How would you improve the ACA?

[Labtec600]

And we all know how well that works. Hospital charges $1000 for something, insurance thinks it should only be worth $500 and just pays the $500. The patient is then responsible for the other $500. But, I do wonder if government doing the job won't result in the same thing.

The patient can't go to a different hospital because the insurance says they will only pay for 'in network' hospitals.

In network hospitals pay what they and the insurance company agreed it would cost. That's why there is in network. Out of network you may end up with out of pockets.

 

[DinoDoc]

But hey, free markets know best. If you want healthcare you should just boostrap a medical school.

In the old system, 85% of Americans had health insurance, and 87% were satisfied with their health care.

 

[Cutlass]

So there should be a system that controls how much will be paid? That's what private healthcare does.

That is not what private healthcare does. Private healthcare dives the cost as high as possible for the purpose of raking off the most profits possible.

 

[Labtec600]

That is not what private healthcare does. Private healthcare dives the cost as high as possible for the purpose of raking off the most profits possible.

To clarify, I am referring to private healthcare insurance.

 

[Cutlass]

To clarify, I am referring to private healthcare insurance.

Which drives up the cost to the insured by raking off as much money for the insurer as possible, and then drives up the cost to the provider, by making the provider spend half his income doing paperwork to justify his bills, and then passes those costs onto the insured, and then if they still don't get the result they like, convene a death panel and kill the insured.

 

[Labtec600]

Which drives up the cost to the insured by raking off as much money for the insurer as possible, and then drives up the cost to the provider, by making the provider spend half his income doing paperwork to justify his bills, and then passes those costs onto the insured, and then if they still don't get the result they like, convene a death panel and kill the insured.

Health Insurance carriers have low profit margins.

And you also said the issue was the Dr. tells the Government want to pay and the Government pays it. You stated this was an issue. Now you're saying health insurance is evil because it drives up costs by making the Dr. have to justify the service they provided and show what they did.

 

[Zelig]

Health Insurance carriers have low profit margins.

You can have arbitrarily low profit margins by paying excessive salaries to pointless paper pushers.

 

[Cutlass]

Health Insurance carriers have low profit margins.

They have very high quantities of profits.

And you also said the issue was the Dr. tells the Government want to pay and the Government pays it. You stated this was an issue. Now you're saying health insurance is evil because it drives up costs by making the Dr. have to justify the service they provided and show what they did.

Cheaper just to pay it. Like 1/3 of the price.

 

[Labtec600]

They have very high quantities of profits.

Cheaper just to pay it. Like 1/3 of the price.

And? It doesnt matter the dollar amount of the profit when expenses are just as high.

And the cost (one of many causing healthcare to increase in price)is paying per test instead of flat fee. The more tests a Dr. runs, the more money he makes.

 

[Smellincoffee]

Limit insurance payments to catastrophic needs and and shift all expected medical expenses to be out of pocket. Insurance as I understand it was not a word coined to cover daily affairs.

 

[Cutlass]

And? It doesnt matter the dollar amount of the profit when expenses are just as high.

It does when those 'expenses' are raised only for the purpose of making the profit rate look low. It's called cost plus contracting.

And the cost is paying per test instead of flat fee. The more tests a Dr. runs, the more money he makes.

Sure. That's one the problems. But it's not a problem the private sector has any answer for, because the private sector caused it.

 

[Cutlass]

Limit insurance payments to catastrophic needs and and shift all expected medical expenses to be out of pocket. Insurance as I understand it was not a word coined to cover daily affairs.

That doesn't work. Because most people would then get less checkups and preventive care than they need. That lowers life expectancy while at the same time increasing total costs through having more emergency and acute care.

 

[Smellincoffee]

How many times a year does someone go in for a "checkup", with or without insurance? Most people don't like going to the doctor at all; I doubt they'll start submitting themselves to batteries of test and the indignities of questions about private matters just because they think it's cheaper because The Insurance is paying for it. They're the ones paying for The Insurance year around.

 

[Cutlass]

How many times a year does someone go in for a "checkup", with or without insurance? Most people don't like going to the doctor at all; I doubt they'll start submitting themselves to batteries of test and the indignities of questions about private matters just because they think it's cheaper because The Insurance is paying for it. They're the ones paying for The Insurance year around.

That doesn't really change anything. Without paid for primary care, many people simply will not get primary care. And because they don't, the total cost to the system will be higher.

 

[hobbsyoyo]

That doesn't really change anything. Without paid for primary care, many people simply will not get primary care. And because they don't, the total cost to the system will be higher.

Yup.

We all get tripped on the terminology of 'insurance' versus 'healthcare'. I certainly understand the semantic quibbling as it's quite justified in this case - the distinction is a big one even if it isn't recognized by the general public (even I interchange the two).

But what we clearly need is some sort of universal healthcare for the reasons Cutlass has said and have been talked about ad naseum in various threads. Whether we get to that through some sort of subsidized insurance scheme, single-payer, government run healthcare, whatever, I don't really care. We need something far better than the system we have and Smellingcoffee's suggestion is absolutely terrible in that regard. In fact, you could argue that he wants more of the same as for most of the population, insurance is terrible and offers little more than catastrophe coverage (that up until the ACA could be revoked at any moment). If that model works so well then why do we have such terrible healthcare outcomes?

 

[Smellincoffee]

Yup.

If that model works so well then why do we have such terrible healthcare outcomes?

Because the air is filled with toxins, our food is full of additives, and virtually every element of our lifestyle is grossly unnatural. We're zoo animals whose health has to be micromanaged by specialists and experts at great cost.

 

[Cutlass]

Because the air is filled with toxins, our food is full of additives, and virtually every element of our lifestyle is grossly unnatural. We're zoo animals whose health has to be micromanaged by specialists and experts at great cost.

That's true of every other developed nations as well. Yet they manage to have better outcomes for as little as half as much money. Clearly there is something about the US system, in and of itself, which is fundamentally not working.

And, really, we know what that is: We have a for profit model of deciding whether people live or die.

 

[galdre]

Our system is morally bankrupt; health insurance companies make profit by denying care. We need a national health insurance, with privately owned, non-profit providers. ACA can not be fixed because it simply enforces a corrupt system that needs to be gotten rid of.

 

[Angst]

There is too much money involved in lobbying. It permeates through all levels of government and both parties.

As Alexis de Tocqueville said “The American Republic will endure until the day Congress discovers that it can bribe the public with the public's money.”
― Alexis de Tocqueville

So the US is fundamentally corrupt (lobbying is just a nicer word for it..), permeating all levels of government?

You guys need a reboot.

The quote confuses me. Is it an argument against redistribution, for it is a quite bad one.

In the old system, 85% of Americans had health insurance, and 87% were satisfied with their health care.

Here, 100% of Danes have "health insurance". I admit I don't have data of satisfaction, but I can't imagine it below 80%.

The punch though - it's way way cheaper.

But I guess it's totally rational to pay double the cost for a 7% increase of approval rate.

edit added quotation marks for clarity

 

[Cutlass]

There is too much money involved in lobbying. It permeates through all levels of government and both parties.

As Alexis de Tocqueville said “The American Republic will endure until the day Congress discovers that it can bribe the public with the public's money.”
― Alexis de Tocqueville

BTW, that quote is not by de Tocqueville. That's just another lie conservatives tell when the truth won't serve their agenda.