance industry loose on Medicare. I am, quite honestly, more interested in solutions that work than anything else.

Except the only solution you offer, is one we already have. If you think that what we have as a health care system right now is truly capitalistic, you are gravely mistaken. There is no true price discover any more due to the federal government.

[erfalf]

And that is the sad part - you actually believe that coverage for everyone is a bad thing.  Just wait until you hit 26 and aren't on Mommy and Daddy's insurance anymore, and Burger King won't have a plan you can afford.  And then there is that pesky broken arm from the skateboarding incident at Woodland Hills.  Also does damage to your rotator cuff, requiring a $50,000 surgery that you just can't quite afford.  So they put a couple stitches in it and send you home, telling you that you will be ok in a few months - do some exercises - nothing to worry about - you really don't need to move your arm up more than even with your shoulder anyway... it's just one of those evolutionary artifacts that you will never miss.

BIG surprise time...Huge!!

Responsibility much? It is not the federal government's responsibility to make everyone's life easy.

[DolfanBob]

OOPS! Joe Joe stuck his foot in his mouth. Or better yet should have.
"They're gonna put y'all back in chains"

[erfalf]

My point exactly.  Progressive THEN and progressive NOW aren't necessarily the same thing.

We were just having a discussion about the Progressive Movement. Historical.

Although the abortion industry has some creepy similarities to some of the goals of the movement.

[heironymouspasparagus]

Responsibility much? It is not the federal government's responsibility to make everyone's life easy.

Ahhhh...the voice of privilege...


It IS the governments responsibility to level the playing field and prevent certain organizations from running roughshod over the weaker members of our society.  This is where your premise becomes wet toilet paper and falls apart like mush.

[erfalf]

Ahhhh...the voice of privilege...


It IS the governments responsibility to level the playing field and prevent certain organizations from running roughshod over the weaker members of our society.

I guess I have the voice of privilege, but I am working my donkey off just to make ends meet. So whatever.

It is the government's responsibility to protect you from others. Not to force others to provide you services at an affordable price. There is a difference.

[DolfanBob]

As much as I dislike him. Michael Moore's movie "Sicko" opened my eyes to a lot of what you are talking about.

[heironymouspasparagus]

I guess I have the voice of privilege, but I am working my donkey off just to make ends meet. So whatever.

It is the government's responsibility to protect you from others. Not to force others to provide you services at an affordable price. There is a difference.

Are you still on parent's insurance?  Or are you living what you preach and working your donkey off as the "rugged individualist" without the safety net?

Actually, protecting you from others does include that as part of the package.  Did you ever complain about the cost of a college class (I'm assuming you went...).  How about the price of a book?  And while paying for that credit hour, did you appreciate the subsidy you were receiving either from the state, or the endowments the private university has - depending on whether you went public or private?  

Or did you do the "rugged individualist" thing that you are promoting and just pay the entire cost yourself??  (Probably double to triple the per credit hour charge.)

[erfalf]

Are you still on parent's insurance?  Or are you living what you preach and working your donkey off as the "rugged individualist" without the safety net?

Actually, protecting you from others does include that as part of the package.  Did you ever complain about the cost of a college class (I'm assuming you went...).  How about the price of a book?  And while paying for that credit hour, did you appreciate the subsidy you were receiving either from the state, or the endowments the private university has - depending on whether you went public or private?  

Or did you do the "rugged individualist" thing that you are promoting and just pay the entire cost yourself??  (Probably double to triple the per credit hour charge.)

Thanks for the patronizing tone, but yes, I am 30, I am on my own if you want to call it that. And have had my own insurance since I was 19. And yes, I went to a state school (the best one...go pokes). But because I take advantage of the subsidies/freebies/whatever you want to call them does not make me agree with them. It just means I'm not an idiot.

[nathanm]

I said Medicare sets the prices, doctors price accordingly. No squeezing, just unreal prices. The natural price discovery is never allowed to happen.

pancakes. You still can't keep your story straight. Either Medicare sets the price for procedures covered by Medicare or doctors set the price. Which is it?

Besides, I don't know about you, but I have different prices for different clients. The ones that have regular work for me get a much better deal. This does not mean that price discovery isn't working in the market. It means bigger buyers get bigger discounts. The point being that the discounts I offer some clients do not in any way prevent me from negotiating whatever deal I like with any other clients that may be interested in my services. So yes, since Medicare essentially dictates pricing for Medicare patients by saying take it or leave it, Medicare reimbursements are not necessarily at market rate (in reality, many services leave a hefty profit margin for the doctor compared to insurance company negotiated rates, while others do not, it's a total package), that does nothing to stop insurers and doctors from negotiating on their own. Nor does it stop doctors, as Gaspar loves to point out, from not dealing with any insurance at all and just letting you handle any paperwork that may be necessary if you are insured.

Medicare is only 21% of the health care market. Why is the other 79% non functional if the problem is a lack of market-based reforms?

Yes I do define it that way, since health care services are not a right, nor should they be. I'm sure you disagree, but why should a service that another provides be considered a right? You have no right to have your car fixed by a mechanic that doesn't want to.

