why medicare for all makes sense

Author: linate

Posts

Total: 83
Buddamoose
Buddamoose's avatar
Debates: 4
Posts: 3,178
2
3
6
Buddamoose's avatar
Buddamoose
2
3
6
Also I'm going to point out

We need to stop the companies from making profits

Elimination of the profit motive while positing no ill effect to innovation and creation.

Holy shit this is absurd, but quite the spicy take nonetheless ūüĒ•


Buddamoose
Buddamoose's avatar
Debates: 4
Posts: 3,178
2
3
6
Buddamoose's avatar
Buddamoose
2
3
6
To recap:

-Linate acknowledged the US is subsidizing the healthcare systems of socialized countries. 
  • This subsidy necessarily being consequential to its existence.
However, this creates a paradox, because if the US is subsidizing others, who is subsidizing the US? 

This being a paradox because there is nobody to subsidize either directly or indirectly, this causing a fiscal crisis that would necessitate the removal of such a program for austerity.

Attempting to conflate the price of healthcare in other nations who often mandate *price* is a naught but a sleight-of-hand. That is as established, a perversion of price.

any removal of direct or indirect subsidy consequentially leads to a raise in price as a subsidization is a measure used to lower the *price* of a commodity or service by reimbursing part or whole of the cost of that goods production or service.  

In Linates mind, he would have you believe that these systems would survive the sudden onset of removal of:

- Defensive Provisions from the US
- Independent securement of trade routes
- advantageous trade policies and other such metrics such as imbalances in cost and price. 

As established, such thought is paradoxical in nature ūüĒ•





linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
-->
@Buddamoose

i dont see a lot of hard numbers from you. just a lot of theorizing.

i dont see where you're getting the fact that we cost twice as much as other countries though. what is your broad answer to that question?
a thirty percent difference in doctors ain't the reason.
a fraction of R and D that i've shown ain't the reason. i showed you only a hundred billiion is spent on R and D. where are your numbers? something more than just you spouting off theories. 
you mention tort reform. forbes says malpractice costs including defensive medicine is a mere fifty billion. that aint why we cost twice as much

i'm guess you have some vague ideas about "regulations" strangling the sector, but i see nothing concrete in terms of numbers

concrete example. how does an MRI in the usa costing a thousand dollars but in other countries only two hundred, help innovation? sure they have the cost of the MRI machine, but after that, it's just the hospital milking the situation for all they can. 

how is it justifiable for a doctor to make twice as much as other countries? just because he spends more in medical school doesn't justify that much of a difference. and, if you agree we needs more doctors, you're basically agreeing they make too much, anyway. you just limit the solutions more than i do.



linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
how is it justified for one hostpital to charge twice as much as another hospital on hte other side of town, for the same procedure? 

i'm not proposing opening up the checkbook for more unchecked spending. i'm proposing putting some checks in place to keep spending down. 

do you propose getting rid of medicaid and medicare cost controls that we currently have? 
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@linate
how does an MRI in the usa costing a thousand dollars but in other countries only two hundred, help innovation? sure they have the cost of the MRI machine, but after that, it's just the hospital milking the situation for all they can. 

simple really.  Let's just make some business generalities and assumptions to see how the money might work.  Let's suppose the MRI is sold to other countries at cost, $200 they are making no profit from that.  In the U.S. they are sold for $1000 and probably sell many more of them which is how they make their profit essentially subsidizing other countries who can only pay the cost price.  What does the company do with these profits?  Do they put them in a vault and swim in them like Scrooge McDuck?  Machines don't last forever, require maintenance etc.  Let's examine the automobile it's far different than what it use to be, more reliable more efficient, safer etc.  Why don't you think they would continue to make the MRI machine more reliable, more efficient, better.  New technology is happening all the time, but that costs money.  First MRI was invented in 1977 do you think it has remained the same in all that time or has it gotten better?  If it's gotten better how did that happen and why?

