Reading Comprehension

professor · 2017-10-14T15:15:57+00:00

Some folks here seem to express interest in discussion beyond golf and sports... So, here's some grist for your mill. I'm curious as to who and how far the...

Tinker

Until you stop a doctor from charging five thousand bucks for cutting a wart of your finger health care costs will never be controlled. The only commercials on tv these days are medical. What is the cost of those ads? The cost is absorbed by the customers like any other business. President Trump won because he reached out to blue collar working America. The people in my state could care less about Russians. They saw most industry including GM and Chrysler leave and it devastated the states economy. If Trump promises to bring back decent paying manufacturing jobs with health care and benefits I’ll give him a shot. The democrats that run this state have brought in a few “ progressive” companies life Fisker. They stole our money and ran. The politicians talk about education and training programs that cost millions, bull shit, these people need jobs now. I’m retired with a pension, but I live in the city , I’m civic association president and on a democratic mayors team and the problems in every urban area in the country come down to one thing, no jobs. The ex Vice President comes from my area, he was a customer of mine, he knows the problem he just doesn’t have a solution, neither do I, but whatever it takes to bring back jobs I’m for, I don’t care who it offends.

Martee

Goods, Services, Commodity, healthcare is not? Healthcare Insurance is? Those are the questions.

Basic services such as the Fire & Police Dept, Emergency Services, Public Education, even the military are all normally classified as public servants, the government pays the salaries, define the services, etc. Obviously the money comes from Tax payers. These services are provided equally to all.

Now there are those who buy Homeowner insurance to cover losses, fire, personal injury, etc, none of which the government pays., People buy insurance to protect themselves for law suits, from loss of work, loss of life, all of these would be commodities.

I do believe that a commodity is something that drives/contributes to the economy, Today in the USA that is vey accurate. Until the providers come under government control, it will continue to be a commodity IMO. Our countries pay our medical personal very well as compared to other countries, yet as a country we spend 30 to 40% more person annually and yet at best we rate somewhere in the top 30s in ranking well below all the other countries people reference.

In short we need to change the healthcare model to go from a commodity to government services.
JMO.

rsvman

Sneakylong I hear what you're saying. As it stands now, we are still giving health care to everybody, even the uninsured. If you show up at an ED with an inflamed appendix, a surgeon will remove it for you, even if you don't have insurance. So it's not like we're tossing people back onto the streets. And yes, other people are paying for those procedures/hospitalizations even in today's system.

Tinker is right that costs are out of control. Surgeons, radiologists, dermatologists, and some other specialties are particularly overpaid. The system has been set up to monetarily reward procedures and to penalize problem-solving and care of complicated problems that require a lot of thinking. I could make more money doing nothing but punch biopsies (which a trained monkey could do) than I can working in my subspecialty. That makes no sense to me at all. But it is what it is.

Maybe it would be better to have a single-payer system, but only if it started by getting rid of the ridiculous financial inequalities among the various specialties/subspecialties. There should not be physicians who make 4-5 times my salary, given that I am a physician with 4 years of med school, 3 years of residency, 3 years of general practice, 3 years of subspecialty training, and now a total of 29 years of practice, and I'm a full professor, to boot.

The other thing a single-payer system would have to do is eliminate the waste that is currently tied up in insurance companies. My concern is that the government, in general, tends to operate things fairly inefficiently (witness the DMV). Over the years I've practiced in a lot of hospitals; the worst one I ever saw was a VA hospital. If a single-payer system involved bringing the entire health care industry down to that level, it would be an unmitigated disaster. People would be begging for insurance companies to come back.

Sneakylong

rsvman

Our system has too many stakeholders out for a profit. Doctors, hospitals, drug companies, medical device companies, insurance companies etc.. With everyone trying to maximize profits it's unsustainable.

We don't have to reinvent the wheel here. Other counties do it better than us. Don't want to hear from the 'we're number one' crowd, because we aren't when it comes to healthcare. For the amount we spend on healthcare we don't get the outcomes other countries do. We're quite a ways down the list.

And then there's the false argument that countries who have a single payer universal healthcare system, they come here for medical procedures. Maybe some do, but again they're the wealthy one's who can afford it. 😉

PA-PLAYA

Sneakylong

If I choose to live a healthy lifestyle... non-tobacco, non-alcohol, maintain a healthy diet, etc... why should I be forced to personally help subsidize the costs of those who personally choose to not live healthily? Why should I be forced to pay for their healthcare coverage?

Isn't a significant portion of these healthcare costs these days attributed to type-2 diabetes? What is the lifestyle (eating/activity level) of those who suffer from this disease?

Why should I be obligated to shoulder the burden of those who choose to live unhealthy lifestyles? What about tobacco and alcohol - should I be obligated to take care of their medical costs despite all of the money spent these days in both the public and private sectors campaigning about the negative health impacts of those habits?

Why should my family be obligated to spend several thousands of dollars each year to take care of those people, when they themselves make such reckless decisions?

