gb hill
Veteran
It will certainly be sold on the world market, but what does that matter. Drill here drill now will create jobs. Your from here in N.C. there's probably more security in an American oil drilling operation than in Dell Computers building a massive factory in Winston Salem taking all those incentives, making promises they didn't keep. Now they are bailing for Mexico and January over 900 + more out of work.
So, perhaps we should try this first, perhaps? And maybe address some other improvements that are not take-overs. Just a thought...we are already running mind-boggling deficits.
Sparrow
Veteran
Tax foreigners living abroad ... that's the answer
wgerrard
Veteran
Greg, excepting the almost inconsequential public option in the House bill, there is no "government run health care" in the offing.
I agree with your call for reform measures, but I am not at all optimistic that they alone will bring down costs and prices.
Thardy
Veteran
Good question. According to a PriceWaterhouseCooper study in 2008, for every dollar spent on insurance :
33 cents goes to - Physicians services
20 cents for - Inpatient sevices
15 cents for - Outpatient cost
14 cents - Drugs
5 cents Other Medical services
6 cents for Govt payments (compliance, claims processing
4 cents Consumer services provider support and Marketing
3 cents Insurer profits
Interestingly, Fortune 500 companies typically will have profits of 5-6% whereas pharmaceutical companies have profits as high as 18-19%, but they only get about 14% of the US healthcare dollar. (Kaiser family foundation )
wgerrard
Veteran
Well, I'd be unhappy. But if BH and Adorama were the only places in New York that sold cameras, I'm not sure I could afford to buy a camera from them.
No one is arguing that competition does not bring prices down if there are low barriers to entry. That's not the case in health insurance. To defend your assertion that health care and health insurance costs would drop dramatically if we allowed interstate sales, you need to demonstrate how and why companies that are not currently competitive within a state will be competitive enough within a region to result in a meaningful drop in costs and prices? If BCBS of NC sell policies in Texas, does that mean that $3000 bill for a two-hour hospital visit is going to drop to $500? Does that mean the anesthesiologist who billed me $900 for walking into my room and asking me "Is everything all right" going to grow a conscience?
dfoo
Well-known
As I've already pointed out my tax rate is less than my colleague who lives in California. Yet I get free health care, and he does not. So clearly this is NOT a taxation issue.
dfoo
Well-known
It seems interesting to me that you refuse to look at models that work perfectly well in other countries. What is even more interesting is that you seem to be quite ignorant of how these health models are even funded. There are many nations with universal health care (Canada, UK, France, Germany to name a few) and each of these nations have different models.
For example, canada is 100% tax funded. Interestingly enough, though, as I've pointed out numerous times our tax rates are not significantly different from US rates.
Thardy
Veteran
Health Insurance is expensive because healthcare is expensive. A man, who's daughter was having surgery complained to me about his premiums going up in price yearly. Actually it was his portion of the premiums (probably $3000 on a total of $12,500 -$13000). He then realized that his daughter, who was having an ACL revision, had the same operation 15 months before, a knee scope before that, and MRIs which is used to diagnose the condition every time.
He also had other sons and daughters in sports who had similar type injuries and operations.
My daughter flipped her ATV while we were in Canada last year. As we rode down the mountain I tried to comfort her by saying we'll get into town and she'll most likely get an Xray and CT of the Neck. The paramedics then placed her in the ambulance and said "the hospital in town has an xray, if she needs a CT you'll have to go to the next town 60 miles away (by ambulance strapped to a board) and to Calgary (3.5 hours away) if she needs an MRI).
I thought to myself "we have CT scanners in physicians offices in the US"., so all I could say was "OK".
As I said before, we can easily cut cost but Americans won't like it.
He also had other sons and daughters in sports who had similar type injuries and operations.
My daughter flipped her ATV while we were in Canada last year. As we rode down the mountain I tried to comfort her by saying we'll get into town and she'll most likely get an Xray and CT of the Neck. The paramedics then placed her in the ambulance and said "the hospital in town has an xray, if she needs a CT you'll have to go to the next town 60 miles away (by ambulance strapped to a board) and to Calgary (3.5 hours away) if she needs an MRI).
I thought to myself "we have CT scanners in physicians offices in the US"., so all I could say was "OK".
