Patting the wrists, rolling the eyes.

[ltl/fb]

Originally posted by Hank Chinaski
If the health-care industry had gone through what the computer industry has experienced, today you might have health-care-at-home, prescriptions that cost a dollar or two, and surgery for only $100 – making health insurance unnecessary except for catastrophic events.

Does that seem far-fetched? It shouldn’t. That’s what health care was like before the federal government started to intervene in the 1960s.

Where'd you c&p this from?

[Hank Chinaski]

Originally posted by ltl/fb
Where'd you c&p this from?

the cut & pastes I've been posting the last few days are lifted directly from Ty's blog. i thought everyone knew that.



Please link, too. It helps me on Technorati.

Oops -- I meant to quote, not edit -- Sorry! -- t.s.

[Replaced_Texan]

Originally posted by Mmmm, Burger (C.J.)
All fair points. How does government solve it?

1) Gov't plan. Well, it makes shopping around unnecessary, at least.

2) Gov't control of plans. Okay, so the gov't says what should be covered. A bit better, but then you see what we do in states--whoever has the most powerful lobby gets their disease covered. And it's still one-size fits all.

3) Information forcing. Well, what's government's role then? To rate plans? Maybe that works, but you still end up with some of hte problems of 2 (e.g., some lobby insists that a "high" plan has to have coverage for a particular disease). Nonetheless, this is the least objectionable.

All in all, though, while government can solve part of the problem, I'm not sure any broad solution doesn't create more problems than it solves.

You keep on talking about plans. The problem with healthcare is that it's not exactly an exact science and the demand curve is artificial. A patient isn't able to weigh the costs and benefits in order to determine a fair price because he relies on his physician to tell him what he needs. The physician also happens to be the seller of the service. Physicians also happent o be in a very closed supply market (the result of licensing and the years of training), physicians have access to treatment that is otherwise inaccessible (drugs and surgery), and that physicians are trusted to provide treatment that is appropriate for the patient. Stark and anti-kickback (government regulations), under these circumstnaces, are not unreasonable methods to realign incentives.

Then healthcare is removed further from the actual consumers and sellers, by having employers purchasing and insurance companies selling a contracted bundles of healthcare services.

[Tyrone Slothrop]

Originally posted by Mmmm, Burger (C.J.)
All in all, though, while government can solve part of the problem, I'm not sure any broad solution doesn't create more problems than it solves.

I'm not sure either, which is why I like to give RT my proxy.

[Tyrone Slothrop]

Originally posted by Hank Chinaski
Because health care is considered too important to leave to the unregulated free market, it is rigorously supervised by politicians. They have brought us Medicare, Medicaid, billions of government research dollars and new legislation every year to regulate health-insurance companies and HMOs. Federal regulation runs to hundreds of thousands of pages.

Has this reduced the price of health care?

No. Every year it becomes more expensive, less user-friendly, more inaccessible – causing well-meaning politicians (and those of the other kind) to impose even more regulations.

If the health-care industry had gone through what the computer industry has experienced, today you might have health-care-at-home, prescriptions that cost a dollar or two, and surgery for only $100 – making health insurance unnecessary except for catastrophic events.

Does that seem far-fetched? It shouldn’t. That’s what health care was like before the federal government started to intervene in the 1960s.

Health care continues to get more expensive -- in part -- because we keep inventing new ways to treat medical problems. If we were paying more now for the same treatments we had in the 1960s, that would be a problem. We aren't.

[Replaced_Texan]

Originally posted by Tyrone Slothrop
Health care continues to get more expensive -- in part -- because we keep inventing new ways to treat medical problems. If we were paying more now for the same treatments we had in the 1960s, that would be a problem. We aren't.

The other thing is there are many ways to approach any given healthcare problem, and no way is the "best" way. Some are more cost effective in the short run, whereas some are more cost effective in the long run. Some aren't cost effective at all and may offer no benefit at all, but we don't know until after a shitload of money has been spent. Insurance companies have no interest in the long run. Patients aren't really thinking about the long run for most healthcare issues.

For example, for a heart issue, one physician may prescribe asprin and blood pressure monitoring and exercise. Another may put the patient on beta blockers and put the patient through a variety of high tech, non-invasive tests. Another (especially one that's getting compensated for it in some way) may go for the cardiac catherization. A fourth could go for bypass surgery. Each could probably argue very well as to the rationale for his or her choice in treatment, and though the utilization review process does have an impact on those decisions, interference by the third-party payor in making those decisions is generally not permitted (though most payors will not pay for services without proper documentation of dignosis). The patient (generally) relies on the physician to make the best choice for him.

[Replaced_Texan]

Originally posted by Hank Chinaski
Because health care is considered too important to leave to the unregulated free market, it is rigorously supervised by politicians. They have brought us Medicare, Medicaid, billions of government research dollars and new legislation every year to regulate health-insurance companies and HMOs. Federal regulation runs to hundreds of thousands of pages.

Shhhh! Goddamnit, some of us rely on those hundreds of thousands of pages for our livelihood.

[Tyrone Slothrop]

Originally posted by Hank Chinaski
Federal regulation runs to hundreds of thousands of pages.

You're advocating smaller fonts?

[Spanky]

Originally posted by Tyrone Slothrop
Can (A) and (B) be the same thing? A birth certificate works for (A), but then that's my (B), too. A Social Security card gets you (C), and I suspect I have one of those somewhere. (D) could be easy, depending on what kind of documentation they have in mind.

When would this take effect? If I'm going to move to another state, maybe I need to do it soon.

I don't get all the sarcasm surrounding the introduction of this bill. You may scoff at this bill, but do you think nothing should be done. Do either of you really think it is not too easy to get a drivers license right now? What is wrong with making it difficult to get a drivers license? I think if you were hit by an illegal alien without car insurance you might have a different opinion.

