MUScoop

Quote from: mu_hilltopper on May 03, 2013, 09:33:30 AM
Co-sign.

Once the Federal Govt got into the business of backing student loans, banks will loan to roughly anyone who wants higher education, regardless of the value of the underlying asset, namely, the future earning power of the degree obtained.

Engineering degrees and anthropology degrees have a vastly different future earning power, yet they are funded the same.

Meanwhile, with this flood of loans, Universities aren't incentivized to cut costs like regular business is, and go the opposite way: the costlier the college, the more prestigious it must be.

Those days are numbered, either via governmental policy changes (less likely) or by education consumers wising up.

BINGO!

Look at two areas of the economy where prices have risen far faster than general inflation:  education and health care.  The common factor is that the government has inserted itself into the funding equation.  The mechanisms are different, but the result has been that education and health care changed from things you bought to things you were entitled to.  Because of this, consumers no longer felt the need to look for the best value, so "sellers" (schools and health care providers) have had carte blanche to raise prices without fear that their market would disappear.

The problem now is that schools and health care providers have gotten so used to the government subsidization that it could take decades to undo the mess.  And every chance we have to mitigate the mess, we instead compound it by expanding the programs.  Look again at healthcare.  Government subsidization caused spiraling costs, which in turn led to fewer and fewer people being able to afford it.  Was the government's solution to cut the program back?  No, the "Affordable Care Act" (a backward term if there ever was one) instead expanded the government subsidization of health care.  Yeah - that's going to work....

Going back to education, if we're ever going to get back to education being a rational market, we will need the government to pull itself out of the funding equation.  This would be a long and painful process...and Americans don't like things to be difficult.  As a result, I suspect we'll keep putting band aids on the problem...and our grandkids will still be talking about how to fix it decades from now.

Quote from: cbowe3 on May 02, 2013, 01:02:58 PM
This is probably the reason they cancelled the Freshman Frontier Program, which I'm still pissed about...long live FFP

I thought it was called the Freshman F'up Program?

Quote from: Hards_Alumni on May 03, 2013, 07:54:21 AM
I hope you're wrong.  I know that school is very expensive, but that is something that each student can decide for themselves.  I don't see the government bailing out everyday people.  It is too expensive, and it would infuriate the folks who have had to take it in the shorts with their property.

My friends who started as HVAC, plumbing, etc apprentices make a pretty good living.  Plus they don't have the enormous debt that exists for a lot of new graduates.  Additionally, there are actually jobs available.  It may sound like heresy, but if I had a child that was college age that didn't get scholarships, grants, financial aid, and was considering college, I'd tell him or her that they should probably not go to college.  The risk/reward just isn't there anymore.

As a side note, I think its great to go to school... the experience is wonderful, the people you meet become life friends, and depending on your major you can still find a job out of school.  I'd suggest going to community college for two years to keep costs low and then transfer to a major university.

I agree with a lot of this.  There are still a huge number of kids that 4-year universities are an excellent fit for, and they will end up being successful in life with their investment in education.  The problem now arises when every Tom, Dick, and Harry are being pushed to go to college no matter their academic level, interests, abilities, etc.  I know more than a handful of people who get a 4-year degree and end up with a $30,000 a year job anyway.  Many 2-year technical/vocational/trade school programs are excellent fits for people to learn a profession and make a comfortable living.  The plumbing example you used is a great example.  The problem is kids are being pushed to 4-year colleges because its "the thing to do."

Kids who have an interest in mechanics, welding, plumbing, electrical work, carpentry, etc. should be steered toward those programs which are in most cases quite affordable.  I have too many friends who have a bachelor's degree in Business/Communication and don't have any marketable skills, while other friends of mine are trained in a particular set of skills with a 2-year technical degree and can find jobs all over.

Quote from: Avenue Commons on May 03, 2013, 10:07:01 AM
I thought it was called the Freshman F'up Program?

Or Financially Fit Parents.

Superbar?? ?-(

Quote from: mu_hilltopper on May 03, 2013, 09:33:30 AM
Co-sign.

Once the Federal Govt got into the business of backing student loans, banks will loan to roughly anyone who wants higher education, regardless of the value of the underlying asset, namely, the future earning power of the degree obtained.

Engineering degrees and anthropology degrees have a vastly different future earning power, yet they are funded the same.

Meanwhile, with this flood of loans, Universities aren't incentivized to cut costs like regular business is, and go the opposite way: the costlier the college, the more prestigious it must be.

Those days are numbered, either via governmental policy changes (less likely) or by education consumers wising up.

the Gov backing the student loan industry is the reason the schools can just increase tuition with ease now.

Doubly true for Grad student subsidies (law/dental/Dr vs insert joke grad degree here)

The total student loan debt burden is over $1 trillion now. The argument has been made that the student loan debt could be to blame for the stagnant economy.  Too much debt = not buying a house/starting a family

And Hards: if I wasn't a recent grad, I wouldnt want the bubble to pop/bailouts to come. but since I've got significant loan debt I wouldnt mind a sweet sweet gov bailout. On the flip side if students start defaulting on their loans en masse taxpayers are going to be on the hook

Furthermore its not MU that will have the problems if tuition gets that out of control. I think the small liberal arts colleges (Carroll, Viterbo, St. Norberts, Marrian) are the ones that will be really unnatural carnal knowledgeed.

Quote from: GooooMarquette on May 03, 2013, 10:04:11 AM
BINGO!

The problem now is that schools and health care providers have gotten so used to the government subsidization that it could take decades to undo the mess. 

Not sure about that.  Yes, Uncle Sam subsidizes health care, but Medicare/Medicaid rates are far below what the market charges .. so much so, that many providers refuse to take those patients. 

The ACA has only affected health care costs over the past couple years since it passed.  The trend in increases has been going for 10-15 years prior.  Why?  Because we keep inventing new and costly ways of keeping people alive, and no one wants to die or feel sick.  Add in an unhealthy populace and an increasing life expectancy .. big problems.

Quote from: mu_hilltopper on May 03, 2013, 10:32:33 AM

The ACA has only affected health care costs over the past couple years since it passed.  The trend in increases has been going for 10-15 years prior.  Why?  Because we keep inventing new and costly ways of keeping people alive, and no one wants to die or feel sick.  Add in an unhealthy populace and an increasing life expectancy .. big problems.

Not to mention hospitals charging prices that are exponentially higher than costs to line the pockets of their executives

Quote from: Victor McCormick on May 03, 2013, 10:36:32 AM
Not to mention hospitals charging prices that are exponentially higher than costs to line the pockets of their executives

Executives that are about as well-suited to make medical decisions as Fr. Pilarz is to coach the men's basketball team.

Quote from: Victor McCormick on May 03, 2013, 10:36:32 AM
Not to mention hospitals charging prices that are exponentially higher than costs to line the pockets of their executives

Which they have been able to charge...because the patients who go to those hospitals don't have to worry about the costs.  In the "old days" when patients knew they would be financially responsble, they scrutinized costs.  This led the hospitals and docs to be much more cognizant (and conservative) in what they charged.  Then, the government disconnected the buying decision (patient) from the payment responsibility (gov't).  This led to patients going wherever they wanted, regardless of the cost.  And the prices went up...and up...and up....

Quote from: Stronghold on May 03, 2013, 10:48:04 AM
Executives that are about as well-suited to make medical decisions as Fr. Pilarz is to coach the men's basketball team.

A hospital executive isn't hired to make medical decisions and a university president isn't hired to coach a basketball team.

Quote from: warriorchick on May 03, 2013, 10:09:06 AM
Or Financially Fit Parents.

Screw you lady. I busted my ass to pay for college and the only reason I got in was because of FFP. I didn't take HS all to seriously when I first got there, but busted my hump JR/SR year. This elitist BS is not what MU should be about. I have life long friends from FFP that are DRs, Lawyers, and college professors, who were accepted into MU solely because of the Program.

Quote from: warriorchick on May 03, 2013, 10:09:06 AM
Or Financially Fit Parents.

Is that a bad thing also don't you have 2 kids at MU? As discussed in this thread no matter how you cut it Marquette is not cheap.

It stands for F*cking Fantastic Partiers   

Quote from: BRMU23 on May 03, 2013, 11:00:21 AM
Screw you lady. I busted my ass to pay for college and the only reason I got in was because of FFP. I didn't take HS all to seriously when I first got there, but busted my hump JR/SR year. This elitist BS is not what MU should be about. I have life long friends from FFP that are DRs, Lawyers, and college professors, who were accepted into MU solely because of the Program.

Calm down dude.  FFP was commonly called that when I was a student there.  I doubt she meant anything by it.

Having worked in the health care business field for a bit I can tell you with 100% certainty the rise in costs has absolutely nothing to do with the government intervention. In fact, it's widely believed in that field that government intervention (price controls, basically) is probably the only way to curtail that rise, hence the backlash to the upcoming involvement.

It has nothing to do with politics either, simply the way the "market" is structured with endless demand.

Quote from: cbowe3 on May 03, 2013, 11:01:35 AM
Is that a bad thing also don't you have 2 kids at MU? As discussed in this thread no matter how you cut it Marquette is not cheap.

It stands for F*cking Fantastic Partiers   

I was not making a judgement call.  I was just repeating a joke that was common among us orientation leaders.

And as for your alternative - maybe that is one of the reasons they revamped FFP.  It is common knowledge that at least in the past few years, excessive partying has been a serious issue  - especially in the summer term before freshman year starts.  Just ask the LIMO drivers that work over the summer.

Quote from: GooooMarquette on May 03, 2013, 10:52:03 AM
Which they have been able to charge...because the patients who go to those hospitals don't have to worry about the costs.  In the "old days" when patients knew they would be financially responsble, they scrutinized costs.  This led the hospitals and docs to be much more cognizant (and conservative) in what they charged.  Then, the government disconnected the buying decision (patient) from the payment responsibility (gov't).  This led to patients going wherever they wanted, regardless of the cost.  And the prices went up...and up...and up....

You are partially correct but you seem to be forgetting about a little thing called health insurance and instead solely blaming the government.  Here is the issue:  Majority of people pay a fixed amount per month (which, if you get insurance through your job, 90% of people probably don't even know what that amount is) and you get unlimited access to care.  Since you have no idea what that care really costs, you have no incentive to moderate your use or any fiscal reason to do so.  If people were in charge of buying their own care, costs would come down very quickly.  

For an excellent, in-depth view of how to change the health care system, read this article:  http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/ (http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/)

Time Magazine did an outstanding expose on the health care cost issue

http://www.time.com/time/magazine/article/0,9171,2136864,00.html

Looks like you need a subscription to read though

Quote from: pux90mex on May 03, 2013, 11:08:43 AM
Having worked in the health care business field for a bit I can tell you with 100% certainty the rise in costs has absolutely nothing to do with the government intervention. In fact, it's widely believed in that field that government intervention (price controls, basically) is probably the only way to curtail that rise, hence the backlash to the upcoming involvement.

It has nothing to do with politics either, simply the way the "market" is structured with endless demand.

Sorry, but you are wrong.  I have worked in healthcare for a bit (20 years) too.  Here (http://www.metricmash.com/inflation.aspx?code=SA0,SAM2,SAE1&recession=false&from=200101&to=201112&period=&political=false) is a chart from the US Bureau of Labor Statistics showing the rise in costs, separating out health care (green line) from the overall rate of inflation in the economy (blue line).  If you go to the bottom and tell the chart to show numbers from 1960 to the present, you see an interesting trend.  Up until about 1965, the inflation rate for healthcare closely tracked the overall inflation rate.  Starting in the mid-1960s, the numbers began to diverge...first slowly, then faster and faster.  Why is the mid-60s relevant?  Because the Medicare law took effect on January 1, 1966.

But yeah, keep telling yourself that the rise in healthcare costs has nothing to do with government intervention. ;)

Quote from: mu_hilltopper on May 02, 2013, 10:11:37 PM
I missed the part of the strategic vision where MU had a plan to combat the fact that the universe of families able and/or willing to pay private school tuition eventually drops to zero in the long run.

In 19 short years, with the average 5% annual increase, MU's tuition is $101k per year.  

Good luck.

Aiming for Harvard or M.I.T. status?

Quote from: warriorchick on May 03, 2013, 11:08:54 AM

And as for your alternative - maybe that is one of the reasons they revamped FFP.  It is common knowledge that at least in the past few years, excessive partying has been a serious issue  - especially in the summer term before freshman year starts.  Just ask the LIMO drivers that work over the summer.

It's the summertime and the first taste of college/freedom that kids get, of coarse they're going to party. Same reason why there are so many writeups in the dorms, kids going to hospital to get their stomachs pumped, kids getting caught with fake ids, etc during the first few weeks of the semester; some kids go nuts and take it overboard once they get out of their parents house. It happens everywhere across the country.

Revamping the program eliminates opportunities for good kids to attend MU. Just because their high school grades weren't spectacular doesn't mean they can't succeed in college. Like BRMU23 said there are students in every class that go on to do great things with their careers and are exceptional representatives for the university. Long live FFP

Also I know you saw the teal

Quote from: Victor McCormick on May 03, 2013, 11:29:00 AM
Time Magazine did an outstanding expose on the health care cost issue

http://www.time.com/time/magazine/article/0,9171,2136864,00.html

Looks like you need a subscription to read though

Forbes and WSJ did an outstanding exposé as well.....came to some different conclusions.

