In depth Health Care Cost article


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Sovereign Court

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This is a really good, in-depth article on why medical costs are what they are.

Very informative. Just thought others might be interested.


Thank you, Dame Jess Door. I work in a related field - this has given me much to consider and maybe discuss in a group I run.


If I may, here's another article on health care that I found informative:

Obamacare architect leaves White House for pharmaceutical industry job

Sovereign Court

Health care is frustrating to talk about because it's a huge system with so many interconnected issues, and fraught with emotion. There's no easy answer. This article doesn't provide any silver bullet. But it's one of the better studies of what the major problems are that I've seen.

Another really good (if much older) look at some of the systemic health care system issues in the US is a podcast episode of This American Life.


Jess Door wrote:
This article doesn't provide any silver bullet. But it's one of the better studies of what the major problems are that I've seen.

Sorry, but, are you referring to the one you already posted or did you forget a link?

Sovereign Court

Referring the article above.


Thanks. I felt stupid asking, but I wasn't sure.

Sovereign Court

Bah, I'd rather you ask than wonder. :)

I have been fortunate to not need to know a lot about our health care system, but I have a college friend that's a medical doctor, my mother is a nurse that specializes in geriatric care, and a good friend is going through some medical issues right now, so this interests me, even though I haven't personally needed much in the way of medical care in my life.


This article made me cry.

Of course, it doesn't contain any of the pictures that the in-print version did, so you may not shed as many tears as I did.

Working Families Foot the Bill -- U.S. Health Care and the Elderly: Capitalist Cruelty

The Exchange

I read Foreign Affairs I think the need for a multi-trillion dollar increase in funds just to prop up pensions is going to be why you really should have voted in support of a million wind turbines...


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yellowdingo wrote:
I read Foreign Affairs

It's a pretty good magazine if you want to know what the American bourgeoisie and its invited guests are thinking.

The Exchange

Comrade Anklebiter wrote:
yellowdingo wrote:
I read Foreign Affairs
It's a pretty good magazine if you want to know what the American bourgeoisie and its invited guests are thinking.

Too bad they don't have a solution for fixing America...

The Exchange

America is beyond sustainability. The only solution I could come up with is Government owned energy Production.

The US Government will need to borrow twenty five trillion dollars and spend it on the construction of one million six megawatt wind turbines in the next ten years converting sea water to Hydrogen and Oxygen for local energy use and export for a profit of twenty five trillion dollars (after loan, interest, and maintenance) over twenty years. These will need to be build along the US gulf coast by 2025.

A replication of this (though using the existing profits will reduce the loan and interest required) will need to be pursued from 2030 - 2050 thus achieving an all up profit of fifty trillion dollars by 2050 from the export of cheap energy owned by the US state.

These are vital outcomes for the US economy because they will need to use twenty five trillion to rebuild the USA as of 2050 leaving a surplus of twenty five Trillion Dollars raising the poorest Americans out of poverty so they are no longer a financial burden on the rest.

Petition: Link

This needs a hundred thousand votes in 24 hours.

Its Do or Die time


Commies commenting on "Bitter Pill"


More from Time Magazine


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The reason medical bills are so high is due to the cost of college education.

It works like this:


  • Doctors graduate from medical school with around $200,000 to $300,000 in debt.
  • Doctors have to charge more for their services to help pay back their loans.
  • The hospitals need doctors so they pay it.
  • The medical equipment companies see large sums of money changing hands, so they charge hospitals more for the equipment.
  • Hospitals pass these costs on to the patients.
  • Patients can't pay such high costs, so they turn to insurance companies.
  • Insurance companies pay hospitals for the care and patients pay their insurance.
  • Hospitals, doctors, and medical equipment people charge the insurance companies more because they have more money.
  • Insurance companies respond by trying to pass more costs to patients and deny care as much as possible.
  • Providers respond by charging more.
  • Health care providers and insurance companies merge to leverage their size in a market power arms race.
  • The last 5 steps repeat in an endless recursion as the costs climb.
  • Meanwhile, patients get progressively worse care for progressively more cost.

