lets do this: end all obama care, and train 1million new docs

and give them contract must work in usa for 10 years

commodify medicine

 

yea dude thats why the prcentage of the population covered by healthcare is going to be alot higher than when before obama entered office.
and the price of healthcare is already risen the slowest than in the past 50 years. there are bad parts but overall its an improvement.

 

the percentage covered yes
the quality drop thru floor
price thru roof
you mean healthcare inflation is biggest in last 50 years yes I agree, bigger than last 10 as well
huge inflatio under obama is partly fed run wild
and simply party government spending gone wild

 

I honestly feel this would be much more helpful than anything else.

But one of the main reasons for the high cost of care that no one is talking about is the high cost of living in the cities. Medical care is an intensive service job, and all those medical care workers need to be paid enough to rent housing in the area, and the rents on the medical buildings are also rather expensive. This often has much more to do with the high cost of land. Especially with lower income people concentrated in the cities.

Another reason is the ridiculous exposure to malpractice liability. Causes malpractice insurance rates to go up, and increases the cost of medical care. In some situations, like emergency rooms where the patients often never pay, it still takes money to pay the liability insurance (the patient can still sue even if they were unable to pay), so the prices for everyone else in the hospital go up.

 

Although that may not be the best use of healthcare funds, I have to say it's far superior to Obamacare, which hasn't added any new medical personal despite the funds expended.

 

Obamacare consisted of nine titles--the fifth was entirely dedicated to the health care workforce.

 

And that translates to how many new healthcare providers...?

 

Basically, doctors will be paid less for each patient and will be expected to see more patients. In other words, doctors will just have to work more for the same amount of money. There is a certain price fixing element going on, because the Medicare system actually limits how much the patient can pay the doctor.

Typical example: The doctor charges 100 dollars for a procedure. You have paid Medicare taxes all your life, and now when you are older, Medicare helps pay your medical costs. Medicare pays 85 dollars to the doctor, and you pay 15 dollars to the doctor. What if your doctor will not do the procedure for 100 dollars and demands 110 dollars? The doctor is not allowed to take more money from you. Your only other option is to pay the doctor the entire 110 dollars yourself. Medicare will not pay. That means lower quality, and the possibility you might not be able to find a doctor who accepts Medicare.

When the government attempts to set prices, it creates a shortage.

 

A more accurate description would be that the doctor charges $100.00 for a procedure, Medicare accepts a 40.00 dollar fee for that service, the patient pays 8 and Medicare pays $32.00.

But ultimately yeah, it's price controls, and the doctor can't take any other extra money from the patient to make up his loss.

 

i say outlaw all healthcare..no medical attention for anyone anymore..people just die sometimes..who cares..ask hillary clinton..

 

A patient can pay more, but then it is like a huge tax, because the patient paid into Medicare all those years and now is not being reimbursed.
If you think about it, it is basically like a 100% tax on any medical procedure that costs more than the fixed price Medicare has set.

There are politicians trying to change this, but most Democrats support the price-fixing system. The idea is that the monopoly on the system allows the government to hold down prices, and if any patient seeks treatment outside the system they are heavily penalized, so more money for everyone else. Whether this strategy can actually hold down prices, or just creates shortages, is a contentious issue among different economists. The question has to be asked, if a doctor would offer a low price under a fixed care system, why would a doctor not offer the same low price in an non-fixed market?

If a doctor charges too much, the patient can go to another doctor, so it is a complicated supply and demand analysis. Trying to impose fixed prices assumes medical providers have some sort of monopolistic power, that demand is much bigger than supply, and that the supply is relatively inelastic, that there is not much correlation to demand, and that supply will not decrease if price is decreased.

 

How about if we just have a market for healthcare where prices are discovered by supply and demand driven open public bidding like every other market.

 

The problem is supply and demand doesn't work when your house is on fire, someone has a gun to your head, or you're suffering from a life threatening disease. If the demand is your life, you'll pay anything. The normal checks and balances of something getting to expensive and consumers walking away from it or finding other solutions doesn't work in services that respond to life threatening crisis.

