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The $200K lesson I learned from getting shot

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Re: The $200K lesson I learned from getting shot

#61

Post by markost »

dnautics wrote: post #35
taylodl wrote: post #32

Earlier quoted context omitted.

Currently the insurance company does, and since they were most likely selected by your employer whose objective was to hold down costs, what do you think that insurer's priorities are going to be? Plus, who's the customer in this situation? For whose business is the insurance company really working for?

no doubt having your employment being tied to your insurance is a really, really bad idea, but may I remind that state of affairs is because of a government incentive put into place by FDR.

I believe it was originally because of postwar wage/price controls, which led to employers giving health insurance to attract employees, which led to the IRS taxing health insurance, which led to Congress exempting health insurance from tax, which led to the current regime we have today, compounded by the McCarran-Ferguson Act as well as the HMO Act.

Re: The $200K lesson I learned from getting shot

#62

Post by nknighthb »

dnautics wrote: post #57
nknighthb wrote: post #55

Earlier quoted context omitted.

It is fair and equal under the law because the government is offering what it can to whom it can. If there is no treatment for person A, there's no requirement -- legal, moral, or ethical -- that one be given. The "null solution" is absurd. It simply provides that the rich get treatment and the poor do not. That would be "fair and equal" only to a barbarian.

>It simply provides that the rich get treatment and the poor do not You're projecting. If you were rich, would you help pay for the healthcare of the poor? Because I'm very much poor, and I give two hours a week towards helping feed people who are sick.

I already do help pay for the healthcare of the poor (as well as the not-so-poor over 65, and your father's VA care, by the way, as well as my grandfather's VA care). By any reasonable global standard, I am, in fact, rich. By American standards I am decidedly upper-middle-class. I make several times the median personal income in the United States. In fact, my 2012 taxes exceeded the US median personal income. I have excellent healthcare, a growing portfolio, and my only debt is a modest low-interest mortgage on an older but well-built house I bought last year and have already done substantial renovation on.

My taxes are too low. They should be increased. I regularly vote as such, as well as making campaign contributions to candidates and causes that would result in my taxes going up. I also make donations to charitable health care organizations such as Planned Parenthood and Doctors Without Borders.

Any more insulting questions?

Re: The $200K lesson I learned from getting shot

#63

Post by maratd »

Frozenlock wrote: post #52
adambard wrote: post #3

Can I be the first non-US citizen in this thread express my incredulity that anything less than universal health care is tolerated? "Barbaric" is the term that seems to strike me whenever I hear of it, hyperbolic though it may be.

Can I be the first non-US citizen to say that universal health care is, by definition barbaric? Adjective Savagely cruel; exceedingly brutal. Primitive; unsophisticated. I fail to see how, when a group decide to take from the minority, it could be seen as anything else than barbaric. It saddens me to see one of the last first world country coming closer to the universal health care trap. Sure, the US medical fees are…

> It saddens me to see one of the last first world country coming closer to the universal health care trap.

We're still quite a ways off and there's been quite a bit of pushback on the small steps Obama took. It's entirely possible the whole thing will be scrapped during the next presidency.

Re: The $200K lesson I learned from getting shot

#64

Post by robbiep »

dnautics wrote: post #54
robbiep wrote: post #51

Earlier quoted context omitted.

Again i'll have to insist you are missing the point. Not my point, although I am advocating it; but the point of universal healthcare is to enable everyone access to the same level of healthcare for free . (Or, paid for by the taxpayers if you insist). The principle is not about ensuring that someone with a specific amino acid substitution receives a specific drug, because this is an example of the specific medical m…

can you define for me what you mean by "the same level of healthcare"? >universal healthcare ... poor care by the treating physician These issues are entangled. I should let you know, that despite being in the US, my father is effectively being treated by a "universal healthcare" system - the VA.

Access to life saving treatment when required, as required, access to free hospital and cheap/free out of hospital medication.

The issues are no more entangled than that 'healthcare providers' are a subset of 'healthcare' and within healthcare providers are going to be doctors administrating care that is not up to the best evidence. Universal healthcare is no defence against that, but either is any other form of healthcare. If you select your own doctor you have every chance of choosing one that may give you treatment against the best evidence.