[Mmmm, Burger (C.J.)]

Originally posted by Spanky
What is wrong with making it difficult to get a drivers license? I think if you were hit by an illegal alien without car insurance you might have a different opinion.

Sure, but all the bill means is that now I'll be hit by an illegal alien without car insurance and a driver's license.


That said, I don't think that's entirely true. From the limited press coverage I've seen, I understand states can provide an unofficial license, marked as such, that allows illegals to drive but does no purport to provide a confirmed identification. In other words, people know it's worth teh paper it's printed on and nothing more, from the face of hte license.

But personally, I'd rather just create national identity cards for these purposes, and be done with it. Why bootstrap off of an entirely different process to achieve this goal?

[Replaced_Texan]

Originally posted by Mmmm, Burger (C.J.)
Sure, but all the bill means is that now I'll be hit by an illegal alien without car insurance and a driver's license.


That said, I don't think that's entirely true. From the limited press coverage I've seen, I understand states can provide an unofficial license, marked as such, that allows illegals to drive but does no purport to provide a confirmed identification. In other words, people know it's worth teh paper it's printed on and nothing more, from the face of hte license.

But personally, I'd rather just create national identity cards for these purposes, and be done with it. Why bootstrap off of an entirely different process to achieve this goal?

Plus, it's going to be expensive as hell and time consuming for the individual DMV offices to verify everything. I didn't see the federal government stepping up to the plate to provide funding in the bill.

[taxwonk]

Originally posted by Mmmm, Burger (C.J.)
Do you actually read what I say before responding? You constantly conflate questions and solutions in response to my challenges. To wit, you say insurance is necessary to prevent families from bankrupting themselves. Well, maybe. Maybe catastrophic insurance is necessary. And maybe people have access to it, or should be given it. But that doesn't call for a single-payer system. And none of that has anything to do with employer-supplied insurance. If I have an automatic reaction, it's to say "give me something more than a knee-jerk 'government solves all the problems and gives my daughters pink ponies, too'"

There are several layers of problems here, which you simplify to one: all people should have health insurance. Well, great, but you haven't made any effort to analyze whether they should have it by paying for it themselves, by getting it through their employers, by getting it through the government. Your simplistic response is "there's market failure, so of course the government should do it." Well, no. There's not market failure, there's a wealth-distribution problem (in your mind) that you think shouldn't impact whether people have accees to health insurance. Fine, we can disagree on that last point, but rather than throwing out barbs, why not make a little effort to analyze problems beyond calling everything market failure.

I nver called for a single-payor solution. I suggested that two first steps would be to (1) regulate health care delivery costs such that the costs imposed for a given item are reflective of the value (i.e., no more $12 plastic urinals or $5 aspirin) and (2) ensure that access to costly procedures and medications is not allocated purely on tha basis of ability to pay (e.g., sorry, you can't pay for a bypass, that means you die).

The first step would actually restore some measure of market-based economics to the system. People of modest means would be able to afford to pay for basic health care needs, thus allowing the existence of a catastrophic insurance market to meet many consumers' needs. I specifically declined to suggest who should supply that catastrophic insurance, because until the pricing is rationalized more, I really can't say that the market will or will not be able to meet the need.

Apparently reading comprehension is contagious, and at times epidemic on this board.

[taxwonk]

Originally posted by Spanky
I don't get all the sarcasm surrounding the introduction of this bill. You may scoff at this bill, but do you think nothing should be done. Do either of you really think it is not too easy to get a drivers license right now? What is wrong with making it difficult to get a drivers license? I think if you were hit by an illegal alien without car insurance you might have a different opinion.

The Wonk Princess just got her license in November. Having been through the process with her, I have to say that no, I don't think it's too easy to get a driver's license. She needed multiple forms of id, proof of insurance, and me to vouch for her, since she didn't have a utility bill or mortgage bill in her own name to establish proof of residence.

So, I guess you could put me in the group of people who feel nothing needs to be done. This is just more bureaucratic idiocy designed to mask the fact that there isn't really a whole lot the government can do to prevent illegals from coming into the country or to prevent people who come in on student or tourist visas from overstaying their welcome. If anything, allowing illegals to get driver's licenses would make it easier to track them, since they would need to show proof of a current address.

[Mmmm, Burger (C.J.)]

Originally posted by Replaced_Texan
Plus, it's going to be expensive as hell and time consuming for the individual DMV offices to verify everything.

I honestly don't see much in the way of verification costs. The cost is twofold: 1) pissing citizens off because they need a bunch of docs (although I think Wonk is already pissed off, so how much worse can it get*); 2) the added cost of having tellers say "sorry, you also need X, please come back tomorrow."

Do the DMVs actually have to authenticate the documents?

*it would be far too outable to tell my DC DMV story. Suffice it to say, they required documents that could obtained only with a drivers license in order to get a drivers license.

[Spanky]

Originally posted by Mmmm, Burger (C.J.)
Sure, but all the bill means is that now I'll be hit by an illegal alien without car insurance and a driver's license.


That said, I don't think that's entirely true. From the limited press coverage I've seen, I understand states can provide an unofficial license, marked as such, that allows illegals to drive but does no purport to provide a confirmed identification. In other words, people know it's worth teh paper it's printed on and nothing more, from the face of hte license.

But personally, I'd rather just create national identity cards for these purposes, and be done with it. Why bootstrap off of an entirely different process to achieve this goal?

A national Identity card would solve all sorts of problems. Voting, Social Security and Medicare Fraud, etc. We have needed one for years. Unfortunately, a national identity card is a political nonstarter. The American public sees such a card as the first step towards a police state.