ObamaCare - "Give up your phone to get it!!!"

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Re: ObamaCare: States Defiant!

Postby GreecePwns on Sat Nov 17, 2012 9:10 am

thegreekdog wrote:The history of health insurance is a fascinating one. Health insurance was not invented until the late 19th century and did not evolve into what we know today until the latter part of the 20th century. In any event, health insurance is a concept that begets rising costs. If a company will pay for my medical care, why would my doctor not charge as much as he/she could possibly get paid? And if the government is backing the health insurance, would not costs skyrocket?

That's the theory, but the exact opposite is happening, TGD.

Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.

And your response is going to be "so what, more people are insured." And my response to you is "who cares if people are getting shitty care and it's costing more and more money."

As for the US healthcare industry being "more" free market than other countries' systems and performing worse, my only response is that being less free market than France or the Netherlands does not make it free market. It's like saying Greece is less financially stable than Portugal. Health insurance is highly regulated, true. But that's not where I'm going with this. Where I'm going with this is that there is no incentive for health insurance companies to lower costs because there is no competition. There is no incentive for healthcare providers to lower costs or provide better care because the system, regulated in this fashion by the governments of the vairous states, rewards them for increasing costs. The Affordable Care Act just pours another layer of cement on the problem, making sure that it will be that much harder to provide affordable care to everyone.

One final note - Most people regularly and happily pooh-pooh the concept that anyone can get free medical care. I don't understand the pooh-poohs. From the age of 18 to the age of 25, I did not have health insurance. I regularly received what medical care I desired and for the most part was not charged anything for it. I know there are people that cannot afford health insurance or healthcare, just like I coudn't afford it when I was younger. And I know there are people with preexisting conditions who cannot get health insurance. I have no problem with the government trying to help those people (I would prefer other people help those people without government intervention, which, by the way, already happens at non-profit hospitals). I read the Affordable Care Act and various summaries on the law, and I cannot understand how anyone who can think for themselves thinks this is anything more than a boondoggle for the health insurance industry and something that will, in the long run, greatly hurt healthcare and the fiscal status of the US government to a staggering degree.
And I'm not defending the Affordable Care Act at all, as you may have seen in my previous posts on the subject. Thinking I am has influenced your admittedly well-written post, and I should have been more clear about that. :(

EDIT: I'll try to salvage it, however, because you put a lot of time into it.

First off, not every country pays its doctors based on # of treatments, nor must it be that way.

http://content.healthaffairs.org/content/22/3/89.full.html
Exhibit 5 of this study counters some of your concerns about state-run healthcare. As I've pointed out above, healthcare spending per capita is much higher here than in other countries. You'd think that we'd be getting at least proportionately more treatments, more examinations and more everything than other countries do as a result, but the fact is utilization rates are similar across the board. The current system is inefficient and I'll display below why a free-market system is also inefficient.

It's often said that the healthcare industry needs more competition, and that removing all restrictions is the way to more competition, which inherently means lower costs apparently (hint: it doesn't).

In fact, however, we can't even assume perfect competition in the healthcare industry (or probably any industry, for that matter). Because companies are not allowed to compete across state lines, market shares for the top health insurance companies are significantly lower than those of other industries (some of the biggest companies like Aetna, UnitedHealth, Humana etc. have around 10 percent market share). But within individual states, we often see one or two companies controlling a 60%+ market share (still relatively low compared to other highly concentrated industries).

With these borders removed, it's quite obvious that these top companies would take larger shares putting the health insurance industry in the state of permanent oligopoly. And oligopoly has proven to be a pretty bad form of competition for consumers (see: cell phone service providers, the media [and not just news, but music, books, nearly everything is in the hands of 7 companies], one can also include the film industry here)
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Re: ObamaCare: States Defiant!

