"RobertR237" wrote in message
...

Sandy,

The following externalities prevent our insurance system from working in
the
case of healthca

1. Forced coverage - you cannot buy insurance to cover what you want.
Regulations force coverage and non coverage based on state politics


And, the insurance companies in the regulated areas are virtually
guarnateed a
profit at or above a certain percentage. The insurance companies have
little
incentive to be efficient or take actions to ensure that fraud is not wide
spread.

agreed


2. Medicare is hard to compete with. Competing with the government is
just
silly, and most businesses don't want to try it.


You don't compete with Medicare but you need to also understand that
Medicare
is a cash cow for many companies who are given huge and lucrative
contracts to
manage the medicare program in each state and a butt screw for the
healthcare
industry who must operate under government imposed price controls,
paperwork
burdens that none of us would accept, and is lucky to collect 50% of what
they
bill.


sounds okay


3. Subsidy of employer based coverage through the tax code. This is the
big one, and most important one here. You cannot get health insurance
because you cannot buy a cradle to grave policy. Your employment
situation
forces you into groups based on job stays and inevitably forces changes
in
policy throughout your life. Instead, you go from dependent of your
parents employment group or groups, to possibly a student group, to then
a
number of employment groups, and then are put in the medicare group. At
each change serious government involvement and inefficiency prevent your
making any choices of importance, taking the market out of the situation,
and driving up costs in ridiculous ways.


As far as the insurance companies are concerned, don't blame it all on the
government. The insurance companies have a very vested interest in making
damn
sure that you don't have a cradle to grave policy. You can also blame the
insurance companies for making it more difficult for older workers to find
jobs. They have some not so subtle ways of discouraging small companies
from
hiring older, supposedly higher risk employees.


Um, not so fast. You are being very cras here. The insurance companies are
doing what makes sense given the system, and I do not see them as evil.
Your jobs example is playing my song though, we need to seperate healthcare
and jobs.


So, you could, if you had paid into a policy for your entire life, have
built up enough reserve for at least one stint of heroic medicine to
extend
your life. This could easily be done for the amount that most workers
pay
into the system now. Also, if you paid more directly, and were more
financially involved in price quality decisions for your care your health
cost would be much reduced. Instead, you likely have ZERO involvement
even
though you are the best person to police it on the scene.


True to a limited degree but not entirely.


Not entirely, but if you are pooled with others, it will work just fine.

4. State licensing. The licensing system is overly burdensome, driving
up
costs


You got that one right!

5. Tort. Defensive medicine is used because you cannot be allowed as a
patient to make decisions based on reasonable outcome expectancies.
Also,
because you have no financial involvement, you just get ALL the tests.
Failure to give a test should not be automatic negligence if its not
called
for the presented systems, unfortunately, juries expect doctors to be
perfect.


Now there is a catch-22 of our current system that has the healthcare
industry
by the preverbial balls. No, you don't just get ALL the tests, in fact if
tests are run that are NOT indicated by the diagnosis, you are not going
to get
paid for them and may find yourself going to jail. On the opposite side,
if
you don't perform the tests that might have caught a treatable condition,
you
will find yourself facing a malpractice lawsuit.

Doctors are people, their staff consists of people, and people sometimes
make
mistakes. Nobody, that I know of, is perfect and beyond mistakes. Add to
our
imperfections, the inability to disassemble the human machine and spec the
parts to a blueprint, and you are guaranteed that not all diagnosis will
be
accurate. The medical industry is working hard to try and overcome these
limitations but it is expensive and will be a long time reaching the
goals.


yep

6. Reverse price competition. Instead of competing on price and value,
the
present system is a strange maze of over and under payment negotiated
without any of the real customers being involved in the negotiation at
all.


I agree, except on the negotiation part. Too often there is NO
negotiation,
just imposed rules that often can't be understood even by those who write
them.
I would challenge you to intrepret the rules for CPT coding and billing.


Only the gov can impose rules. Local providers here started a new tactic -
throw out the cheapest payor. The patients got letters saying no more using
this hospital, they called thier company, the company called the payor, and
the payor blinked and raised its payouts.

7. Inability to refuse care. Emergency rooms cannot turn you away for
any
reason at all. While inability to pay is likely a good restriction, how
about we tell you that you are not eligible due to lack of need -
GOODBYE.

That can't be determined without spending time, money, and physician
resources
to determine the "need". Catch-22!


Not always, and less is still better. There are the patients that use the
system too much. They want service, not just a check out. So, check them
out, and then tell them they are not an emergency and need to see their
doctor. DO NOT TELL THEM WHAT IS WRONG WITH THEM!

Think about it.

Or, when you pester the ER all the time, and never pay, we send you away
for
consistent REFUSAL to pay.


It does not fit to our liberal mentality.


It will when grandpa is waiting for rationed healthcare.

8. Cost shifting of socialist systems from countries with government
healthcare to the US. These systems will begin to fail the day the US
forces the pharmaceutical companies into the same situation they force
our
doctors into. Namely, you must charge the US government covered patients
the lowest price you charge anyone, or we throw you in jail. Now,
progress
in healthcare will virtually cease.


Ah, you do show some knowledge of this point. Good.

Sorry Sandy, I am not out in any field on this. I am just unwilling to
look
at the present system and accept it. It sucks. Really, the system we
have
is outside the stadium and it started with job based health insurance.

I would argue that one with you, I feel it started with the Mediare
program and
state Medicaid has inflicted additional injury to the system. The advent
of
the HMO's was the final nail in the coffen.

Socialist healthcare will not improve the system in the US for anyone
except
the working poor and stupid. 80% of us will suffer.


It won't improve the system for anyone. PERIOD! The working poor and
stupid
already have better access to healthcare than many of the working
middleclass.


We likely mean the same working people, those who make just enough not to
get aid, but not enough to buy the overpriced non-employer group coverage.


Your question assumes that someone would have no insurance until after
they
found they had cancer. Of course, no one will sell it to you then. That
would be stupid, and wouldn't work. But wait, that's what we have now.
Once you spend ALL your money, then you get Uncle Sugar to pay. Thus
rewarding lack of financial responsibility.


On this we both agree and disagree. I have been self-employed for over 25
years. I bought a good health insurance policy but over that period of
time,
the costs and coverages of that policy changed. The coverage had to be
constantly dropped with a higher and higher deductable untili it became
just
major medical only. The costs thought, even with dropping coverage rose
to
over $1500 per month. Alternatives were not existant, nobody would
consider
coverage for less. I finally had to drop out when they wanted to increase
premiums to $1800 per month. That was five years ago and I have no idea
what
they would want to charge today.

And they can do this because you are not a group. Their are groups of self
employed banding together now, but if you are already undesirable risk it
will be hadr to get in one.


Lastly, your link does not support your statement, and is hardly
conclusive
at all. No findings were made on quality of care. Also, healthcare is
definitely NOT the largest contributor life expectancy. Sanitation, life
style, diet, and climate would all beat out health care. Your doctor can
add a year or two on average. Better living and genes can add decades.


As far as the quality of the healthcare system in the US, it stands second
to
none. That can easily be seen if you visit any of the major medical
centers in
the US and check out the patient population for the number of foreign
patients
who come here for treatment. If our life expectancy is lower, it can be
directly attributed to diet and life style.




agreed