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Bail Out II : Swingers Discussion 115138
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TOPIC: Bail Out II
Created by: cher98
Original Starting post for this thread:
What say you now CONSERVATIVES of your maverick's new plan? Estimates now put the cost at $300B on top of the $700B Bail Out I

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As for the consumer side of things, the ability to allow insurance companies to sell in any state is one of the things that McCain desires that would truly help people. If no carrier in your state offers a high deductable policy, it rules out the HSA's that Congress put into law a few years ago. When there are high deductables, the policy usually costs much less and is a great way for people to have catastrophic coverage. Also, when there is a deductable, consumers CAN and DO negotiate for better prices with providers. With the co-pay system, that is not possible. How could that be you ask? If a provider waives the co-pay, the insurance company can drop that provider from their network. There is also the threat of being prosecuted for insurance fraud (I have primary care friends who have gotten letters of warning from carriers for writing off co-pay). There are two very good examples of consumers price shopping, cosmetics and heart surgery. I am not sure if you have read about the fair number of Americans going to India and China for heart surgery.

Mentone AL
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Island, Thanks for the rational post! See, Liberals and Conservatives can have a rational discussion. I did a 3 month temporary with Kaiser about 5 years ago. After 15 yrs in the "private" world, it was a true adventure!!! I will say that the care that was given was good. The lack of paperwork was WONDERFUL. The only minuses that I saw were the pace was S-L-O-W, and there was little incentive for efficient use of time. If some of the cases ended up taking longer than expected ( a common event in almost any hospital), it was not unusual for the later afternoon cases to be cancelled,and put on another day. The only other place I have seen that happen is in the VA. The common factor is that there is no incentive for most of the staff, since everyone is on salary. A genuine worry that I have for a nationalized health system is that the incentive to work hard and do the hours needed will go away.

Mentone AL
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Given Barack Obama’s relentless populism this cycle, the Wall Street Journal analysis of his tax cuts should surprise no one. They find that Obama relies less on actual cuts in tax rates and more in specific “refundables”, grants that filers receive whether they have a tax liability or not. Instead of reducing taxes, Obama makes his redistributionism explicit.

Six of the seven listed in the Obama plan are these "refundables," money people get from the federal government even if they pay no taxes at all. These are not Ttax cuts," but instead welfare grants based on specific social policy. It’s blatant redistributionism, as the money comes from tax increases on the wealthy.

Destin FL
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fun I left out a major point. The other part of the consumer side of the equation is pricing. In most normal markets pricing levels are under constant consumer pressure. In Healthcare how many people know how much an x-ray costs, or an MRI, or an appendectomy, etc. Consumers don't have the information nor do they seem interested at the time to use it. If I need an appendectomy damn it, I want it done now! It hurts! That's the biggest market force for the consumer -- I want to live.

That's why I insist that for-profit-healthcare doesn't work well. The normal market incentives either don't exist or they don't function well.

Key West FL
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Fun You make some very great points. But there all on one side of the ledger, insurers and service providers -- not consumers. I used to love HMO's. Lived in Cal. in the 80's my daughter was born at a Kaiser Permanente in SF.

The side of the equation that I referred to earlier is the consumer. There are no real market forces from were the consumer sits. Yes I can change drug stores and save a few bucks but that's about it. I can't change physicians easily even if there in my network. When your ill you want to get well. No one shops for services when there in pain. No one searches for a cheaper deal when their child breaks a leg. Healthcare is not a commodity. Maybe Insurance is a commodity but like I said earlier the Insurers have the incentives turned upside down.

Key West FL
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Island, there are market forces in health care. PMD by Blue cross is a perfect example. Providers must agree to about a 50% discount on the UCR to be in listed as a preferred provider. The majority of insurance companies in our region have in network and out of network providers. If the patient elects to go out of "network" they pay the difference. Hospitals form buying groups that negotiate better prices on drugs and supplies. This cuts millions of dollars from the costs. The HMO is a perfect example of the market forces. I am an independent business person that has overhead and expenses whether I work or not. Therefore, I should not be treated better or worse than any other legal business person.

Mentone AL
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I would like to inject a little conservative in you!

er... not necessarily "little" in size!

Brownwood TX
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tort You're just too much!

As for my basic issue healthcare is not a commodity. Healthcare does not lend itself to market forces from a basic consumer activity. No one checks the Sunday sales adds for healthcare. No one seeks a bargain when they're sick. For-profit-healthcare has many, many weaknesses. Insurers have built in disincentives to cover the insured. The insurance market incentives are upside down. Not to mention the 500 insurers in the US add layers and layers of overhead.

I didn't even mention drug companies that now spend more on marketing than they do on research. Marketing "restless leg syndrome" and gremlins hiding under your toe nails -- ask your doctor if "hard dick" is right for you --its border line ludicrous. Not to mention we have to subsidize the "private" drug plans for seniors -- up to 50%.

Key West FL
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20 years ago the cost of cell phones and personal computers were such that most households did not have even one of these items, let alone both. Now, many households possess several of each. I say this to point out that I believe it innacurate to pin the blame of increased cost on the spread of technologies such as CAT and MRI. Insurance industry, pharma, and medical device sales junkets are the envy of kings and queens. If "joe sixpack" were to be made aware of the excess there would be a revolt. I'm not saying cutting those expenses would solve the problem but that practice certainly creates at least for me, the "let them eat cake" attitude.

Nanjemoy MD
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What I was trying to point out is that the average American does not think about the changes in health care over the past 30 years. We can reduce the costs to the old days, but we would have to accept a lot of people being dead sooner. I was also pointing out the defensive use of testing. In my own practice, I order thousands of defensive lab tests per year, My friends who are in the ER order CT scans and MRI on hundreds of patients that most likely do not need them. Why you ask? No one gets a malpractice case due to ordering excessive tests. Are there problems, sure there are. But it is problem with litigations, lifestyles,and unreal expectations.

Mentone AL
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TOPIC: Bail Out II