There you go. Notice it all started with the cost of doctors attending college. That's where we need to start. Obamacare is a band-aid for the symptoms of a broken system at best.


darth_borehd wrote:

The reason medical bills are so high is due to the cost of college education.

It works like this:


  • Doctors graduate from medical school with around $200,000 to $300,000 in debt.
  • Doctors have to charge more for their services to help pay back their loans.
  • The hospitals need doctors so they pay it.
  • The medical equipment companies see large sums of money changing hands, so they charge hospitals more for the equipment.
  • Hospitals pass these costs on to the patients.
  • Patients can't pay such high costs, so they turn to insurance companies.
  • Insurance companies pay hospitals for the care and patients pay their insurance.
  • Hospitals, doctors, and medical equipment people charge the insurance companies more because they have more money.
  • Insurance companies respond by trying to pass more costs to patients and deny care as much as possible.
  • Providers respond by charging more.
  • Health care providers and insurance companies merge to leverage their size in a market power arms race.
  • The last 5 steps repeat in an endless recursion as the costs climb.
  • Meanwhile, patients get progressively worse care for progressively more cost.

There you go. Notice it all started with the cost of doctors attending college. That's where we need to start. Obamacare is a band-aid for the symptoms of a broken system at best.

Add to that: we haven't increased the number of medical doctors we train in about 30 years. Colleges aren't increasing enrollment and we haven't accredited any new colleges. This eliminates competition at multiple levels.

Doctors have to pay for massive ammounts of malpractice insurance because the legal system is messed up.


4 people marked this as a favorite.
Caineach wrote:
darth_borehd wrote:

The reason medical bills are so high is due to the cost of college education.

It works like this:


  • Doctors graduate from medical school with around $200,000 to $300,000 in debt.
  • Doctors have to charge more for their services to help pay back their loans.
  • The hospitals need doctors so they pay it.
  • The medical equipment companies see large sums of money changing hands, so they charge hospitals more for the equipment.
  • Hospitals pass these costs on to the patients.
  • Patients can't pay such high costs, so they turn to insurance companies.
  • Insurance companies pay hospitals for the care and patients pay their insurance.
  • Hospitals, doctors, and medical equipment people charge the insurance companies more because they have more money.
  • Insurance companies respond by trying to pass more costs to patients and deny care as much as possible.
  • Providers respond by charging more.
  • Health care providers and insurance companies merge to leverage their size in a market power arms race.
  • The last 5 steps repeat in an endless recursion as the costs climb.
  • Meanwhile, patients get progressively worse care for progressively more cost.

There you go. Notice it all started with the cost of doctors attending college. That's where we need to start. Obamacare is a band-aid for the symptoms of a broken system at best.

Add to that: we haven't increased the number of medical doctors we train in about 30 years. Colleges aren't increasing enrollment and we haven't accredited any new colleges. This eliminates competition at multiple levels.

Doctors have to pay for massive ammounts of malpractice insurance because the legal system is messed up.

Though states that strictly limit malpractice payouts haven't seen the predicted drops in medical costs.


thejeff wrote:
Caineach wrote:
darth_borehd wrote:

The reason medical bills are so high is due to the cost of college education.

It works like this:


  • Doctors graduate from medical school with around $200,000 to $300,000 in debt.
  • Doctors have to charge more for their services to help pay back their loans.
  • The hospitals need doctors so they pay it.
  • The medical equipment companies see large sums of money changing hands, so they charge hospitals more for the equipment.
  • Hospitals pass these costs on to the patients.
  • Patients can't pay such high costs, so they turn to insurance companies.
  • Insurance companies pay hospitals for the care and patients pay their insurance.
  • Hospitals, doctors, and medical equipment people charge the insurance companies more because they have more money.
  • Insurance companies respond by trying to pass more costs to patients and deny care as much as possible.
  • Providers respond by charging more.
  • Health care providers and insurance companies merge to leverage their size in a market power arms race.
  • The last 5 steps repeat in an endless recursion as the costs climb.
  • Meanwhile, patients get progressively worse care for progressively more cost.

