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Employer health plans are getting pricier and skimpier

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Re: Employer health plans are getting pricier and skimpier

#361
post #218

Earlier quoted context omitted.

> One thing that will not make healthcare less expensive is "Medicare For All". It will just shift the bill to different people. Now, you can argue it's the morally correct course of action, or those people who will be forced to foot the bill (upper middle class taxpayers) are more capable of doing so, but you cannot credibly claim with a straight face that it will make anything cheaper. In fact, the opposite will oc…

> Having every person under the same plan that has the negotiating power of 327.2 million people will definitely drive costs down. Don't want to pay what the government says it is going to pay? Good luck finding customers then, because the government is bargaining on behalf of all of the customers in the US. So my mom and her boyfriend are both under Medicare now, as was her late 2nd husband. My mom and I had both ge…

>But they can - and will - find other procedures. Not making enough money from that doctor's visit? Well, we better do some tests, then, just to be sure there's no lurking problem. Oh, there was a spot on that X-ray - more tests. We didn't find anything serious, but there was a benign growth that you probably should get taken care of. Don't worry, it's a quick procedure, it could potentially be done as an outpatient but you might want to make it an overnight hospital stay just to be sure. Shit, you contracted an infection in the hospital? Gotta extend that stay until you're better.

Right. This is exactly what we want (save the MRSA). The problem with the American healthcare system isn't just that it's expensive; it's expensive and still has worse outcomes than in other industrialized countries. Part of the reason for that is that patients cut off their care for financial reasons, and not because they've reached a satisfactory conclusion about their state of health.

The way you describe the mindset isn't a function of Medicare per se, but of the fact that there's still a profit motive involved, even when receiving Medicare funding, in a system that is largely privately-funded. Maybe releasing that source of pressure and competition and scarcity will change the way people on both sides of the doctor-patient relationship approach their care.

Re: Employer health plans are getting pricier and skimpier

#363
post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

And what's more - look at the UK where we spend half as much per capita on healthcare and achieve broadly similar results. Yes, if you get a sporting injury you're going to be waiting 6-8 weeks for physio, but if you have a heart attack, cancer, are in a serious accident there is no wait.

Oh the thought of going to the doctor without that time of uncertainty about the bill that'll be coming. $200? $500? No, no bill is coming.

Re: Employer health plans are getting pricier and skimpier

#364
post #351

Earlier quoted context omitted.

This sounds like an ignorant view of getting proper healthcare. There are more things to check because older people have more medical problems, therefore more tests, more treatments, etc. We would have to see what would happen if you gave a 25 year old medicare in this country, I doubt it would be the same experience that an elderly person would have.

There is a very strong correlation between which additional tests are requested and what the hospital can charge under Medicare reimbursement codes. (My mother's boyfriend is a former doctor, and intimately familiar with the health-care system from the other side of the table.) Both of them are also in fairly good health (my mom has no pre-existing conditions, her boyfriend has some issues with his back but nothing u…

And yet for all that, Medicare is vastly cheaper per capita than private healthcare. You get more service for less money? Sign me up.

Re: Employer health plans are getting pricier and skimpier

#365

Earlier quoted context omitted.

Software Engineers in the US often make 2x as much as our European counterparts, yet we don't have any artificial limits on the number of people able to study Software Engineering. I'm not disagreeing with you the point on the AMA, but even if they removed their limits -- would many more people want to enter the field? It seems extremely intensive, not only during your education and residency, but on the job too. 12+…

>In 2011, 43,919 students applied to medical schools. However, only 20,176 of those applicants were accepted into at least one medical school. In other words, 54% of applicants got rejected to every medical school they applied to. Even if we remove the bottom 10% or even 20% of un-accepted individuals (who we might assume, unfairly or not, are not cut out to be doctors) an absolutely significant number of people woul…

I wonder what’s the graduation rate for medical school? You’d think it should be difficult enough to flunk out 2/3 of the students (like engineering), but I’m guessing that is not the case.

Re: Employer health plans are getting pricier and skimpier

#366

Earlier quoted context omitted.

And do you think those specialists would exist here if we had medicare for all? no, evidence: all those other countries that have that and no such specialists.

Yes they would. The Americans also go to other countries to seek treatment in special cases. Also, if our healthcare works well to treat rich foreigners in special cases, but sucks otherwise — I say, we should scrap it. But sure, we can cherrypick metrics all day long.

This is a great point more people should make. There’s nothing “America first” about preserving the inefficiencies of a system just so that very wealthy people from everywhere can get care and leave (and ultimately specialists would anyway still exist, even if their treatments aren’t covered by Medicare)

Re: Employer health plans are getting pricier and skimpier

#367

Earlier quoted context omitted.

>In 2011, 43,919 students applied to medical schools. However, only 20,176 of those applicants were accepted into at least one medical school. In other words, 54% of applicants got rejected to every medical school they applied to. Even if we remove the bottom 10% or even 20% of un-accepted individuals (who we might assume, unfairly or not, are not cut out to be doctors) an absolutely significant number of people woul…

I wonder what’s the graduation rate for medical school? You’d think it should be difficult enough to flunk out 2/3 of the students (like engineering), but I’m guessing that is not the case.

It's practically 100%. Once you're in, they'll do everything in their power to graduate you (legitly). Every incentive they have points at a perfect graduation rate.

EDIT: In the US, anyway. Things are different in, say, Caribbean medical schools.

Re: Employer health plans are getting pricier and skimpier

#368

Earlier quoted context omitted.

If only we had examples where the government running something like healthcare resulted in a better outcome for citizens. Perhaps a country in Europe, as developed as the US is. I mean, a country that we literally border with would be too much to ask for. Perhaps some of us would be less amused by the concept of government-run healthcare. Too bad we don't have the example of literally all of Europe, Australia, and Ca…

In my opinion, the best yardstick for a health care system is how long you have to wait to be treated for cancer. By that yardstick, countries like Canada and England stack up quite poorly when compared to the USA. Canadians don't come to the US to save money on health care. They come to the US because they have an expensive potentially fatal medical condition, and they might not survive a six month waiting period fo…

The wait time thing is a total canard. Countries like Canada do have long wait times for things that do not require immediate attention. As an example, often you make your appointment for a physical a year in advance. And then, people who like to twist the facts into a false narrative point to the "year long wait time" to get a physical. Nonsense.

Re: Employer health plans are getting pricier and skimpier

#369
post #177
post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

> (I don't want to hear one thing about negotiating power. That is a debunked line of reasoning. Medicare/Medicaid cover more people than many single payer systems in other countries, and their costs are still outrageous) It is illegal for Medicare to negotiate drug prices. That needs to be fixed.

And Medicare costs are lower than private healthcare. OP just seems to be arguing that it's not low enough?

Re: Employer health plans are getting pricier and skimpier

#370
post #188

Earlier quoted context omitted.

they sue and get awarded insane damages, which is probably something that could be regulated more strictly, but then what do i know.

You think the government should cap the price of suffering? What do you think should happen with malpractice or medical errors? For example, take this recent news story and pretend this was in the USA, where a woman goes in for a routine procedure and ends up with an abortion. https://nypost.com/2019/09/24/doctor-performed-abortion-on-w... How would you like to strictly regulate damages for that? What do you think is…

People like to point to malpractice and lawyers and blame it all on that. Every actual study I've read totals the cost of tort liability (insurance, law suits, damages, etc.) at about 5% of total health care spending. Significant to be sure, but not the bogey man people like to make it out to be.
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