We need to improve our healthcare system, no doubt. But a huge part of that should also involve each individual doing his/her part to not add to the burden, when possible.

The ever-growing neglect of people forgoing a healthy lifestyle cannot be overstated as it pertains to this issue.

candukid

PA-PLAYA If I choose to live a healthy lifestyle... non-tobacco, non-alcohol, maintain a healthy diet, etc... why should I be forced to personally help subsidize the costs of those who personally choose to not live healthily? Why should I be forced to pay for their healthcare coverage?

If I can afford to live in a better area with less crime why should I be forced to subsidize the costs of policing downtown?
If I can afford to better protect myself from fire etc. why should I be forced to subsidize the fire department in the slum area across town?
If I can afford to live a better lifestyle and eat healthier foods and get regular checkups, why should I subsidize the poor people who cannot afford the things I can?
(sarcasm if you don't understand)

P.S. the government makes way too much money off alcohol and tobacco to do away with those items...

Sneakylong

PA-PLAYA

Should people who live in apartments be able to send their kids to public schools? After all renters don't pay real estate taxes and are therefore subsidized by people who own homes. I'd rather subsidize poor people in order to get access to quality healthcare than wealthy oil companies.

The subsidy argument doesn't hold water.

rsvman

candukid. Right, so why not communism? All for one, one for all. Why not give up freedom altogether?

Why reward hard work, persistence, intellect, or talent?

PA-PLAYA

candukid

Although I respect your opinions here as a frequent poster - I think you've sorely missed the point. I pay taxes for those other services, for the greater good of my community, which quite often involves extenuating circumstances that don't necessarily pertain to one's level of personal responsibility. Police, fire departments, etc. are not part of this particular discussion. I pay for those services, willingly. I understand how those aspects often don't involve the aspect of one's personal responsibility. No problem there whatsoever.

And.... on the rare occasion - lifestyle choices don't factor (some cancers, or inherited/otherwise diseases). But a majority of the time - lifestyle choices make an enormous impact on one's health. The stats are available. They're out there. I've done my homework. A majority of our (American) healthcare expenses are related to activity level/diet/lifestyle choices. In other words - most of those situations come down to personal decisions/responsibility/discipline.

Yes, we are (for the most part) a lazy country. Doctors inform us that our diets are going to shorten our lifespans. "Change your diet to more protein and less carbs" they tell us. "Eat more veggies and fruits, and get 30 minutes of moderate activity daily into your lifestyle." How many of us actually do it? "You've got a spot on your lungs, might be best if you stop smoking." How many of us stop smoking despite that news? "You have the onset of liver disease because of your alcohol intake." How many of us stop drinking when presented with that news? Or... "You have high cholesterol and need to change your diet to avoid a potential stroke/heart attack."

I mean - at what point should we not hold people accountable for their lifestyle choices? And why should it involve a healthy person having to shoulder the burdens of those who know their situations but yet choose to not make the necessary lifestyle changes to get healthy?

Why should I be obligated to pay for the laziness and indifference of others?

I shouldn't. I spend $1500+ per month for my family's health insurance, and (imo) that's entirely too much. But I pay it anyway, despite the fact that my family requires medical care less than 4-5 times per year (total).

Why should I be obligated to spend more? If we nationalize healthcare - my healthcare expense/tax withholding for subsidized healthcare would go up 40% more.

No thanks. I pay 10x more into the system than I get back from it already.

candukid

rsvman
Yes we all live in communist counties unlike the land of the free (only industrialized nation where YOU can go bankrupt if you are unfortunate enough to get sick). If that's what you think the rest of are then so be it. I will never understand your mentality. Fuck the little guy: Your fellow countryman. Dammit I worked and I'm not going to help out. All for one! Whohaw

rsvman

candukid Wow. You seem to have completely misinterpreted my post. I was merely asking questions in the hope of stimulating some reasonable discussion.

The fundamental concept is this: human beings, in general, are best motivated by rewards. This is a proven psychological fact. What kind of long-term success of a system can be expected if rewards are removed from the equation? What is the benefit of intellect and hard work? What is going to motivate people to do their best if the rewards of doing so are taken away from them and given to people who don't even try?

candukid

PA-PLAYA
But why does it work in other countries? It's because of greed. You worked hard to afford your lifestyle. You are probably one of the privileged. Most of you country is below middle class. They cannot afford the care you can. I pay my taxes like you but they go to pay for all those things. Am I pissed about it? Ya. Would I change it? No fucking way! My tax freedom day is in June. Look it up. I just do with a little less than you. I don't own the latest loaded F150. I don't own the 70 inch 4K tv. Mine is only 50". We learn to do with less. Americans seem to think that they are owed the lavous lifestyle and damn if I'm going to pay more so some lowlife who has nothing can get help when sick.

candukid

PA-PLAYA Why should I be obligated to spend more? If we nationalize healthcare - my healthcare expense/tax withholding for subsidized healthcare would triple.