As I said before, we can easily cut cost but Americans won't like it.
wgerrard
Veteran
I've never noticed a CT scanner in my GP's office. They're in the local hospital. Of course, I'm not out in the mountains of Alberta.
You shouldn't have expected a doctor's office in that part of the country to have a CT scanner?
gb hill
Veteran
Well enlighten me! All we hear is how terrible it is from the right & I never hear anything positive from the left. My biggest fear is that our government seldem if ever gets anything right! I mean look at the recession, both sides blaming each other & the jobless rate keeps going up. You might not of read in an earlier post about my son. He works a PT job with no benefits but gets help from services such as NOVANT & medical ministries. All this is free to him & it irks me that even if he did get full time pay, with the salary he makes with the cost of insurance the way it is, he couldn't afford it.
Competition across state lines is just one aspect of things that must be fixed.
Notice with many health insurance programs, they force you to go to certain doctors. The HMOs have negotiated deals with doctors and hospitals. One can't go to a specialist before seeing a primary care physician. It's these types of arbitrary rules that need to be eliminated.
With car insurance, if someone crashes into me, I can get my car fixed at the shop of MY choice. I don't have to go to a 'preferred provider' or a list of shops that are members of a 'car maintenance organization.' It's ridiculous to force people to only go to certain hospitals or doctors. Open things up with competition! I think I've said that word a few times.
Expand health insurance coverage so that every American has access to reasonably priced health insurance, using private plans. Let the PATIENT choose the plan, let the companies compete for the business. Don't tie to employment. Let the individual deduct the cost of insurance from income tax. Force the insurance companies to compete on price and service. Prevent them from picking only low risk patients.
People should be able to make good decisions BEFOREHAND, based on good information, not find out what they are getting afterwards. No one would buy a camera not knowing what features it has until after it arrives!
Have rules to protect patients against abuses. Tort reform to reduce malpractice premiums for doctors.
Provide incentives for those that need help to purchase health insurance. This reduces the number of people that only show up at the emergency room which is the most costly form of health care.
Thardy
Veteran
There was not a CT scanner in the HOSPITAL for that town (it was no smaller than the town I live in here in the US) ... it was in the HOSPITAL 60 miles away.
In the Hospital where I live here in the US there are two in rooms separated by a big concrete wall. The Physician who has one is a Cardiologist who uses it to do thin slices of the heart to diagnose coronary artery disease in those who have critical blockages in their coronary arteries that were not suspected by stress testing. The nearest MRI was in Calgary, we have at least 3 in my small town city here in the US.
Doing nerve blocks for post operative pain control (not absolutely needed but is nice) until a couple of years ago was done blindly. You just stick a needle where you thought the nerve was located and you pretty much got it.
The detail man came around and said standard of care is soon going to be Ultrasound guided nerve blocks; so we purchased one (NOT the hospital, a group of physicians) it came at a price of $30,000. We liked it so much we bought a second unit for our other facility. It has increased our success rate tremendously and has helped us pursue procedures we've never done before.
Patients in some areas demand the latest greatest in technology; as a matter of fact the people of this community got really angry that a smaller community 15 miles away got a brand new beautiful hospital with the latest equipment and rooms like suites on a Seabourn Cruise ship. Guess what? We'll be moving in to a spanking new 250 million dollar hospital in 309 days.
Hey, we can make your healthcare a whole lot cheaper.
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John Rountree
Nothing is what I want
I agree that Dell's closing was a blow to North Carolina's economy. But, it also proves the point about corporate priorities, whether it is health care or computers. Despite a very competent work force, despite massive financial incentives, despite promises from Dell, they realized they could make more money by moving their operations to Mexico. What is their primary concern? Providing jobs? No, it is making money. Health care, which is far more fundamental than computers (remember the Constitution says the government should provide for the general welfare of the people) is also governed by the same economic principles. And, as I said earlier, there are only two ways to make a profit if you are an insurance company. BTW, Dell is paying back all the incentive money, with interest, to the state of North Carolina. I also find it funny to moan about the 2%-3%profit margins earned by the insurance carriers, if we can believe that number. Talk to the insurance companies and they will tell you they are barely scraping by. But talk to a stock broker and you will find out that insurance companies are one of the best investments you can make. As Billy Shakespear said: "Me thinks thou protest too much."
