All those in favor of socialized health care

[ballz2wallz]

Originally Posted by SpicyMcVoodoo

Help me understand this...why would the private industry (HMOs) set their prices off what the government says (Medicare)?

All insurance companies do. Medicare is the 'standard' not because they are forced to be, but because the government is setting an example. If the government continues to lower the percentages they are willing to pay, then why can't the insurance companies do it? And they do...thereby causing the doctors to continue to raise prices just to cover overhead...

If the government can do it, anybody can do it.

[WickedLou9]

Originally Posted by Ardentfrost

Yeah, but you can't require something, then say if they can't do it, it will be provided. Gov't loans for school can be turned down, and people either don't go or they go into debt. Your suggestion says people HAVE to buy something with their own money. Even if they have an oversight thing that fines people if it is determined they CAN in fact afford insurance, unless the fine is more than actual insurance, it's not economically viable for anyone to have insurance.

I'm just wondering how, with the plan outlined, that would be addressed.

For one a fine is a total loss. Even if the fine was less than the health insurance, at least if you buy insurance you are getting something in return. I don't think people should be allowed to opt out because doing so screws over everyone else. If someone opts out and gambles with thier health and then has a catastrophic illness, they go bankrupt and everyone else foots the bill, even though that one individual paid nothing.
Like I said, Massachusetts has instituted this plan already. There are alot of other details that I am sure I don't know, but they are requiring things like all employers over a certain size have to provide health insurance or face fines of some kind, all individuals are required to have insurance , I believe they give assistance to those who can't afford it. They are also phasing it in. At first there are no fines, then they start small and will eventually become larger.
Mass. Bill Requires Health Coverage - washingtonpost.com

www.kansascity.com | 06/30/2007 | Massachusetts now requires health insurance for all

Today the home of some of the nation’s most prestigious hospitals and medical schools becomes the first state in the nation to require its 6.5 million residents to have health insurance or face financial penalties.
Making insurance mandatory — and more affordable — is the centerpiece of a law to reduce the ranks of the state’s 400,000 uninsured and the number of people who seek costly “uncompensated” care in hospital emergency rooms.
Although today marks the beginning of the “individual mandate” — the legal obligation to obtain health insurance — the real deadline is Dec. 31. When Massachusetts residents file their state tax returns next spring, they must certify that they had acceptable coverage by the end of 2007 or lose a $219 personal exemption. The penalty grows steeper in subsequent years.
The state’s 175,000 employers have to pitch in, too. Businesses with 11 or more full-time employees that do not offer health insurance must pay an annual “fair share” assessment of $295 per employee. The government, for its part, is defining basic coverage and trying to make insurance more affordable. Under its new Commonwealth Care program, it is subsidizing coverage with no annual deductible on a sliding scale for people with incomes of up to 300 percent of the federal poverty level, or $61,950 for a family of four. About 130,000 low-income people are already enrolled either in Commonwealth Care or MassHealth, the state’s Medicaid program, state figures show. The poorest pay no premiums.
Those who do not qualify for subsidies and cannot get coverage through their jobs can buy low-cost but unsubsidized health plans through the Connector Authority under the Commonwealth Choice program. Costs are still too high for some. Already, state officials expect to exempt 60,000 residents from the new mandate because they cannot afford the insurance, but earn too much to qualify for subsidies. The state’s costs are a concern, as well. Some analysts wonder whether Massachusetts will be able to keep funding the $1.6 billion-a-year program if the economy slumps or costs jump over the next few years.

[SpicyMcVoodoo]

Originally Posted by ballz2wallz

All insurance companies do. Medicare is the 'standard' not because they are forced to be, but because the government is setting an example. If the government continues to lower the percentages they are willing to pay, then why can't the insurance companies do it? And they do...thereby causing the doctors to continue to raise prices just to cover overhead...

If the government can do it, anybody can do it.

I don't understand your argument about docs raising prices to cover their overhead. I thought HMOs set prices per procedures that they're willing to pay, not a flat percentage of whatever docs charge. That being the case, docs have no incentive to raise prices because the HMOs simply will not pay more than the prices they set for a given procedure. And since no one is paying for anything other than boob jobs with cash these days, there's no point in raising prices. Docs aren't going to get more money.

[ballz2wallz]

Originally Posted by SpicyMcVoodoo

I don't understand your argument about docs raising prices to cover their overhead. I thought HMOs set prices per procedures that they're willing to pay, not a flat percentage of whatever docs charge. That being the case, docs have no incentive to raise prices because the HMOs simply will not pay more than the prices they set for a given procedure. And since no one is paying for anything other than boob jobs with cash these days, there's no point in raising prices. Docs aren't going to get more money.

As with any business, doctors have bills to pay, overhead, staff, etc. They have to bring in a certain amount of money to cover those costs. That's not a big deal, and I'm sure everyone agrees on that.

Insurance companies decide how much they are willing to pay per procedure, you're right. Every year, or almost every year, Medicare (the government) continues to lower how much they are willing to pay by a certain percentage. Why do they do this? Read on...