Quote from: ATL MU Warrior on May 03, 2013, 11:24:08 AM
You are partially correct but you seem to be forgetting about a little thing called health insurance and instead solely blaming the government.

Agree that private insurance plays a part, but it's much smaller.

First, providers' charges are naturally tied to what the largest payer is willing to pay.  That's Medicare.  Second, while all insured patients only feel price increases indirectly, private insurance beneficiaries still have closer contact with rising costs -- through rising insurance premiums.  This could have been a factor in federally insured plans as well...except that no politician wanted to be the one to raise Medicare premiums.  At the end of the day, Medicare is bigger than other payers, and Medicare beneficiaries are far more shielded from cost increases than other beneficiaries.

So yes, private insurance plays a part...but a much smaller part.

Quote from: GooooMarquette on May 03, 2013, 11:40:19 AM
But yeah, keep telling yourself that the rise in healthcare costs has nothing to do with government intervention. ;)

This isn't the proper forum for a full on discussion, I just don't understand how the U.S., with the least amount of government intervention in the field of healthcare of industrialized countries, spends more, by far, than any other country both gross and per person. How do you explain that one?

(Feel free to PM me as I love talking healthcare biz but realize this is a terrible bore to most here with absolutely no relevance to mubb)

Quote from: GooooMarquette on May 03, 2013, 11:40:19 AM
Sorry, but you are wrong.  I have worked in healthcare for a bit (20 years) too.  Here (http://www.metricmash.com/inflation.aspx?code=SA0,SAM2,SAE1&recession=false&from=200101&to=201112&period=&political=false) is a chart from the US Bureau of Labor Statistics showing the rise in costs, separating out health care (green line) from the overall rate of inflation in the economy (blue line).  If you go to the bottom and tell the chart to show numbers from 1960 to the present, you see an interesting trend.  Up until about 1965, the inflation rate for healthcare closely tracked the overall inflation rate.  Starting in the mid-1960s, the numbers began to diverge...first slowly, then faster and faster.  Why is the mid-60s relevant?  Because the Medicare law took effect on January 1, 1966.

But yeah, keep telling yourself that the rise in healthcare costs has nothing to do with government intervention. ;)

New expensive ways to treat an unhealthier population that is living longer with chronic problems.  There is your problem.  How many MRI's get taken every year?  How many of them necessary?  The cost of pharmaceuticals has increased substantially since there are more identifiable problems with people and there are more pharmaceuticals developed to treat these illnesses.  Life expectancy has increased and thus the burden on medicare has increased.  Sure, the government pays the bills on medicare, but the doctors/insurance companies are also to blame.  Doctors have to cover their own asses due to medical malpractice, so they order more testing (more money!).  Of course, insurance companies are forced to raise the rates to make up for this cost... and a lot of this cost gets passed onto the the customer(government in cases of medicare).

The entire system is a giant CF.  There is no easy fix.  The current step in the right direction is to have everyone contribute to the health care system.  There are far to few people paying into HC, and too many people taking money out of the system... So those paying in will end up paying more and more.  I know a lot of people object to being forced to buy HC insurance (or anything for that matter), but it has to happen.  If people don't buy their insurance until they are already sick they will never pay enough money in to cover what they take out.  Additionally, the people who don't have insurance still go to the doctor, and they go to the ER.  Who pays for that?  The doctors have to pass the cost somewhere.  Insurance.  Medicare.  etc.

Honestly, the only way to fix the problem is for people to take better care of themselves and involve themselves more in their health care.  But the system is totally incentivized against doing that.  $500 copay to go the doctor?  Can't afford that, just hope the problem goes away, or wait until its an emergency.  Then when the time comes the problem is the same for the patient, but the cost for the insurance company is SIGNIFICANTLY higher.  blah blah blah, I could talk about this for hours, but I guess this thread has already gone WAY off of the original topic.

nm

By the way, warriorchick's own sister was a FFP kid at Dayton and used the opportunity to mature into an absolutely outstanding adult.  But of course there wasn't a scholly that went along with that opportunity and the full financial burden rested on my in-laws (and her).  Personally, I was thrilled to hire a MU FFP following his graduation in 2012 and he's a very valuable and motivated employee.  I do know that he's very passionate about the program and wrote several strongly worded letters directly to Fr. Pilarz.  I must admit that I'm not familiar with the revisions that took place recently.  For those 'in the know' I'd appreciate being further informed.

Quote from: Terror Skink on May 03, 2013, 09:30:24 AM
Another84:

I contacted my friend about the whole scholarship issue and targeting the highest level students and this is in summary what she said.

It is an incredibly competitive marketplace for the highest level students.  They can go pretty much anywhere they want and go there for free.  If schools have enough money, they can be very strong in that pool, but for those schools that don't have those resources, concentrating too much on those students can be harmful to their overall academic profile if you don't have the $$ to be competitive for the next level of student.

.

Have to disagree with the  "free" statement. Top schools have so many bright kids that the only way you are getting a scholarship is if you demonstrate financial need.  You need both merit and financial need.

Quote from: GooooMarquette on May 03, 2013, 11:40:19 AM
Sorry, but you are wrong.  I have worked in healthcare for a bit (20 years) too.  Here (http://www.metricmash.com/inflation.aspx?code=SA0,SAM2,SAE1&recession=false&from=200101&to=201112&period=&political=false) is a chart from the US Bureau of Labor Statistics showing the rise in costs, separating out health care (green line) from the overall rate of inflation in the economy (blue line).  If you go to the bottom and tell the chart to show numbers from 1960 to the present, you see an interesting trend.  Up until about 1965, the inflation rate for healthcare closely tracked the overall inflation rate.  Starting in the mid-1960s, the numbers began to diverge...first slowly, then faster and faster.  Why is the mid-60s relevant?  Because the Medicare law took effect on January 1, 1966.

But yeah, keep telling yourself that the rise in healthcare costs has nothing to do with government intervention. ;)

Could also be due to more expensive treatments becoming available such as more advanced chemotherapy, organ transplants, as well as longer life expentancies

But yeah, just ignore other factors to suit your agenda  ;)

Quote from: pux90mex on May 03, 2013, 12:12:28 PM
I just don't understand how the U.S., with the least amount of government intervention in the field of healthcare of industrialized countries, spends more, by far, than any other country both gross and per person. How do you explain that one?

+1000000000000

Not only spends more with lower government intervention but also has lower life expectancies than other countries

Quote from: Hards_Alumni on May 03, 2013, 12:13:39 PM
New expensive ways to treat an unhealthier population that is living longer with chronic problems.  There is your problem.  How many MRI's get taken every year?  How many of them necessary?  The cost of pharmaceuticals has increased substantially since there are more identifiable problems with people and there are more pharmaceuticals developed to treat these illnesses.  Life expectancy has increased and thus the burden on medicare has increased.  Sure, the government pays the bills on medicare, but the doctors/insurance companies are also to blame.  Doctors have to cover their own asses due to medical malpractice, so they order more testing (more money!).  Of course, insurance companies are forced to raise the rates to make up for this cost... and a lot of this cost gets passed onto the the customer(government in cases of medicare).

The entire system is a giant CF.  There is no easy fix. 

This.

GoooooMarquette, correlating 1965 and a rise in health care costs with Medicare getting started doesn't hold water.   Lots of factors hit health care finances in the last 50 years, from vast technology advances, pharma advances, life expectancy advances, to obesity rate advances, and dozens more.  

As pux90 wrote, and is fully correct, Federal intervention is widely understood to be a source of cost control in this area.

I'll use your phrase:  "Sorry, but you are wrong."  

Quote from: mu_hilltopper on May 03, 2013, 01:18:58 PM
This.

GoooooMarquette, correlating 1965 and a rise in health care costs with Medicare getting started doesn't hold water.   Lots of factors hit health care finances in the last 50 years, from vast technology advances, pharma advances, life expectancy advances, to obesity rate advances, and dozens more.  

As pux90 wrote, and is fully correct, Federal intervention is widely understood to be a source of cost control in this area.

I'll use your phrase:  "Sorry, but you are wrong."  

What do you think led to the overutilization?  Oh, I know - systematically disconnecting purchasing decisions (patient) from payment (government).  If I had to pay for an x-ray, I'd think long and hard about asking for a second one.  But if I know Uncle Sam is paying, I'll go in and demand one.  Not that complicated, fellas.

Quote from: GooooMarquette on May 03, 2013, 01:23:23 PM

What do you think led to the overutilization?  Oh, I know - systematically disconnecting purchasing decisions (patient) from payment (government).  If I had to pay for an x-ray, I'd think long and hard about asking for a second one.  But if I know Uncle Sam is paying, I'll go in and demand one.  Not that complicated, fellas.

My wife is a PT at a relatively affluent hospital in the Milwaukee area and sees this all the time with the government funded patients.  Gets a patient that is told therapy should be able to treat the issue but surgery might as well and the government backed patient ALWAYS chooses surgery over PT.  PT would be infinitely less expensive and the outcome just as good, but because the patient doesn't care about cost they go for the quick fix.

Quote from: GooooMarquette on May 03, 2013, 01:23:23 PM

What do you think led to the overutilization?  Oh, I know - systematically disconnecting purchasing decisions (patient) from payment (government).  If I had to pay for an x-ray, I'd think long and hard about asking for a second one.  But if I know Uncle Sam is paying, I'll go in and demand one.  Not that complicated, fellas.

Seriously, are you talking about the US or Canada?  

In the US, the Feds cover about 95 million people. Private health care insurance covers 195 million people in the US.  

What you just wrote about paying for an x-ray?  Goes double for people on private health insurance.

"It's not that complicated, fella."

Quote from: mu03eng on May 03, 2013, 01:36:53 PM
My wife is a PT at a relatively affluent hospital in the Milwaukee area and sees this all the time with the government funded patients.  Gets a patient that is told therapy should be able to treat the issue but surgery might as well and the government backed patient ALWAYS chooses surgery over PT.  PT would be infinitely less expensive and the outcome just as good, but because the patient doesn't care about cost they go for the quick fix.

A surgery that would not have been available 60 years ago due to advances in modern technology and medicine. Again, you guys are missing the point.

Medicare/medicaid is legally required to charge no more than 1.5x what is needed for the procedure and overhead (including the doctor's salary). That's how you control costs.

Medicare also doesn't need to have a profit margin. Medicare doesn't have to pay dividends to shareholders.

Which do you think is really more cost effective?

Quote from: Victor McCormick on May 03, 2013, 01:42:01 PM
A surgery that would not have been available 60 years ago due to advances in modern technology and medicine. Again, you guys are missing the point.

And an issue that would have been ignored 60 years ago as a scratch.  Yes there are new and more expensive treatments but if people had stake in that expense they would be less inclined to go that route unneeded.

And it's not just newfangled surgeries, I got my ACL replaced and meniscus removed, if I had paid full boat it would have been $50k.  I could have gone through therapy and been good for my life just couldn't have really done sports.  ACL repairs have been around for years, why are they so expensive?  And I had to pay out of pocket to make the call to repair the ACL to a certain level, definitely higher than someone on medicare or medicaid or title 19 or badger care.

Quote from: Victor McCormick on May 03, 2013, 01:43:23 PM
Medicare/medicaid is legally required to charge no more than 1.5x what is needed for the procedure and overhead (including the doctor's salary). That's how you control costs.

Medicare also doesn't need to have a profit margin. Medicare doesn't have to pay dividends to shareholders.

Which do you think is really more cost effective?

It's not controlling costs, it's diverting them.  Those "unpaid" costs then roll over to the private insurances to pay that cost.  So taxpayers who are insured privately subsidize medicare on the front end(taxes) and the back end(premiums).

Quote from: mu03eng on May 03, 2013, 01:50:44 PM
It's not controlling costs, it's diverting them.  Those "unpaid" costs then roll over to the private insurances to pay that cost.  So taxpayers who are insured privately subsidize medicare on the front end(taxes) and the back end(premiums).

You just made the case for a single payer system better than I ever could have. Thanks!  :)

Others here have stated:  "Federal intervention is widely understood to be a source of cost control in this area."

On a very simplistic level, this is correct.  If a provider wants to charge $100 for a service like an x-ray, Medicare will usually say that only $80 is covered, and the provider only gets $80.  Cost containment, right?  If you don't look too closely, the answer looks like yes.  But here's the problem:  Medicare keeps paying the provider $80 every time it performs (and re-performs) that service.  So if the provider performs the service once, it gets paid $80; if it performs the service ten times, it gets $800, and so on.  Increased utilization leads to increased overall payment.  In theory, Medicare may deny some after a while...but these controls have proven not to work.

Now recall that the patient - who ultimately makes the decision whether to go back in and ask for another service - often bears little to no financial responsibility for that service.  He can keep asking for more and more, the provider will often keep performing it more and more, and Medicare will keep paying for it again and again.  Sometimes this is because the provider really believes it may help.  Other times it's because the provider is afraid of being sued for malpractice.  And yet other times, it may be due to a truly malicious provider (that's called fraud).  In any event, in this world where the purchasing decision is de-coupled from the payment responsibility, Medicare's superficial "cost containment" strategy will fail.

