The Real Problem With Health Care In America

Discussion in 'Political Opinions & Beliefs' started by Primus Epic, Apr 10, 2019.

  1. fencer

    fencer Well-Known Member

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    You don't have to imagine how it would work. I've posted these links a number of times. Surgery Center of Oklahoma is non-emergency but not necessarily elective procedures. Atlas.md is primary care and they offer software, documentation and support (at a price I'm sure) for clinics that want to follow their direct pay subscription model. Both places post their prices and services online. The Atlas.md clinic in Wichita costs 50 to 100 dollars a month for their subscription and all services they provide at the clinic are included. If you contact them, they will be happy to share their documentation with you. If you're a doctor or want to hire doctors and run a clinic they'll be happy to help you set it up.

    https://atlas.md/wichita/
    Surgery Center of Oklahoma
     
  2. 557

    557 Well-Known Member

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    Yes, our discussions include all that. I also understand payments are usually lower than the billing and fee schedules are just window dressing. I’ll try and be more clear.

    The amount of the check I write can equal the amount of the check the insurance company writes, and my friend still makes more profit from my check. As I said, I can write a smaller check and he still can be as profitable as receiving a larger check from an insurance company. You have to figure efficiency and the time value of money as well as less direct cost for his billing.

    He chose his profession mainly because it’s profitable. He doesn’t hate money! Not everyone is the same I suppose so I doubt this is universal. But it’s common sense and it happens. That was my only claim.
     
  3. 557

    557 Well-Known Member

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    I actually was able to figure this out in high school when my dad was injured in a work related accident without any insurance. Providers aren’t all greedy bastards that won’t work for reasonable returns. The market still has power if the consumer is willing to wield it.

    The idea insurance is the holy grail and our inability to break that spell allows the consumer to be collectively raped by the healthcare/insurance complex.
     
  4. CourtJester

    CourtJester Well-Known Member

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    You figured out exactly what? And no one said healthcare providers are greedy bastards. Nor did any one say insurance is the holy grail.

    You have a right to your opinions even if you can't provide any actual evidence to support them.
     
  5. CourtJester

    CourtJester Well-Known Member

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    Yes as already stated non emergency care is applicable to competition assuming transparency in pricing and objective measurement of quality. Unfortunatly in the real world most of the really expensive medical care isn't on a non- emergency basis.

    And on their site what they provide for that fee doesn't include surgeries, hospital care, MRI's or most services needed in the case of serious issues. What they have is basically a monthly fee to access basic GP services.
     
    Last edited: Apr 19, 2019
  6. CourtJester

    CourtJester Well-Known Member

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    Improve the efficience of which market?
     
  7. 557

    557 Well-Known Member

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    What kind of evidence would you like?
     
  8. CourtJester

    CourtJester Well-Known Member

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    Last edited: Apr 19, 2019
  9. CourtJester

    CourtJester Well-Known Member

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    Or this from the Kaiser Foundation study:

    • Those without insurance for an entire year pay for one-fourth of their care out-of-pocket.39 In addition, hospitals frequently charge uninsured patients much higher rates than those paid by private health insurers and public programs.40,41
     
  10. 557

    557 Well-Known Member

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    You have a right to your opinions even if you can’t provide any actual evidence to refute my claims.
    I’m aware of all this. You are missing the point. The consumer will get screwed if they don’t stand up for themselves. If the checker at Wal-mart double charged you for an item and you let them then you can’t complain. Your link supports my position ironically. :)

    I just love how reality means nothing on this forum. Only what news media vomits out for us to lap up. Oh well. I will try and dig up some bills and post redacted versions.
     
  11. danielpalos

    danielpalos Banned

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    the health care market.
     
  12. fencer

    fencer Well-Known Member

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    So couple the subscription for primary care at the clinic with a high deductible HSA for emergency services, returning insurance to its intended function of defraying costs for catastrophic events.
     
  13. CourtJester

    CourtJester Well-Known Member

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    No if you are paying a monthly fee for a subscription that is exactly the same as very low functioning insurance. And obviously from the website that insurance basically covers no more that access to a GP. Anything more is either paid for by the individual or by another insurance policy

    .
     
    Last edited: Apr 20, 2019
  14. CourtJester

    CourtJester Well-Known Member

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    What are you going to prove by digging up medical bills? And why don't you explain if you can how my link proves your position. My link has proven exactly what I claimed which is that the ininsured pay much more for the same care than large onsurance companies. You have failed totally to provide any actual evidence to the contrary.

    Of course if your " standing up for themselves" actually means not paying your bills and sticking the rest of us with your cost then it would seem your feeling righteous about such behavior is undeniable proof of a weak character.
     
  15. CourtJester

    CourtJester Well-Known Member

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    There is no healthcare market. Here is the definition of a market:

    An actual or nominal place where forces of demand and supply operate, and where buyers and sellers interact (directly or through intermediaries) to trade goods, services, or contracts or instruments, for money or barter.
    Markets include mechanisms or means for (1) determining price of the traded item, (2) communicating the price information, (3) facilitating deals and transactions, and (4) effecting distribution. The market for a particular item is made up of existing and potential customers who need it and have the ability and willingness to pay for it.

    Read more: http://www.businessdictionary.com/definition/market.html
     
    Last edited: Apr 20, 2019
    Belch likes this.
  16. HockeyDad

    HockeyDad Well-Known Member Past Donor

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    Yea right, health care costs have been doubling every decade since 1960 (except when they more than tripled from 1970 to 1980). I honestly don't have a clue on how it could be fixed but it is entering crisis mode.

