25
   

Free, Public Healthcare

 
 
JPB
 
  1  
Reply Sat 13 Jun, 2009 09:24 am
@McGentrix,
^^ What he said!
0 Replies
 
JPB
 
  1  
Reply Sat 13 Jun, 2009 10:26 am
Obama's weekly radio/internet address was on health care reform.

link
0 Replies
 
Thomas
 
  1  
Reply Sun 14 Jun, 2009 09:29 am
@Robert Gentel,
Robert Gentel wrote:
Why do you think that it needs to be a "market failure" to have room to lower costs? Why isn't the exorbitant cost alone something worth addressing even if it doesn't qualify as a market failure?

Because room for lower costs, by definition, is room for providers to increase their profits. And because in the absence of market failure, competition between providers enforces that providers pass on their lower cost to their customers.

Robert Gentel wrote:
I think that this is a false premise. Around the world public health care is cheaper than private health care more often than it isn't and the evidence just doesn't support this claim.

Around the world public health care is cheaper because the governments rather than private companies pay the patients' medical bills. It isn't cheaper because government rather than private companies employ the doctors. In countries where governments pay the bills but don't employ the doctors, health care is not consistently cheaper than in countries where governments pay employ the doctors. This is consistent with my opinion that market failure in the health care system is mostly concentrated in the insurance part of it, not in the doing-the-actual-work part of it.

Robert Gentel wrote:
This doesn't fix that the fundamental costs are exorbitant. There isn't just one problem of lacking health care coverage, the costs alone with the insurance issue put aside are outrageous.

I disagree. It does fix the disincentive for health insurance companies to encourage prevention. It does fix the astronomical sums health insurers spend on passing the buck and finding excuses to deny or delay coverage for people with expensive illnesses. It creates an incentive for streamling medical records. These points alone are probably the greater part of what makes America's system so inefficient.
Robert Gentel
 
  1  
Reply Mon 15 Jun, 2009 04:27 pm
@Thomas,
Thomas wrote:
Because room for lower costs, by definition, is room for providers to increase their profits. And because in the absence of market failure, competition between providers enforces that providers pass on their lower cost to their customers.


But unless they are all running at a loss that's still room for a lower cost in a public system. And without needing to compete with others for the reputation of quality it could be a bare bones system that provides just the basics.

Do you really think there is no "overkill" (for lack of a more appropriate word) in the private medical industry that couldn't be trimmed in a bare bones public system?

Quote:
Around the world public health care is cheaper because the governments rather than private companies pay the patients' medical bills. It isn't cheaper because government rather than private companies employ the doctors. In countries where governments pay the bills but don't employ the doctors, health care is not consistently cheaper than in countries where governments pay employ the doctors.


I think this got mangled somewhere, as it seems to contradict itself (unless I am reading it wrong).
Thomas
 
  1  
Reply Mon 15 Jun, 2009 07:38 pm
@Robert Gentel,
Robert Gentel" wrote:
But unless they are all running at a loss that's still room for a lower cost in a public system.

How so? The public sector has no secret information on cost cutting that the private sector doesn't have. So where is this room for lower cost that you're talking about?

Robert Gentel wrote:
Do you really think there is no "overkill" (for lack of a more appropriate word) in the private medical industry that couldn't be trimmed in a bare bones public system?

Sure, but it could just as easily be trimmed with a public health insurance plan that pays only the bare-bones part of the patients' medical bills.

Robert Gentel wrote:
I think this got mangled somewhere, as it seems to contradict itself (unless I am reading it wrong).

You're right. I mangled it on editing. It should have been: "In countries where governments employ the doctors, healthcare is not consistently cheaper than in countries where governments pay the patients' medical bills, but don't necessarily employ the doctors." (For clarity: Costs seem to be roughly similar in both systems, and both systems are substantially cheaper than America's, in which health insurance and health care providers typically work through the private sector.)
Robert Gentel
 
  1  
Reply Mon 15 Jun, 2009 08:08 pm
@Thomas,
Thomas wrote:
How so? The public sector has no secret information on cost cutting that the private sector doesn't have.