Quote from: GooooMarquette on May 03, 2013, 01:57:42 PM
Others here have stated:  "Federal intervention is widely understood to be a source of cost control in this area."

On a very simplistic level, this is correct.  If a provider wants to charge $100 for a service like an x-ray, Medicare your insurance company will usually say that only $80 is covered, and the provider only gets $80.  Cost containment, right?  If you don't look too closely, the answer looks like yes.  But here's the problem:  Medicare your insurance company keeps paying the provider $80 every time it performs (and re-performs) that service.  So if the provider performs the service once, it gets paid $80; if it performs the service ten times, it gets $800, and so on.  Increased utilization leads to increased overall payment.  In theory, Medicare your insurance company may deny some after a while...but these controls have proven not to work.

Now recall that the patient - who ultimately makes the decision whether to go back in and ask for another service - often bears little to no financial responsibility for that service.  He can keep asking for more and more, the provider will often keep performing it more and more, and Medicare your insurance company will keep paying for it again and again.  Sometimes this is because the provider really believes it may help.  Other times it's because the provider is afraid of being sued for malpractice.  And yet other times, it may be due to a truly malicious provider (that's called fraud).  In any event, in this world where the purchasing decision is de-coupled from the payment responsibility, Medicare's your insurance company's superficial "cost containment" strategy will fail.

FIFY.  You do know that Medicare was modeled after private insurance, correct?  Again, you are correct with a lot of your thinking.  Just don't get your fixation on Medicare being the only (or even major) villian. 

Quote from: ATL MU Warrior on May 03, 2013, 02:05:08 PM
FIFY.  You do know that Medicare was modeled after private insurance, correct?  Again, you are correct with a lot of your thinking.  Just don't get your fixation on Medicare being the only (or even major) villian.  

I don't disagree with you in terms of the initial problem.  But here's the thing:  Medicare took a relatively small problem and turned into a big problem.  And with the ACA, they took a big probem and turned it into a huge one.  And even though Medicare was originally modeled after private insurance, Medicare has since taken over the lead role in policy and process-making.  So now, every time Medicare does something, private insurers follow...instead of the other way around.  So your "fix" might have recognized the problem back in the 60s and 70s, but today, Medicare is front and center in any discussions about the disconnect between purchasing decisions and payment responsibility.

Don't mean to sound like I'm taking it out on you - you seem to be closer to understanding the issue than most around here.

Quote from: GooooMarquette on May 03, 2013, 01:57:42 PM
Others here have stated:  "Federal intervention is widely understood to be a source of cost control in this area."

On a very simplistic level, this is correct.  If a provider wants to charge $100 for a service like an x-ray, Medicare will usually say that only $80 is covered, and the provider only gets $80.  Cost containment, right?  If you don't look too closely, the answer looks like yes.  But here's the problem:  Medicare keeps paying the provider $80 every time it performs (and re-performs) that service.  So if the provider performs the service once, it gets paid $80; if it performs the service ten times, it gets $800, and so on.  Increased utilization leads to increased overall payment.  In theory, Medicare may deny some after a while...but these controls have proven not to work.

As ATL MU said, you are correct in some of your thinking, except that it fails to link government intervention as the big reason for increases.

Your 10 x-ray example?   Private insurance pays for x-rays too.  And the re-performance of x-rays.  And they have double the people covered, and way higher reimbursement rates.  For every x-ray Medicare pays for, private insurance is paying for 3.

The private insurance economy is likely 3-4x bigger than what Uncle Sam spends on health care.   

Those facts are incongruous with your idea that the government is to blame for health care increases.

Quote from: mu_hilltopper on May 03, 2013, 02:52:46 PM

The private insurance economy is likely 3-4x bigger than what Uncle Sam spends on health care.   

They're both about 50%.

A lot of hilarious liberal talking points in this thread.

I guess it's worked so well for Cuba and Britain, so it must work well here...

Quote from: warrior07 on May 03, 2013, 02:55:40 PM
They're both about 50%.

A lot of hilarious liberal talking points in this thread.

I guess it's worked so well for Cuba and Britain, so it must work well here...

Care to back up your 50% figure?  I got my numbers from this CNN article:  http://www.cnn.com/2012/06/27/politics/btn-health-care  .. 95 million covered by the US Government, private insurance is 196 million.  Do you disagree with their figures?

Not sure if you are aiming that "liberal" comment at me.  I am far from it.

Quote from: warrior07 on May 03, 2013, 02:55:40 PM
They're both about 50%.

A lot of hilarious liberal talking points in this thread.

I guess it's worked so well for Cuba and Britain, so it must work well here...

I have no opinion on the healthcare debate, but this is a douchebag comment and exactly why I hate politics.

You can't have an honest conversation/debate without somebody referring to the other as some sort of right-wing lunatic or a communist.

ugh.

Quote from: pux90mex on May 03, 2013, 12:12:28 PM
This isn't the proper forum for a full on discussion, I just don't understand how the U.S., with the least amount of government intervention in the field of healthcare of industrialized countries, spends more, by far, than any other country both gross and per person. How do you explain that one?

(Feel free to PM me as I love talking healthcare biz but realize this is a terrible bore to most here with absolutely no relevance to mubb)

Pux, just a little anecdotal stuff.  I spent this morning with my little girl at the doctor's office.  She was diagnosed Type 1 diabetic almost two years ago. Type 1 has nothing to do with diet, it isn't a life choice situation, she just lost the lottery on this one and has to give herself 3 to 4 insulin shots a day because her pancreas doesn't work.

Today we finally got the insulin pump for her which we have been hoping to do for over a year now. Cost of the pump, $8,000 and expected to last 4 years.  That's before a drop of insulin is put in, or test strips used, etc, etc.  Insurance is covering much of it, but there's a healthy out of pocket cost as well. 

Now, on one hand I go, wow, this is expensive stuff.  On the other hand, it's amazing technology that keeps getting better and I want medical companies to be rewarded for finding new technologies.  I'm one that writes a thank you letter to Eli Lilly, for finding the drugs that help her.  I have relatives that write nasty letters to drug companies because of the costs.  Seems, like so many things, people tend to be on one side or the other.  There are tradeoffs with everything.  My sister-in-law from Canada but lives here in Calif, she had her lasik done up in Canada dirt cheap because it was elective and she could choose to wait.  For disease, longer term care stuff her parents are going through, she rails on the system for its inefficiencies, etc.  Tradeoffs everywhere.  We could spend hours talking about the litigiousness of the USA vs other nations in this area, also....plus getting into over prescribed procedures, etc, etc.  Plenty of blame to go around.

Quote from: warrior07 on May 03, 2013, 02:55:40 PM
They're both about 50%.

A lot of hilarious liberal talking points in this thread.

I guess it's worked so well for Cuba and Britain, so it must work well here...

Funny you should say that, Cuba and Britain (along with 37 other countries) both have higher life expectancies than us

http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Quote from: Victor McCormick on May 03, 2013, 03:13:33 PM
Funny you should say that, Cuba and Britain (along with 37 other countries) both have higher life expectancies than us

http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Which in no way coorolates to stress levels or health eating habits only medical care?

Quote from: Victor McCormick on May 03, 2013, 01:53:05 PM
You just made the case for a single payer system better than I ever could have. Thanks!  :)

Now it proves the current system is dumb.  Single payer doesn't fix it either because that removes all incentives to innovate or be the prefered doctor who can charge a little more.  And single payer is much more susseptible to corruption than the current system

Quote from: Red Stripe on May 03, 2013, 12:23:17 PM
^ good post

People need to stop taking little Johnnie in every time he sneezes or calling for an ambulance in a non-emergency because they don't have transportation etc.

Wait until you add millions more to the rolls....this is only going to happen more and more while doctors go bye and bye faster and faster.  Not that a lot of people predicted this was going to happen, but we did it anyway.

Quote from: mu03eng on May 03, 2013, 01:36:53 PM
My wife is a PT at a relatively affluent hospital in the Milwaukee area and sees this all the time with the government funded patients.  Gets a patient that is told therapy should be able to treat the issue but surgery might as well and the government backed patient ALWAYS chooses surgery over PT.  PT would be infinitely less expensive and the outcome just as good, but because the patient doesn't care about cost they go for the quick fix.

I've been going to PT for my shoulder for 5 months, about to opt for surgery.  Wish I had done the surgery from the get go.  I know it's different for everyone, but in my particular case it will cost much more as I'm going to have the surgery now on top of all the PT sessions that didn't fix the injury.  Healthcare is tricky, as I think we all know.  Not black and white answers.

Quote from: Victor McCormick on May 03, 2013, 03:13:33 PM
Funny you should say that, Cuba and Britain (along with 37 other countries) both have higher life expectancies than us

http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

You might want to retract the Cuba thingy....there has long been issues with the data and just how trustworthy it is from that nation

http://www.autentico.org/oa09889.php


Also a number of papers done on life expectancy and infant mortality rate data in this regard.  http://www.nationalcenter.org/NPA547ComparativeHealth.html



Data is also different from one source to another.  Some suggest USA is higher than what Wiki (that sage source of truthiness) has to say.   http://www.worldlifeexpectancy.com/world-rankings-total-deaths

Quote from: mu03eng on May 03, 2013, 03:41:28 PM
Which in no way coorolates to stress levels or health eating habits only medical care?

It correlates to all of those things. But are you saying the medical system doesn't have an impact?

Quote from: ChicosBailBonds on May 03, 2013, 04:01:57 PM
You might want to retract the Cuba thingy....there has long been issues with the data and just how trustworthy it is from that nation

http://www.autentico.org/oa09889.php


Also a number of papers done on life expectancy and infant mortality rate data in this regard.  http://www.nationalcenter.org/NPA547ComparativeHealth.html



Data is also different from one source to another.  Some suggest USA is higher than what Wiki (that sage source of truthiness) has to say.   http://www.worldlifeexpectancy.com/world-rankings-total-deaths

Fair enough. Cuba is a 3rd world country. I'd hope we'd be ahead of them. But Chicos even in the lists you supply we are in 30th place and behind a whole bunch of countries with single payer health systems. I don't think that hinders my case at all.

Quote from: Victor McCormick on May 03, 2013, 04:03:52 PM
It correlates to all of those things. But are you saying the medical system doesn't have an impact?

We have the most advanced medicine in the world as is what about single payer system is going to change our life expectancy?  What is it about single payer that will vault us past those other systems?

I think the US health care is so advanced and some our choices as a society are so poor that we are lucky to be 37th in the world.  Yes our current system sucks but single payer isn't the answer that will make things worse.  Change the lifestyle

Taught my children that something that is " free" holds no value
Spent 30 years in the medical field and because people have no knowledge of real costs they don't care what the real price is.  I have seen many people who have told me "price is of no consequence"  until they find  they must pay out of pocket. People should pay for lifestyle choices and minor treatments and not have to worry about catastrophic diseases bankrupting them.

Quote from: ChicosBailBonds on May 03, 2013, 03:52:17 PM
I've been going to PT for my shoulder for 5 months, about to opt for surgery.  Wish I had done the surgery from the get go.  I know it's different for everyone, but in my particular case it will cost much more as I'm going to have the surgery now on top of all the PT sessions that didn't fix the injury.  Healthcare is tricky, as I think we all know.  Not black and white answers.

And for every you there is someone that would do fine with just PT.  Even if its 3 to 1 not helped to helped from a relative cost standpoint its a net gain.  Without applying cost to decisions you never reduce costs because there is no reason for the consumer to do so

Quote from: warrior07 on May 03, 2013, 02:55:40 PM
They're both about 50%.

A lot of hilarious liberal talking points in this thread.

I guess it's worked so well for Cuba and Britain, so it must work well here...

You know, its comments like this that make you totally intolerable.  The rest of us grown ups can have a nice conversation but you seem to have to always throw in your two cents.

We get it.  You're a conservative.  You hate liberals. 

Now try contributing to conversations instead of just running your mouth.  It just makes you look like a child, and makes everyone lose respect for you.

Quote from: Victor McCormick on May 03, 2013, 04:05:18 PM
Fair enough. Cuba is a 3rd world country. I'd hope we'd be ahead of them. But Chicos even in the lists you supply we are in 30th place and behind a whole bunch of countries with single payer health systems. I don't think that hinders my case at all.

And yet when push comes to shove, the elite from those countries come here to get treated.  Some of it is geography, we are still a very spread out country with large swaths of land where you are 50 miles from a nearest doctor...compared to some of those countries on that list where their nation is the size of South Carolina or Montana...that makes health care more convenient, etc.  How much litigation goes on in those other countries?  Etc, etc.  I don't find that example apples to apples every time it is brought up without normalizing for some of those variables.

Like I mentioned, my sister-in-law is Canadian (an attorney) and for some stuff she will say her system is great and for others, she absolutely deplores it.  Tradeoffs for everything.

Quote from: elephantraker on May 03, 2013, 05:54:19 PM
Taught my children that something that is " free" holds no value
Spent 30 years in the medical field and because people have no knowledge of real costs they don't care what the real price is.  I have seen many people who have told me "price is of no consequence"  until they find  they must pay out of pocket. People should pay for lifestyle choices and minor treatments and not have to worry about catastrophic diseases bankrupting them.

