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How messed up is our healthcare system?

Discussion in 'GatorNana's Too Hot for Swamp Gas' started by oragator1, Feb 17, 2020.

  1. mdgator05

    mdgator05 Premium Member

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    First, we do have government in mass transportation, because mass transit is a market that generally doesn't lend itself to free markets with competition well (multiple competing subway lines would be difficult to construct, for example). Second, the reason why we don't have or need government to provide clothing, food, or housing is that we have effective mechanisms by which to control the costs of those products. While each are needs, they naturally have competition. If I don't like the cost of clothing, I can go find a different company to provide me clothing. It is a market with high rates of natural competition and limited ability for a single company to decide whether or not I receive clothing. I also have acceptable outside options to the purchase of new clothing (e.g., keeping my current clothes or buying used clothes).

    In health care situations, the procedures and medications driving up costs are often those with limited outside options other than death. I can't buy a used heart surgery. I can't shop for other chemo drugs other than the ones only made by one firm that are just as effective at its primary functional value. The high fixed costs of operating a hospital mean that hospital systems, in local areas, are naturally going to consolidate. The same for many pharmaceutical products, where they are enforced monopolies for a given period of time and, under certain conditions, remain so due to the lack of a large market, even when they can charge millions to affected patients.

    Unless people become willing to die for financial reasons, or are willing to let their negotiating proxy credibly threaten that, they don't have the ability to lower the price on these sorts of procedures. The problem is that most people aren't okay with that and don't even view their insurance company as a negotiating proxy but rather an adversary that is trying to deny treatment.
     
  2. gatorpa

    gatorpa GC Hall of Fame

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    How much of those expenditures are elective?.... ex cosmetic procedures?

    I'd bet we lead the world in per capital cosmetic procedures by a long shot.
     
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  3. gatorpa

    gatorpa GC Hall of Fame

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    Trouble is what are the "basics", what's "extra"?? Ex.. 40 yr old needs a hip replacement due to an injury in their youth. Does he get it or do they just say nope here's pain pills move along?
     
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  4. mutz87

    mutz87 #nowaytospinit VIP Member

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    The more I think about it the more I feel the need to be more blunt. This isn't meant as an insult or knock your career, but to encourage a bit of self assessment after having railed about socialism and communism many times now. As a public employee, your career earnings, your health care, your retirement and your (presumably) UF public school education, were all funded or largely subsidized by taxpayers. This isn't per se true socialism, but it is in the context of how we understand public vs private funding.

    To say or suggest as you have multiple times now that universal health care means a country is socialist or communist and people should go live elsewhere if they want socialism is to be completely unaware of how *socialism* has benefited your life. Not to mention, but every advanced democracy in the world has some sort of universal or single-payer health care system and you know what, they are still democracies, not socialist or communist countries. And you know why? Because it's foolish to equate providing a much needed service that most people could not afford on their own with that of communist China or some other like country. And it's foolish to think that trying to help people avoid losing their homes or livelihood due to illness is somehow big bad communist bogeyman as opposed to being a rational, humane basis for providing for the greater good.
     
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  5. wgbgator

    wgbgator Tiny "Boop Squig" Shorterly Premium Member

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    I agree with this, but it somewhat misses the subtext of his point. If you read closely his beef appears to be with everyone getting the same stuff, even people with government funded retirement or that went to public school still might believe that not everyone deserves the "stuff" they get themselves by virtue of their privilege, status, station or wealth, simply because they think other people are unworthy of it. Equality is their enemy.
     
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  6. mdgator05

    mdgator05 Premium Member

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    Not even close in terms of the number of procedures. But elective procedures typically go through alternative payment systems, as they should. What drives health insurance costs is largely the life saving or substantial productivity increasing procedures.
     
  7. AzCatFan

    AzCatFan GC Hall of Fame

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    That gets down to the brass tacks of any plan. What's necessary, what's desirable, and what is purely elective. Some on either side is obvious. Surgery to save one's life is absolutely necessary. A nose job for purely cosmetic reasons is purely elective. But there's plenty of grey area in the middle.

    To answer the question about hip surgery, one should do a cost/benefit analysis. What would the cost of the hip surgery be versus the cost of lifetime of pain pills? Are there expected side effects of the pain pills that might drive up costs in the future, i.e. kidney issues that could have been avoided? Quality of life questions both today and in the future? Answer those questions, and you should hopefully be able to find an answer to the question regarding surgery or pills. Someone in his 40's, it's likely surgery would be best. Someone in their 80's, surgery is likely not the best option.
     
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  8. gatorpa

    gatorpa GC Hall of Fame

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    Chart isn't clear, it is titled "Health expenditures" with Private being a huge par of the US bar. (It doesn't say health ins costs)

    I can list many things that could be considered a health expenditure.

    For the sake of discussion it would be good to know the details no?
     
  9. gatorpa

    gatorpa GC Hall of Fame

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    A logical reasonable plan... not common for Gov red tape to get right... or Ins companies at times either...;)
     
  10. WarDamnGator

    WarDamnGator GC Hall of Fame

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    I disagree. We already have the most expensive health care system in the world per capita. With a true single payer system, taxes may go up, but everyone's healthcare costs would go to $0, and on average people would be better off financially, without the worry of going bankrupt if they get sick. I mean, if I had to pay an even extra $10,000-$20,000 in taxes, but not be on the hook for the $46,000/yr in premiums and deductibles I mentioned above, there is no doubt that I'd be better off ... It would only add to the debt if we let it, but it would be more than paid for with the money people save on out of pocket expenses, premiums, deductibles, and what corporations are saving by getting out of employee healthcare business.

