|
disjoe posted:Insurance companies at least theoretically are incentivized to work to lower healthcare costs, but they're not incentivized to pass those costs on to consumers. Insurers pushed for bundled payments since forever. Providers refused to go along with it because they axiomatically refuse anything Payers want. Also because until the last decade or so most payers were still using paper systems. For the same reason: "Insurers want us to use computers. So that must be bad for us. Lets try to administer billions of dollars using paper". Helsing posted:Obamacare utterly fails to address this problem for much of the population. It's a lottery system where the quality of your care is dependent on where you live, and it leaves the most dysfunctional parts of the system untouched while downloading all the costs onto middle class consumers. Your insinuation that it's basically just as good as single payer is idiotic and even most of it's liberal defenders will admit the system was far from ideal. The biggest problem with Obama care is that too many people are still on Employer based plans. Killing them is the first step towards fixing the system.
|
#
¿
Jan 3, 2017 01:39
|
|
|
|
| # ¿ May 14, 2024 13:13 |
|
|
Subjunctive posted:I feel like having 2 insurance personnel for every 3 doctors might be a sign of misallocated healthcare resources. And how many dentists, dental technicians, nurses, home case assistants and other Providers are there? The number is North of 5 million.
|
|
#
¿
Jan 3, 2017 18:12
|
|
|
tekz posted:Is this some sort of 'make it so miserable for everyone that there's a massive push for UHC' accelerationist plan? By pushing more people into the individual market you lower the overall cost per person of the pool. Plus it means that you can pick a plan and a Payer that has the Providers you want to see. Plus it helps make the Payers accountable. Right now Payers can piss off Members nilly willy and it just don't matter. As long as the VP of HR is happy they keep the account. Plus it stops hiding the up to 80% of the cost that the employer picks up that people don't see. A ton of people just see the $20-150 a pay period and think that is how much insurance costs. They aren't seeing the hundreds of dollars the employer is kicking in (tax free).
|
|
#
¿
Jan 4, 2017 00:47
|
|
|
Helsing posted:I live in a country with universal healthcare but at the moment something I'm doing for work involves researching available insurance plans for small businesses / individuals and it's loving nightmarish. Health insurance is not the kind of thing that lends itself to market mechanisms, from what I've been told I gather research on how people pick between options in situations like this shows that even savvy and well educated professional types usually tend to choose plans based on arbitrary features like which option is listed first. This just isn't an area where market mechanisms operate well and trying to force a market solution merely worsens outcomes. The plans employers provide are subject to the same rules and regulations that the individual market is. My employer offers High Deductible health plans on Bronze, Silver and Gold which are nearly identical to what I can get in the exchange. The only difference is the ~$500 subsidy my employer provides. Medicare for all is a joke of a plan. Literally no one in the industry takes it seriously. Unless you want to put every provider in the country out of business overnight. The key problem with American healthcare is that the care is too expensive, but people don't talk about how to get costs down, they talk about how to pay for it. Medicare for all or no the cost of providing healthcare is increasing faster than any payer plan can handle. If left unchecked it will be 30% of our total economy in less than 15 years.
|
|
#
¿
Jan 4, 2017 02:09
|
|
|
ToxicSlurpee posted:Frequently the plans are utterly misleading as well. At work we had an HR guy come around and show us the math on the plans. Turns out the most expensive one loving sucked and the cheapest one with the highest out of pocket maximum was actually the best deal, especially if something catastrophic happened to you. At a number crunching and actuarial level the high-end plans can be proven to make your care worse. You are more likely to be over tested and over treated if the providers think it isn't going to cost you anything. You end up paying more for worse outcomes.
|
|
#
¿
Jan 4, 2017 02:16
|
|
|
Helsing posted:Wow, the industry that benefits the most from an extremely inefficient system is full of people who don't think the system should be abandoned. I'm shocked. Feel free to address the point that Medicare reimburses at or below cost and shifting the entire population to it would put providers out of business instead of attempting to deflect. Medicare's costs are rising almost as fast as Private Insurers costs. If you bother to inform yourself you will find that Medicare is driving a portion of the Private Sector costs because over time their payment schedule has been forced from slightly above cost to slightly below cost. This forces the private sector to subsidize Medicare. Medicaid is even worse and is very far below cost, the additional costs are again pushed to the private sector. The second factor driving private premiums up faster is that they aren't crippled with a retarded congress. They're trying to prepare for future cost increases. Congress is intentionally letting those build up for Medicare to cause the system to fail. You'll notice that they idea of increasing the revenue from the payroll tax that funds Medicare is never discussed, only how benefits should be cut. Medicare's cost savings would mainly be administrative, and those are debatable, and would do nothing to prevent the long term cost of care increases. Even if you waved a magic wand and removed 100% of Payer cost and Profit you only drop 2-3 years worth of Medical inflation. Since healthcare wasn't affordable back in '14-15 you don't end up fixing anything. The price providers are charging is constantly increasing and the quantity of services demanded is constantly increasing. People always focus on the payer side because they love to beat up on insurance companies. Yet they aren't driving the cost. The providers are. Xae fucked around with this message at 04:53 on Jan 4, 2017 |
|
#
¿
Jan 4, 2017 04:49
|
|
|
Aliquid posted:Yes you idiot. Healthcare is a right and should not be for-profit. I literally want health insurance companies to go out of business. Hospitals will be fine. Provider = Hospital Payer = Insurer If you're going to flame someone you should at least get a loving clue. When you say to a Hospital "I'm going to pay you at or below cost for everything" they go out of business. No organization can sustain a deficit forever. This isn't a hard concept.