So much truth to this, especially that first sentence.  It doesn't matter if it is medical, or tickets to the movies or whatever, if someone has no skin in the game (i.e. they don't pay for it), then it is less valued and cheapened.  If I receive 2 free movie tickets for tonight and don't go...no big deal, didn't cost me anything.  If I paid for two tickets tonight and don't go, I'm pissed...I just wasted money.  This is why when you have nearly 1/2 the population not paying for services, they don't have any clue what they cost and thus don't give a damn in how they are run, operated, etc....they didn't pay for it.  This is the crux of the problem.  Everyone should pay something.

Quote from: ChicosBailBonds on May 03, 2013, 03:52:17 PM
I've been going to PT for my shoulder for 5 months, about to opt for surgery.  Wish I had done the surgery from the get go. 

What's the issue & surgery?

Quote from: mu_hilltopper on May 03, 2013, 03:08:53 PM
Care to back up your 50% figure?  I got my numbers from this CNN article:  http://www.cnn.com/2012/06/27/politics/btn-health-care  .. 95 million covered by the US Government, private insurance is 196 million.  Do you disagree with their figures?

Not sure if you are aiming that "liberal" comment at me.  I am far from it.

I'm thinking about spending, which is split about in half. Sources are from the federal government.

http://online.wsj.com/article/SB10001424053111903635604576472411389580364.html

Of course, Wikipedia claims that it's actually up to about two-thirds.

https://en.wikipedia.org/wiki/Health_care_in_the_United_States

I see Hards has taken a break from frothing at the mouth in the face of Republican legislators at the Capitol in Madison to contribute here.

Hope you're enjoying Act 10, loser.

Quote from: ChicosBailBonds on May 03, 2013, 06:42:50 PM
So much truth to this, especially that first sentence.  It doesn't matter if it is medical, or tickets to the movies or whatever, if someone has no skin in the game (i.e. they don't pay for it), then it is less valued and cheapened.  If I receive 2 free movie tickets for tonight and don't go...no big deal, didn't cost me anything.  If I paid for two tickets tonight and don't go, I'm pissed...I just wasted money.  This is why when you have nearly 1/2 the population not paying for services, they don't have any clue what they cost and thus don't give a damn in how they are run, operated, etc....they didn't pay for it.  This is the crux of the problem.  Everyone should pay something.

The crux of the problem is that nobody, whether insured or uninsured, has any idea what the true costs of healthcare are, because nobody pays them directly.  It's not something that can be layed at the feet of only the poor/uninsured.

Read the article I linked earlier in the thread...it's very clear on the issues and proposes a common-sense solution for REAL reform.  And, because it's real reform, it will likely never happen, which is a shame because it would help immensely.

Quote from: Victor McCormick on May 03, 2013, 03:13:33 PM
Funny you should say that, Cuba and Britain (along with 37 other countries) both have higher life expectancies than us

http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

I would guess a factor in the US having a lower life expectancy is the number of people without healthcare bringing the averages down.

Quote from: warrior07 on May 04, 2013, 03:06:18 AM
I'm thinking about spending, which is split about in half. Sources are from the federal government.

http://online.wsj.com/article/SB10001424053111903635604576472411389580364.html

Of course, Wikipedia claims that it's actually up to about two-thirds.

https://en.wikipedia.org/wiki/Health_care_in_the_United_States

First off, I am willing to admit I could be wrong.  I really am.   

The WSJ article is a prediction for 2020, so that's not quite the evidence we need.  The article does seem to suggest that currently it's a 54/46% split, with the Government paying the smaller portion.   This could be true, although I still find it surprising. (see below)

The wiki article .. I also find surprising, suggesting 60-65% is government spending.   Unfortunately, no source is cited in the article, so we really don't know where that number came from.

I gotta ask.  Isn't it really counter-intuitive to think a system that covers 90m people costs MORE than the system that covers 195m people?   I mean, is that what these stats suggest, that Medicare and Medicaid (etc) are SO broken they pay out nearly triple per person than the private market option?    Don't you find that hard to believe, in light of the admittedly scant statistics we've uncovered here?

Let me start by saying I don't know which numbers are correct.

The govt. programs cover primarily the elderly and poor...both of which require more care (and more expensive care) than the generally healthier middle/upper class.  Maybe that's the reason that the spending on govt. programs is nearly equal with private even though private covers about twice as many people.

Quote from: mu_hilltopper on May 04, 2013, 08:51:10 AM
First off, I am willing to admit I could be wrong.  I really am.   

The WSJ article is a prediction for 2020, so that's not quite the evidence we need.  The article does seem to suggest that currently it's a 54/46% split, with the Government paying the smaller portion.   This could be true, although I still find it surprising. (see below)

The wiki article .. I also find surprising, suggesting 60-65% is government spending.   Unfortunately, no source is cited in the article, so we really don't know where that number came from.

I gotta ask.  Isn't it really counter-intuitive to think a system that covers 90m people costs MORE than the system that covers 195m people?   I mean, is that what these stats suggest, that Medicare and Medicaid (etc) are SO broken they pay out nearly triple per person than the private market option?    Don't you find that hard to believe, in light of the admittedly scant statistics we've uncovered here?

The 54/46 split doesn't seem too far out of the realm of possibility.  The people covered by medicare/caid are the poor and elderly, generally.  In other words, the two groups of people who would be likely to be less healthy than those who would have the means and/or are of an age to have private insurance.  If they are less healthy, they probably are requiring more interventional care, treatment, etc.  So despite there being twice as many people on private insurance than medicare/caid it's at least seems plausible to me that the actual spending gap is lower.

Quote from: warrior07 on May 04, 2013, 03:08:39 AM
I see Hards has taken a break from frothing at the mouth in the face of Republican legislators at the Capitol in Madison to contribute here.

Hope you're enjoying Act 10, loser.

Thanks for proving my point.

Quote from: mu03eng on May 03, 2013, 06:00:59 PM
And for every you there is someone that would do fine with just PT.  Even if its 3 to 1 not helped to helped from a relative cost standpoint its a net gain.  Without applying cost to decisions you never reduce costs because there is no reason for the consumer to do so

Don't get me wrong, I don't disagree with you.  In fact, my knee issues were largely fixed with PT.  I wish my doctor had given me a bit more on the odds of success for the shoulder. If he would have said PT has a 50/50 chance of improving things but it will take 4 months to find out and cost X, but if doesn't work we have to do surgery anyway....well that's one thing.  Instead it was handled as, we're going to do physical therapy and see if we can get this taken care of.  If not, we'll got to phase 2...surgery.  I might have opted out of phase 1, all the time put into, etc and gone directly to phase 2. 

Quote from: Jay Bee on May 04, 2013, 12:29:51 AM
What's the issue & surgery?

Labrum is part of it.  I dislocated my shoulder and fractured clavicle way back in the day (Marquette days) playing volleyball.  I've had issues on and off, but nothing terrible.  I injured it again about 6 months ago and now some pain discomfort doing certain things, limited range of motion, etc.

Quote from: ATL MU Warrior on May 04, 2013, 06:51:21 AM
The crux of the problem is that nobody, whether insured or uninsured, has any idea what the true costs of healthcare are, because nobody pays them directly.  It's not something that can be layed at the feet of only the poor/uninsured.

Read the article I linked earlier in the thread...it's very clear on the issues and proposes a common-sense solution for REAL reform.  And, because it's real reform, it will likely never happen, which is a shame because it would help immensely.

Yeah, I read it...there were some good ideas in there and some I find troublesome.  I know one common theme I hear (it was also in the article), is that too many tests are ordered by doctors that are unneeded.  What is almost NEVER addressed with these claims is what happens when a test isn't run, because a doctor is trying to not overly test these patients, and something happens....lawsuit city.  The doctor is damned if he does and damned if he doesn't.

That is absolutely my biggest issue with this article...6 long pages and not ONE single word on tort reform.  I don't know how you have a healthcare cost "fix" discussion and not look at all sides, including the absurdity in costs that are directly driven by the legal side of the house.

On the issue of price, which the article addresses, I do expect price differences to be honest.  It's not like we are all ordering a muffler.  An MRI by one clinic might be using an entirely different machine, tech expertise, etc than another clinic.  A different level of service, I do expect some fluctuation.  Now, how much is probably a good debate.

Quote from: mu_hilltopper on May 04, 2013, 08:51:10 AM
First off, I am willing to admit I could be wrong.  I really am.   

The WSJ article is a prediction for 2020, so that's not quite the evidence we need.  The article does seem to suggest that currently it's a 54/46% split, with the Government paying the smaller portion.   This could be true, although I still find it surprising. (see below)

The wiki article .. I also find surprising, suggesting 60-65% is government spending.   Unfortunately, no source is cited in the article, so we really don't know where that number came from.

I gotta ask.  Isn't it really counter-intuitive to think a system that covers 90m people costs MORE than the system that covers 195m people?   I mean, is that what these stats suggest, that Medicare and Medicaid (etc) are SO broken they pay out nearly triple per person than the private market option?    Don't you find that hard to believe, in light of the admittedly scant statistics we've uncovered here?

Here's the White House making the same claim of "about half":

http://www.whitehouse.gov/administration/eop/cea/TheEconomicCaseforHealthCareReform

You raise a good question. Honestly, it does not surprise me. Consider the people involved. The people on Medicare are going to be using a LOT more healthcare resources than someone 25-55. Also, lower income people on Medicaid, etc., will tend to have a higher correlation with the use of health care. When I go into any waiting area (eyes, general practitioner, specialties), it often seems like the ratio of retirees to non retirees is 80/20.

I think the people with high deductible, HSA type plans just have a much greater disincentive to go to the doctor compared to someone on government care. If I have to pay the entire freight of a checkup (and I usually do), it makes me less willing to go compared to someone who has to pay little or nothing per visit.

Quote from: Jay Bee on May 04, 2013, 12:29:51 AM
What's the issue & surgery?

Injury from patting himself on the back. 

Quote from: tower912 on May 04, 2013, 05:30:45 PM
Injury from patting himself on the back. 

I just read the entire thread in one sitting and got to that post like it was a punchline.  That was outstanding.  Also, JFB rules.  Enjoy the double-dipped Thibs.

Quote from: GooooMarquette on May 03, 2013, 11:40:19 AM
Why is the mid-60s relevant?

Chemotherapy
Radiation Cancer Therapy
Organ Transplantation (Heart, Liver, Lung, Kidney)
Artificial Hearts and Cardiac Assist Devices
ECMO
Modern Burn Surgery
Vasopressors
Statins
Long Term Ventilator Care
Modern Critical Care
Laparoscopic Surgery
Robotic Surgery
Emergence of HIV
Immunopharmacology
Joint Replacement
Dialysis
Pacemakers and Implantable Defribrillators
Modern CPR and Cardiac Arrest Care
Angioplasty
Advanced Antibiotics
Dozens of Vaccines
MRI
CT
PET
Recombinant Pharmaceuticals
tPA

All of the above were developed during or after the 1960s.  This list goes on and on because the real change in the cost curve is that we have more people surviving longer and diverse, expensive treatment options.

Quote from: warrior07 on May 04, 2013, 05:09:16 PM
I think the people with high deductible, HSA type plans just have a much greater disincentive to go to the doctor compared to someone on government care. If I have to pay the entire freight of a checkup (and I usually do), it makes me less willing to go compared to someone who has to pay little or nothing per visit.

The flip side to this is that if we discourage people from going to get health care when the problem is minor (and cheap to treat), said problem could develop into something that is major (and expensive to treat).

Quote from: dwaderoy2004 on May 05, 2013, 08:15:05 AM
The flip side to this is that if we discourage people from going to get health care when the problem is minor (and cheap to treat), said problem could develop into something that is major (and expensive to treat).

I never understood why more medical plans aren't set up so that  preventative care is free or low cost. Most dental insurance plans are run that way (cleanings and checkups are free).  My company also has a wellness plan where if you don't maintain a healthy lifestyle (smoke, or fail to properly treat your Type II diabetes or high blood pressure), your payroll deduction for health insurance is significantly higher.

Quote from: warriorchick on May 05, 2013, 08:26:32 AM
I never understood why more medical plans aren't set up so that  preventative care is free or low cost. Most dental insurance plans are run that way (cleanings and checkups are free).  My company also has a wellness plan where if you don't maintain a healthy lifestyle (smoke, or fail to properly treat your Type II diabetes or high blood pressure), your payroll deduction for health insurance is significantly higher.

Cleanings and checkups are free?  Damn, I need your dental plan.  They aren't free for us...and of course nothing is "free" anyway, someone has to pay for the time of Hygientist, the xrays, etc

Quote from: tower912 on May 04, 2013, 05:30:45 PM
Injury from patting himself on the back. 

All the times you asked me to mildly spank you on your behind.

It was originally directed at Victor, but anyone that advocates for a single payer system is free to answer.  What about single payer will improve out current system from where it is.  If we all acknowledge it has the most innovative and advanced capabilities, what about single payer will allow that to continue while bending the cost curve?

Quote from: mu03eng on May 06, 2013, 12:47:34 PM
What about single payer will improve out current system from where it is.