So poor people should be left to die in the street if they can't pay? Or do you prefer the current system, where they're not left to die in the street and we all get to pay for their crazy expensive care that could have been prevented by 5 minutes of a doctor's time and an $5 antibiotic scrip. Sounds like cutting off your nose to spite your face to me.

I think what we are saying is that Medicare is already dysfunctional. The head honchos have already put a due date on the whole thing, 2033 I believe. Some parts are already underwater. While that is over 20 years away, I don't think sitting on our hands waiting is a solution.

Please fix the private insurance market so that we have that option when the time comes. Instead you complain about how Medicare somehow is breaking the system, but without explaining how.

Um, yes, a program where the premium is withheld from your SS check and costs little more out of pocket for most of the users is probably going to be pretty popular. Let's see the comparison between Medicare and a private insurance firm that has infinite resources and let's see how it turns out.

You clearly have no conception of how Medicare actually works. It has required coinsurance payments. Not surprising. Everyone who has actually used it loves it, while folks who haven't all hate it. It's really weird how that works. Moreover, Medicare Advantage plans, which generally cover more stuff, are rated less favorably than the normal Medicare Part A/B.

Um, no. Low cost does not equal efficiency. When I say efficiency, I mean that patients can go to doctors and get procedures with little to no dictation from any other entities besides the patient and doctor.

Read an economics textbook so you understand what efficiency actually is. A system that is less expensive for a given standard of care is by definition more efficient. Unfortunately for us, most countries have health care systems that are more efficient than ours. That's OK in and of itself. Efficiency isn't everything. I would be totally fine with having a less efficient system if we actually had better patient satisfaction. Ideologically driven capitalists may feel otherwise, of course.

To address the point you made that had nothing whatsoever to do with efficiency, read your insurance plan documents and see what things you need to get pre-approved for. You'll likely be very surprised if you think you don't have to get permission beforehand for many procedures. Sure, maybe you've got a great PPO plan and can go see that cardiologist without bothering your GP about it. Then you can get ready for a long discussion with your insurance company as to whether or not you actually need that stent. You act as if our system is somehow different than the others. It's not, at least in that regard, we just have more sets of rules and more people writing and paying the bills.

You keep mixing insurance and health care choices. People in the U.S. have ultimate choice in what health care provider they choose. Insurance only comes in to the payment for said services. Don't mix the two up.

And in Canada (and the UK, and Germany, and France, and basically every other country in the world) they have the same choice. There is nothing exceptional here in that regard. And given that most people's access to health care is mediated by their health insurer, it's perfectly fair to bring them into the discussion of choice.

Out of curiosity, do you want a public option that is solvent, or like Medicare?

I prefer solvency. Solvency wouldn't be an issue if health care costs (not price, costs) weren't growing at twice or more the rate of inflation and hadn't been doing so since before I was born. (Insurance premiums have risen even faster than overall spending..go figure)

Except the only solution you offer, is one we already have. If you think that what we have as a health care system right now is truly capitalistic, you are gravely mistaken. There is no true price discover any more due to the federal government.

The only solution you offer is to make people's care worse without any actual plan for making the system you're throwing them into any better. Where are the action items? All you've thrown out there so far are ideological platitudes.

[heironymouspasparagus]

Thanks for the patronizing tone, but yes, I am 30, I am on my own if you want to call it that. And have had my own insurance since I was 19. And yes, I went to a state school (the best one...go pokes). But because I take advantage of the subsidies/freebies/whatever you want to call them does not make me agree with them. It just means I'm not an idiot.

May not be an idiot, but certainly don't live your "convictions".  Wouldn't that be considered hypocritical?

And yes, you did show extraordinarily good sense in going to OSU!   "GO POKES!!" is how it should be written, though.


Actually, the argument you should have made and should be making NOW is that the subsidies/freebies/etc you enjoyed are part of what is called the social contract.  It encompasses a shared risk/benefit element where you actually ARE now paying for those things now, in a distributed fashion by your state income taxes.  And will continue to do so as a resident of this state.  (Assuming you stay employed, of course).

And if you ever get to the point (may be there now, even) where your taxes end up exceeding what benefit you derived, then you are subsidizing someone else, in exactly the same fashion I subsidized YOU a few years ago, and I was previously subsidized by someone before that.  But then you also get the benefit of the contribution made by that person when they get out and find work, to maintain infrastructure, and hopefully build a better overall society.  (And yeah, I know how this kind of falls apart when the Oklahoma legislature and Mary Fallin gets involved...)

That person you (and I) are subsidizing today is more likely to have a better job, earn more money, pay more taxes, and be less of a burden on society (us).  Hopefully leading to a reduced societal cost, since they won't have to be boxed up in prison for whatever reason that might have occurred without the opportunities you and I help provide through that education.  It is NOT a case of do we get to pay none or a lot.  It IS a case of do we get to pay some or a whole lot more.

Health insurance is exactly the same.  If everyone participates, then you and I don't have 40% of our hospital/doctor/medicine bills paying for others who are not insured - we get a benefit - reduced subsidies to others.  That is what the people you are listening to on Fox don't want you to understand.