There you go. Notice it all started with the cost of doctors attending college. That's where we need to start. Obamacare is a band-aid for the symptoms of a broken system at best.

Add to that: we haven't increased the number of medical doctors we train in about 30 years. Colleges aren't increasing enrollment and we haven't accredited any new colleges. This eliminates competition at multiple levels.

Doctors have to pay for massive ammounts of malpractice insurance because the legal system is messed up.

Though states that strictly limit malpractice payouts haven't seen the predicted drops in medical costs.

Of course not. Doctors aren't going to give up their salaries that are already based off of an inflated price just because one of the inflation mechanisms is eliminated. People are used to paying those prices, so they are going to keep charging them and pocketing the difference.


My hatred of Obamacare and it's tax on "Cadillac-plans" (i.e., plans that keep working class people can afford to use) continues unabated.

Race to the Bottom Health Care as Employers Seek to Avoid ObamaCare Tax on Decent Health Plans


Comrade Anklebiter wrote:

This article made me cry.

Of course, it doesn't contain any of the pictures that the in-print version did, so you may not shed as many tears as I did.

Working Families Foot the Bill -- U.S. Health Care and the Elderly: Capitalist Cruelty

Woops, this is linked to the home page not the article.

Fixed


I still hate Obamacare:

Affordable Care Act's Achilles Heel? Blaming Patients, Not Profiteering


Again, this is your were talking about- You would stillhate it even if it solves all problems.


Yeah, well, in the meantime:

7. A tale of the 31 million

More than 48 million people are currently uninsured. A new study in Health Affairs estimates that even after full ACA implementation up to 31 million of those will still be without coverage.

That starts with the 14 states and counting who have rejected the expansion of Medicaid, the single most important provision in the ACA for expanding healthcare access, (with the help of the Supreme Court ruling gutting the federal sanction for opting out). Others will lose their employer-sponsored coverage due to the ACA taxes on employers, the provision excluding dependent coverage for small businesses that enter the health exchanges, and all of those who will still find insurance far too costly to buy, especially in a recession that has never ended for millions of people.

Political posturing by those on the right opposed to any reform of our broken healthcare system and the bunker mentality of liberal allies of the Obama administration who for their own partisan reasons tend to gloss over serious flaws in the “legacy” law of the Obama years have obscured the reality that our healthcare crisis is far from over and in desperate need of more systemic overhaul.

Studies this year alone show the U.S. ranks last among 17 major industrial nations in life expectancy, but is ahead of the others in first-day infant mortality rates. That will not end with the ACA.

Nurses will continue to make the case for joining the community of nations with a genuinely universal national or single payer healthcare system based on individual patient need, not corporate profits.


When her eyes widen, she kinda scares me, but still I dig it.


Caineach wrote:
[Of course not. Doctors aren't going to give up their salaries that are already based off of an inflated price just because one of the inflation mechanisms is eliminated. People are used to paying those prices, so they are going to keep charging them and pocketing the difference.

In two sentences you've nailed why supply side economics and replacing income tax with sales tax won't work. Ever.

Liberty's Edge

1 person marked this as a favorite.

It is worth noting that tort reform hasn't saved patients money because doctors haven't adjusted their prices. Malpractice insurance premiums haven't magically fallen like the interests behind gutting your rights said they would.

Tort reform isn't about saving you money or anything. It's about preventing you from being able to recover a loss from a business that wronged you. Of course urns more and more moot since mandatory arbitration clauses scree you out of your right to access the courts for redress of wings in the first place.


3 people marked this as a favorite.
Krensky wrote:

It is worth noting that tort reform hasn't saved patients money because doctors haven't adjusted their prices. Malpractice insurance premiums haven't magically fallen like the interests behind gutting your rights said they would.

Tort reform isn't about saving you money or anything. It's about preventing you from being able to recover a loss from a business that wronged you. Of course urns more and more moot since mandatory arbitration clauses scree you out of your right to access the courts for redress of wings in the first place.