Honestly, Google it. I'm not going to explain every facet of a single payer health system to you. Our country has been having this debate for 3 years.

http://en.wikipedia.org/wiki/Single_payer

Quote from: warriorchick on May 05, 2013, 08:26:32 AM
I never understood why more medical plans aren't set up so that  preventative care is free or low cost. Most dental insurance plans are run that way (cleanings and checkups are free).  My company also has a wellness plan where if you don't maintain a healthy lifestyle (smoke, or fail to properly treat your Type II diabetes or high blood pressure), your payroll deduction for health insurance is significantly higher.

Medical plans are set up that way. Its the law.

That is the basis of the ACA. All insurance plans are required to have free preventative care with no copay. Its actually quite a bit of services that are included.

http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

When they address tort reform (serious tort reform), I'm all ears. 

If single payor is so great why did  it have to be  passed without being read or commented on?  And why aren't Pols included in this great coverage?
And Chico's, 30 years of being involved with start-up medical companies allows me to comment on Tort reform: If people knew how much the spector of bogus law suits adds to the cost of medicine, they would revolt. example: the phony science that caused 3 Billion dollars to be taken from manufacturers of silicon breast implants. years later a 10,000 nurse study showed silicon to be the inert material we all knew it was.

Quote from: elephantraker on May 06, 2013, 05:11:34 PM
If single payor is so great why did  it have to be  passed without being read or commented on?  And why aren't Pols included in this great coverage?
And Chico's, 30 years of being involved with start-up medical companies allows me to comment on Tort reform: If people knew how much the spector of bogus law suits adds to the cost of medicine, they would revolt. example: the phony science that caused 3 Billion dollars to be taken from manufacturers of silicon breast implants. years later a 10,000 nurse study showed silicon to be the inert material we all knew it was.

I have no doubt...and I love bringing up the breast implant faux story as well.  Crazy.  Almost destroyed the industry just as General Aviation was essentially destroyed due to liability issues, etc. 

Quote from: Victor McCormick on May 06, 2013, 03:45:54 PM
Honestly, Google it. I'm not going to explain every facet of a single payer health system to you. Our country has been having this debate for 3 years.

http://en.wikipedia.org/wiki/Single_payer

Oh I understand single payer healthcare just fine, but I want you to articulate for me what single payer will do to bend the cost curve without sacrificing innovation and capabilities.  If you can't then why should we do it?

Quote from: elephantraker on May 06, 2013, 05:11:34 PM
If single payor is so great why did  it have to be  passed without being read or commented on?  And why aren't Pols included in this great coverage?
And Chico's, 30 years of being involved with start-up medical companies allows me to comment on Tort reform: If people knew how much the spector of bogus law suits adds to the cost of medicine, they would revolt. example: the phony science that caused 3 Billion dollars to be taken from manufacturers of silicon breast implants. years later a 10,000 nurse study showed silicon to be the inert material we all knew it was.

Single payer wasn't passed.  Nor was it ever introduced.

Quote from: Victor McCormick on May 06, 2013, 03:50:09 PM
Medical plans are set up that way. Its the law.

That is the basis of the ACA. All insurance plans are required to have free preventative care with no copay. Its actually quite a bit of services that are included.

http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

No such thing as free.   Someone else gets to pay for you.

Quote from: mu_hilltopper on May 03, 2013, 10:32:33 AM
Not sure about that.  Yes, Uncle Sam subsidizes health care, but Medicare/Medicaid rates are far below what the market charges .. so much so, that many providers refuse to take those patients.   The ACA has only affected health care costs over the past couple years since it passed.  The trend in increases has been going for 10-15 years prior.  Why?  Because we keep inventing new and costly ways of keeping people alive, and no one wants to die or feel sick.  Add in an unhealthy populace and an increasing life expectancy .. big problems.

Yep! My wife and are retired and when we went on Medicare to our surprise our Doctor did no take Medicare.  I went on the Medicare provider web site and the first ten I called though they accept Medicare do not take new Medicare patients. We had to go to a concierge practice. We pay the doctor 3000 a year just to be our doctor. Must say the I am getting good quality care and worth the price. He actually spends much more time with you as their practice is limited to 500 patients. Just a note... I go each month for a B12 injection for pernicious anemia. He bills Medicare 15 dollars. I pay nothing, but he only get 45 cents back from Medicare and my co-insurance. No wonder doctors are not taking new Medicare patients...they would go out of business in a hearbeat.

I was watching C-Span and a spokes person for the administration was explaining that families of 4 that earn around 30-40k per year would get a  subsidy up to about 11k a year if they got their coverage through the exchanges designated in the ACA. A family in that category would also not pay more than 2% of gross income for their premium. Well our medicare, co-insurance and part D insurance runs us about 7200 per year. If you add in the 3k we pay for our concierge doctor and 5.5 K Long Term Health insurance my wife and I are paying about 18% of our income at present for health coverage. I would like to know where is our subsidy since we are retired and on a fixed income. I guess at 74K a year we are considered wealthy. And to add insult to injury our Social Security is taxed as income. I can't imagine how much more the government is going to squeeze out from us once we start taking distributions on our 401ks which will dramatically increase our income. It's my understanding that our Medicare premium will increase from the 228 per month to 500 next year. So I guess you know who is paying for all that "free" preventive care in the ACA. It's we seniors.

Quote from: muwarrior69 on May 07, 2013, 03:45:00 PM
I was watching C-Span and a spokes person for the administration was explaining that families of 4 that earn around 30-40k per year would get a  subsidy up to about 11k a year if they got their coverage through the exchanges designated in the ACA. A family in that category would also not pay more than 2% of gross income for their premium. Well our medicare, co-insurance and part D insurance runs us about 7200 per year. If you add in the 3k we pay for our concierge doctor and 5.5 K Long Term Health insurance my wife and I are paying about 18% of our income at present for health coverage. I would like to know where is our subsidy since we are retired and on a fixed income. I guess at 74K a year we are considered wealthy. And to add insult to injury our Social Security is taxed as income. I can't imagine how much more the government is going to squeeze out from us once we start taking distributions on our 401ks which will dramatically increase our income. It's my understanding that our Medicare premium will increase from the 228 per month to 500 next year. So I guess you know who is paying for all that "free" preventive care in the ACA. It's we seniors.

Here is the real question: Where is the $11K of subsidy that goes to the family who makes $40K coming from?  $40K is pretty darn close to the median family income, so multiply 11K times about half the number of families in the US?  You are closing in on a trillion dollars - A YEAR.

Quote from: warriorchick on May 07, 2013, 04:07:43 PM
Here is the real question: Where is the $11K of subsidy that goes to the family who makes $40K coming from?  $40K is pretty darn close to the median family income, so multiply 11K times about half the number of families in the US?  You are closing in on a trillion dollars - A YEAR.

I forgot the good part. Families that earn up to 92K per year that get coverage through the exchanges will also be eligible for a subsidy, albeit considerably less than 11K but still eligible.

Quote from: muwarrior69 on May 07, 2013, 03:45:00 PM
So I guess you know who is paying for all that "free" preventive care in the ACA. It's we seniors.

Yeahhhh .. gentle reminder?  It's the seniors who use way more of the health care dollars in the country.  

At age 60, the per capita spending on health care rockets upward.  In macro terms, the young are subsidizing the old.

Not to say that's wrong to perform generational wealth shifting, but the idea that seniors are "paying for all that 'free' preventive care in the ACA" is entirely false.

With so much talk about controlling costs, how can we when some hospitals charge $30,000 more than another for the same operation.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/08/one-hospital-charges-8000-another-38000/?hpid=z1

Quote from: reinko on May 08, 2013, 09:42:46 AM
With so much talk about controlling costs, how can we when some hospitals charge $30,000 more than another for the same operation.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/08/one-hospital-charges-8000-another-38000/?hpid=z1

I am guessing these are list prices and are meaningless.  If you ever read an EOB from your healthcare provider, you would know that the negotiated prices are 40%-80% lower.  Sometimes it's more than that.  jsglow recently received a bill on which the original charge was $880. Our insurance company's negotiated rate was $90.

And if your insurance company allows you to receive treatment at a hospital that charges that much more and then pays the bill, you are being insured by a very poorly run company.

Notice that the article is comparing bills for the same procedure that were submitted to Medicare. It didn't say Medicare paid the entire amount.  And if your provider doesn't accept Medicare assignment and you don't have supplemental insurance, shame on you for not shopping around.

Quote from: warriorchick on May 08, 2013, 09:54:06 AM
I am guessing these are list prices and are meaningless.  If you ever read an EOB from your healthcare provider, you would know that the negotiated prices are 40%-80% lower.  Sometimes it's more than that.  jsglow recently received a bill on which the original charge was $880. Our insurance company's negotiated rate was $90.

And if your insurance company allows you to receive treatment at a hospital that charges that much more and then pays the bill, you are being insured by a very poorly run company.

Notice that the article is comparing bills for the same procedure that were submitted to Medicare. It didn't say Medicare paid the entire amount.  And if your provider doesn't accept Medicare assignment and you don't have supplemental insurance, shame on you for not shopping around.

I did read the article, and yes these are submitted prices, and yes they talk that they get negotiated down...but if different hospitals have different negotiating start points for prices, obviously, you are incentivitized to start at the highest point possible, giving yourself the best chance to have the highest amount paid by Medicare.

Shouldn't a CATscan cost (roughly 10-15%) the same thing across the country?

Quote from: mu_hilltopper on May 08, 2013, 08:53:42 AM
Yeahhhh .. gentle reminder?  It's the seniors who use way more of the health care dollars in the country.  

At age 60, the per capita spending on health care rockets upward.  In macro terms, the young are subsidizing the old.
Not to say that's wrong to perform generational wealth shifting, but the idea that seniors are "paying for all that 'free' preventive care in the ACA" is entirely false.

Like I said above a family whose income is 40K will pay no more than 2% of their income about 800 dollars a year. My wife and I are paying 7200 a year. So who is subsidizing who...it's folks like my wife and I.

Quote from: reinko on May 08, 2013, 09:59:17 AM
Shouldn't a CATscan cost (roughly 10-15%) the same thing across the country?

The company I work for uses a benefits broker, a few years ago he talked to us about controlling costs and mentioned as as example that medical costs in SE Wisc. are among the highest because of all of the facilities here. In particular he mentioned MRI's being high because there are more MRI machines here than in the entire province of Ontario (or something to that affect). It's about ROI.

Quote from: Hards_Alumni on May 07, 2013, 09:20:38 AM
Single payer wasn't passed.  Nor was it ever introduced.

It's the pipe dream that you guys want, and some are arguing that when O'B Care flops wildly, as it likely will, it's the next step.

Quote from: reinko on May 08, 2013, 09:42:46 AM
With so much talk about controlling costs, how can we when some hospitals charge $30,000 more than another for the same operation.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/08/one-hospital-charges-8000-another-38000/?hpid=z1

I'd also want to know if it is truly the "same operation".  Why does Marquette charge more than UW-M for the "same" bachelor's degree in Education?   ;)

Quote from: reinko on May 08, 2013, 09:59:17 AM
I did read the article, and yes these are submitted prices, and yes they talk that they get negotiated down...but if different hospitals have different negotiating start points for prices, obviously, you are incentivitized to start at the highest point possible, giving yourself the best chance to have the highest amount paid by Medicare.

Shouldn't a CATscan cost (roughly 10-15%) the same thing across the country?

I agree.  And if the government is negotiating from the top down as opposed to the bottom up, that's another reason they shouldn't be running healthcare.

Quote from: warriorchick on May 08, 2013, 09:54:06 AM
I am guessing these are list prices and are meaningless.  If you ever read an EOB from your healthcare provider, you would know that the negotiated prices are 40%-80% lower.  Sometimes it's more than that.  jsglow recently received a bill on which the original charge was $880. Our insurance company's negotiated rate was $90.

And if your insurance company allows you to receive treatment at a hospital that charges that much more and then pays the bill, you are being insured by a very poorly run company.

Notice that the article is comparing bills for the same procedure that were submitted to Medicare. It didn't say Medicare paid the entire amount.  And if your provider doesn't accept Medicare assignment and you don't have supplemental insurance, shame on you for not shopping around.

Seniors can opt out of Medicare. If they do, they loose their social security...so not really an option. If your provider does not accept Medicare your supplemental will not cover it as well as they only pay the 20% that Medicare "allows" and does not pay. No Medicare no supplemental. Medicare reimbursements are terribly low which is why our doctor charges us 3K a year. Do we really want to go to single payer system where the government will dictate what a Doctor will be paid? You think there is a Doctor shortage now? Just wait!

Quote from: muwarrior69 on May 08, 2013, 10:04:33 AM
Like I said above a family whose income is 40K will pay no more than 2% of their income about 800 dollars a year. My wife and I are paying 7200 a year. So who is subsidizing who...it's folks like my wife and I.

No, sorry, it is not.  

While you may find examples of 40 year olds paying less than 70 year olds, this is not the case for all 40 and 70 year olds.   In macro terms, the characteristics are quite clear.  20-30-40-50 year olds are just far healthier and in far less need of health care services than 65+ year olds.  

I suppose you could also generalize and say "the healthy subsidize the sick."   By and large, youth are healthy, the older you get, the more health care you demand.  This illuminates the fact that the younger, healthier populations subsidize the older, less healthy.