It seems you are saying that universal healthcare means that you will get poor healthcare. I vehemently disagree with this proposition, not just based on your single anecdote but because I live in a country with a universal healthcare system and I have worked within it and in a few months I will be dispensing care from within it as a doctor. Every system has failures but this criticism isn't an indictment of the entire system

Re: The $200K lesson I learned from getting shot

#65

Post by tzs »

robomartin wrote: post #34
restlessmike wrote: post #27

I'm sure this has been pointed out many times when these posts pop up, but what is shocking to me is that we tolerate $200k medical bills for this sort of emergency care, as long as we aren't the ones paying for them ourselves. The healthcare industry needs a lot more transparency. Every hospital should be required (if they choose to accept Medicare/Medicaid patients) to publish prices in an easily comparable format…

> The healthcare industry needs a lot more transparency. OK, yes. What it really needs is to be an open market both for care and insurance. Competition has amazing ways to both improve quality and affordability. This has been proven time and time again across a myriad of fields both within and well outside of medicine. Nothing beats open market competition. When providers and insurance companies truly have to compete…

> Funny that the very people who passed it will not have to live within this monstrous framework.

It applies to Congress.

Re: The $200K lesson I learned from getting shot

#66

Post by dnautics »

nknighthb wrote: post #62
dnautics wrote: post #57

Earlier quoted context omitted.

>It simply provides that the rich get treatment and the poor do not You're projecting. If you were rich, would you help pay for the healthcare of the poor? Because I'm very much poor, and I give two hours a week towards helping feed people who are sick.

I already do help pay for the healthcare of the poor (as well as the not-so-poor over 65, and your father's VA care, by the way, as well as my grandfather's VA care). By any reasonable global standard, I am, in fact, rich. By American standards I am decidedly upper-middle-class. I make several times the median personal income in the United States. In fact, my 2012 taxes exceeded the US median personal income. I have…

Without getting into the fact that, yes, worldwide I'm certainly not "poor"...

Don't you see how what you say is a problem? Most of the ways you listed where you are "helping" are involuntary and inefficient. When I go out and help, I'm actually putting food directly in the hands of the people who are hungry. I won't say the org. I work for is perfect, but there is a far closer to 1-1 yield on the fruits of my effort. Because it's personal, it also makes me feel good. I think I'm less inclined to think, "well, gee, there's some welfare queen living off of my dole". There's accountability. If the welfare system screws up, there's a chain of unelected bureaucrats that are only held accountable to narcissistic fools who are elected based on unrelated wedge issues like abortion. If my volunteer organization screws up, then the donors stop giving and find other places for their money to help (without sounding too capitalistic about it, there are indeed competing orgs that could fill its shoes on a dime).

You're trying to vote to make the burden on other people greater, which will create a bigger bureaucracy, which will in all likelihood be more inefficient. Why not, instead of taxing people more, work harder to create a society that just does more efficient things to help? It's hard, because getting people to be BETTER people is not easy. But it's way worth it.

Yeah, there are problems in our country, like a kleptocratic upper class, but you don't think there might be better solutions that actually address that problem than the bludgeoney "tax 'em more!!1" - which, ultimately is based in the ugly emotion of envy?

Re: The $200K lesson I learned from getting shot

#67

Post by dnautics »

robbiep wrote: post #64
dnautics wrote: post #54

Earlier quoted context omitted.

can you define for me what you mean by "the same level of healthcare"? >universal healthcare ... poor care by the treating physician These issues are entangled. I should let you know, that despite being in the US, my father is effectively being treated by a "universal healthcare" system - the VA.

Access to life saving treatment when required, as required, access to free hospital and cheap/free out of hospital medication. The issues are no more entangled than that 'healthcare providers' are a subset of 'healthcare' and within healthcare providers are going to be doctors administrating care that is not up to the best evidence. Universal healthcare is no defence against that, but either is any other form of heal…

no, I am saying in universal healthcare, you will get poor or no healthcare if you are poor and you will get good healthcare if you are rich. You will simply shift around who gets marginalized. For example: If you have a country that aggressively hounds, say, educational debtholders - because, maybe the nation decided to socialize educational debt. How long will it be till the bureaucratic machine calculates the bottom line and decides to use the system to redflag people and those people are effectively forced to avoid the government healthcare system. It could be anything else, say, "child support deadbeats". Or "illegal immigrants".

If you think that there will be an effective firewall between the two systems, I've got a bridge I want to sell you.