Where do you get that number from? You must make a hell of a lot of money. $4500 a month works out to $54,000 a year just on healthcare. I don't think so unless you are making at least $300,000 a year. Then income tax would be about a third $100k. That's what we pay and that gets us everything.

PA-PLAYA

candukid

I take offense to this. We are not "privileged." My wife and I worked our asses off for everything we have, which isn't much - but what little we have is paid for. And we pay more than our fair share of taxes.

We delayed our gratification. We saved. We worked ourselves out of debt (instead of declaring bankruptcy) like so many other people do when they get over-extended and can't afford liquor or smokes.

We paid our debts. We paid into the system. And fuck this noise about covering someone else's "woe is me bullshit" when we've personally "been-there, done that" without assistance from anyone else.

We worked our asses off to get where we are. We are not privileged.

Just so you know.

So stop with the blanket assumptions. You don't know what we've been through. You don't speak for me.

Peace.

PA-PLAYA

My apologies candukid

You're a good dude. I'd tee it up with you in a heartbeat.

I just feel a bit biased when it comes to someone potentially assuming that I should pay more taxes, when I'm already forking over 42% of my/our income to taxes.

I've got no issues with you. You're a good dude. 🙂

candukid

I see you changed triple to 40% more

PA-PLAYA

candukid

Yes. From roughly $18k per year to $25/yr (subsidized).

Why should I be required to fork over $7k more per year when even the local McDonald's offers affordable healthcare insurance?

Don't want to work - do you really deserve healthcare insurance? I mean - if you're disabled - we have that covered in our taxes already. That's part of our taxation already.

If you're not willing to work, why should you feel entitled to rely on others to take care of your healthcare needs?

That's ultimately what this comes down to. People not paying into the system, versus people who are paying into the system, and then obligating those already paying into the system to cover those who aren't.

It's a huge problem. We need reform, don't get me wrong. I'm not a heartless bastard. But my wife already works until May 15th for absolutely nothing. I think that's too much, but I can stomach that for "the greater good" of those "less fortunate."

Should she have to work until July for nothing? August? September?

We should not punish those who are already helping subsidize the healthcare industry as it is. Improve the economy, put people to work. This all fixes itself.

At least for those willing to work.

candukid

PA-PLAYA
Sorry. And I am not a communist so guess we are even.
I don't know US tax rates but if you are paying $1500 a month on top of your income tax I'd be interested to know what the total loss of income is as a percentage.

candukid

No sweat. You are good too. 42% is a lot. That is about what I pay and I probably make more than you. For that rate we get healthcare for everybody. Your insurance companies etc are in it for profit. We up here are not. That is the fundamental problem as I see it. Everybody needs their slice of pie. America's pie would be about twice the size of ours to give the same end result. Get your costs down to a reasonable level and cut out the vultures and it would work without you paying any more money.

PA-PLAYA

I think the "reform" part needs to be directed more at the insurance industry. You'll get no argument from me that these shit weasels are making entirely too much money, and although I'm not entirely opposed to them making money - they shouldn't be raking in life-changing gobs of money.

I just think that when you have an overextended industry of medical professionals (who accrue hundreds of thousands of dollars in college tuition debt just to become certified doctors) and they suddenly feel like they're not making enough money (given the level of their responsibilities, not to mention how much they have to pay annually in liability insurance in additional to their repayment of college loans) that we are quickly happening upon a time where we are going to experience a significant shortage of healthcare professionals and surgeons.

If I need open-heart surgery, the last thing I want is a disgruntled surgeon who feels he/she is sorely underpaid opening up my chest to save my life.

And if he/she has to haggle back and forth with the insurance companies to get what they feel is reasonable compensation for their efforts - then something is seriously wrong.

We do need reform. But I feel we need to reform the insurance industry more so than anything else. They are the fattest cats in the barn.

candukid

PA-PLAYA We do need reform. But I feel we need to reform the insurance industry more so than anything else. They are the fattest cats in the barn.

And that, is the crux of it all

candukid

But I thought your congress was a republican majority? For 8 years they fought The Affordable Health Care Act. Saying they had something SO MUCH BETTER. Still waiting. oh and they have Senate too! All three levels and they still can't get anything done?

professor

candukid
Exactly!!! But, still we're addressing the symptoms in this thread and not the problem.

PA-PLAYA

candukid

It requires both sides coming together to fix it. We were divided back in 2012, and 5 years later we're still divided. We can point fingers all we want, but it doesn't change the fact that the people that were elected to serve (then, and since then) have refused to come to the table and hash out a compromise that works for the greater good.

I have never, in my 48 years of existence on this planet, seen such a divided country.

And that doesn't bode well moving forward. Without compromise and working together - nothing improves and society suffers as a consequence.

professor

Well, since the conversation changed to a specific topic, it might be more manageable. The issue is third party insurance companies. They offer no service and cull their money right off the top. Tort reform is part of this problem. California has made progress because of changes they've made.

Whether or not healthcare is a right? That's more about how civilized we think we are or want to be. But, if we're gonna subsidize all the uninsured's trips to the ER, we might as well fix the damn system - the problem.

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