Quote from: mu_hilltopper on May 08, 2013, 10:49:24 AM
No, sorry, it is not.  

While you may find examples of 40 year olds paying less than 70 year olds, this is not the case for all 40 and 70 year olds.   In macro terms, the characteristics are quite clear.  20-30-40-50 year olds are just far healthier and in far less need of health care services than 65+ year olds.  

I suppose you could also generalize and say "the healthy subsidize the sick."   By and large, youth are healthy, the older you get, the more health care you demand.  This illuminates the fact that the younger, healthier populations subsidize the older, less healthy.

Your missing the point. The ACA is based on income levels for those not on Medicare. If the ACA is to be fair they should cap premiums for all based on income. Why should a senior pay 5-10% of their fixed  income for premiums with no subsidies while working families earning 40K be capped at 2%. Families who earn up to 92K a year will get a subsidy while no one on Medicare will.

Quote from: warriorchick on May 08, 2013, 10:18:40 AM
I agree.  And if the government is negotiating from the top down as opposed to the bottom up, that's another reason they shouldn't be running healthcare.

I don't believe that's how Medicare works.  They have set prices for procedures, so it doesn't matter what a provider may list as the cost to them.  Medicare does not negotiate with individual providers, they just set a price that they deem to cover the entire cost of the procedure, including equipment, hospital time, salaries and overhead.  

Now, the higher list prices may affect what a provider receives from private insurance, as they do negotiate with individual providers.

Quote from: warriorchick on May 08, 2013, 09:54:06 AM
I am guessing these are list prices and are meaningless.  If you ever read an EOB from your healthcare provider, you would know that the negotiated prices are 40%-80% lower.  Sometimes it's more than that.  jsglow recently received a bill on which the original charge was $880. Our insurance company's negotiated rate was $90.

And if your insurance company allows you to receive treatment at a hospital that charges that much more and then pays the bill, you are being insured by a very poorly run company.

Notice that the article is comparing bills for the same procedure that were submitted to Medicare. It didn't say Medicare paid the entire amount.  And if your provider doesn't accept Medicare assignment and you don't have supplemental insurance, shame on you for not shopping around.

Where my wife works, the best example is reusable ice packs.  They have to bill any time someone uses an ice pack.  The billed rate is $90 per "unit" or time segment used.  Some insurances have negotiated a $25 rate, some $50, some $90, etc.  In case you missed it, this is a REUSABLE ice pack and at the cheapest the insurance is paying more than the cost of the ice pack in the first place for one use.

And for those advocating for Medicare, it may be a federal program but it is administrated by the states.  Before the expansion of Medicare, Illinois is behind in medicare reimbursment payments to the tune of $1.7 billion

http://www.sj-r.com/carousel/x1545203621/Deadbeat-Illinois-Medicaid-expansion-could-lead-to-more-payment-delays?zc_p=0 (http://www.sj-r.com/carousel/x1545203621/Deadbeat-Illinois-Medicaid-expansion-could-lead-to-more-payment-delays?zc_p=0)

Is that the new model, we'll pay when we feel like it and the provider has to operate in a cash flow nightmare for 6-9 months?  I had an Illinois ER manager come into our managerial accounting class as part of MU's MBA program and he talked about all the Lean/Six Sigma, cost accounting, and process flow activities to improve patient efficiency.  On average they reduced patient wait/treatment times by 2 hours, and reduced cost by 40%.  All that savings went into merely covering the cost of 6 months of medicare cash short falls.

TRAIN. WRECK.

http://thehill.com/blogs/healthwatch/health-reform-implementation/294501-baucus-warns-of-huge-train-wreck-in-obamacare-implementation

Quote from: mu03eng on May 08, 2013, 12:51:16 PM
And for those advocating for Medicare, it may be a federal program but it is administrated by the states.  Before the expansion of Medicare, Illinois is behind in medicare reimbursment payments to the tune of $1.7 billion

You are incorrect.  Medicare and Medicaid are not the same.  Medicare is administered by the federal government through the Social Security Administration.  Medicaid is administered by the states.

If you don't know the differences between Medicare and Medicaid I am not sure you are in a strong position to lecture those that may or may not be advocating for an expansion of Medicare.

Quote from: BME to MD on May 08, 2013, 02:44:41 PM
You are incorrect.  Medicare and Medicaid are not the same.  Medicare is administered by the federal government through the Social Security Administration.  Medicaid is administered by the states.

If you don't know the differences between Medicare and Medicaid I am not sure you are in a strong position to lecture those that may or may not be advocating for an expansion of Medicare.

I apologize, I will endeavor to not interchange the names of the two programs again.  I know the difference between the two, the point remains, Medicaid is targeted at low income families, primarily those that are likely to not have their own insurance.  And medicaid can't control cost anymore than medicare can.

Quote from: ChicosBailBonds on May 08, 2013, 10:16:47 AM
It's the pipe dream that you guys want, and some are arguing that when O'B Care flops wildly, as it likely will, it's the next step.

So just to review:

Single payer is a pipe dream.

You know that I belong to a group.

You know that is what I and this group want is single payer.

You think that single payer is the next logical step after a presumed government mandated health care flop.

I want to live in your world.

Quote from: muwarrior69 on May 08, 2013, 11:06:42 AM
Your missing the point. The ACA is based on income levels for those not on Medicare. If the ACA is to be fair they should cap premiums for all based on income. Why should a senior pay 5-10% of their fixed  income for premiums with no subsidies while working families earning 40K be capped at 2%. Families who earn up to 92K a year will get a subsidy while no one on Medicare will.

I think you are missing Hilltopper's point.  Are you upset that young people can get very cheap life insurance?  Are you upset that middle aged people with safe driving records pay much lower car insurance premiums?

Also, by taking the total 2011 Medicare expenditures ($1,000,000,000,000.00) and total beneficiaries (48 million) I just calculated the average expenditure per Medicare patient to be ~$21,000.  

Keep in mind that total national healthcare expenditures in 2011 was $2.7 trillion for 311 million people.  Therefore seniors representing 15.4% of the total population absorbed 37% of our national healthcare expenditures.

Per AARP the average out-of-pocket cost per Medicare beneficiary was ~$4,550.  

Quote from: BME to MD on May 08, 2013, 03:07:08 PM
I think you are missing Hilltopper's point.  Are you upset that young people can get very cheap life insurance?  Are you upset that middle aged people with safe driving records pay much lower car insurance premiums?

Also, by taking the total 2011 Medicare expenditures ($1,000,000,000,000.00) and total beneficiaries (48 million) I just calculated the average expenditure per Medicare patient to be ~$21,000.  

Keep in mind that total national healthcare expenditures in 2011 was $2.7 trillion for 311 million people.  Therefore seniors representing 15.4% of the total population absorbed 37% of our national healthcare expenditures.

Per AARP the average out-of-pocket cost per Medicare beneficiary was ~$4,550.  

You are incorrect.  We are talking about health insurance, not life insurance, they are not the same.

If you don't know the differences between health insurance and life insurance I am not sure you are in a strong position to lecture those that may or may not be advocating for an expansion of health insurance.

Quote from: mu03eng on May 08, 2013, 02:49:41 PM
I apologize, I will endeavor to not interchange the names of the two programs again.  I know the difference between the two, the point remains, Medicaid is targeted at low income families, primarily those that are likely to not have their own insurance.  And medicaid can't control cost anymore than medicare can.

Medicare is certainly better than Medicaid given that its recommendations essentially guide healthcare reimbursement and its rules on things like early readmission or hospital acquired pneumonia rates are working to decrease these costly outcomes.

However, the only hope for true cost control is rationing.  I highly recommend Daniel Callahan's visionary book "Setting Limits: Medical Goals in an Aging Society."

Quote from: reinko on May 08, 2013, 03:10:19 PM
You are incorrect.  We are talking about health insurance, not life insurance, they are not the same.

If you don't know the differences between health insurance and life insurance I am not sure you are in a strong position to lecture those that may or may not be advocating for an expansion of health insurance.

+1 fastest hoisting by one's own petard in internet history  ;D

Quote from: reinko on May 08, 2013, 03:10:19 PM
You are incorrect.  We are talking about health insurance, not life insurance, they are not the same.

If you don't know the differences between health insurance and life insurance I am not sure you are in a strong position to lecture those that may or may not be advocating for an expansion of health insurance.

Not trying to interrupt the focus of the Superbar mudfight.  Just trying to illustrate to muwarrior69 that healthcare insurance like all other types of insurance (life and car included) is based on risk estimation.

Back to the eternal battle of freedom vs communism!

Quote from: BME to MD on May 08, 2013, 03:07:08 PM
I think you are missing Hilltopper's point.  Are you upset that young people can get very cheap life insurance?  Are you upset that middle aged people with safe driving records pay much lower car insurance premiums?
Also, by taking the total 2011 Medicare expenditures ($1,000,000,000,000.00) and total beneficiaries (48 million) I just calculated the average expenditure per Medicare patient to be ~$21,000.  

Keep in mind that total national healthcare expenditures in 2011 was $2.7 trillion for 311 million people.  Therefore seniors representing 15.4% of the total population absorbed 37% of our national healthcare expenditures.

Per AARP the average out-of-pocket cost per Medicare beneficiary was ~$4,550.  

I am upset that folks regardless of age (i.e. less than 65) that earn up to 92k a year will get a subsidy while those of us forced on Medicare have to pay full freight after paying into Medicare all those years do not receive a subsidy. I am also upset that Doctors and other health care providers are not being reimbursed by Medicare so that they can stay in practice. Medicare is not the end all and be all that many who want a single payer system think it is.

Quote from: mu03eng on May 08, 2013, 03:19:37 PM
+1 fastest hoisting by one's own petard in internet history  ;D

Unsure if you understand reinko's sense of humor.

Quote from: muwarrior69 on May 08, 2013, 03:34:52 PM
I am upset that folks regardless of age (i.e. less than 65) that earn up to 92k a year will get a subsidy while those of us forced on Medicare have to pay full freight after paying into Medicare all those years do not receive a subsidy. I am also upset that Doctors and other health care providers are not being reimbursed by Medicare so that they can stay in practice. Medicare is not the end all and be all that many who want a single payer system think it is.

We are all paying full freight to keep Medicare and Social Security going*.  In fact we are paying an extra 0.9% in Medicare taxes on all income over 200k single filer or 250k married jointly.  Average per capita income is ~40k which would equate to a Medicare tax rate of $580 per year.  Given that the average Medicare beneficiary paid in the equivalent of $580 and is now benefiting to the tune of 21k per year after 4.5k per year out of pocket that seems like a very generous subsidy.

The argument about providers is very true but unfortunately the only possibilities to change that behavior are to control private insurance payments to a degree most Americans would consider it a government takeover, increase Medicare reimbursement rates also impossible given the focus is on decreasing government spending, or to further strengthen rules about which types of providers must see Medicare patients which is also highly unlikely.


*There is a real possibility (with ever increasing likelihood) that my generation will never benefit from either of these programs also.

Quote from: BME to MD on May 08, 2013, 03:48:52 PM
We are all paying full freight to keep Medicare and Social Security going*.  In fact we are paying an extra 0.9% in Medicare taxes on all income over 200k single filer or 250k married jointly.  Average per capita income is ~40k which would equate to a Medicare tax rate of $580 per year.  Given that the average Medicare beneficiary paid in the equivalent of $580 and is now benefiting to the tune of 21k per year after 4.5k per year out of pocket that seems like a very generous subsidy.

The argument about providers is very true but unfortunately the only possibilities to change that behavior are to control private insurance payments to a degree most Americans would consider it a government takeover, increase Medicare reimbursement rates also impossible given the focus is on decreasing government spending, or to further strengthen rules about which types of providers must see Medicare patients which is also highly unlikely.


*There is a real possibility (with ever increasing likelihood) that my generation will never benefit from either of these programs also.

Something we do agree on. I really worry for my daughter and granddaughter.

Now back to the Al to talk basketball.

Quote from: Hards_Alumni on May 08, 2013, 02:57:14 PM
So just to review:

Single payer is a pipe dream.  Of the left, yes

You know that I belong to a group.  Yes, you have admitted to being in said aisle.

You know that is what I and this group want is single payer.  You, I don't know...the group...yes and there videos, and speeches, and articles, and policy positions by the truckloads to back it up.

You think that single payer is the next logical step after a presumed government mandated health care flop.  No, that's not what I said.  I said SOME argue that is the next step.

I want to live in your world.  No thanks, I'd prefer you keep your hands in your own world and stop messing around with mine.

Quote from: muwarrior69 on May 08, 2013, 04:19:44 PM
Something we do agree on. I really worry for my daughter and granddaughter.

Don't worry, they'll just keep printing money......money money money....what could POSSIBLY go wrong?

Quote from: Hards_Alumni on May 08, 2013, 03:37:26 PM
Unsure if you understand reinko's sense of humor.

Unsure if you understand mine

Quote from: ChicosBailBonds on May 08, 2013, 07:57:20 PM

(Rant warning)

We are smart people. We all took logic class. We should be able to have a discussion without trying to corner the "other side" and devolve into political posturing. That's not using logic, that's using rhetoric.