No secret, the public system would not be run for a profit. Subtract the profit and you already have a small part of the cost cut that the private sector has no motivation to provide. And because you aren't competing with anyone you don't need a nice building in a good location, you don't need any marketing, and you don't have the latest technology.

Quote:
So where is this room for lower cost that you're talking about?


Besides eliminating profit, the public health care system can be cheaper by paying under market value for their labor and by providing a lower level of service than the private sector provides. They would not attract the best and the brightest similar to how public solicitors earn less than the private sector on average and there would be a similar motivation to avail yourself of private care if you can afford it.

In short, when you eliminate the need to compete for a profit, you can lower a lot of the operating costs of the system. You don't need to outdo the rival institutions, you don't need the latest technology and any advertising and you don't need the best and the brightest doctors and staff. You are the Southwest airlines of health care but you don't even need to turn a profit like them. You can cut all the frills because you don't need to care about your brand.

Quote:
Sure, but it could just as easily be trimmed with a public health insurance plan that pays only the bare-bones part of the patients' medical bills.


But the bare bones service in the same nice hospital by the same well-paid doctor is not going to be as cheap as the government clinic in a run-down part of town that is employing doctors of lesser cost and quality.

The different level of service you can provide when you aren't competing and don't need to provide the same level of service can cut costs dramatically.

Quote:
You're right. I mangled it on editing. It should have been: "In countries where governments employ the doctors, healthcare is not consistently cheaper than in countries where governments pay the patients' medical bills, but don't necessarily employ the doctors." (For clarity: Costs seem to be roughly similar in both systems, and both systems are substantially cheaper than America's, in which health insurance and health care providers typically work through the private sector.)


I don't advocate that the government employ all doctors and in every place I have lived where the government employs some doctors yet others are in private practice the public system is cheaper.

For example, here in Costa Rica the government has a monopoly on insurance, and also provides public health care to its citizens. The monopoly and economy of scale of the insurance does make it very cheap but it's still much cheaper to go to the public hospitals with doctors employed by the government than it is to go to the private hospitals.

So those who can afford it seek private care, and those who can't have a free safety net that is not as nice and comfortable but that does its job of keeping people alive and healthy relatively well.

I don't know of any example of a dual system like that where the private system is not more expensive than the public one but I don't know that many examples myself. Do you know of any such example where the public sector is not cheaper?
ossobuco
 
  1  
Reply Mon 15 Jun, 2009 10:58 pm
@Robert Gentel,
Listening to Robert, while crabby as usual.
ossobuco
 
  1  
Reply Mon 15 Jun, 2009 11:09 pm
@ossobuco,
Oh, I missed the new post..

Well, hell, I'll probably be crabby.
ossobuco
 
  1  
Reply Mon 15 Jun, 2009 11:24 pm
@ossobuco,
but I'll pick out this line -

It just doesn't need to cost anywhere near what it costs in the US to provide the basic fundamentals of health care.

0 Replies
 
Green Witch
 
  2  
Reply Wed 17 Jun, 2009 04:40 am
Yes, the cost is the real issue here. I am the first person in my family to run a successful business and not be able to afford insurance for myself and my workers. My grandfather didn't even bother buying insurance because as a fairly wealthy man, he felt he could just afford to pay his medical bills himself - which he did back in the 1960's. My father's monthly bill for each employee back in the 70's was about $11 per month per person. Even if you factor in inflation that is an affordable figure.

Here's an example of something I came across in my files the other day: In 1991 I had a lyme test and the total for the doctor visit and the lab test was $142 total. I had a lyme test two years ago and the bill for the same doctor, but different lab came to $549. Big difference and because of it I will be skipping the test this year.

When my husband I first looked into getting health insurance a decade ago it would have cost us about $5000 per year for an HMO, now it would cost us $12,000 for less coverage. We also need a special disability insurance to cover the health insurance bills if we get sick and can't work - that's another $4,000. Small business people cannot afford insurance anymore, and the last thing this country needs is people not starting a business because they are afraid of being without insurance.