"MRI is likely to become even more important in the medical world in the near future. Medical researchers are working on combining MRI machines with other imaging equipment in order to make it easier and faster to diagnose a patient. For example, cancer centers across the U.S. are investing in new technology that combines an MRI and positron emission tomography (PET) machine into one."

what is going to make that possible?  Money, where is that money going to come from?  Profits

You espouse greed and corruption in these companies often, I'm going to ask for some actual evidence that is the major cause of increasing healthcare costs.
Greyparrot
Greyparrot's avatar
Debates: 4
Posts: 22,887
3
4
10
Greyparrot's avatar
Greyparrot
3
4
10
-->
@TheDredPriateRoberts
It's no secret or mystery that the government actually benefits from rising healthcare costs, as it gives them an opportunity to seize control of that industry. That's the entire purpose of many crony regulations that drive costs through the roof, not just in the medical industry, but in all government regulated industries. Government creates problems that only government can solve, and the people are blind.
linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
-->
@TheDredPriateRoberts

if a hospital uses the mri machien twice a day, in a year they have seven hundred thousand dollars. that pays for the machine and costs, with plenty of profit as the years roll by. how does that help the mri machine people innovate? yes, if we give the manufacturer the profit they need, that helps innovation, but anything beyond that is just the hospital taking everything for all it's worth. you guys act like there must be some complex cost factors causing us to cost so much in the usa, but i'd liken it to luxory cars. it doesn't cost a lot to make these cars relative to other cars.... it's just that there's a big demand. basic supply and demand. 

you asked for numbers. i'd say my above hypothetical is sufficient to show there's plenty going on that wouldn't justify what they charge. i'd also point out that we can look at this from the process of elimination. you guys keep saying things are adding to the cost to justify the price, but everytime you contend something, i show it to be small fries. as i said in the last post, a doctor shortage doesn't explain why we cost twice as much, nor does research and development, nor does malpractice law suits. 
so where are your numbers? i see you guys throwing around a lot of theories but not using much in way of numbers. if you have another theory for why it costs so much i'm sure i can show those to not stick too as to why we cost twice as much as everyone else. 
linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
also, would you get rid of the price controls we currently have on medicaid and medicare?

if we didn't have those controls, couldn't someone use all the arguments you are using to say why we shouldn't get to the point we currently are? we'd end up paying a bunch of money we don't need to, just because you guys have some cockamamie ideas about why healthcare is justifed in costing so much. if we can cost control what we do on those programs, there's no reason we can't go a little further too. 
linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
or another example. you buy name brand stuff. does the manufacturing justify the cost? not always, probably not usually i'd guess. there might be some incremental cost factors making it more expensive, but everyone knows a lot of times you are just paying for the brand. they charge more because they can. 
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@linate
if a hospital uses the mri machien twice a day, in a year they have seven hundred thousand dollars. that pays for the machine and costs, with plenty of profit as the years roll by. how does that help the mri machine people innovate? yes, if we give the manufacturer the profit they need, that helps innovation, but anything beyond that is just the hospital taking everything for all it's worth. you guys act like there must be some complex cost factors causing us to cost so much in the usa, but i'd liken it to luxory cars. it doesn't cost a lot to make these cars relative to other cars.... it's just that there's a big demand. basic supply and demand. you asked for numbers. i'd say my above hypothetical is sufficient to show there's plenty going on that wouldn't justify what they charge. i'd also point out that we can look at this from the process of elimination. you guys keep saying things are adding to the cost to justify the price, but everytime you contend something, i show it to be small fries. as i said in the last post, a doctor shortage doesn't explain why we cost twice as much, nor does research and development, nor does malpractice law suits. so where are your numbers? i see you guys throwing around a lot of theories but not using much in way of numbers. if you have another theory for why it costs so much i'm sure i can show those to not stick too as to why we cost twice as much as everyone else. 

ok so your issue is that hospitals make too much money, not the companies making the drugs or equipment.  
Costs are not just one thing, but a number of, and I have given many links to show that.