visiondr
cyclic iconoclast
There's nothing arbitrary about the practice of requiring "gate keepers" in a health care system. It's a method that is proven all over the world to save money. The exact same medical visit to an ophthalmologist, for example, will cost as much as three times more than that provided by an optometrist. That in itself is not a bad thing if the MD were to provide better care than the OD for the same condition. But in many cases that's simply not the case. Unnecessary visits to specialists are one driver of increased health care costs. Why do you think that insurance plans that permit you to go directly to any specialist you choose without first seeing a primary care physician are the more expensive plans?
wgerrard
Veteran
Competition across state lines is just one aspect of things that must be fixed.
Notice with many health insurance programs, they force you to go to certain doctors. The HMOs have negotiated deals with doctors and hospitals. One can't go to a specialist before seeing a primary care physician. It's these types of arbitrary rules that need to be eliminated.
With car insurance, if someone crashes into me, I can get my car fixed at the shop of MY choice. I don't have to go to a 'preferred provider' or a list of shops that are members of a 'car maintenance organization.' It's ridiculous to force people to only go to certain hospitals or doctors. Open things up with competition! I think I've said that word a few times.
Expand health insurance coverage so that every American has access to reasonably priced health insurance, using private plans. Let the PATIENT choose the plan, let the companies compete for the business. Don't tie to employment. Let the individual deduct the cost of insurance from income tax. Force the insurance companies to compete on price and service. Prevent them from picking only low risk patients.
People should be able to make good decisions BEFOREHAND, based on good information, not find out what they are getting afterwards. No one would buy a camera not knowing what features it has until after it arrives!
Have rules to protect patients against abuses. Tort reform to reduce malpractice premiums for doctors.
Provide incentives for those that need help to purchase health insurance. This reduces the number of people that only show up at the emergency room which is the most costly form of health care.
Well, at long last, a ray or two of something unlike soundbites.
I have no objections to your suggestions. But, I doubt the degree of competition that would ensue, as well as the ability of new insurers to enter the market. As someone pointed out earlier, we "opened" the phone business to competition. The results have been disappointing.
More fundamentally, the question of how for-profit corporations are going to provide unprofitable services remains on the table. I don't think they can. I think they have already demonstrated they cannot.
So, while the reforms you suggest have merit, they do not solve the real problem and would not bring adequate health care to all, regardless of ability to pay.
We should look seriously at the approaches taken by other countries, understanding they are more like us than they are not. We need to understand that, in a democracy, the government expresses the will of the people and is not evil.
wgerrard
Veteran
I once lived in a city -- the largest in the country -- where the only hospital couldn't afford to sterilize needles before they were reused. Hospital visits were dirt cheap.
Obviously, ways exist to reduce costs. The real issue, though, is whether those reductions are enough to make health care affordable to all. For example, how can we make cancer treatment cheap enough so an unemployed person with no savings can pay for it out of pocket?
I don't think we can count on the private sector to deliver that. In fact, I don't think we can trust the private sector to lower prices in response to lower costs.
gb hill
Veteran
One argument I hear is that there will be a shortage of doctor's, especially specialist who will no longer find it profitable to go into a certain field because their pay will be capped if the gov. takes over health care. Also I understand that insurance companies set a fee on what they will pay a hospital for services. From what I have read of the ridiculous charges for hospital services the problems extend way more than just blaming insurance companies
Mcary
Well-known
The United States could easily afford tax payer funded universal health care for the majority if not all of its citizen simple by reducing the defense budget to a percentage of the GDP that matches that of other G20 nation's. Of course these cuts would likely mean a complete withdrawl of all U.S force's based overseas including those we've had stationed in Europe, Japan and Korea for the past 50-60 years. It would also like mean major changes in most of our defense/security agreement such a the NATO treaty that would either shift a portion of the United States current commitment to the other treaty member's or simply leave them unfilled.
BTW what I've written above is the easy part. The hard part is getting senator Snuffy or congress woman Snuffiet to sign a defense budget/bill that would likely cut thousand of jobs in their state(s).