want a beer for the show?

"mass exudice"



Huh?

Sorry "mass exodus"
You really added alot to this conversation that has been pretty civil up untill now except for your 2 posts. Hopefully I spelt civil correctly.
Chad

I'm becoming the new "Ernie"....lol



Was I not civil when I compared pill pushers to pill pushers?



Geez....

[IMG][/IMG]

Only Politician here is Arnold Schwarzenegger, Baena has to go polish the knobs now, bye bye!

OK, so we all agree on the problem, it's the solution that eludes us.


So to carry forward your line of reasoning, and not leave it hanging...

If you had a choice between two government run and privately run "institutions", which would you choose based on wanting to receive the best quality of service and most efficient operation (affecting your ability to RECEIVE the best quality service)?

Worded differently, would you say government is typically better at qos and efficiency?

This is a faulty line of questioning as it starts with a premise (the government sucks, because) meant to direct the person being asked a question into that original premise.

It's also not very effective as we are comparing two different things: the government and private sector.

I didn't leave anything hanging nor partially carry a line of reasoning: I challenge(d) the notion, the oft repeated dogmatic mantra, that the government sucks and the private sector is awesome at delivering goods and/or services. Well, I think the private sector does a good job of delivering many things, such as hot dog buns, mayonnaise, and delicious beer. And sometimes AV systems, despite manufacturers. Nobody questions this and there is no pending legislation for the government to take over the production and delivery of beer and mayonnaise and Sonos systems.

However, the private sector has not done a very good job of delivering health care. When it is good, it is expensive. And sometimes, it is not good. And still expensive.

Which is the reason the government got involved to tackle the problem in the first place. Especially the issue of people not insured or being able to afford health care. Which taxes the existing system even more. Unless everybody is cool with that situation...

So it seems illogical to complain about the government being wasteful, inefficient, and all around sucky when the private sector seems to have not done a very good job of delivering the service in the first place. And we're not talking about beer or mayonnaise here, we're talking about health care.

You should not be engaging a line of quesitoning asking me to defend government. You should be asking yourself, and everybody else, if the private sector should deliver health care to the citizens or if the government should manage it (more than it is managed now).

The private sector has failed at delivering health care (unless you're wealthy). So I think the question should be asked of people who pshaw and scoff at government, why are you defending the continuance of the private sector delivering this service?

And you should not get distracted by ideological canards such as 'lawsuits drive the costs up!' and 'everybody gets health care in an emergency room' and 'Socialism!'

But while working yourself through these questions you have to acknowledge that the answer has been a Yes from our government and the populace that elected them, a central platform of the current Administration, signed into law years ago, challenged in court, and challenged in Congress 41 times.

So while I wait for the state portals to deal with the overloaded servers (we have time, the deadline is not for 2 1/2 months), I'll acknowledge the government sucks because the servers are down. But not for one second will I wish for the private sector to take over because of all the times private companies have frustrated me to no end (even with *all* of my choices) and their servers crashed as well.

Well put, BigPapa.

I have been a CI for 9 years now. Never in my life have I worked at a job where I didn't have medical insurance. This is my first... let me tell you, it sucks!

If it were just me and I wasn't raising 2 teenagers on my own, I wouldn't or couldn't care less about ObamaCare. When I left my last job, I checked into a COBRA plan because I wanted to keep my medical insurance. It was going to be over $700 a month! NO WAY IN HELL could I have afforded that...

The reason medical bills are so high in this country is because of the insurance system (they are like the Mafia). Look into it!

Why do they charge you $10 for a single Tylenol pill in the ER? Because the insurance company will only pay 30% of that at best! This is a fact.

Some medical practices will cut you a cash break because of this.(If you aren't insured) Unfortunately, I haven't found a single one here in WA that does this.

I am not saying that this plan is the direction our country should take, I'm just saying that some people are in great need of medical care and it is way overpriced for individuals without insurance coverage is all......

I'm beginning to wonder if you think "logical canard" means "empirical truth that does not jibe with my own political and societal ideology." ;-)

Ask a few doctors if their exhorbitant annual malpractice insurance fees--necessitated by unchecked litigation or threat thereof--are just a "logical canard..." I'm guessing they'll explain that malpractice insurance fees are tangible cost drivers that they pass on to us patients.

On the other hand, the notion of "private sector health care" IS very much a "logical canard." Calling our health care system "private sector" is like calling particiption in the federal income tax system "voluntary." In truth, we've not experienced "private sector" (i.e. free market) medical care provision in this country for 50+ years.

First--as previously stated--government introduces enormous cost distortions into "private markets" via Medicare, Medicaid and TriCare. I'm not saying these programs are necessarily bad, but they DO confer/shift costs to those of us outside of those programs and add considerable overhead costs via arduous compliance and reporting requirements. Just as you are not performing profitable work while filling out tax forms, a doctor is not delivering value to patients while he completes Medicade paperwork for services he's forced--by the government-- to deliver at a discounted rate.

More critically, "private sector" medical, insurance and pharma markets are the most heavily regulated and artificially controlled markets on earth. The extent of government involvement IS de facto Corporatism. How has Corporatism served us...? We both agree that it has not served us well as regards affordable health care delivery.

You argue that the "private sector" (i.e. free market) has failed us and that we must abandon the free market model. I argue that the government destroyed the medical free market decades ago and that we are suffering the ravages of corporatism and governmental overreach.

Given the precarious financial state of EVERY government entitlement and given government's structural inhibitors to innovation, I assert that injecting more government into our health care market will inevitably kill both the patient and the doctor.

Only time will tell which of us has correctly diagnosed what ailes us.

