Trump as tragicomedy

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Kriegsspiel
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Re: Trump as tragicomedy

Post by Kriegsspiel » Wed Aug 01, 2018 10:19 am

Desert wrote:
Wed Aug 01, 2018 7:57 am
Regarding Canada, I think their system is far superior to ours, just looking at outcomes and spending per person.
Didn't Canada's Supreme Court rule that it was a human rights violation to force their citizens to rely solely on their nationalized healthcare?
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Desert
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Re: Trump as tragicomedy

Post by Desert » Wed Aug 01, 2018 11:17 am

pugchief wrote:
Wed Aug 01, 2018 9:52 am
Outcomes and per capita spending is only one measure. What about the people who are diagnosed with X, and have to wait 2 years to see a specialist. Apparently somewhat common in Canada. So are you willing to have that scenario in the event you or a family member gets X?

Be careful what you wish for.
Point taken.

Here's an interesting little summary of a few countries' healthcare systems.

https://www.nytimes.com/interactive/201 ... acket.html

The innovation that the U.S. system brings is a very interesting point.
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Re: Trump as tragicomedy

Post by flyingpylon » Wed Aug 01, 2018 11:19 am

Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
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Re: Trump as tragicomedy

Post by Maddy » Wed Aug 01, 2018 11:53 am

flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.
Ding! Ding! Ding!
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moda0306
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Re: Trump as tragicomedy

Post by moda0306 » Wed Aug 01, 2018 12:26 pm

flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
Isn't one of the main ideas behind single-payer to actually engage a negotiation framework that allows for universal coverage AND lower prices, rather than one or the other?

And yes it was about Trump... we meander around here.
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Xan
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Re: Trump as tragicomedy

Post by Xan » Wed Aug 01, 2018 1:00 pm

flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
As my earlier anecdote noted, by opting out of the insurance system, you can save 90% off the sticker price, no questions asked. That sounds like a way to get around the exorbitant prices.
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moda0306
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Re: Trump as tragicomedy

Post by moda0306 » Wed Aug 01, 2018 5:57 pm

Xan wrote:
Wed Aug 01, 2018 1:00 pm
flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
As my earlier anecdote noted, by opting out of the insurance system, you can save 90% off the sticker price, no questions asked. That sounds like a way to get around the exorbitant prices.
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?

I think I must be misinterpreting.
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Re: Trump as tragicomedy

Post by D1984 » Wed Aug 01, 2018 6:16 pm

moda0306 wrote:
Wed Aug 01, 2018 5:57 pm
Xan wrote:
Wed Aug 01, 2018 1:00 pm
flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
As my earlier anecdote noted, by opting out of the insurance system, you can save 90% off the sticker price, no questions asked. That sounds like a way to get around the exorbitant prices.
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?

I think I must be misinterpreting.
I think it was back when he talked about having an elbow re-set for around $300 instead of circa $3000.

I would like to add a couple of points, though:

One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.

Two, the plural of anecdote is not data; just because Xan got a good price as a cash-paying patient does not mean most people will; in fact, as per the chargemaster example noted above, the uninsured usually get hit with the WORST prices. The local hospital system in my city has essentially a monopoly and their charges to uninsured patients are as follows: If you make the poverty level or less, free or nominal; if you make from 100% of the FPl to 200% of FPL, prices are based on a sliding scale from almost nothing to roughly what BCBS of Georgia would pay; if you make one cent above that you pay the FULL chargemaster rate, no ifs, ands, or buts (with the singular exception that certain imaging services get 10% or 15% off the chargemaster price). oh, and even if the hospital does discount its prices due to your being poor enough, the doctors who work on you can (and generally do) still charge the full amount.

Three, every other country that has health care prices lower than ours (which is pretty much....all of them) has the government directly or indirectly negotiate prices; this is true whether the system in single provider (UK, Spain, New Zealand, plus Hong Kong as far as hospital care is concerned); single-payer (Canada, Taiwan, South Korea), or some form of private or nonprofit universal coverage (Germany, Netherlands, Japan, Israel, Switzerland, etc) or a hybrid of single-payer and private non-profit (France). Strangely enough, none of them rely on patients acting as cost-control kamikazes and trying to negotiate rates with providers themselves. They all have lower prices (see the IFHP reports if you don't believe me) as a result. Funny how that works.
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Re: Trump as tragicomedy

Post by Maddy » Wed Aug 01, 2018 6:22 pm

moda0306 wrote:
Wed Aug 01, 2018 5:57 pm
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?
I regularly get 40 percent off the sticker price from an orthopedist for paying cash on the barrelhead. He says that's about the same discount the insurance companies are getting. My one other experience with discounts comes from my participation in a health care sharing ministry. They are associated with a company (the Karis Group) that negotiates bills on behalf of member-patients--mostly major stuff. From what I've heard, they routinely get much larger discounts than that.
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Re: Trump as tragicomedy

Post by ochotona » Wed Aug 01, 2018 9:30 pm

What D1984 said. Basically, we're suckers but we think we live in this great utopia. Sorry about the thread drift.
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Xan
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Re: Trump as tragicomedy

Post by Xan » Wed Aug 01, 2018 9:45 pm

D1984 wrote:
Wed Aug 01, 2018 6:16 pm
One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.
This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
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Re: Trump as tragicomedy

Post by boglerdude » Thu Aug 02, 2018 1:06 am

https://johnhcochrane.blogspot.com/2018 ... pathy.html

From the comments
"And one thing about the Canadian system: it is a big free rider on the inventions of others, mainly the American medical and pharma industry. Canada does not invent anything, does not produce any significant output in medical devices and pharmaceutical drugs (and neither do many other countries). Canada free rides on America to do all this (and on Americans to pay for all this).
All that equipment for those surgeries you had? They were probably invented and/or produced in the US."
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