    [​IMG]
     
    Last edited: Apr 20, 2019
  17. 557

    557 Well-Known Member

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    My claim was I have negotiated paying less than insurance companies do at times. I explained in detail why that is actually a cost savings to providers so in effect that is the opposite of sticking you with bills. Correct?

    I have said in previous threads I’ve paid always out of pocket. I’ve never not payed a bill for service rendered. Sometimes it’s been above insurance sometimes comparable and sometimes much less. That’s one reason I hate our system. Multiple rates for the same procedure/service is stupid.

    Your link showed how providers overcharge uninsured consumers. I’m not disputing that. I’m just saying as long as we put up with it, it won’t change. It’s like going to the car dealership and paying the first price the sleazy salesman shoots you. It’s not logical. Consumers need to stop being pawns. That’s my point.
     
  18. hudson1955

    hudson1955 Well-Known Member Past Donor

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    Fee for those covered by insurance is the same as those who have no insurance. However, if doctors want to see patients, they are forced to sign up for insurance plans and forced to accept the companies fee schedules. They do this because the majority of their patients woukd not even be able to pay the. reduced fee insurance plans pay.
    Most contracts doctors and hospitals have with insurance plans offered by the companies have a clause that the provider ?cannot waive the deductible or co-payment or face a civil suit or being removed from the plan.
    The only time a proviider can lower their fees for a patient is if they have no insurance. Hospitals won't even admit a non-emergency patient unless they pay their deductible upfront.

    This is the problem with most PPACA plans and individual plans, the deductible is too high for most people and families.

    Federal employees have great group insurance plans because the group is so large. Those with low health care expenses cover those with more expenses.

    This is why I think States should set up a variety of group plans citizens can buy. Why should employers be the only ones offered group plans? Actuariallly, this benefits insurance companies and insureds. It brings down overall cost. In addition the State can negotiate with the Companies on premiums, deductibles and out of pocket costs. Also they can require that companies continue to insurance people as long as premiums are paid. Enough of yearly plans. Premium increases should also be set by the State Insurance Commission.
     
    Last edited: Apr 21, 2019
  19. Professor Peabody

    Professor Peabody Well-Known Member Past Donor

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    https://findahealthcenter.hrsa.gov/
     
  20. Belch

    Belch Well-Known Member

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    Get the government out of it.

    Start looking at health care the same you do any service. Capitalism will eventually lower the costs to what you can afford and that will be that.

    Sorry, but you might not expect more than leeches and blood letting if you don't earn enough to pay for it, but I'm sure that you'll be able to afford something.

    Think of health care like you do TVs. You might not be able to afford the best, but walmart probably has a black friday 99 dollar special.
     
  21. danielpalos

    danielpalos Banned

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    Yes, the healthcare sector is a market for those goods and those services.
     
  22. CourtJester

    CourtJester Well-Known Member

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    Read the definition of " market" once again with comprehension . The only possible market that could ever exist for healthcare would be totally elective proceedures. If you have ever had a heart attack or cancer or any major problem you would understand that bidding or competition for service and price comparison is impossible in emergency situations or in any situation where the diagnosis and proceedures are not totally routine.
     
  23. emilynghiem

    emilynghiem Active Member Past Donor

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    Dear @Primus Epic:
    The solution used by Cooperatives such as PPC in Portland/Houston
    is to set up contracts to pay providers based on Medicare pricing.

    This doesn't require "going through govt" but organizing 1500 members per coop chapter
    in order to set standard rates and pricing that are lower than insurance, and without high deductibles, profits or exclusions.

    EX: www.patientphysiciancoop.com
    Because this is set up as Nonprofit, this takes the best advantages of each program or approach
    and cuts out excess cost, waste or profit so 94% of money paid goes toward care and services
    and only 6% is used to cover minimalized cost of administrative costs (3 paid staff per chapter).
    With 1500, the estimated resources for health/medical care is $5-10 million.
    So with that much money as leverage, use to pay at half the cost of insurance,
    the money saved can be used by members to pay for their own clinic centers and hire their own providers.
    This puts control back in the hands of consumers to hire and negotiate at Medicare rates.
     
  24. fencer

    fencer Well-Known Member

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    So it isn't possible to have a subscription medical service and a catastrophic care insurance policy? Its low functioning if the clinic can handle the vast bulk of your needs? I don't see any reason the clinic subscription couldn't be paid as part of the deductible of your HSA policy. No, I think you're just not willing to admit there might be a better way to provide healthcare than whatever you're advocating.

    You're also wrong about emergency care. There is no reason that can't be arranged in advance just as many other services are. My current insurance has arrangements with most of the hospitals in the area so I can go to any of their emergency rooms. A few months ago I was limited to just two hospitals so if I'd had an event during that time I knew where I would have to go to have it handled. Further, emergency healthcare could be arranged similar to phone service. All the major phone carriers have deals in place that make it possible for their clients to connect to any network without additional charge. Hospital systems could have the same kind of (roaming) arrangements to provide services for competing system clients just as phone companies do. The only thing that keeps these kinds of options from occurring is government intervention.
     
  25. danielpalos

    danielpalos Banned

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    nobody said it was a free market. it is heavily influenced by the socialism of Government.
     

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