Accepting that is why we have community fire departments and police. It's why we probably need some kind of basic social medicine. No this is not an endorsement of Obamacare or a claim everyone (or even anyone) should get Cadillac medical services without paying a premium. Just a concession that going to the other extreme of supply and demand isn't the answer either.​

 

It is to the point that you bring up fire departments because fire protection was a private business for a long time in the US and elsewhere. If you wanted to protect your house from fire you subscribed to the local fire company, which would come and battle a fire at your house or try to protect your house if your neighbours house caught fire, but do nothing to stop your neighbours house from burning. Needless to say this less than optimal deployment of firefighters and their equipment contributed directly to seemingly inconsequential house fires becoming the widespread conflagrations that periodically consumed large portions of cities and towns. As a result many towns and cities instituted taxes to buy out the private fire companies and form them into municipal firefighting companies or created their own public firefighting services that were obliged to fight all fires.

I do not see much of a difference between private firefighting and private health care as far as the public expense and risk is concerned. The government already pays for almost half of the health care provided in the US because people cannot afford private care. How much real difference is there between the private health insurers of today and private fire companies of the past?

 

It's funny because medical tourism is a free-market system, and it sure seems to work. The fact we have companies that specialize in setting up medical tourism, seems to suggest that it most certainly can, and does work.

And alternatively, every system that has gone full into socialized medical care has declined. That seems to suggest treating it like police and fire, doesn't work.

 

There is certainly some wealthy foreigners coming to the US for health care but there is even more US citizens going to other countries for health care. There are even some insurers in the US who offer all expense paid trips for a customer and their immediate family if they go overseas for care. The quality is as good or better at 1/2 to 1/10th cost.

 

I don't think that follows. Most folks suffering from life threatening issues are not passing on local treatment to shop around for a cheaper solution via medical tourism — they're going impossibly into debt to try and pay anything that is asked for a chance to survive.

I'm not claiming to have all the answers and I don't think going fully into socialized medicine is a reasonable one anyway. I do think some base line guaranteed medical services, emergency services and preventative medicine come to mind, may eventually be part of the answer. Just like basic police and fire services. I think many other medical services will remain in the private sector, and many of us won't be able to afford all the options.

Will the level of medical care in this nation decline? I sure hope so. It's ridiculous today. When I was younger a doctor offered you medical advice and insight. Now people think he should take responsibility for your health, that he should provide pain free, instant, and guaranteed solutions. That ridiculous level of expectation is ridiculously expensive and a big reason why health care costs are out of control.

People need decline, they need less doctors offering them a Lipitor with their cheeseburger, a CNS cocktail because they're feeling depressed, or a lap band instead of smack in the head with instructions to go run laps when they don't like their weight.​

 

http://www.theguardian.com/uk/2005/feb/01/health.india

Unless you consider coronary heart disease to be non-life-threatening, then I suggest your claim is false. By the way, 6 month waits for treatment of life threatening health conditions is normal in the UK. In the US, it's almost non-existent. Wait times are so low, we generally don't even track wait times in the US as a whole. There are specific states with bad government policies that have wait times, but not over all.

This shouldn't be hard to figure out either. When resources are limited by government budgets, then when demand out paces those budget limits, the result is bad service on a waiting list. In a free-market capitalist system, as there are more paying patients, there are more resources, which are then used to service those patients in a timely manor.

But again, even in those areas, the result is that there is reduced service. It's unavoidable, because government budgets are limited and static. Whereas a free market system with paying customers, is dynamic. As more people use a service, more money from those paying customers is available to expand service.

http://www.healthcare-today.co.uk/content.php?contentId=13983

So they don't have specialists and surgeons on standby 24-hours a day. Why? Because they don't have the money. Government is not a giant piggy bank, with endless cash, and keeping highly trained (in UK terms consultants) Surgeons and Doctors on standby all night long is horrendously expensive. So the result is they don't. Then when someone has a crash at night, and goes to the hospital, no one there is qualified to help them. Result is 20% higher fatality rates than US Emergency rooms.

Again, the funding of the government run Emergency rooms, does not increase with patient care. So when there is more demand for services, than the money available, this is the result.