I don't know if the US has always been this politically polarized, or if I'm just old enough now to realize it. Either way, it drives me nuts, and I honestly think it's a big problem in this country.

(end of rant).

Quote from: Guns n Ammo on May 09, 2013, 09:14:01 AM
(Rant warning)

We are smart people. We all took logic class. We should be able to have a discussion without trying to corner the "other side" and devolve into political posturing. That's not using logic, that's using rhetoric.

I don't know if the US has always been this politically polarized, or if I'm just old enough now to realize it. Either way, it drives me nuts, and I honestly think it's a big problem in this country.

(end of rant).

+10000000000000000000000000000000000000000

Quote from: Guns n Ammo on May 09, 2013, 09:14:01 AM
(Rant warning)

We are smart people. We all took logic class. We should be able to have a discussion without trying to corner the "other side" and devolve into political posturing. That's not using logic, that's using rhetoric.

I don't know if the US has always been this politically polarized, or if I'm just old enough now to realize it. Either way, it drives me nuts, and I honestly think it's a big problem in this country.

(end of rant).

I think that those truly passionate about their politics have always held beliefs that could be classified as polarized as to the role of government towards its citizens. Here's a contrast for you, though. I grew up watching guys like William F Buckley Jr and Daniel Patrick Moynihan debate every fortnight or so on PBS. Substantive, thought provoking and usually civil. Today it's Sean Hannity and Chris Matthews screaming every night in a game of "gotcha". Ubiquitous, anecdotal and angry.

Quote from: Lennys Tap on May 09, 2013, 10:01:05 AM
I think that those truly passionate about their politics have always held beliefs that could be classified as polarized as to the role of government towards its citizens. Here's a contrast for you, though. I grew up watching guys like William F Buckley Jr and Daniel Patrick Moynihan debate every fortnight or so on PBS. Substantive, thought provoking and usually civil. Today it's Sean Hannity and Chris Matthews screaming every night in a game of "gotcha". Ubiquitous, anecdotal and angry.

Agreed.

I respect people's passion, but maybe it's the shouting down and dismissing of ideas that bothers me.

Debates and discussions are great, but "gotcha" stuff is sooo unproductive in my mind.

I actually like hearing both sides because I don't think there is anything to be learned by me seeking out people with my same opinion.

But, I don't want to listen to a bunch of posturing and rhetoric.

Quote from: Guns n Ammo on May 09, 2013, 10:35:17 AM
Agreed.

I respect people's passion, but maybe it's the shouting down and dismissing of ideas that bothers me.

Debates and discussions are great, but "gotcha" stuff is sooo unproductive in my mind.

I actually like hearing both sides because I don't think there is anything to be learned by me seeking out people with my same opinion.

But, I don't want to listen to a bunch of posturing and rhetoric.

Totally agree.  I don't watch the idiots on TV, nor do I subscribe to an entire policy of a party.

Quote from: Guns n Ammo on May 09, 2013, 10:35:17 AM
Agreed.

I respect people's passion, but maybe it's the shouting down and dismissing of ideas that bothers me.

Debates and discussions are great, but "gotcha" stuff is sooo unproductive in my mind.

I actually like hearing both sides because I don't think there is anything to be learned by me seeking out people with my same opinion.

But, I don't want to listen to a bunch of posturing and rhetoric.

Debates on war, enhanced interrogation, taxation, immigration, healthcare, etc., are complex. Much easier to call people "unpatriotic" for non support or scream "Blood for oil!" at the supporters. The idea that one side has a monopoly on "family values" or "social justice" is nonsensical but we have a very uninformed electorate and catch phrases and negative ads are what works on them.

Quote from: Lennys Tap on May 09, 2013, 11:09:36 AM
...but we have a very uninformed electorate and catch phrases and negative ads are what works on them.

I agree 10000%, but I hope for a more intellectual approach from Jesuit-taught MU grads.

We know logic. We understand how to debate a topic without resorting to a bunch of emotional appeals and attacks.

The average American is a moron, and we have to live with that. But, we should/can expect more from an MU grad.

I don't hear anyone arguing that the health care system we have in the US is on the right track.   We are clearly pouring huge sums of money into it, (IIRC, the highest % of GDP of any country in the world).    It is strangling the economy just as surely as $4 a gallon gasoline.    The question is how we can get the maximum benefit for our dollar, be it getting more coverage for what we are currently paying or getting our current coverage for less.   There are ideas all over the spectrum.   But what we are currently doing clearly can't be sustained.   

Quote from: tower912 on May 09, 2013, 11:43:21 AM
I don't hear anyone arguing that the health care system we have in the US is on the right track.   We are clearly pouring huge sums of money into it, (IIRC, the highest % of GDP of any country in the world).    It is strangling the economy just as surely as $4 a gallon gasoline.    The question is how we can get the maximum benefit for our dollar, be it getting more coverage for what we are currently paying or getting our current coverage for less.   There are ideas all over the spectrum.   But what we are currently doing clearly can't be sustained.   

+1

6 pages of mostly civil discussion (pretty good for a what could be a sensitive subject on the Superbar) in and of itself shows the enormous complexity of the USA health care system.  I always thought that the ACA is just the start of reforming it. 

I don't hear anyone arguing that the health care system we have in the US is on the right track.  That's what always bothered me was that everyone agrees on this but seems more interested in cheap political points.  The House of Reps has voted like 40 times to repeal it.  Instead of wasting time on something that's 100% not going to happen why not offer an addition to current law that will drive down cost?

A few points I see daily ( from the hospital side of things).

Hospitals cannot survive on Medicare and Medicaid rates....especially trauma based and rural hospitals, let alone advance.

For example, Indiana has passed a new law that providers must now bill Medicaid or Medicare instead of pursuing Third Party Liability Insurance Companies. This alone will cost Indiana Hospitals hundreds of millions of dollars yearly. This money is spent to subsidize their uninsured patients, charity programs, and trauma centers. Net result, charity guidelines  (400% of poverty level) will now be reduced to 250-200% of poverty level. Those falling between 250-400% will now be sent to collection agencies, sued, and garnished.....

Med-Mal insurance is outrageous. Some states have tried to limit settlement amounts, etc, to try to curb the costs, but not enough has been done.

Who is actually making the most money out of this? My position it is the health insurance companies. Copays and deductibles are skyrocketing while premiums have gone up.

The medical equipment and pharmaceutical companies are making the largest profits and paving our road to financial hell with their continued advancement of the science.

Demand for healthcare has always been nearly infinite.  What has changed in the last 50-60 years is a profound expansion of medical science allowing medical providers to delay serious complications of chronic disease and to acutely save lives that in the past would have been beyond our capacity to save.

A good example of the paradigm is ECMO (extra corporeal membrane oxygenization) therapy which is essentially a device that takes over for a patient's heart and lung function.  Ongoing ECMO therapy requires a perfusionist (expert on the ECMO machine) to be in the hospital 24 hours a day, an ICU bed, usually 24/7 one on one nursing care, and all the other associated ICU staff (attending physician, PA/NP/resident, nutritionist, pharmacist, and cardiac or vascular surgeon to implant and monitor to blood access catheters).  ECMO is extraordinarily expensive care considering the ICU stay alone can cost >$10,000 per day.  

Since ECMO is such a resource intensive treatment most hospitals restrict its use to short term use (< 3 days in adult, < 3 weeks in neonates - it works better in neonates).  However, the bleeding edge of medical technology continnues to surge forward with the University of Maryland reporting that they kept a 24 year old patient alive on ECMO for 107 days until he could receive a double lung transplant.  

Any attempt to 'bend the cost curve' is a Quixotic mission unless it meaningfully addresses the American demand for life extension.  We cannot bend the curve with cost controls alone.

http://www.umm.edu/news/releases/world_record.htm (http://www.umm.edu/news/releases/world_record.htm)

I think that is one thing people miss.  They want Health Care to be a treated like any other market...but it just isn't the same.  If you're having a heart attack, you're not going to shop around for the best deal.  People aren't going to say "no" to a $500,000 procedure if it'll save their life.  Companies aren't evil for pursuing profits, but in the case of health care, they basically hold all the cards and can charge whatever they want. 

In the U.S. we happen to value life and Drs. and Nurses are trained and dedicated to sustaining life. Extraordinary measures are commonly used as no one wants to be responsible for not doing their best to save a life.
I don't get why Pharma and Medical device companies are cast as the bad guys or their profits maligned. They provide a product that you can refuse to use if you like. If people knew the markup on other products( clothing for example) they would be amazed but it seems to be the Healthcare Industry that is cast as the evil entity. And virtually no one pays the inflated bill on hospitalisation, usually it is a fraction of that.

Quote from: elephantraker on May 10, 2013, 10:16:33 AM
In the U.S. we happen to value life and Drs. and Nurses are trained and dedicated to sustaining life. Extraordinary measures are commonly used as no one wants to be responsible for not doing their best to save a life.
I don't get why Pharma and Medical device companies are cast as the bad guys or their profits maligned. They provide a product that you can refuse to use if you like. If people knew the markup on other products( clothing for example) they would be amazed but it seems to be the Healthcare Industry that is cast as the evil entity. And virtually no one pays the inflated bill on hospitalisation, usually it is a fraction of that.

Actually, I have a stupid question. (I don't work in healthcare).

Why are the prices so inflated and then negotiated down? That just seems weird/shady, doesn't it? Feels like I'm buying a used car.

I understand that insurance companies negotiate volume discounts. Makes sense.

But, the prices generally just seem super inflated to begin with.

I would like to add the caveat that healthcare workers are dedicated to sustaining life when that extension is consistent with the wishes of the patient or their surrogates. 

I for one believe that the American relationship with death powerfully shapes our national policy on healthcare and is perhaps the strongest contributor to our massive spending.

Quote from: Guns n Ammo on May 10, 2013, 10:24:13 AM
Actually, I have a stupid question. (I don't work in healthcare).

Why are the prices so inflated and then negotiated down? That just seems weird/shady, doesn't it? Feels like I'm buying a used car.  
I understand that insurance companies negotiate volume discounts. Makes sense.

But, the prices generally just seem super inflated to begin with.

Two words....risk and litigation. The malpractice debate everyone understands. No on wants to be harmed by a doctor and want to be able to sue if they are; thus high malpractice insurance. I worked in big pharma all my working career. For every drug that makes it to market 9 don't. I worked on a drug where the company spent 100 million in R&D on a particular drug only to be not approved by the FDA. Developing new drugs is a very expensive endeavor. We americans are the only citizens that pay the freight for R&D as we are the only country that does not set prices by a government.

Quote from: muwarrior69 on May 10, 2013, 11:23:46 AM
Two words....risk and litigation. The malpractice debate everyone understands. No on wants to be harmed by a doctor and want to be able to sue if they are; thus high malpractice insurance. I worked in big pharma all my working career. For every drug that makes it to market 9 don't. I worked on a drug where the company spent 100 million in R&D on a particular drug only to be not approved by the FDA. Developing new drugs is a very expensive endeavor. We americans are the only citizens that pay the freight for R&D as we are the only country that does not set prices by a government.

Well, that would explain high prices, and I understand that. You make money in mass production by stamping out the same widget over and over and over. The cost of R&D goes down the more you can repeat the same thing. Drugs are always evolving, so the cost of R&D is very high (vs a frying pan).

But, why are some things priced at $30,000, and then reduced to like $5000 if you pay in cash?

My experiences are brief and limited, but it feels like I'm shopping at TJ Maxx or something.

(maybe I should go to a better hospital).

Quote from: muwarrior69 on May 10, 2013, 11:23:46 AM
Two words....risk and litigation. The malpractice debate everyone understands. No on wants to be harmed by a doctor and want to be able to sue if they are; thus high malpractice insurance. I worked in big pharma all my working career. For every drug that makes it to market 9 don't. I worked on a drug where the company spent 100 million in R&D on a particular drug only to be not approved by the FDA. Developing new drugs is a very expensive endeavor. We americans are the only citizens that pay the freight for R&D as we are the only country that does not set prices by a government.

As someone who has also worked in Pharma (I don't anymore) I can say this is totally accurate, and a lot of people just don't know.  At my previous job, my group was tasked with doing the stability testing for a conversion of an adult dosage inhaler to a child dosage inhaler.  We worked on that for at least 3 years with 10 dedicated scientists working 40+ hours a week.  By the time I had left, they still had not perfected the product to a degree that it would pass the FDA regulations.  Imagine how much money was spent on this one drug alone... a drug they KNEW worked.  Simply trying to convert from adult to child dosage cost millions and millions.

Quote from: BME to MD on May 10, 2013, 08:12:20 AM
Any attempt to 'bend the cost curve' is a Quixotic mission unless it meaningfully addresses the American demand for life extension.  We cannot bend the curve with cost controls alone.

We need Death Panels!

In all seriousness, I totally agree with this general point. My wife and I have had the conversation many times about our preference for maximizing the end quality of life vs the end quantity of life.

Quote from: Guns n Ammo on May 10, 2013, 11:49:19 AM
Well, that would explain high prices, and I understand that. You make money in mass production by stamping out the same widget over and over and over. The cost of R&D goes down the more you can repeat the same thing. Drugs are always evolving, so the cost of R&D is very high (vs a frying pan).