Postby jj3044 on Sat Nov 17, 2012 10:30 am

thegreekdog wrote:Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.


jj3044 wrote:The law does much more than create more "freeloaders". It also tries to change the healthcare delivery system, which today is VERY ineffective. Here's how:

-Make preventive well-visits free (fully insurance paid) annually, allowing for much earlier identification of diseases and conditions such as hypertension, diabetes, and yes, cancer, which in early stages typically do not have many symptoms. By the time symptoms are noticed, usually damage has already been done. By identifying and treating these conditions earlier, the condition costs much less, and will over all reduce the burden of treatment in the system today.

-Encourage a performance-based fee structure from insurers to providers. I currently live in Rhode Island, and "Patient centered medical homes" are the new buzz word... meaning that most of the resources needed to treat a patient are located within the practice (dietician, physical therapist, nurse case manager) to facilitate better care. When the patient meets better-than-average outcome measures, the practice gets paid more. Also, electronic health records are being installed so that if a patient goes to a different doctor, they can pull up the patient's information, see that they had a CT scan last month that was negative, and NOT order an unnecessary, duplicate test.

-Encourage employers/insurers to utilize value-based benefit designs. Basically these designs encourage proper use of the healthcare system by rewarding plan participants for being proactive in their health such as having an annual physical, taking a health risk assessment, or speaking to a health coach.
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Re: ObamaCare: States Defiant!

Postby DoomYoshi on Sat Nov 17, 2012 7:10 pm

This thread has some impressive girth. I can't believe I never posted here yet.
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Re: ObamaCare: States Defiant!

Postby thegreekdog on Sat Nov 17, 2012 8:07 pm

GreecePwns wrote:
thegreekdog wrote:The history of health insurance is a fascinating one. Health insurance was not invented until the late 19th century and did not evolve into what we know today until the latter part of the 20th century. In any event, health insurance is a concept that begets rising costs. If a company will pay for my medical care, why would my doctor not charge as much as he/she could possibly get paid? And if the government is backing the health insurance, would not costs skyrocket?

That's the theory, but the exact opposite is happening, TGD.

Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.

And your response is going to be "so what, more people are insured." And my response to you is "who cares if people are getting shitty care and it's costing more and more money."

As for the US healthcare industry being "more" free market than other countries' systems and performing worse, my only response is that being less free market than France or the Netherlands does not make it free market. It's like saying Greece is less financially stable than Portugal. Health insurance is highly regulated, true. But that's not where I'm going with this. Where I'm going with this is that there is no incentive for health insurance companies to lower costs because there is no competition. There is no incentive for healthcare providers to lower costs or provide better care because the system, regulated in this fashion by the governments of the vairous states, rewards them for increasing costs. The Affordable Care Act just pours another layer of cement on the problem, making sure that it will be that much harder to provide affordable care to everyone.

One final note - Most people regularly and happily pooh-pooh the concept that anyone can get free medical care. I don't understand the pooh-poohs. From the age of 18 to the age of 25, I did not have health insurance. I regularly received what medical care I desired and for the most part was not charged anything for it. I know there are people that cannot afford health insurance or healthcare, just like I coudn't afford it when I was younger. And I know there are people with preexisting conditions who cannot get health insurance. I have no problem with the government trying to help those people (I would prefer other people help those people without government intervention, which, by the way, already happens at non-profit hospitals). I read the Affordable Care Act and various summaries on the law, and I cannot understand how anyone who can think for themselves thinks this is anything more than a boondoggle for the health insurance industry and something that will, in the long run, greatly hurt healthcare and the fiscal status of the US government to a staggering degree.
And I'm not defending the Affordable Care Act at all, as you may have seen in my previous posts on the subject. Thinking I am has influenced your admittedly well-written post, and I should have been more clear about that. :(

EDIT: I'll try to salvage it, however, because you put a lot of time into it.

First off, not every country pays its doctors based on # of treatments, nor must it be that way.

http://content.healthaffairs.org/content/22/3/89.full.html
Exhibit 5 of this study counters some of your concerns about state-run healthcare. As I've pointed out above, healthcare spending per capita is much higher here than in other countries. You'd think that we'd be getting at least proportionately more treatments, more examinations and more everything than other countries do as a result, but the fact is utilization rates are similar across the board. The current system is inefficient and I'll display below why a free-market system is also inefficient.

