[geeks] healthcare was: nVidia 8800GT for Apple Mac Pro

[Shannon Hendrix]

On May 22, 2008, at 08:50 , Phil Stracchino wrote:

> Patrick Giagnocavo wrote:
>> Mike Meredith wrote:
>>> On Wed, 21 May 2008 17:28:15 -0400, Patrick Giagnocavo wrote:
>>>> Socialized healthcare == RATIONED healthcare
>>>
>>> ROFL! Unless the US has infinite resources to allocate to  
>>> healthcare,
>>> it also has healthcare rationing. Open your wallet. See those bits
>>> of paper with "$" written on them ? They're ration tickets. It may
>>> or may not be a better rationing systems, but it's still a
>>> rationing system.
>>>
>> My point is, that you can have as much health care as you can  
>> afford and the market can provide.  You get to be in charge, not  
>> some bureaucrat who doesn't even have an MD.
>
> Instead, you're subject to the whims of some accountant who doesn't  
> even have an MD.  And if the accountant doesn't think you need that  
> treatment, you'll pay a "full price" that no-one else does.
>
> I personally think most of the healthcare problems in this country  
> could be solved simply by requiring the hospitals to charge everyone  
> the same rate.  That room that you want to charge me $1000 a day  
> for, but my medical insurance company can get it for $75 a day?   
> Charge me $75 a day for it, and cut out the middleman.
>
> If they can stay in business while charging my insurance company  
> "contracted rate", then they can stay in business while charging me  
> the same rate.

Careful what you wish for.

It is not uncommon for something that costs you directly $500, to be  
charged to insurance companies at several times that.

For example, common case:

You have a procedure done which costs $600, and a 20% co-pay.

Sounds great, right?

But then after having it done, you find out the allowable insurance  
charge is $5000, and so your co-pay is $1000.  Many procedures, you  
are not allows to pay out of pocket, you must use insurance.  Neat  
little scam, but perfectly legal.

Recently a woman was in the news because she lost a case like this.   
The hospital absolutely robbed here, and it is perfectly legal.

> And if everyone was charged the "contracted rate" that medical  
> insurance companies get to pay, most people would never need to have  
> medical insurance at all, because they could afford their own  
> medical care.

The problem is how to transition to that without everyone losing  
healthcare in the meantime.

The base problem is that insurance was originally for emergencies, not  
standard care.

But for various reasons, insurance started covering nearly every  
medical visit, and the hospitals, clinics, and doctor's offices all  
got lazy and started charging more.  It was free money, and they fed  
on it voraciously.

It drove (some) medical salaries and medical operation profit margins  
up and it became a business for profit rather than for taking care of  
people.

This drove the cost up and the efficiency of most medical operations  
down, so now the insurance companies can't afford to pay out like they  
used to, and the bloated system is addicted to the cash flow.

20 years ago, a doctor I still visit had 2 nurses and 2 partners.  You  
almost never waited, lab results were perfectly done, and it was all  
very efficient and I felt like I was well cared for.

Now they have a dozen nurses, several administrative staff, and a much  
larger office.

The visits now take longer, they don't do as good a job, and it costs  
around 7 times as much as before even after insurance pays their  
increasingly smaller part.

There is no reason that office could not be run with a single  
secretary about about 4 nurses, but as long as the cash keeps coming  
in, they will continue to be bloated, and will not fight back against  
insurance handling overhead.

None of them can claim to be victims, because the entire medical  
industry created this mess by feeding off of it and manipulating it.

The hospitals are even worse, with insurance handling now requiring  
dozens of people who do nothing to take care of patients.  It's all  
overhead, and they don't really care as long as the cash keeps coming  
in.

> The medical insurance business as it now exists is little, if  
> anything, more than a way for a bunch of accountants and speculators  
> to stand in between the patients and the caregivers and siphon off a  
> fat share of the money.  Let's face it - if they weren't making a  
> profit off the business, they wouldn't be IN the business.  The  
> hospitals are complicit in the scheme by agreeing to charge insurers  
> anywhere from five to twenty times less than they charge uninsured  
> private petients.

It's more complicated than that even.

Look at Sentara, one of the largest medical operations companies in  
the USA.

They also own Optima insurance, which makes up a large percentage of  
the insurance they process.

The first question is, "How can they afford to operate if they have to  
pay their own bills?"

Actually, it is a huge scam.  For 15-20 years they had Optima match  
steadily increasing charges for medical services.

This had the effect of forcing the other insurance companies to  
increase their coverage, or they'd lost customers or be in violation  
of regulations, laws, etc.

So in the end this increased Sentara's revenue, even though it seems  
like it should have hurt them.

It might not be a long term win, but it certainly has made a lot of  
people involved rich in the meantime.

That's just one of many ways the system has been abused.

A lot of it though, as I said above, is just simple laziness.   
Insurance payments became free money, and encouraged people to use  
medical services more often than they normally would.

The increased income has led to bloat and dependency on the now broken  
system.

The trick is how to fix it, and it definitely does need to be fixed.

Socializing it is not the answer in the USA, the mess is just an  
excuse to move that way because it sounds good to people who want a  
handout and who don't realize the strings attached to it.

The other big issue is that in the USA, the "government" socialized  
bits will be contracted out to the same people who created the current  
mess, so how can anyone imagine this will fix things?

-- 
"Where some they sell their dreams for small desires."