|
|
#
¿
Jan 4, 2017 04:54
|
|
|
Helsing posted:I'm sure that you also oppose the implementation of any kind of labour saving technology or international trade that potentially displaces workers as well. This is certainly not special pleading on behalf of your specific industry. After all, it's not as though the rest of the first world has managed to provide comparable or superior healthcare outcomes with lower spending through single payer systems. quote:What I really find interesting about this post is that from the beginning I've been very obviously focused on how prohibitively costly health care is for actual people, and yet you literally cannot conceive of anyone being concerned about anything except cost inflation. Here's a headline: the lack of adequate care and the financial burden the current system is placing on people is a far bigger issue than cost. Healthcare wasn't always unaffordable. It became unaffordable due to medical inflation. It has been sitting there growing at 7-10% a year for decades. The inflation has to be stopped because 7-10% growth is just not sustainable under any payer system. quote:The United States is at the epicenter of the wealthiest and most powerful global civilization that has ever existed. It is completely capable of providing decent and affordable healthcare to its population. Switching to a public system modeled on the Canadian single-payer insurance model or even the British system would save a lot of money that is wasted on administrative overhead in the current highly inefficient system. quote:As far as reducing costs there are many options and all they require is the political will to implement them. Hey, I'm just spitballing here but perhaps it's time to let medical professionals enjoy the same stimulating blast of free trade that manufacturing workers have been enjoying since the 1980s. Crack down on unnecessary medical procedures, take a harder line in negotiations, purge the lobbyist parasites, and perhaps if the doctors kicks up a fuss bring in Chinese and Indian doctors to undercut their wages. quote:
Just nationalizing the payers is literally the dumbest thing you can do. It is the one thing worse than doing nothing. Because the only thing that happens is shifting a cost that is growing uncontrollably onto the public books. With no cost control and at the current growth rates Medical Care will be 30% of the US economy in 10 years. It is projected to start to drop in ~15 years due to "natural demographic changes". It will be something like 40-45% of the US economy at its height. Single Payer is a lovely hill to die on in the United States. CO, a blue state, put single payer on the ballot in 2016. It lost by 80 points. There are plenty of countries that have non-single payer systems that work well. Implementing a system that mimics one of those is a winnable fight that can improve people's lives. And as a side note, Medicare isn't the panacea everyone who doesn't have it thinks it is. Its claims get denied much more than private insurers do. It is just that when they get denied the provider fixes the problem and resubmits to medicare instead of trying to bill the patient. I spent my last couple of years in the industry dealing with the Re-submission poo poo. If I hammered home one thing it was that providers are loving poo poo at paperwork. We had a project that was billed as this miraculous RULES ENGINE (tm) that could determine if a providers claim would get rejected. It was just a bunch of stupid poo poo "Hey, if you diagnose a broken left arm make sure the treatment is coded for treating a broken left arm. Not a broken right arm or a broken left leg. ". One of the smarter things Obamacare did was mandate the ICD10 changeover, which hopefully kills off all these lovely homegrown coding systems hospitals used then tried to transcribe to ICD9. Xae fucked around with this message at 23:53 on Jan 4, 2017 |
|
#
¿
Jan 4, 2017 23:50
|
|
|
The Insect Court posted:Gladly. The point is wrong because if Medicare reimbursed below "cost"(which is usually vaguely and arbitrarily defined by people who make this argument) is wrong, because if it were true then providers would not contract with Medicare. 21% of doctors are no longer accepting new Medicare patients. 3% Do not accept any Medicare patients. http://kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/
|
|
#
¿
Jan 5, 2017 00:19
|
|
|
ToxicSlurpee posted:When I hosed up my knee the first time the bone doctor I went to was a super friendly guy with a pretty thick Southern accent. When he heard that my primary care doctor ordered an MRI for it he pretty bluntly said "if you were ever wondering why medicine is so drat expensive in America that's why. $5,000 for an MRI or $50 for an X-ray. 95% of the time I can tell you what's wrong with either of them. Which would you rather pay for?" I later came to find out that the doctor I was seeing at the time just did MRIs for basically everything that was wrong with you. The other thing is that you aren't just getting an MRI, you're probably getting some crazy rear end fancy poo poo with 100x the resolution needed. http://www.npr.org/templates/story/story.php?storyId=120545569 TL;DR in Japan they have price controls for imaging. So even though they have a ton of MRI machines they are mid range work horses that are still good enough for 99% of uses. In the US every hospital wants a research grade one for the 1 in a million patient that needs a super high tech one.