But the magic of the market should force them to adjust their prices.

The only solution is to remove all government subsidies and regulations. Then the Invisible Hand will make everything perfect.
</snark>


Tort reform? I'm talking workers revolution here, people!

Vive le Galt!

Liberty's Edge

I know, and it's so adorable. ;)


[Scribbles Citizen K(e)rensky's name on a list]


Hee hee!

Why are you laughing, Comrade Anklebiter? That's horrible!

It is horrible, Comrade Anklebiter, but it only affects UPS supervisory personnel (and maybe some non-union clerks--sorry, dudes)!

(Also thanks to Citizen Dragon, because I never would have seen an article on this--as opposed to seeing in person all the supes walk around with long faces--if he hadn't forced me to look at The Blaze.)

Btw, scuttlebut around work is that supes who smoke will have to pay something like $150/month extra for their insurance. Suckers!


The supes should form some sort of organization to collectively fight for their benefits.


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It's amusing how often that comes up.

Mostly, of course, because UPS only promotes from within. Every supe, manager, whatever, has risen through the ranks (yes, even the CEO--although his route wasn't the normal one) and, thus, most of them were originally members of the International Brotherhood of Teamsters who turned their back on their union brothers, crossed the class line, and started sucking corporate [redacted].

Call it a failure in empathy if you will, but I don't have much sympathy for them.

(I do feel bad for the clerks and "specialists," though.)


Having a union fosters an "us vs them" mentality. I know you don't care and would want to promote that mentality further, but some other people see it as a negative.


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Well, then I guess it's a good thing the supes aren't in a union.

[Shrugs]

UPS squeezes the supes for $60 million dollars, I laugh, and the union's "us vs. them" attitude is what you want to discuss?

Whatever.

"Between the working class and the employing class (and their supervisor lackeys) there is nothing in common."

Vive le Galt!


That wasn't intended as some sort of analysis of the entire story.

I do find the story very interesting.

ACA forces more companies to cover employees.
In lots of families, both spouses have jobs.
UPS will more easily be able to cut spousal benefits for employees, since those spouses will have access to coverage elsewhere.
UPS will save $60 million by doing this.
Therefore, the ACA is a bad thing, because it saves UPS $60 million a year.

Companies are always going to screw employees, but now certain news outlets and politicians are helping to provide some cover, so that the company doesn't look like the bad guy. Thanks Obama.


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You know, if I were of a paranoid bent, I'd almost think it was designed to profit the health-care industry by reigning in escalating costs on the backs of the working class and, in the process, totally discredit socialized medicine for generations to come.

Oh, wait a minute. It was. (Well, the first part anyway)


Agreed. I'm more hopeful than you are, I think it'll lead towards a single-payer system.

As much as some republicans hate Social Security or Medicare, proposing to repeal either without replacing them with something better isn't conducive to a long political career. I think taking health care coverage out of people's hands will encounter the same phenomenon.


Democrats Fail Labor Again: Labor Leaders, Obamacare, and the Fate of the Unions

I had to cynically laugh when my local union president did a volte-face on Obamacare yesterday at the monthly membership meeting.

F$~*ing stooge...

Grand Lodge

Pathfinder PF Special Edition, Starfinder Roleplaying Game Subscriber
Comrade Anklebiter wrote:

If I may, here's another article on health care that I found informative:

Obamacare architect leaves White House for pharmaceutical industry job

Classic example of the continuing revolving door between Washington and corporate.

Grand Lodge

3 people marked this as a favorite.
Pathfinder PF Special Edition, Starfinder Roleplaying Game Subscriber
Comrade Anklebiter wrote:

Democrats Fail Labor Again: Labor Leaders, Obamacare, and the Fate of the Unions

I had to cynically laugh when my local union president did a volte-face on Obamacare yesterday at the monthly membership meeting.

F!&&ing stooge...

Obamacare is the flawed compromise between a real progressive medical system and no change at all. There are working models for a truly progressive health care system. However the vested interests, and the Congressmen they paid for, were simply not going to implement anything nearly as progressive as single payer plan or a totally public-funded option. What we got, was what these vested interests were willing to let pass, which means that the profit channels at the bottom of the costs of health care were going to remain protected.