Seven of the top 10 most profitable hospitals in the United States are nonprofit facilities
‚ÄúMost hospitals lose money, but there are a few very profitable ones and we need to pay attention to why they are making so much‚ÄĚ and how it affects consumers, said lead author Gerard Anderson, a Hopkins health policy professor.
Hospital profitability sinks to levels not seen since the financial crisis
https://www.cnbc.com/2018/04/24/hospital-profitability-sinks-to-levels-not-seen-since-financial-crisis.html

also your assumption is the hospitals get paid or reimbursed for everything that is billed out

While hospitals average 7% profit margins, uncompensated care costs can be more than 5% of revenue.
Hospitals’ operating margins in all states would decline. And hospitals in most of the 31 states which expanded Medicaid under the ACA would have negative operating margins by 2026, according to the analysis.

studies have estimated that the bills for all types of health care that the uninsured cannot pay ‚Äď the uncompensated cost of care ‚Äď is up to $73 billion a year, a significant portion of which is shifted into higher costs for Americans with insurance and their employers, according to HHS.

 TransUnion found just under half of patients did not pay off hospital bills of $500 or less two years ago. The company attributed the increase to higher deductibles and patient responsibility growing from 10 percent to 30 percent over the last few years.The Affordable Care Act has given more people access to health care, but it has driven deductibles up, in some cases, making it harder for patients to pay,
Since 2010, 79 rural hospitals have closed, according to the North Carolina Rural Health Research Program. 

hardly seems hospitals are raking in the profits you claim does it.  There's a few that do very well, perhaps we should learn from their model if possible.

From previous posts we have all but eliminated the following as a cause of increased healthcare
Drug Companies
Equipment Manufacturers
And now Hospitals
where would you like to point the cross hairs next?

TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@linate
or another example. you buy name brand stuff. does the manufacturing justify the cost? not always, probably not usually i'd guess. there might be some incremental cost factors making it more expensive, but everyone knows a lot of times you are just paying for the brand. they charge more because they can. 
that is a choice isn't it, you can choose to not receive treatment as well, perhaps instead of an MRI you could opt for a plain old x-ray, it's cheaper, not as good, but hey it's a choice right?  Much like the luxury car example you gave, if you want the best, you have to pay for it, it costs more.  why would you think healthcare is any different?

so you want saks fifth avenue level of healthcare or goodwill level?
linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
-->
@TheDredPriateRoberts

thanks for the hospital profit margin information. i wasnt aware of that. but you aren't making the case that people should remain uninsured.

if we give them something to pay with, someone is going to take the money and give them service.

if the current rate is two thousand patients per doctor, we can give them a patient per day more, or a ten percent increase to match the ten percent uninsured rate, and someone is going to take the money. this sort of maneouver might not work out so well for some business models, but the bottom line point is that we give people access first and ask questions later. they will still have the same profit margins albeit with just seeing more patients to pull it off. that sector will adjust to accomodate, even if there are some losers in the process. 

also, alternatively, we could give the uninsured and poor medicaid, and some doctor will take the bait. these paitents might have to wait in line, but it's not like they have no access. i actually strongly support this, but i know it wouldn't be politically popular. 

alternatively, we could just spend a little more for healthcare. if that means we spend twenty percent of our GDP on healthcare instead of 18 percent, so be it. at least people have healthcare.

if we have the money, someone will take it, bottom line. 

i dont know what point was served by you pointing to a bunch of articles showing that the uninsured run up costs on medical providers. this is irrelevant. and if anything, it just shows that if we reimbursed at around the going rate for these guys, it wouldn't be a problem for providers. 

linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
also i think it might just come down to whether or not the government can pick and choose wisely what parts of the health sector to reduce reimbusements on. i don't like if there's no clear cut rule we can employ, but that doesn't mean it can't be done. 