|
|
#
¿
Jan 5, 2017 00:33
|
|
|
cheese posted:Can you really not loving comprehend that if every single American were covered under Medicare, that this would enable us to have significant leverage to negotiate lower rates for a wide variety of services, procedures and medications? Your argument is literally "Single payer would not matter because costs would be the same" when half of the loving point is that single payer gives you a strangle hold over costs. Costs are not fixed. They are not chiseled in the stone of the loving Lincoln Memorial. Medicare doesn't negotiate prices. It sets procedure prices by a formula and it is legally forbidden from negotiating drug prices. You're not describing Medicare for All, you're describing a new program. Xae fucked around with this message at 16:31 on Jan 8, 2017 |
|
#
¿
Jan 8, 2017 16:28
|
|
|
Dr. Fishopolis posted:
Countries use differing definitions of live birth and viable birth. The USA uses the broadest definition. Many second and third world countries use more narrow versions. The WHO did a study on this in '06 and concluded that until everyone is using the same set of criteria it is impossible to compare across countries accurately.
|
|
#
¿
Jan 9, 2017 16:52
|
|
|
Dr. Fishopolis posted:Oh I see. So, America just has a different definition of "baby" than every other country, which is why by every measure and report it only seems to have a horrifying infant mortality rate. When in fact, we have the best babies, really the most amazing number of deaths per 1,000 live births. Everyone says that, they say "America has a really incredible rate of baby death". That's what they say, it's really incredible. The best. quote:The legal requirements for registration of fetal deaths and live births vary between and even http://apps.who.int/iris/handle/10665/43444 The TL;DR is that the US record almost all births, even premature births, as live births. Many countries classify premature or non viable births as either stillbirths or spontaneous abortions. While the WHO has a definition they would like everyone to follow many developing countries do not use it. Xae fucked around with this message at 18:15 on Jan 9, 2017 |
|
#
¿
Jan 9, 2017 18:08
|
|
|
Dr. Fishopolis posted:Are you arguing that the ranking data from the CDC and the WHO itself is incorrect? Both data sets show the United States around 30th down the list of developed countries for infant mortality. Most of that information is in my quote. The rest of it is in the document. I'm not your secretary. It isn't my job to do your homework. It is your job to inform yourself, preferably before spew bullshit all over the place.
|
|
#
¿
Jan 9, 2017 19:49
|
|
|
Dr. Fishopolis posted:According to the document you've linked, the WHO does in fact apply their corrections to the country rankings they publish. And guess what? It tracks almost identically with the data that the CDC publishes. Reread it. The report corrects for missing data, aggregation mismatch and countries using different formulas. It explicitly calls out that it did not adjust for live/still born definition differences. It also says because of that not to use the data to compare different countries Dr. Fishopolis posted:Well, this deepens the well. Why the gently caress does America have nearly twice as many preterm births as the UK? Obesity is currently the largest known factor, but it doesn't account for all differences. Lack of pre-natal care is another issue, but the USA has higher premature birth rate even with people getting pre-natal care. And since this is 'murica there is also a racial discrepancy as well. The first studies aren't expected for a couple more years. Working through the differences in how countries collect stats and define terms has slowed the research. Until those come out it is anyone's guess. Or anyone's blank screen to project what they want it to be.
|
|
#
¿
Jan 9, 2017 22:46
|
|
|
FlamingLiberal posted:Companies moving operations out of China into the poorer Southeast Asian countries to save money has been going on for years now Some of the companies are planning on jumping right to automation instead of seeking cheaper labor. Foxconn, of iPhone game, plan on replacing something like 100,000 workers in China with robots. We're at the point where near slave labor is still more expensive than robots.
|
|
#
¿
Jan 11, 2017 17:23
|
|
|
sitchensis posted:FWIW, I was reading these forums around 2007 or so and goons were very saavy at seeing the signs of the impending sub-prime mortgage catastrophe that eventually led to the 2008 GFC. Much more so than any mainstream economic coverage that was, like today, breathlessly reporting how amazing everything was. We're about due for another recession. The test will be if it is just a normal one or another "Great Recession". Housing is in a pretty unique position to gently caress the global financial system. Subjunctive posted:When did wage growth suppression start being corporate policy? Is there a real change that was recent? About 2 seconds after the first guy paid another guy to do work.
|
|
#
¿
Jun 28, 2017 03:09
|
|
|
|
| # ¿ May 14, 2024 13:13 |
|
|
Differentiating between income types is dumb. Different types of income and different types of credits and deductions is 90% of tax complexity.
|
|
#
¿
Jun 30, 2017 18:57
|
|