The question was plainly laid out, and the choice was put forward... Do you take this badly flawed solution over no solution at all? Anyone who thought that Obamacare was a stepping stone to socialised medicine had some severe blinders in place.


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LazarX wrote:
The question was plainly laid out, and the choice was put forward... Do you take this badly flawed solution over no solution at all? Anyone who thought that Obamacare was a stepping stone to socialised medicine had some severe blinders in place.

What, you mean it isn't a socialized takeover of the American economy? What are the Tea Party folks going to do? </snark>

Of course their reps are still threatening to torpedo the economy if it isn't killed.

I still think it may be a stepping stone to socialized medicine. A very small step in itself, but it does establish that the government has responsibility for healthcare. It will be interesting to see how it evolves.

Grand Lodge

Pathfinder PF Special Edition, Starfinder Roleplaying Game Subscriber
thejeff wrote:
LazarX wrote:
The question was plainly laid out, and the choice was put forward... Do you take this badly flawed solution over no solution at all? Anyone who thought that Obamacare was a stepping stone to socialised medicine had some severe blinders in place.

What, you mean it isn't a socialized takeover of the American economy? What are the Tea Party folks going to do? </snark>

Of course their reps are still threatening to torpedo the economy if it isn't killed.

I still think it may be a stepping stone to socialized medicine. A very small step in itself, but it does establish that the government has responsibility for healthcare. It will be interesting to see how it evolves.

Of course they're looking to kill it. But much of the reason is because they've attached it to "Obama", for whom their hate has no bounds in logic. They may very well might have cheered it on if it was called "Bushcare" or "Reagancare" instead. After all the original blueprint for this could be found in the Heritage Foundation, which is not exactly the most liberal or socialist group in the neighborhood, and Mitch Rommney pretty much set up a version of Obamacare in his state.

Grand Lodge

1 person marked this as a favorite.
Pathfinder PF Special Edition, Starfinder Roleplaying Game Subscriber
Irontruth wrote:
Having a union fosters an "us vs them" mentality. I know you don't care and would want to promote that mentality further, but some other people see it as a negative.

It's always been labor vs management since before the days of feudalism. Removing labor's ability to have representation and organise does not make that essential struggle go away. That's like saying that removing child labor laws won't lead to child labor.

It doesn't have to be that way. There are reasons why Henry Ford was inherently a better person, than either Rockerfeller or Carnegie, no matter how much more the latter two gave to charity.


LazarX wrote:
Of course they're looking to kill it. But much of the reason is because they've attached it to "Obama", for whom their hate has no bounds in logic. They may very well might have cheered it on if it was called "Bushcare" or "Reagancare" instead. After all the original blueprint for this could be found in the Heritage Foundation, which is not exactly the most liberal or socialist group in the neighborhood, and Mitch Rommney pretty much set up a version of Obamacare in his state.

Well it was originally proposed, if I understand the chain of events correctly in a successful attempt to block better healthcare proposals.

And they want to kill it partly because "Obama", but also partly because if it does get entrenched they know people will like it and it'll be much harder to get rid of. Look how much trouble it's been to kill Medicare or Social Security. Much easier to kill the new government program before people realize it actually helps them.

Plus, yet more evidence that big government can actually help. It took 40 years to even start pushing back on the New Deal. This isn't as big a deal, but it's still going to hurt Republicans.

If they really thought it would be a horrible failure, they'd let it go, having made their token efforts to stop it and then tie it to Obama and the Democrats for a generation.


thejeff wrote:
If they really thought it would be a horrible failure, they'd let it go, having made their token efforts to stop it and then tie it to Obama and the Democrats for a generation.