for example. you say drug providers aren't a problem. you say ninety percent of drugs are generic as proof that they aren't a problem. the thing is, i know of drugs that are generic that cost hundreds of dollars. i dont know if there's an underlying reason they have to cost that much, but i dont see a reason,and i would suppose like luxory cars and name brand stuff, it's just a mark up that isn't necessary. kind of like how pharma boy got in the news for running up the price of the epi pen. there was no underlying need for the added cost.... he just did it because he can. so, my point that i was getting to, is that the government would have to be wise enough to pick which sectors to cut back on and which not to. i admit i dont know if the government is competent enough to do this, but i think it could be done right.  same goes for medical equipment providers. i dont know if an MRI machien needs to cost two hundred grand. but this might be an unjustified mark up. and, same goes for MRI prcedures from hospitals.... they might be able to skim some off the top to pull it off without hurting hospitals too much. 
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@linate
thanks for the hospital profit margin information. i wasnt aware of that. but you aren't making the case that people should remain uninsured. 
good, i'm not making a case for people remaining unisured or not receive the medical treatment they need, in fact we could and should do a better job of helping people get the care they need.  Giving it all to the government isn't the way, hence my arguments to try and prove that.

if we give them something to pay with, someone is going to take the money and give them service. if the current rate is two thousand patients per doctor, we can give them a patient per day more, or a ten percent increase to match the ten percent uninsured rate, and someone is going to take the money. this sort of maneouver might not work out so well for some business models, but the bottom line point is that we give people access first and ask questions later. they will still have the same profit margins albeit with just seeing more patients to pull it off. that sector will adjust to accomodate, even if there are some losers in the process. also, alternatively, we could give the uninsured and poor medicaid, and some doctor will take the bait. these paitents might have to wait in line, but it's not like they have no access.
I'm not sure you fully understand the current state of things.  Look around locally, are there practices that are not accepting new patients?  There certainly are several here.  Why do you think that is?  How can you ask them to take more and work even longer hours than they already do?  Many have to do hospital rounds, charting etc when not seeing patients.  Things they can't bill for, and you want them to take more?  Doesn't sound very realistic.  If an area already has limited access because the doctors are full, what good is giving people insurance or paying more if it's just not possible to accept anymore, given a finite number of hours in a day?

i actually strongly support this, but i know it wouldn't be politically popular. alternatively, we could just spend a little more for healthcare. if that means we spend twenty percent of our GDP on healthcare instead of 18 percent, so be it. at least people have healthcare. if we have the money, someone will take it, bottom line. i dont know what point was served by you pointing to a bunch of articles showing that the uninsured run up costs on medical providers. this is irrelevant. and if anything, it just shows that if we reimbursed at around the going rate for these guys, it wouldn't be a problem for providers. 
the point of the articles was to show what isn't causing increased prices in healthcare, no substantial increases anyway.  This whole topic, whether here or on the news is looking for someone to blame, a scapegoat.  Perhaps there's nothing really to blame, except people are living longer and are getting fatter?
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@linate
What I don't think that is generally being understood by the public is this is a socialist system in many ways (healthcare)  Like robbing Peter to pay Paul or Robin Hood.  Those who can are paying more to make up for the shortfalls caused by those who can't or don't pay.  I have yet to see any real evidence of all this profit making, money hording system or entity that is to blame for the way things are.  I don't believe in ghosts but if I ever see one I will!
I'm not claiming to have all the answers or even the right ones, however I also think I know a bad idea when I hear one not proven by facts and evidence, and that is the idea the government can do a better job running the whole thing even when they don't do the best job just running part of it.
We agree in that we want people to receive the care that they need
Shortages can cause increase costs
Usage can increase costs
These are the only things I can think of right now that could cause increase costs of any substantial degree.  Apparently malpractice doesn't add that much even though I thought it did.
Polytheist-Witch
Polytheist-Witch's avatar
Debates: 1
Posts: 4,188
3
3
6
Polytheist-Witch's avatar
Polytheist-Witch
3
3
6
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@Polytheist-Witch
so with one link you said what took me paragraphs to say, thanks a lot!!!  LOL
the U.S. is the great welfare providing nation of the world, time to stop that.
Polytheist-Witch
Polytheist-Witch's avatar
Debates: 1
Posts: 4,188
3
3
6
Polytheist-Witch's avatar
Polytheist-Witch
3
3
6
-->
@TheDredPriateRoberts
So you think screwing the research of medical treatment is good? 
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@Polytheist-Witch
no not at all, I think the U.S. shouldn't be paying the lions share so all the other countries can benefit from our taxes and citizen's money.
in other words this "negotiating and enforcing trade deals to prevent other countries from freeloading off of American researchers."
"If U.S. companies earned more revenue from foreign nations, then the American companies could spend more on R&D. This ultimately would result in new treatments and inject more competition into the U.S. drug market, leading to lower prices for American patients."