In the 60s the government thought they would 'honor the elderly' of our society by providing them with healthcare, thus the beginning of Medicare/Medicaid. Nobody thought this such a big deal, given that the elderly didn't live much past the age of 65, as the 'senior citizen/retirement' age was set then. But now, as with social security, we have people living decades after, not merely years after, and it's 'breaking the bank' so to speak...our government can't afford it.

As a result, each year the government cuts back on what they will spend on their procedures. I know this because quite often, too often, my dad gets pissed when he gets the word that Medicare is cutting back on what they'll pay. He gets pissed because every other insurance companies follows suit...they all cut back on what they're willing to pay.

Now, when the insurance companies cut back on what they pay, the doctors get payed less. Insurance is the primary source of income for doctors, not out-of-pocket cash from the patients. Therefore, when insurance companies don't want to pay, the doctors lose money. As a result, in order to cover the cost of their overhead, they increase prices.

Let's look at a recent example of the free market at work in healthcare. Most of you will likely remember lasik surgery, a corrective surgery for eyesight. For some reason, there was no government regulation in this procedure, and capitalism was allowed to run free. When the procedure first started, it was quite expensive...roughtly $10,000 for one procedure. But as more doctors began to learn the procedure, the supply was higher, and the demand was lower, the prices dropped. Now, you can get them done for $400 dollars, though as with any free-market system, you want to consider the quality of the physician performing them...the whole 'quantity vs. quality' thing. You can get a decent lasik surgery done for just over $1000 now.

So I ask, why can't the rest of healthcare work in that way? The answer is, it can!

[SpicyMcVoodoo]

Originally Posted by ballz2wallz

Now, when the insurance companies cut back on what they pay, the doctors get payed less. Insurance is the primary source of income for doctors, not out-of-pocket cash from the patients. Therefore, when insurance companies don't want to pay, the doctors lose money. As a result, in order to cover the cost of their overhead, they increase prices.

This doesn't make sense. If the primary source of income for doctors is insurance, and insurance decides how much they get paid, what good does it do for doctors to increase prices when insurance companies will veto their price increase? There are no cash paying customers to raise prices on to make up for the less profitable insurance paying customers.

Originally Posted by ballz2wallz

Let's look at a recent example of the free market at work in healthcare. Most of you will likely remember lasik surgery, a corrective surgery for eyesight. For some reason, there was no government regulation in this procedure, and capitalism was allowed to run free. When the procedure first started, it was quite expensive...roughtly $10,000 for one procedure. But as more doctors began to learn the procedure, the supply was higher, and the demand was lower, the prices dropped. Now, you can get them done for $400 dollars, though as with any free-market system, you want to consider the quality of the physician performing them...the whole 'quantity vs. quality' thing. You can get a decent lasik surgery done for just over $1000 now.

So I ask, why can't the rest of healthcare work in that way? The answer is, it can!

The reason lasik has gone down is price is because of the machines that do the procedure. It's primarily a machine procedure, and the machines are expensive as shit. Naturally, before the machines could proliferate, those who had the machines could charge a premium.

Doing heart surgery is not comparable. There are no machines that can proliferate to bring down the price. The only thing you could do is proliferate heart surgeons, which isn't going to happen unless you do away with the requirement of accredited medical schools and licensing exams.

[ballz2wallz]

Originally Posted by SpicyMcVoodoo

This doesn't make sense. If the primary source of income for doctors is insurance, and insurance decides how much they get paid, what good does it do for doctors to increase prices when insurance companies will veto their price increase? There are no cash paying customers to raise prices on to make up for the less profitable insurance paying customers.

dude, that's how it works. And I believe you're wrong in thinking they pay a set amount. They pay a percentage mostly, like 60% or something. For example, you have a minimum amount you have to pay for the year, like $500 or something for the deductable, then after that the rest is covered by insurance.

The reason lasik has gone down is price is because of the machines that do the procedure. It's primarily a machine procedure, and the machines are expensive as shit. Naturally, before the machines could proliferate, those who had the machines could charge a premium.

Doing heart surgery is not comparable. There are no machines that can proliferate to bring down the price. The only thing you could do is proliferate heart surgeons, which isn't going to happen unless you do away with the requirement of accredited medical schools and licensing exams.

You're arguing about this when this is information from the horse's mouth. If this is something you disagree with, take it up with the docs, but this is STRAIGHT from the docs themselves.

[Rouger2]

Originally Posted by SpicyMcVoodoo

I doubt it. I have a family member who's a surgeon, and he constantly bitches saying stuff like, "I just did XYZ procedure today, and guess how much the HMO paid me...$300!" Doctors are constantly complaining that they're getting shafted by HMOs, in terms of price and how they have to argue to get paid, and there's nothing they can do about it because if docs only accepted cash payments they'd go out of business. IMO, the culprit here are the HMOs, who have every financial incentive to pay for as little care as possible at prices as low as possible.

Does that lower the price of health care? No the only thing that happens is the savings for the HMO become profits. People think HMO being tough on what doctors charge will make health care less what a laugh.