People talk about "free" insurance, but nothing has trapped us and taken away our freedom more than our inability to pay for our own insurance as a collective country. I'm sure thousands (millions?) of Americans are trapped in work situations they hate because they can't walk away from the health benefits.

If Americans really believed in freedom, they would demand the system be restructured so everyone pays into the pool based on their income and no matter what their condition. Medical personnel need to be paid fairly without insurance companies gouging them for the occasional malpractice suit and the medical establishment needs to learn how to better manage their costs.
0 Replies
 
H2O MAN
 
  1  
Reply Wed 17 Jun, 2009 06:15 am


This country has Free, Public Health care.
If you can make it into an emergency room, they are obligated to treat and care for you even if you can't pay.

It's not a perfect set-up, but let's not make matters worse by socializing health care.
H2O MAN
 
  0  
Reply Wed 17 Jun, 2009 06:38 am



The fact that Obama is using scare tactics and fear-mongering to sell
his socialized health care plan tells me that he has an ulterior motive...
0 Replies
 
FreeDuck
 
  2  
Reply Wed 17 Jun, 2009 08:21 am
@H2O MAN,
H2O MAN wrote:



This country has Free, Public Health care.
If you can make it into an emergency room, they are obligated to treat and care for you even if you can't pay.

It's not a perfect set-up, but let's not make matters worse by socializing health care.

That's not free nor is it health care. It's emergency treatment and it costs plenty, whether or not you can afford to pay for it.

How, exactly, will socializing health care make matters worse?
Walter Hinteler
 
  1  
Reply Wed 17 Jun, 2009 09:42 am
@H2O MAN,
H2O MAN wrote:

This country has Free, Public Health care.
If you can make it into an emergency room, they are obligated to treat and care for you even if you can't pay.


We don't have "soializing health care" here, only mandatory health insurance with more than 250 different insurance companies.
And the emergency room here is exactly what the name says: for emrgencies = generally you can't walk but are carried there.

Anyway, I've the very same question FreeDuck already asked above.
JPB
 
  1  
Reply Wed 17 Jun, 2009 09:43 am
David Walker with real suggestions on health care reform. I really like this guy.

http://www.cnbc.com/id/15840232?video=1152838103&play=1
0 Replies
 
H2O MAN
 
  1  
Reply Wed 17 Jun, 2009 10:54 am
@FreeDuck,
FreeDuck wrote:


How, exactly, will socializing health care make matters worse?


Name one program that is run by the government that could not be run more efficiently by the private sector.
H2O MAN
 
  1  
Reply Wed 17 Jun, 2009 10:56 am
@Walter Hinteler,


Emergency room should be just as they are for you, but anything goes here in the states and the system is abused.
0 Replies
 
Green Witch
 
  1  
Reply Wed 17 Jun, 2009 11:34 am
@Walter Hinteler,
I hit Walter's reply button, but this is for H2OHead - How do you figure emergency care is free? Either the hospital has to absorb the cost or more likely they will over bill a patient who has insurance to make up for the loss which results in higher premiums. Hospitals that can't make up the cost go out of business and leave poor communities without any care. Not only that - if you slice off your finger the hospital is not required to reattach it, if they can, they are only required to do the minimum of patching up the wound and send you on your way. Only if they know you can pay for the surgery will they perform it. How medieval is that? Is that how you want the American health care system to function? Is that something to be proud of?
Green Witch
 
  1  
Reply Wed 17 Jun, 2009 11:36 am
@H2O MAN,
Fire Departments - just check out the history of the fire departments in the US.

I also think we better off with social security and medicare than without. You are welcome to decline your benefits when you qualify. Take a look at American history before these programs came into effect.
H2O MAN
 
  1  
Reply Wed 17 Jun, 2009 11:38 am
@Green Witch,

Yes, fire departments that are run by the private sector are much better and far more efficient than any run by the federal government.

The exception would be fire departments run by our military.
 

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