It's often said that the healthcare industry needs more competition, and that removing all restrictions is the way to more competition, which inherently means lower costs apparently (hint: it doesn't).

In fact, however, we can't even assume perfect competition in the healthcare industry (or probably any industry, for that matter). Because companies are not allowed to compete across state lines, market shares for the top health insurance companies are significantly lower than those of other industries (some of the biggest companies like Aetna, UnitedHealth, Humana etc. have around 10 percent market share). But within individual states, we often see one or two companies controlling a 60%+ market share (still relatively low compared to other highly concentrated industries).

With these borders removed, it's quite obvious that these top companies would take larger shares putting the health insurance industry in the state of permanent oligopoly. And oligopoly has proven to be a pretty bad form of competition for consumers (see: cell phone service providers, the media [and not just news, but music, books, nearly everything is in the hands of 7 companies], one can also include the film industry here)


This is going to sound like I'm blowing you off, but I'm really not. If hospitals were run by and hopsital employees and doctors paid by the federal or state governments, it would make more sense to me for statists, socialists, and others, to support such a program. I would probably support such a program, given that it is probably easier to go that way than to the free market way (Ron Paul will strike me down for that). However, the Affordable Care Act is not such a program and makes, what I think is a bad situation, much worse.

In other words, while I will argue that free market is better than socialized medicine, I will not argue that socialized medicine is not better than the status quo. At least not in this thread and probably not in others.
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Re: ObamaCare: States Defiant!

Postby thegreekdog on Sat Nov 17, 2012 8:08 pm

jj3044 wrote:
thegreekdog wrote:Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.


jj3044 wrote:The law does much more than create more "freeloaders". It also tries to change the healthcare delivery system, which today is VERY ineffective. Here's how:

-Make preventive well-visits free (fully insurance paid) annually, allowing for much earlier identification of diseases and conditions such as hypertension, diabetes, and yes, cancer, which in early stages typically do not have many symptoms. By the time symptoms are noticed, usually damage has already been done. By identifying and treating these conditions earlier, the condition costs much less, and will over all reduce the burden of treatment in the system today.

-Encourage a performance-based fee structure from insurers to providers. I currently live in Rhode Island, and "Patient centered medical homes" are the new buzz word... meaning that most of the resources needed to treat a patient are located within the practice (dietician, physical therapist, nurse case manager) to facilitate better care. When the patient meets better-than-average outcome measures, the practice gets paid more. Also, electronic health records are being installed so that if a patient goes to a different doctor, they can pull up the patient's information, see that they had a CT scan last month that was negative, and NOT order an unnecessary, duplicate test.

-Encourage employers/insurers to utilize value-based benefit designs. Basically these designs encourage proper use of the healthcare system by rewarding plan participants for being proactive in their health such as having an annual physical, taking a health risk assessment, or speaking to a health coach.


I need more details (e.g. links). I've read the law at least twice, and I don't remember seeing anything like this in it.
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Re: ObamaCare: States Defiant!

Postby jj3044 on Sun Nov 18, 2012 11:18 pm

thegreekdog wrote:
jj3044 wrote:
thegreekdog wrote:Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.


jj3044 wrote:The law does much more than create more "freeloaders". It also tries to change the healthcare delivery system, which today is VERY ineffective. Here's how:

-Make preventive well-visits free (fully insurance paid) annually, allowing for much earlier identification of diseases and conditions such as hypertension, diabetes, and yes, cancer, which in early stages typically do not have many symptoms. By the time symptoms are noticed, usually damage has already been done. By identifying and treating these conditions earlier, the condition costs much less, and will over all reduce the burden of treatment in the system today.