    But I'd advocate for not going straight to a single payer system. The plan I support is a hybrid plan where, for example, individual may have to pay their first $5,000 out of pocket, and families pay their first $15,000 out of pocket, every year, before the "single payer lite" kicks in... people could buy low cost plans to cover their out of pocket expenses or just self insure. It would limit abuses like going to ER for a sniffle if people had to pay for it themselves to a point ...
     
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  11. gatorknights

    gatorknights GC Hall of Fame

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    I ran into one of my best wrestling friends who was facing double knee replacements in his early 40's. He was a 4 time all american, and told me that the knee replacements at the time had a shelf life, so he would be having to have a re-do in his early 60's. Well, he's there now. Would that be considered "elective" because he chose to continue wrestling while his knees were being torn apart competing at that elite level? I know I ejected because I didn't want to find myself in the same situation. Plus, it didn't hurt that UF came into the picture.

    I'd be curious to find out from a professional like you how that plays out, and the advances in technology after the last f-f-f-f- 40 years? :(:D. What are you finding these days? :)
     
  12. VAg8r1

    VAg8r1 GC Hall of Fame

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    In Canada he gets it with no out of pocket cost. Unfortunately, he has to put up with a waiting time of up to one year. In the US he gets it with little or no waiting time and a huge bill if he doesn't have good health insurance.
     
  13. altalias

    altalias GC Hall of Fame

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    You seem to be confused. MAGA was Trump's slogan in 2016. In 2009 Obama was POTUS. His people decided who did or didn't get prosecuted.

    The monkeys at corporate scored huge, and the rest of us got financially sodomized. CHANGE WE CAN BELIEVE IN!

    I fixed it for you.

    Seriously? trying to blame Trump for what happened in '09?
     
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  14. altalias

    altalias GC Hall of Fame

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    I don't think that is true. I heard him several times say that he didn't care what they passed because he is rich enough to go any where in the world to get the best treatment. It is the every day person who would suffer. (In is opinion)
     
  15. gtr2x

    gtr2x GC Hall of Fame

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    It may be little or no waiting time if u have an existing doc relationship. However, for a new patient it could easily be a month or probably more to get the initial appt for a specialist.
     
  16. ursidman

    ursidman GC Hall of Fame

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    Since we are looking at the proportion of public vs private expenditures - however we define them as long as all those things remain constant across the expenditures of every country the comparisons are valid.
     
  17. VAg8r1

    VAg8r1 GC Hall of Fame

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    Apparently, he may or may not have intended his comments to be taken seriously. He did say that he would leave the country.
    Rush Limbaugh: I'll Leave Country Over Health Bill
     
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  18. gatorknights

    gatorknights GC Hall of Fame

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    Where did I blame Trump for 09?

    Seriously? Supporting criminal level financial sodomization? Preying on people who don't know any better and shouldn't have had to?

    You what, now that I think about it, you're right. Who can't get behind crushing jobs, ruining lives, breaking up families, crushing markets while evaporating retirement funds. Now that's change we can believe in. MAGA baby!
     
  19. ursidman

    ursidman GC Hall of Fame

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    McConnell is the leading senatorial recipient of campaign donations for 2020 from Big Pharma.

    Pharmaceutical Manufacturing: Top Recipients | OpenSecrets
    Rank Candidate Amount
    1 McConnell, Mitch (R-KY) $165,186
    2 Tillis, Thom (R-NC) $140,100
    3 Cornyn, John (R-TX) $104,140
    4 Gardner, Cory (R-CO) $99,303
    5 Coons, Chris (D-DE) $97,575
    6 Sanders, Bernie (D) $88,022
    7 Warren, Elizabeth (D) $78,599
    8 Daines, Steven (R-MT) $61,500
    9 Harris, Kamala (D-CA) $54,396
    10 Warner, Mark (D-VA) $41,207

    No wonder there seems to be so much conflict with a bi-partisan bill to lower drug prices that it looks like it won't get voted on this year. It's how things don't get done.

    McConnell, Grassley at odds over Trump-backed drug bill
    Senate Majority Leader Mitch McConnell (R-Ky.) on Tuesday said Senate Republicans have “internal divisions” on a bill to lower drug prices and that he does not know yet whether the measure will get a vote.

    McConnell warns Pelosi's drug-pricing plan is DOA
    Senate Republicans are warning Speaker Nancy Pelosi that her much-anticipated drug pricing plan is dead and will not be considered in the Senate.

    In an interview, Senate Majority Leader Mitch McConnell (R-Ky.) ruled out any action on the bill, which would call for Medicare to negotiate drug prices for a minimum of 25 medicines and target drugs that cost the American health system the most. Pelosi rolled out the plan on Thursday to intense opposition from the drug industry, and McConnell.
     
  20. nolancarey

    nolancarey GC Hall of Fame

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    That's what insurance already is. You pay in, theoretically for yourself, but it pools for the other people too.
     
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