Same is true of preventative care. The UK has free preventative care, and yet by all measures American's get many times more preventative care than Brits.

You are confusing different concepts. The 'level' of care will not decline. The 'quality' of care is what will decline. The 'level' may actually go up, as more and more people take advantage of 'free' health care services. But at the same time, the 'quality' of care will drop.

To explain the difference, take the average hospital ward in America. Two bed per room. Monitoring equipment, Air conditioning, fresh blankets and sheets, TV, fresh meals. The average hospital ward here in Ohio, has 100 patients max on a floor of 50 rooms. And about 20 staff to monitor them.

Compare that to France. We increase the number of beds per room is up to 6. The result is the 'level' of health care has increased from 100 patients on a floor, to 300, but no more A/C, no more fresh sheets and blankets, no more TV, windows are left open, if the patient has a problem they have to ring a bell, meals end up being more like military rations, and the staff is down to 10 per floor.

The quality of the care is what is ruined. This is why universally, US survival rates are always consistently higher than any socialized health care system.

Well, on this there is a problem. The problem is with the patent system. We need to reform the patent system, if not eliminate it.

Right now, pharmaceutical companies make a product, and sell it, and then when the patent runs out, they flip a tiny atom here or there in the structure, and then re-patent the 'new' product and sell it. In reality, it's no better than previous version. The primary purpose is of course to maintain a patent hold on the drug, not to actually make a better drug.

Then of course they have to spend millions in advertising to convince doctors that the new expensive drug is better than the now open market no-longer-patented drug. And of course your average doctor doesn't have unlimited time to look up the drug comparison trials, to determine if the claims are true.

Also, doctors and patients alike, don't have any motivation to restrict their services. Patients don't have any reason to cut their uses as long as they are not paying the bill. If you are on Medicare, and government is covering the costs.... why not take all the tests you can? As a doctor, as long as your patient isn't paying the cost, you are actually motivated to give as many tests as you can, not just because you are compensated for those tests, but also because in the 1 in 1,000,000 chance you miss something, and get sued for missing it. It's safer to give every test you can, to avoid a lawsuit.

The problem is, only a free-market capitalist system is going to fix this. If you have the government pay for all health care, what incentive will change? Now the patient won't even get a co-pay. What reason does he have to restrain his health care binge?

 

It is 1/10th the cost in some rare cases. Again, most of these people are engaging in free-market capitalism. I'm all for that.

The key issue is that *NONE* as in, not a single one of these people, are going to government run health care facilities. Yes, in some cases.... the care is better. I agree!!

You do realize that some of the hospitals in America are government run? You do realize that government has it's hands involved in *most* health care systems across the country?

The health care facilities people go to in other countries are *ALL* free-market capitalist non-government places. When people travel to India, they don't go to Indian government run hospitals. Why? Because they SUCK, just like all government run hospitals do. When they go to Singapore, they don't go to government run hospitals in Singapore... they go to the free-market capitalist hospitals, because they are good, and the government run hospitals SUCK.

The fact American's engage in free-market capitalism, and look for deals outside the country, is no more surprising than people who look for deals from cheaper imported goods at Walmart. Do I want to pay $1,000 for the 36" American made TV, or the $600 48" imported TV? Hmmmmmmm.... choices choice.

I can sum up your post with "Well duh".

Here's the more telling and interesting aspect. Why do people in countries with 100% free health care, also engage in medical tourism? Which is the bigger surprise, that American's shop around for a lower price, to avoid a higher price, or that foreigners that have ZERO price, look for places they can pay money to get services they supposedly get for free in their home country?

Why did the guy from the link in my previous post, travel to India to get heart surgery, and pay cash to do it, when he could get the heart surgery from the UK for ZERO? Of course the answer is really obvious. UK health care sucks. He would have had to wait months on months, on a waiting list, hoping that he survived long enough to get the surgery. Of course that was just something 'minor' like heart surgery. If it had been cancer, some patients become inoperable, because the cancer spreads during the months on months they waited on the list. Now they have terminal cancer.

Again, this is the system that people on the left wish to inflict on the American public. This is the system people in those countries flee from, and are willing to pay money to foreigners thousands of miles away, to get the service they need.