>Access to life saving treatment when required, as required, access to free hospital and cheap/free out of hospital medication

What happens when that medication is fundamentally uncheap, like herceptin, in New Zealand? Sure, herceptin is contrived, because that's a patenting issue. what if it's discodermolide, which doesn't exist in more than ~10 g quantity in the universe and is rediculously expensive to manufacture? Who gets/who doesnt?

Ultimately, no treatment is life-saving. We all die. Which ones are worth it? Who makes a valuation on life? How long until we find a hyperexpensive drug that prolongs the life of a politically-connected child with an orphan disease, and people begin to question, "why is this person's life subsidized", but not mine?

Re: The $200K lesson I learned from getting shot

#68

Post by nknighthb »

dnautics wrote: post #66
nknighthb wrote: post #62

Earlier quoted context omitted.

I already do help pay for the healthcare of the poor (as well as the not-so-poor over 65, and your father's VA care, by the way, as well as my grandfather's VA care). By any reasonable global standard, I am, in fact, rich. By American standards I am decidedly upper-middle-class. I make several times the median personal income in the United States. In fact, my 2012 taxes exceeded the US median personal income. I have…

Without getting into the fact that, yes, worldwide I'm certainly not "poor"... Don't you see how what you say is a problem? Most of the ways you listed where you are "helping" are involuntary and inefficient. When I go out and help, I'm actually putting food directly in the hands of the people who are hungry. I won't say the org. I work for is perfect, but there is a far closer to 1-1 yield on the fruits of my effort…

Why would you expect greater inefficiency when every piece of empirical evidence we have, including Medicare itself in the United States, shows the exact opposite?

Government is an instrument of society. I'm trying to use that societal instrument in a proven manner to solve societal problems that otherwise suffer a tragedy of the commons.

Re: The $200K lesson I learned from getting shot

#69

Post by coryrc »

hsitz wrote: post #53
coryrc wrote: post #8

> They also enter a social contract that promises to provide them affordable coverage when they’re older and no longer healthy, as a form of back payment for cross-subsidizing today’s aged and ill. This is only true if the law requires younger people to pay more than their cohort consumes on an average basis, so as to transfer even more wealth from the working young to the retired, wealthy elderly. Hmmm http://www.fo…

I'm not clear on to what extent the mandatory coverage requires young people to pay more than the expected cost of their cohort, or if it simply requires them to carry their own expected cost so that the older insured people (or, perhaps, simply the taxpaying citizenry) don't have to pay health care costs of the younger uninsured generation. The author of the article also says, "Young people are typically healthy. On…

"The newly announced rules limit insurers to charge their oldest customers no more than three times as much as younger ones"

Re: The $200K lesson I learned from getting shot

#70

Post by dnautics »

nknighthb wrote: post #68
dnautics wrote: post #66

Earlier quoted context omitted.

Without getting into the fact that, yes, worldwide I'm certainly not "poor"... Don't you see how what you say is a problem? Most of the ways you listed where you are "helping" are involuntary and inefficient. When I go out and help, I'm actually putting food directly in the hands of the people who are hungry. I won't say the org. I work for is perfect, but there is a far closer to 1-1 yield on the fruits of my effort…

Why would you expect greater inefficiency when every piece of empirical evidence we have, including Medicare itself in the United States, shows the exact opposite ? Government is an instrument of society. I'm trying to use that societal instrument in a proven manner to solve societal problems that otherwise suffer a tragedy of the commons.

The US system is terrible, for so many reasons, so using it as an argument that socialized medicine is a solution is kind of a strawman. How did we care for people 50 or 60 years ago, when medicine was LESS socialized than it is now, and arguably care and outcomes were more compassionate in spite of less technology?

How, exactly are you solving the tragedy of the commons by expanding on its status as a "commons"?

And "Government is an instrument of society". That's true, but a somewhat vacuous statement. It's a very special instrument of society; and it is worth thinking about whether or not its special status makes it the "appropriate instrument". Do we really want the organization that invades brown countries and spies wantonly on everyone to be managing our medical system?

Before you dismiss that - when you vote for president (who is where the buck stops in terms of accountability) do you take into account whether or not he bombs brown people or spies? Do you want that part of the decision process contaminating the decision vis a vis his or her ability to manage the healthcare part?

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