-Encourage a performance-based fee structure from insurers to providers. I currently live in Rhode Island, and "Patient centered medical homes" are the new buzz word... meaning that most of the resources needed to treat a patient are located within the practice (dietician, physical therapist, nurse case manager) to facilitate better care. When the patient meets better-than-average outcome measures, the practice gets paid more. Also, electronic health records are being installed so that if a patient goes to a different doctor, they can pull up the patient's information, see that they had a CT scan last month that was negative, and NOT order an unnecessary, duplicate test.

-Encourage employers/insurers to utilize value-based benefit designs. Basically these designs encourage proper use of the healthcare system by rewarding plan participants for being proactive in their health such as having an annual physical, taking a health risk assessment, or speaking to a health coach.


I need more details (e.g. links). I've read the law at least twice, and I don't remember seeing anything like this in it.

I am assuming you just mean the second and third point, as the free well-visits has been highly publicized, and I'm sure it was communicated to you when your plan renewed (assuming you are in the USA).

For the other two points, I doubt I'll have time to actually go through to find the sections (although, I may in the next few days... let's see how Thanksgiving goes and how many tasks my wife gives me :lol: ). For the third point, I am specifically referencing the grants for businesses to start a wellness program, and the law allowing employers/insurers to now use up to 30% of the premium as a wellness incentive (i.e. the aforementioned well visits, coaching programs, etc).
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Re: ObamaCare: States Defiant!

Postby Lootifer on Mon Nov 19, 2012 4:36 pm

Question: what does frer market healthcare look like? (High level question)
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Re: ObamaCare: States Defiant!

Postby Symmetry on Mon Nov 19, 2012 4:44 pm

Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


Tough one for free marketeers, fantasists that they are. Look for the phrase "crony capitalism" in responses. It's kind of a get out clause for them when their ideas screw up against reality.
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Re: ObamaCare: States Defiant!

Postby Lootifer on Mon Nov 19, 2012 4:53 pm

Shoosh. Push ur rhetoric elseware Scot... I mean sym
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Re: ObamaCare: States Defiant!

Postby Symmetry on Mon Nov 19, 2012 4:57 pm

Lootifer wrote:Shoosh. Push ur rhetoric elseware Scot... I mean sym


The Symmetry commune apologizes, by order of our governing wing.
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Re: ObamaCare: States Defiant!

Postby aad0906 on Mon Nov 19, 2012 5:01 pm

jj3044 wrote:Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.


Healthcare costs increased also DUE to technological advance. 200 years ago, if you had cancer, you'd never find out and simply die. No cost. 30 years ago if you had cancer, they put you and a machine that radiates a very large part of your body and your survival chances increased tremendously, but it did cost a lot of money and the therapy also damaged healthy tissue. Of course you would now get older and... the older we get the more healthcare we need (simple math plus older people generally need more healthcare than younger people). Nowadays we have machines that can treat tumors with pinpoint precision. Higher chances of survival and less damage to healthy tissue but... exponentially more expensive as these high precision machines can cost in excess of $1 million each. The mere fact that we can now discover more and more diseases/ailments and also treat them lease to higher healthcare cost.
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Re: ObamaCare: States Defiant!

Postby Symmetry on Mon Nov 19, 2012 5:10 pm

aad0906 wrote:
jj3044 wrote:Healthcare costs increased substantially, as a percentage of GDP from 1968 to 2008. Why? I'm sure the growing number of obese people and increases in the average age of our population had much to do with it. But one would think technological advancement would breed less need to spend money on healthcare. There are a number of studies showing what drives healthcare costs in the US. Such factors include increase utiliation of health insurance created by increased consumer demand (which will only increase now that we have "free" health insurance), new treatments, and more intensive diagnostic screening. Other researchers indicated that healthcare providers are rewarded for treating and testing patients rather than curing them. None of these cost factors are helped by the Affordable Care Act.