An astute observation with which I wholeheartedly agree.


thejeff wrote:
LazarX wrote:
Of course they're looking to kill it. But much of the reason is because they've attached it to "Obama", for whom their hate has no bounds in logic. They may very well might have cheered it on if it was called "Bushcare" or "Reagancare" instead. After all the original blueprint for this could be found in the Heritage Foundation, which is not exactly the most liberal or socialist group in the neighborhood, and Mitch Rommney pretty much set up a version of Obamacare in his state.

Well it was originally proposed, if I understand the chain of events correctly in a successful attempt to block better healthcare proposals.

And they want to kill it partly because "Obama", but also partly because if it does get entrenched they know people will like it and it'll be much harder to get rid of. Look how much trouble it's been to kill Medicare or Social Security. Much easier to kill the new government program before people realize it actually helps them.

Plus, yet more evidence that big government can actually help. It took 40 years to even start pushing back on the New Deal. This isn't as big a deal, but it's still going to hurt Republicans.

If they really thought it would be a horrible failure, they'd let it go, having made their token efforts to stop it and then tie it to Obama and the Democrats for a generation.

Except of course there is the slightest sliver of possibility that they are responding to the push from their constituency to oppose the plan and are worried if they are not seen as staunch opponents to such an unpopular and confusing plan they will be voted out of office for somebody more suitably representative?

You know, representative government and all that.

Grand Lodge

Pathfinder PF Special Edition, Starfinder Roleplaying Game Subscriber
Skeletal Steve wrote:
thejeff wrote:
LazarX wrote:
Of course they're looking to kill it. But much of the reason is because they've attached it to "Obama", for whom their hate has no bounds in logic. They may very well might have cheered it on if it was called "Bushcare" or "Reagancare" instead. After all the original blueprint for this could be found in the Heritage Foundation, which is not exactly the most liberal or socialist group in the neighborhood, and Mitch Rommney pretty much set up a version of Obamacare in his state.

Well it was originally proposed, if I understand the chain of events correctly in a successful attempt to block better healthcare proposals.

And they want to kill it partly because "Obama", but also partly because if it does get entrenched they know people will like it and it'll be much harder to get rid of. Look how much trouble it's been to kill Medicare or Social Security. Much easier to kill the new government program before people realize it actually helps them.

Plus, yet more evidence that big government can actually help. It took 40 years to even start pushing back on the New Deal. This isn't as big a deal, but it's still going to hurt Republicans.

If they really thought it would be a horrible failure, they'd let it go, having made their token efforts to stop it and then tie it to Obama and the Democrats for a generation.

Except of course there is the slightest sliver of possibility that they are responding to the push from their constituency to oppose the plan and are worried if they are not seen as staunch opponents to such an unpopular and confusing plan they will be voted out of office for somebody more suitably representative?

You know, representative government and all that.

Save that it doesn't always work that way. We've got cases of Congressmen going strongly anti-abortion, anti-gun control, and anti-gay marriage even though the majority of their polled constitutents indicate a preference otherwise.

The sad honest truth is that representation is generally determined less from voter desire than from those fundraising organisations with deep pockets. And that our Congressmen and Senators do spend virtually every day in office canvassing for re-election funds.


LazarX wrote:


Save that it doesn't always work that way. We've got cases of Congressmen going strongly anti-abortion, anti-gun control, and anti-gay marriage even though the majority of their polled constitutents indicate a preference otherwise.

Maybe. If they feel like personally they can get away with it. It's a calculated risk to vote on anything one way or another. If your bet is that Obamacare is going to blow up (Seemingly a good bet) then having a record that you can point back to of voting against it is a good thing. If your opponent in the next election can go AND HE VOTED FOR OBAMACARE with a black and white image of your face and bloody red lettering across the screen and Obamacare is seen to be a gigantic failure, then you are in deep, deep trouble.

Gun Control, Abortion, and others are issues that are divisive, and already known percentages. A Representative can make a judgement of the risk of going against majority will versus the dollars he might get in support from interested parties. Obamacare is a Win/Lose proposition. If you are a moderate/conservative Democrat or liberal/moderate Republican you might be in some serious trouble. It's holding a hand grenade and pulling the pin and then squeezing tight and hoping it does not go off in your hands.

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