it makes the point that the U.S. pays more for healthcare and yet other countries benefit because of it.  

Other countries are "screwing the research of medical treatment" with their price controls, lack of patent controls.

"Mexico provides no data protection at all unless innovators undergo a substantial legal process. That means Mexican drug firms¬†can immediately startusing innovators‚Äô data to test the effectiveness of knockoff ‚Äúbiosimilars,‚ÄĚ
Polytheist-Witch
Polytheist-Witch's avatar
Debates: 1
Posts: 4,188
3
3
6
Polytheist-Witch's avatar
Polytheist-Witch
3
3
6
-->
@TheDredPriateRoberts
no not at all, I think the U.S. shouldn't be paying the lions share so all the other countries can benefit from our taxes and citizen's money.

We benefit from our taxes and money. I don't complain about taxes when I have roads and water and a toilet. I don't complain about drug prices when I get state of the art treatment and not lines. I don't want to rely on the interest of other nations to do research OR NOT. Which would be the case.
TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@Polytheist-Witch
We benefit from our taxes and money. I don't complain about taxes when I have roads and water and a toilet. I don't complain about drug prices when I get state of the art treatment and not lines. I don't want to rely on the interest of other nations to do research OR NOT. Which would be the case.

I agree I don't want to rely on other countries and I don't want them to rely on the U.S., which they do and one reason their costs are less.  I want as even a playing field as possible.
Yes citizens should benefit from taxes and money, not other nations or non citizens.

91 days later

linate
linate's avatar
Debates: 0
Posts: 222
0
1
1
linate's avatar
linate
0
1
1
-->
@TheDredPriateRoberts

what say you on this?

'A, or 'the', major problem we have five percent of patients that cause half our healthcare expenses. this could potentially be regulated by creating a "high risk" category in the industry, where reimbursement is lower. If we reduced that category of expense by half, we should reduce the overall cost of healthcare by a quarter. (think of the GDP numbers, instead of 18 percent, we'd be closer to other countries) Think of the bigger picture- the average that is spent on each of those patients is $40,000 per year. You could hire a doctor to take car of just five of them and his salary would be paid for.  Trying to manage care like that is easier said than done though. So what happens is we end up having the healthcare industry milk each procedure and charge too much overall, just because they can"
http://www.pnhp.org/news/2014/september/8-facts-that-explain-what%E2%80%99s-wrong-with-american-health-care

TheDredPriateRoberts
TheDredPriateRoberts's avatar
Debates: 0
Posts: 3,383
3
3
6
TheDredPriateRoberts's avatar
TheDredPriateRoberts
3
3
6
-->
@linate
Not found, error 404

there are already similar things in place, nurse coordinators follow up within 48 hours of people being discharged and try to get them an appointment with their pc, the goal is to stop readmittance since Medicare/Medicaid won't pay for another readmittance in 30 days.  Don't underestimate the benefit of making people responsible for their own choices and health.  I'd have to search it, but I think some European countries are tackling obesity, which is a huge risk for heart disease, diabetes etc.