But, why are some things priced at $30,000, and then reduced to like $5000 if you pay in cash?

My experiences are brief and limited, but it feels like I'm shopping at TJ Maxx or something.

(maybe I should go to a better hospital).

There are multiple reasons for the inflated price.  First, medicare and medicaid don't reimburse at the "true cost" of procedures so the providers play a shell game of inflating private insurance to cover the medicare short fall.  The same thing for the uninsured, they are "covered" by the inflated prices.  There is also the malpractice premium mentioned before.

The last reason is actually financial accounting funny business because of incorrect cost accounting.  If you look at a hospital, if you were accounting for cost correctly, where most hospitals make money is services like PT, OT, pharmacy, blood lab, etc.  The surgeries themselves have the highest cost because of all of the overhead(doctors) so to make the numbers work they have to charge high prices and discount then keep costs down on the services portion even though the margins are huge.  Basically they rob the Peter(services) to pay Paul(doctors, specifically surgeons)

Quote from: mu03eng on May 10, 2013, 01:54:24 PM
There are multiple reasons for the inflated price.  First, medicare and medicaid don't reimburse at the "true cost" of procedures so the providers play a shell game of inflating private insurance to cover the medicare short fall.  The same thing for the uninsured, they are "covered" by the inflated prices.  There is also the malpractice premium mentioned before.

The last reason is actually financial accounting funny business because of incorrect cost accounting.  If you look at a hospital, if you were accounting for cost correctly, where most hospitals make money is services like PT, OT, pharmacy, blood lab, etc.  The surgeries themselves have the highest cost because of all of the overhead(doctors) so to make the numbers work they have to charge high prices and discount then keep costs down on the services portion even though the margins are huge.  Basically they rob the Peter(services) to pay Paul(doctors, specifically surgeons)

That makes sense. In most businesses there are some loss leaders that are used to support the more profitable areas.

Thanks for the info.

Quote from: Lennys Tap on May 09, 2013, 10:01:05 AM
I think that those truly passionate about their politics have always held beliefs that could be classified as polarized as to the role of government towards its citizens. Here's a contrast for you, though. I grew up watching guys like William F Buckley Jr and Daniel Patrick Moynihan debate every fortnight or so on PBS. Substantive, thought provoking and usually civil. Today it's Sean Hannity and Chris Matthews screaming every night in a game of "gotcha". Ubiquitous, anecdotal and angry.

Excellent examples, Lenny. I remember enjoying those two. I would add Gorge Will, James Kilpatrick, William Safire, Davis Broder, Ellen Goodman, and Robert Maynard to that list. The discourse could be sharp and pointed but it was always well reasoned and certainly civil.

Cokie Roberts delivered the eulogy at Betty Ford's funeral. She pointed out how bipartisan consensus was often reached when her father, Hale Boggs, had dinner with Jerry Ford. Over steaks and scotch they would find the best solution for America. If neither man could find it within himself to find that solution the wives, Lindy Boggs and Betty Ford, would help their husbands find that consensus.

The lack of civility in America is depressing. It is all the fault of those damn liberals, mind you...

Quote from: Guns n Ammo on May 10, 2013, 02:38:45 PM
That makes sense. In most businesses there are some loss leaders that are used to support the more profitable areas.

Thanks for the info.

Ammo,

I have not been subjected to the US medical system (non-military) for decades so my perspective on patient care and attendant costs is limited. I do have insight on drug discovery & development. I was part of the GE team that set up a JV in Singapore and Shanghai between GE, Harvard Care Group, Quintiles, and Sun MicroSystems. We established infrastructure (virtual and brick and mortar) for Clinical Trials in Asia. To get a molecule to market with regulatory approval takes a decade. The failure rate is 98%. And the investment in a molecule through Phase III approaches $1 billion. The capital required is enormous, the risks are high, and the potential for return is staggering. Drug companies build into their cost model a capital reserve for litigation as well as recovery for failed trials.

Drug discovery and development as a research imperative functions relatively efficiently. But as a business model it is beginning to break down. Unless there can be systemic or institutional relief from predatory litigation many promising molecules will never reach market. 

Quote from: Lennys Tap on May 09, 2013, 10:01:05 AM
I think that those truly passionate about their politics have always held beliefs that could be classified as polarized as to the role of government towards its citizens. Here's a contrast for you, though. I grew up watching guys like William F Buckley Jr and Daniel Patrick Moynihan debate every fortnight or so on PBS. Substantive, thought provoking and usually civil. Today it's Sean Hannity and Chris Matthews screaming every night in a game of "gotcha". Ubiquitous, anecdotal and angry.

Agree.  I used to get a kick out of watching Buckley and others debate.  Remembering Saffire at the NY Times....they wouldn't dream of putting someone like him on those pages now. 

Lots of gotcha politics, but that has also happened for longer than people think in my view.  It's just been more subtle in the past, less in your face.  The agendas driving what was talked about, what was printed on the front page, etc, has been there for a LONG time.

But it's hardly just the media talking heads, it goes down to the grass roots, it goes into institutions themselves.  Today's IRS revelation out of Cincinnati is just another classic example of targeting....this time they were caught, how many times are these things done for intimidation purposes and they aren't caught.  Really sad.

Quote from: Guns n Ammo on May 09, 2013, 11:33:49 AM
I agree 10000%, but I hope for a more intellectual approach from Jesuit-taught MU grads.

We know logic. We understand how to debate a topic without resorting to a bunch of emotional appeals and attacks.

The average American is a moron, and we have to live with that. But, we should/can expect more from an MU grad.

Just a gentle reminder that Sen. Joseph McCarthy is a Marquette graduate.

Quote from: Guns n Ammo on May 10, 2013, 10:24:13 AM
Actually, I have a stupid question. (I don't work in healthcare).

Why are the prices so inflated and then negotiated down? That just seems weird/shady, doesn't it? Feels like I'm buying a used car.

I understand that insurance companies negotiate volume discounts. Makes sense.

But, the prices generally just seem super inflated to begin with.

Most health insurance policies pay up to "usual and customary" charges.  as reimbursements drop, charges go up and "usual and customary" increases to make up the short fall.  It's a vicious circle.

Quote from: ZiggysFryBoy on May 10, 2013, 10:58:49 PM
Most health insurance policies pay up to "usual and customary" charges.  as reimbursements drop, charges go up and "usual and customary" increases to make up the short fall.  It's a vicious circle.

Say what? How much were your silicones? Well worth it, I say. I thought you looked plenty feminine before the rack, but with those you are pure estrogen!

If you're a private pay (i.e., don't have the gubbment paying for you or the procedure isn't covered through an insurer for which there is a contractual allowance), I'd spend some time shoppin.. now that I think of it.. those of us with high deductible plans who won't max out in a year should consider shopping around a little more.

The best plan for health care is that once past a certain weight or age you go to prison. Prisoners get privileges for caring for the obese and elderly. They do the best they can. Also, weed is completely legal in these prisons to ease pain.

Quote from: ZiggysFryBoy on May 10, 2013, 10:58:49 PM
Most health insurance policies pay up to "usual and customary" charges.  as reimbursements drop, charges go up and "usual and customary" increases to make up the short fall.  It's a vicious circle.

Most policies pay the negotiated rate in network and pay usual and customary out of network.  Usual and customary has become the Medicare reimbursement rate in many policies making it very low.  This has greatly increased the risk of using a provider out of network, because the patient is responsible for 100 percent of the amount above usual and customary.

Quote from: mu03eng on May 03, 2013, 01:36:53 PM
My wife is a PT at a relatively affluent hospital in the Milwaukee area and sees this all the time with the government funded patients.  Gets a patient that is told therapy should be able to treat the issue but surgery might as well and the government backed patient ALWAYS chooses surgery over PT.  PT would be infinitely less expensive and the outcome just as good, but because the patient doesn't care about cost they go for the quick fix.

Sounds like a patient who is given the option to lose weight, eat healthier, and exercise but elects to undergo a quadruple bypass.

Quote from: mu03eng on May 03, 2013, 05:41:52 PM
We have the most advanced medicine in the world as is what about single payer system is going to change our life expectancy?  What is it about single payer that will vault us past those other systems?

I think the US health care is so advanced and some our choices as a society are so poor that we are lucky to be 37th in the world.  Yes our current system sucks but single payer isn't the answer that will make things worse.  Change the lifestyle

But that will make the many of the health care companies suffer IF WE TAKE CARE OF OURSELVES.

What a novel idea!

Quote from: GooooMarquette on May 03, 2013, 01:57:42 PM
Others here have stated:  "Federal intervention is widely understood to be a source of cost control in this area."

On a very simplistic level, this is correct.  If a provider wants to charge $100 for a service like an x-ray, Medicare will usually say that only $80 is covered, and the provider only gets $80.  Cost containment, right?  If you don't look too closely, the answer looks like yes.  But here's the problem:  Medicare keeps paying the provider $80 every time it performs (and re-performs) that service.  So if the provider performs the service once, it gets paid $80; if it performs the service ten times, it gets $800, and so on.  Increased utilization leads to increased overall payment.  In theory, Medicare may deny some after a while...but these controls have proven not to work.

Now recall that the patient - who ultimately makes the decision whether to go back in and ask for another service - often bears little to no financial responsibility for that service.  He can keep asking for more and more, the provider will often keep performing it more and more, and Medicare will keep paying for it again and again.  Sometimes this is because the provider really believes it may help.  Other times it's because the provider is afraid of being sued for malpractice.  And yet other times, it may be due to a truly malicious provider (that's called fraud).  In any event, in this world where the purchasing decision is de-coupled from the payment responsibility, Medicare's superficial "cost containment" strategy will fail.

And the doctors and health care that continually accepts them says, "Thank you very much, come again!"

But we don't fault them, right, because the government is the stupid one for continually paying?



If I look at Education and where it's heading, health care will follow (is following?) suit: minimally paid workers who push papers, deal with patients like clockwork in small increments of time, heavily tech driven, less person-to-person interaction, quality suffers...all the while people complain and businesses who profit it from it tout the positives and never the negatives.

In the education realm, teachers will be needed less. Interactive software, apps, and programs that can instantly discern student weaknesses and target them are replacing teachers. Voice recognition software will improve to the point that you just need to talk to a screen; handwriting scanners will detect writing mista....ah forget it, who will write anything by hand anymore in the future!

In the future, little nanobots that circulate our bodies will do the recording and transmitting of our bodily functions to a dispensary where we can pick up bottles of pills that will correct whatever ails us.

We will be less reliant on doctors and more reliant on the engineers who innovate, program, and maintain the machines

nvm

Not that we didn't say this back in 2008.  Absolute TRAIN. WRECK.

http://washingtonexaminer.com/insurers-predict-100-400-obamacare-rate-explosion/article/2529523

Quote from: ChicosBailBonds on May 13, 2013, 07:13:42 PM
Not that we didn't say this back in 2008.  Absolute TRAIN. WRECK.

http://washingtonexaminer.com/insurers-predict-100-400-obamacare-rate-explosion/article/2529523

I thought the Health Care sector was in on the formation of this....wwaaaaiiiitttt a minute!

Quote from: 77ncaachamps on May 14, 2013, 02:04:46 AM
I thought the Health Care sector was in on the formation of this....wwaaaaiiiitttt a minute!

LOL.  You mean strong armed into it.  Play ball or else....sort of like the IRS B.S. going on right now.  The intimidation tactics are Nixonian at this point.  Amazing.

Quote from: ChicosBailBonds on May 14, 2013, 10:26:41 AM
LOL.  You mean strong armed into it.  Play ball or else....sort of like the IRS B.S. going on right now.  The intimidation tactics are Nixonian at this point.  Amazing.

I am astounded as Benghazi, the IRS witch hunt, and AP Gate are all significant issues. If this was another man there would be righteous indignation and challenges to competency.  What confounds me , though, is how a CinC can be asleep at the wheel on an international terror attack on sovereign American soil yet unleash the dogs of fascist rule against honest citizens. I mean, at least the Big Time fascists of the 1940's were consistent.

(http://4.bp.blogspot.com/-UNn2qO8XUxg/URPODqdMWdI/AAAAAAAAAI4/MB5w7JBVk-k/s1600/Ita-CV33-Mussolini.jpg)

Quote from: keefe on May 16, 2013, 04:25:43 AM
I am astounded as Benghazi, the IRS witch hunt, and AP Gate are all significant issues. If this was another man there would be righteous indignation and challenges to competency.  What confounds me , though, is how a CinC can be asleep at the wheel on an international terror attack on sovereign American soil yet unleash the dogs of fascist rule against honest citizens. I mean, at least the Big Time fascists of the 1940's were consistent.

(http://4.bp.blogspot.com/-UNn2qO8XUxg/URPODqdMWdI/AAAAAAAAAI4/MB5w7JBVk-k/s1600/Ita-CV33-Mussolini.jpg)

I think it is hilarious that people think that Benghazi is the first US embassy to have been attacked.  The uninformed majority buying into the talking points thrown at them every day.  Truly classic.  I thought you were smarter than this.  I mean, there were only 12 separate attacks on US embassies under GWB, yet not a work is uttered regarding those catastrophes.  :o

Or the fact the Republican party voted to cut funding for embassy security.  Just sayin'.