Why do you think companies like Timely Medical started up and operate in Canada?
http://timelymedical.ca/

Because Canadian government run "free" health care sucks, and people are willing to pay this company thousands of dollars to help them escape from the Canadian system.

 

Because it's worked so well for our school system.


​

 

why would you want to train one million new doctors...create jobs?...we dont need no sticking new jobs

 

They are all going overseas for care because of one thing, overseas care providers tell them how much their care will cost, which is impossible in the US.

There are some few hospitals in large cities in the US that are operated by municipal authorities but the vast majority of hospitals in the US, over 95%, are private non-profit or for profit entities. The government does have some regulation of health care but it does not have any regulation over the single most important factor, price.

People from the US go to hospitals overseas because the private hospitals in the US will not tell them how much their care will cost, and if they do it is far more than the care they can get elsewhwere.

If health care in the US was a market people might shop at home, but it is not so they don't. You can get a firm price for a hip replacement from a private hospital in Belgium or India but not from a private hospital in the US.

He could afford it, simple as that. It does not mean that health care in the UK sucks, because everyone in the UK can avail themselves of it so some things have to wait. In the US the rationing is determined by simply excluding large portion of the population from care by making it too expensive for them to afford.

If Canadian health care is that bad one would expect a massive public clamour to dismantle it. It seems that the public health care system in Canada has a huge approval rating, over 80%. According to polls less than 5% would support its dismantling.

 

My grandfather was a doctor and general surgeon he earned out of medical school and thereafter what a union senior tradesman made in his area and that was the norm a modest home, car, enough to live like an older steel worker and he had iron clad job security. He never cared about being rich his profession was to heal the sick if he lived decently it was enough. It helped he went to state university for it the debt was minimal the school loans were assured he had a bachelors degree in biology he was going to get a good job once he became a doctor he was assured being able to repay. Which he did in five years.

As for the training of doctors how does that help the poor get to see doctors we have no money, the ACA at least I can get into the Federal Exchange and get medical coverage its something.

 

Not entirely true.
http://kfor.com/2013/07/08/okc-hospital-posting-surgery-prices-online/

There is a growing movement of hospitals to post prices up front.

Now granted there is some amount of truth there. It's not impossible. It's difficult. The question though is why? What is different about health care, than any other service in a free-market capitalist system? The answer is government. There are a number of ways in which government has created this nightmare we have today.

Without going into massive detail, first they had wage controls, and high tax rates in the 1930s. Companies looking to try and attract better quality people, and companies looking to get better benefits for their executives, discovered they could offer health insurance as a benefit.

Second, government offered a tax benefit for providing health insurance, which made it even more common to have health insurance through the employer.

Third, government created Medicare and Hospital Insurance, both of which made the prices meaningless to patients. Combined with insurance through the employer, most patients never look at prices, because they are all passed on to someone else.

As more people move towards catastrophic insurance coverage, and more patients demand up front pricing, and as competition from medical tourism becomes more prevalent, the push towards more posted prices will continue. There is also a growing number of doctors that have banned insurance, and will only practice on a cash basis.

Not true. Medicare and Medicaid both have direct control over payouts. In fact, it is this very system of paying out less than the cost of service, that causes the cost shifting that pushes up private patients bills.



As you can see, historically and to present day, the payout of Medicare and especially Medicaid is consistently below the profit line. Meaning that hospitals are routinely losing money on every single Medicare and Medicaid patent they provide care to. In order to not go bankrupt, they then shift that cost to private patients. In other words, the vast majority of the high costs the average private patient is faced with, is directly due to their costs being used to subsidize government patients, which do not pay for the cost of their treatment.

This is yet another reason why completely private hospitals in other countries, which do not have to charge the cost shifts from government patients, can charge lower rates than US hospitals.

Not true either. If you never got a firm price, how would you know the price in Belgium or India was cheaper? That makes no sense. The problem is merely that government programs have driven up the price, so that patients know they can get cheaper service outside the country.