Healthcare costs increased also DUE to technological advance. 200 years ago, if you had cancer, you'd never find out and simply die. No cost. 30 years ago if you had cancer, they put you and a machine that radiates a very large part of your body and your survival chances increased tremendously, but it did cost a lot of money and the therapy also damaged healthy tissue. Of course you would now get older and... the older we get the more healthcare we need (simple math plus older people generally need more healthcare than younger people). Nowadays we have machines that can treat tumors with pinpoint precision. Higher chances of survival and less damage to healthy tissue but... exponentially more expensive as these high precision machines can cost in excess of $1 million each. The mere fact that we can now discover more and more diseases/ailments and also treat them lease to higher healthcare cost.


Early diagnosis is pretty key here too, and that does require regular visits to a doctor, or at least not putting off a problem until you need to visit a hospital emergency room.

Catching stuff early, especially when it comes to cancer or heart disease (the biggest killers), reduces cost. A health system that focuses on the most severe cases will always cost more. Early diagnosis is good, but if the financial incentive is to avoid ruinous testing until you need to visit an emergency room, then general healthcare costs will increase.
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Re: ObamaCare: States Defiant!

Postby Night Strike on Mon Nov 19, 2012 6:15 pm

Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


A system where everyone buys the policies and coverages that they need for themselves and their families instead of it being provided through an employer. A system where the government doesn't mandate such mandatory coverage as paying for hair implants or sex-specific coverage when the buyer is of the opposite sex.
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Re: ObamaCare: States Defiant!

Postby Symmetry on Mon Nov 19, 2012 6:40 pm

Night Strike wrote:
Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


A system where everyone buys the policies and coverages that they need for themselves and their families instead of it being provided through an employer. A system where the government doesn't mandate such mandatory coverage as paying for hair implants or sex-specific coverage when the buyer is of the opposite sex.


Dude, chicks are kinda different from dudes, medically and such. You don't need to worry yourself. Or at least, not so fervently.

Of course, I'm not implying that you have a deep degree of interest in Gay sex, perhaps even prurient, that you find difficult to acknowledge, I just wanted to point that out in legalese, as, of course, neither of us are talking about how ridiculous your fear of gay people might possibly be relevant.
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Re: ObamaCare: States Defiant!

Postby Lootifer on Mon Nov 19, 2012 8:22 pm

Night Strike wrote:
Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


A system where everyone buys the policies and coverages that they need for themselves and their families instead of it being provided through an employer. A system where the government doesn't mandate such mandatory coverage as paying for hair implants or sex-specific coverage when the buyer is of the opposite sex.

So the insurance model is the free market model? Interesting. Because the insurance model still places distorted incentives on the providers.
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Re: ObamaCare: States Defiant!

Postby DoomYoshi on Mon Nov 19, 2012 9:15 pm

Lootifer wrote:
Night Strike wrote:
Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


A system where everyone buys the policies and coverages that they need for themselves and their families instead of it being provided through an employer. A system where the government doesn't mandate such mandatory coverage as paying for hair implants or sex-specific coverage when the buyer is of the opposite sex.

So the insurance model is the free market model? Interesting. Because the insurance model still places distorted incentives on the providers.


Night strike is high as a kite.

A free market model would have no insurance at all. Health insurance would be illegal. Right now if you have an insurance plan and you go to the doctors, the doctor determines that the insurance company can afford to pay $800 per visit, and charge that. Because the consumer has no idea of the costs, they can't ever make a rational choice about cost and benefit. If the consumer had to pay that $800 per visit directly, they would look for a cheaper doctor and the cost would enter a free market bidding war.

Until, of course, some doctors banded together and started price fixing.
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Re: ObamaCare: States Defiant!

Postby Night Strike on Mon Nov 19, 2012 10:26 pm

DoomYoshi wrote:A free market model would have no insurance at all. Health insurance would be illegal. Right now if you have an insurance plan and you go to the doctors, the doctor determines that the insurance company can afford to pay $800 per visit, and charge that. Because the consumer has no idea of the costs, they can't ever make a rational choice about cost and benefit. If the consumer had to pay that $800 per visit directly, they would look for a cheaper doctor and the cost would enter a free market bidding war.