It appears it is you who's ideology doesn't reconcile with reality and accepts an oft repeated canard. Until you can provide some real credible information that malpractice litigation is a key driver of the high cost of health care I'm going to give this notion the respect it deserves, which is calling it a canard. That's what it is.


You just destroyed a large amount of resistance to Obamacare: ie 'Socialism'


I did not say we must abandon the free market model. I challenged a notion: that does not mean I beleve some supposed direct opposite of it.

The current changes to health care are not an abandonment of the free market any more than they are 'Socialism!'


Yes, I understand your assertion. I challenge it. There are many challenges to the 'government = structural inhibitors to innovation' comment (NASA, energy, space, this very internet we're arguing on), not to mention I've worked with or for private sector companies that were wasteful, slow, and not particularly innovative. The concept that the government is slow, too expensive, and ineffectually vs the private sector is an article of faith oft repeated but never really provable beyond simple assertions or anecdote (the IRS sucks!) By and large the government doesn't compete with the private sector.

This does not mean I assert the equal opposite contention, only that I challenge the original assertion, especially in response to health care.

Sorry Mogul,
I can't agree with anything you've written. While I agree with your notion of that our federal government would (and will) probably screw up O'Care. most of your talking points stated in your above post are not on target.

In fact, so off target, I'm not sure where to start picking it apart.... but to say:

* Big Insurance and Pharma, seem to be very regulated, but their lobby is only eclipsed by the energy lobby and they have gamed the system long ago. The notion that they are regulated to death is what they'd (and the federal gov't) like you to believe.

* IF you're suggesting (and I'm not sure this was your intent) that malpractice insurance rates are a large part of the escalating health care costs, that is myopic and simply false. Yes, doc's rates are high, but this is a small pimple on the ass of an elephant. I do agree that tort reform is one part of the equation in reducing the runaway train, but it is because hospitals and docs must constantly practice defensive medicine, which hugely trumps up the costs. But eliminating MP insurance would barely scratch the surface of the problem. Your claim, if indeed that is what you are saying, is a long stated myth by the right wing that is a deflection of the real problem (practicing defensive medicine).

Health care costs were on an escalating track long after Medicaid was introduced so if that was the stimulus for escalating costs, it sure took a long time for the graph to begin it's steep incline. And it has not been for the last 50 years, more like 30 years that overall costs began getting stupid. I can remember health care costs in the early 80s still being reasonable. My direct feeling is things started rising in the late 80s.

I do not buy into the argument that the federal government is the root cause of high costs, which seems to be what you are suggesting. That is also myopic ....and if the majority of the American public actually believe that, then we are all doomed. Because if we can't acknowledge the real problems, that it is multi faceted, that there is no magic bullet solution.... then we will never solve the problem.

Step 1 in the 12 step is admitting there is a problem, but the other 11 steps are defining the problems and your points are simply off target Sorry.

I have no answers but I do have a question.

If the American Health Care Act is so unwanted by the people as we keep being told, why are connections to the internet site constantly clogged? Is it a plot or is it because there are too many people trying to gain access?

I am directly involved in health care and Mogul seems to understand many of the factors of why the ACA is not good for this country. No one is arguing that this system was not messed up in the first place, but the ACA will not fix what it was intended to fix. I would say the poor or worse yet the working poor will have just as hard of a time obtaining health care once this law goes into effect.  People that have insurance that are happy with it will see costs go up higher than they were already inflated to support the newly insured.

He is also right that the private sector health care costs are inflated due to government programs, but I will concede that it is not the only factor.  When Medicare doesn't even cover an office's overhead cost, then who do you think picks up the rest, private insurance. Don't get me started on Medicaid because in some states you are lucky if you get paid at all. Pre-ACA it didn't bother me so much to see a patient without insurance because you could make it up. In the ACA era, even though more people have insurance, they will be paying us at a rate that hardly covers overhead.  Since most of us went into medicine because we truly believe in caring for the patient, we will blindly go bankrupt.  We are confronted with comments like TSS makes when we try to make our case to the public.

Malpractice does increase the cost of Healthcare. Defensive medicine is a big part, but also passing cost to insurance companies and patients contribute. Some OB/GYN doctors pay 6 figures a year for malpractice. Try having that fixed cost on an annual basis and see what you have to do to prices.  That has to be passed on.  Medicare says screw you, this is all we are giving you, while the private insurers will increase some, but not much.  When all our payers are treating us like Medicare than we are done.

I think this country needs to decide what it wants.  Does it want healthcare that provides everything to everybody.  Is it our right to be on dialysis until we are 90 years old.  Should I expect a hip replacement when I am 91 despite having heart disease.  Should Medicare pay for bypass even though I still smoke. If so, be prepared to fork out more money as this is the path we are on now and don't think we could keep it up even if we wanted to.  Do we want national health care that has a limited budget so people over 55 year old won't get to go on dialysis while waiting for a kidney.  I think the sweet spot would be somewhere in between.  Instead of the ACA, we should have concentrated on fixing Medicare so it didn't go broke and work with private insurance companies to come up with creative ways to provide insurance to the working poor.  I emphasize working because there are safe guards for the disabled and poor, albeit they need some fixing too.

This is a huge issue and don't think we will solve this on Remote Central's installer forum, but looks like we are making an excellent attempt at trying.
Chad

FP Crazy, you make some excellent points as to why the cost of Health care is high and my summery above doesn't discuss some of them.  I am only arguing that the ACA wasn't and isn't going to solve most of the things that cause rising health care cost, and this thread is about whether the ACA is the answer to affordable healthcare.