That makes no sense. You pay taxes your whole life, nearly 50% of your income, far greater taxes than we pay here, and yet you are going to spend thousands on thousands to fly thousands on thousands of miles, to another country, to have doctors you can barely understand, assuming they speak English at all, far away from your friends and family, and have some doctor you have never met before in your life, put you under the knife...... just because you enjoy blowing money? That's your logic? That's your big rational explanation? Excuse me if I'm not convinced.

And no people are not excluded. Just wrong sorry. Please list the thousands of people who went to a US hospital, who were just 'excluded' from health care. Doesn't happen. You can't name a single individual. That includes me, since I've gone to the hospital without money or insurance, and I was treated.

They routinely interview people with horrible experiences, who say it's a good system. Same in the UK, and many others.

I watched a video where a lady waited 3 years unable to walk, because she needed knee surgery. Now she was waiting another 3 years, to operate on the other knee. She said the system was good. When asked what she thought of the American system, where knee surgery would rarely ever be longer than a 3 week wait, she simply didn't believe it. She said that it isn't possible because all elective surgery has year long waiting lists.

In short, she believed her system was great, because she didn't have any understanding of what a good system was. If you don't realize that people in America are not waiting years on end, in suffering and pain, to get what is a relatively simple surgery, you can fully support your system even if it's horrible.

We're talking about a country where in some towns they actually have a lottery for who gets to have a doctor. Literally some towns if you need a doctor, and you are not on the patient list, you have to put your name in a lottery

http://blogs.wsj.com/health/2008/08/06/in-canada-doctors-use-lottery-to-drop-patients/

And ironically, Oregon had a lottery for state subsidized health care. So socialized medicine is just as bad in the US, as in other countries. It all goes back to the universal problem with all socialism. Eventually you run out of other people's money to spend, and then you have real rationing. The amount of money available in a socialized system is always static. In a free-market capitalist system it is always dynamic.

 

That's great, but the fact is most people are motivated by earning a good income. Not just a good income, but an income that is fitting for what a doctor has to do to get that income these day. The training and cost today to be a doctor is crazy. You are not going to go $100,000 in debt, to earn $40,000 a year. Not going to happen. Again, so your grand father was a wonderful altruistic man. Wonderful. Most men are not going to go through all that, unless they get to earn the big bucks. There's a reason why hundreds of thousands of doctors from other countries, immigrate to the US to practice. We benefit from these talented individuals coming here, and they benefit from $$$. Without that motivation, they are not going to come. Period.

Lastly, the problem with isn't with training new doctors. The problem is with the school system and medicare and medicaid.

First Medicare and Medicaid make earning a living difficult for the GP. The payouts are low, and GPs lose money seeing Medicaid and Medicare patients. That's why often you hear of doctors refusing to accept new patients from these programs.

Second, the school system has been hindered by government and the AMA which has constrained the ability of new medical schools to open. In a normal free-market capitalist system, as the demand for medical training increased, the number of schools and institutions providing that training would increase to meet the demand. That would lower the price. But the number of medical schools in the US declined from somewhere around 160 some schools in 1910, to about 80 some schools in the 60s. The AMA using the power of government through accreditation, was able to close almost 50% of the schools. The purpose of course, was to limit the supply of doctors, thus insuring high wages for the highly demanded doctors.

But it also had the effect of jacking up the price of medical training by limiting the number of schools for doctors. This effect, though unintentional, will have the effect of driving up doctor wages, simply because no doctor will work for low-wages, when they have to pay a massive cost to get educated.

So training more doctors alone, isn't going to be a solution. It will require more medical schools, which will lower the cost of medical education. Then after the cost of education is decreased, then doctor wages will also decrease. Then, finally, the cost of health care itself will decrease.

This process is coming to fruition as we speak. There has been a slight boom in medical schools opening across the country. And the number of applicants ratio to student positions available is dropping. So the signs are looking good, provided government doesn't screw it up before the free-market capitalist system fixes the problem itself. I think that this honestly is the very reason liberals in government are in such a panic to pass all their legislation crap before the problem goes away on it's own. If they don't take advantage of the problems they caused while they are still problems, the system will fix itself before they and pass all their crap.