Until, of course, some doctors banded together and started price fixing.


That's true. I just pointing out an area where free market principles would be better than the current system without completely removing the current mechanisms.

Symmetry wrote:
Night Strike wrote:
Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


A system where everyone buys the policies and coverages that they need for themselves and their families instead of it being provided through an employer. A system where the government doesn't mandate such mandatory coverage as paying for hair implants or sex-specific coverage when the buyer is of the opposite sex.


Dude, chicks are kinda different from dudes, medically and such. You don't need to worry yourself. Or at least, not so fervently.

Of course, I'm not implying that you have a deep degree of interest in Gay sex, perhaps even prurient, that you find difficult to acknowledge, I just wanted to point that out in legalese, as, of course, neither of us are talking about how ridiculous your fear of gay people might possibly be relevant.


Your point? Of course people of different sexes are different, yet insurance policies aren't written to take that into account. Under group insurance plans, people have to pay for treatments that would be applicable to only people of the opposite sex (or even to people who want to change their sex). If a person is never going to use such options, why are they paying for them?
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Re: ObamaCare: States Defiant!

Postby Night Strike on Tue Nov 20, 2012 7:37 am

Don't worry, the REALITIES of Obamacare keep showing up as complete opposites of what the government promised when they passed it. Today we mention the lie of "getting to keep your doctor if you want" while also sprinkling in a prime example of how more governmental regulations put small, local businesses (that liberals are supposed to love) out of business while benefiting the big corporations (that liberals love to hate in their rhetoric) that can eat the costs of regulations and survive while competition closes.

SPRINGFIELD, Mo.-- A longtime Springfield doctor in private practice says he can't afford to keep his doors open. Dr. Shelby Deckard says government regulations are leading to the end of his 37-year practice.

Deckard and his employees say every day is a sad one, as they prepare to say farewell to their patients and friends.

Spending time with patients is one of Deckard's priorities.

"He's pretty laid back," said patient Stan Coffman.

It's likely what's kept many coming back.

"I think at least 20 years," Coffman said.

But Deckard believes taking his time has actually gone against what he calls the secret to survival.

"You've got to see twice as many people or you've got to do twice as many things that may be unnecessary," Deckard said.

Deckard took the road less traveled more than 15 years ago, choosing to stay in private practice.

"My partners became employees of the hospital, and I just came in on my own, and was able to get a young partner with me," said Deckard.

Now, Deckard says more fees, lower reimbursements, and time consuming regulations have made having his own office too costly.

"We have the business; that's not the issue. It's just a matter of trying to combat the overhead. This Obama stuff this year has totally destroyed us with all the expenses," Deckard said.

He says he and his partner each made only $2,300 in September, and $3,000 last month.

"My young partner has had to work a second job the last year and a half," Deckard said.

Deckard and Dr. Brian Neely sent a letter out to patients, telling them, "It has become impossible to sustain a viable private practice."

They'll close Dec. 28.

"Oh, I was shocked. I guess it's due to this Obama healthcare deal," says Jean Borgmeyer, a patient of nearly 30 years.

"Unfortunately, it's sad every day, because we get reminded, dealing with the patients," Deckard says.

"Now, I have to find a doctor, and I'll never find another one like him that you can call and get a prescription for cough syrup," says Borgmeyer.

For Dr. Deckard, it's a farewell to longtime friends and the end of a dream.

"I'm done, because I can't do what I want to do, as far as taking care of people," says Deckard.

The White House says the Affordable Care Act, signed in 2010, aims to improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices.

http://www.ky3.com/news/ky3-springfield-mo-doctor-dr-shelby-deckard-private-practice-closing-20121119,0,3622284.story
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Re: ObamaCare: States Defiant!

Postby AndyDufresne on Tue Nov 20, 2012 11:13 am

Strike's again!


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Re: ObamaCare: States Defiant!

Postby Symmetry on Tue Nov 20, 2012 11:28 am

Stuff that NS may have missed- the doctor is 67 years old, so well past retirement, I doubt that healthcare reform is why he's shutting down.

But then again, we have the patient addicted to prescription strength cough syrup to think about:

"Oh, I was shocked. I guess it's due to this Obama healthcare deal," says Jean Borgmeyer, a patient of nearly 30 years.

"Unfortunately, it's sad every day, because we get reminded, dealing with the patients," Deckard says.

"Now, I have to find a doctor, and I'll never find another one like him that you can call and get a prescription for cough syrup," says Borgmeyer.


Hmm. This sounds a bit dodgy to me.
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Re: ObamaCare: States Defiant!

Postby Phatscotty on Tue Nov 20, 2012 3:17 pm

Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


I don't know. Health care, in general, has never experienced the free market, not in my lifetime. My grandpa tells me stories though, about my 5 other aunts and uncles.

They just paid the doctor the money when they needed the doctor.
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Re: ObamaCare: States Defiant!

Postby Lootifer on Tue Nov 20, 2012 4:06 pm

Phatscotty wrote:
Lootifer wrote:Question: what does frer market healthcare look like? (High level question)


I don't know. Health care, in general, has never experienced the free market, not in my lifetime. My grandpa tells me stories though, about my 5 other aunts and uncles.

They just paid the doctor the money when they needed the doctor.

The real cost of healthcare has risen significantly with time, even in a single generation (dont confuse this with the price, price is what the butchered distorted system pops out - the $8000/p.a. or whatever number gets thrown around).

This is because healthcare has become far more complex and requires more raw materials (doctors/nurses work-hours, doctors/nurses training time, more cost-intensive equipment and more cost-intensive medicine). This is ok because the results are far better, we now live longer healthier lives.

In your Grandads time you could just pay the doctor for your annual cold and occasional spained ankle; however if you tore the miniscus in you knee, sorry bucko, you were given a crutch and declared "lame". Now we dont have to put up with that, we can get surgery and fix that up; however the real cost of the fix isnt cheap, and likely to be beyond the means of 90% of the population (the surgery I had at the beginning of the year would have been in the tens of thousands of dollars order of magnitude) - hell likely even more; not many have a spare couple of thousand to spend on a treatment which in the old days we may have just put up with for the rest of our lives.

Thats where the insurance and socialised models have evolved from. Healthcare isnt cheap; however not everyone needs it. Apart from the elderly not everyone will need a horribly expensive major surgery during their normal year to year life. So insurance is just a form of socialisation under the guise of a "free market" tag - as Doom says, the real free market would be user pays.

Now in reality the true free market option would almost be unanimously rejected by the population. Only the true Libatarian stalwarts like BBS would fight for it;

The moderate libatarians would likely offer some kind of coupon type deal (I think Friedmans' education policy is one such example, though cant remember off the top of my head - not sure if it would work in Healthcare - education is cheap in comparison).
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Re: ObamaCare: States Defiant!

Postby kentington on Tue Nov 20, 2012 4:15 pm

I don't know what system would work. All I know is that if I had to pay for the treatments of the kidney stone out of pocket, then I would have need to just die instead. It wasn't coming out on its own.
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Re: ObamaCare: States Defiant!

Postby AndyDufresne on Tue Nov 20, 2012 4:24 pm

kentington wrote:I don't know what system would work. All I know is that if I had to pay for the treatments of the kidney stone out of pocket, then I would have need to just die instead. It wasn't coming out on its own.

Kentington, you could have always gone to a nice low-cost private surgeon.

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Re: ObamaCare: States Defiant!

Postby DoomYoshi on Tue Nov 20, 2012 5:07 pm

kentington wrote:I don't know what system would work. All I know is that if I had to pay for the treatments of the kidney stone out of pocket, then I would have need to just die instead. It wasn't coming out on its own.


The prices are only so high because of market manipulation.
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