Socialized Healthcare and the Problem of Calculation

[Dunemeister]

So you abolish one group of people and replace them with government run folks. Insurance people are less efficient than government run programs?

Absolutely. There's a great myth afoot that businesses are more efficient than governments, and it's total bollucks.

Which means doctors will work harder and longer for less. Great deal for them huh?

That's not the experience of the rest of the modern industrialised world. [50% sarcasm]Besides, we demand this of teachers, why not doctors?[/50% sarcasm]

You really believe the government is going to do a better job than the private sector can? no checks and balances? Sounds like a run away system to me. How do you check for fraud and abuse?

Yes. Health is a matter of public policy, therefore the government has a legitimate role to play there. To check for fraud and abuse, you set up an independent, empowered ombusdman to look into complaints.

Besides, it should be obvious to anyone who has interfaced with the American medical system that fraud and abuse are already rampant. The situation can hardly get worse. Doctors are systematically (and very successfully) bribed by insurance and pharmaceutical companies. People are charged exorbitant amounts for drugs and treatments (arguments about R&D are BS, because only about 10% of the big companies' budgets are allocated to research; well over 70% is devoted to marketing). And there seems to be no check against all this fraud and abuse in the vaunted free-market system you're defending.

 

[Autodidact]

I think that part of what complicates this is that we already don't have a system in which the consumer (the patient) buys a service (medical care) directly from a business (the doctor.) So a lot of ordinary free market rules don't apply. Most of us go through a health insurer, who intervenes between the buyer and the seller. Further, the seller there-the insurance company--usually sells their product--insurance--to an employer. So there's a lot of layers between the consumer and the seller, that mucks up the normal rules that a free market is the most efficient service provider.

I also want to point out that we really are all in this together. It benefits me for my neighbor to be healthy. If my neighbor is healthy, he can work and contribute to the economy and pay taxes. If he's not, I may end up supporting him one way or another. So health care, like education, is one of those things that benefits people other than the ones directly receiving the service.

 

[Reverend Rick]

I haven't seen the research (but am willing to look for it) but I think that doctors in other countries are on the average more satisfied with their jobs than here.

This is where I believe I personally have insight and first hand experience. I have about twelve doctors who I have a personal relationship with. Two are Canadian, Eight are Indian, One is Pakistani and the other one is Asian. Eleven of the twelve where born outside the United States and immigrated here. They where very dissatisfied with their native countries that had socialised medicine. I have watched their practices grow and have help them design their medical facilities they have recently built. Medical records is a big expense for them. Most are going paperless now. One surgeon does robotic surgery on patients that are thousands of miles away. They don't worry about office management or billing, they have a staff for that. They focus on the patient and the care they recieve. All of them came here to get ahead in life and live the American dream. Their quality of life improved ten fold when they came to this country.

I honestly believe that we will not attract medical talent to this country if we go to socialised medicine.

Rick: Why do you think the entire world that has universal health care spends about half as much as we do, and gets better care?

I truly don't believe they recieve the same caliber of care we do in a timely manner. Cheaper? Perhaps. Better? No way!

The only good that will come from socialised medicine is, people who cannot afford medical care will get it. The rest of us will recieve a lower caliber of service. When we get socialised medicine there will not be one more exam room or one more doctor appointment on the books. The wait for services will increase and the quality of care will diminish.

One more thing. We already provide health care to the poor. Many people choose to drive a new car or spend their income on other things than health care. They have computers, cellphones, high definition television, blue ray, designer clothes but somehow cannot afford to pay their doctor bills. I say they have their priorities out of wack and when I pay for their health care, by proxy, I am paying for their electronics.

 

[Autodidact]

This is where I believe I personally have insight and first hand experience. I have about twelve doctors who I have a personal relationship with. Two are Canadian, Eight are Indian, One is Pakistani and the other one is Asian. Eleven of the twelve where born outside the United States and immigrated here. They where very dissatisfied with their native countries that had socialised medicine. I have watched their practices grow and have help them design their medical facilities they have recently built. Medical records is a big expense for them. Most are going paperless now. One surgeon does robotic surgery on patients that are thousands of miles away. They don't worry about office management or billing, they have a staff for that. They focus on the patient and the care they recieve. All of them came here to get ahead in life and live the American dream. Their quality of life improved ten fold when they came to this country.

Anecdotes are not data. Are you aware of any research on the subject?

My own friends who are doctors absolutely hate the direction their practices have taken. One gave up a private practice to work on contract in emergency rooms, because the paperwork was just too aggravating.

I honestly believe that we will not attract medical talent to this country if we go to socialised medicine. I truly don't believe they recieve the same caliber of care we do in a timely manner. Cheaper? Perhaps. Better? No way!

How do you think we could find out? What would be a valid measure of the quality of care?

The only good that will come from socialised medicine is, people who cannot afford medical care will get it. The rest of us will recieve a lower caliber of service. When we get socialised medicine there will not be one more exam room or one more doctor appointment on the books. The wait for services will increase and the quality of care will diminish.

And as you have shown us several times, it's all about you. I will point out that with universal care, more prosperous people can still pay a little extra for more deluxe insurance, so those who can afford it will not suffer any decrease in quality. Does that reassure you?

One more thing. We already provide health care to the poor.

Exactly. But we do it in the most costly and ineffective way possible--the emergency room.

Many people choose to drive a new car or spend their income on other things than health care. They have computers, cellphones, high definition television, blue ray, designer clothes but somehow cannot afford to pay their doctor bills. I say they have their priorities out of wack and when I pay for their health care, by proxy, I am paying for their electronics.

This is simply false. Actually, you're paying for their health care directly, but you're paying around ten times what you need to.

 

[methylatedghosts]

If you live longer, would you not see the doctor more times in your life?

I would tend to think that people with a longer lifespan have healthier lifestyles and therefore wouldn't necessarily need to visit the doctor as often.

The thing is, the way it's set up in the U.S. is that people would be more inclined to leave a doctor's visit till later because of the costs. This means that a minor illness could complicate and become a major problem. With socialised healthcare (my last doctors visit cost me $5 and a $3 perscription), people are much more likely to visit the doctor because it's much cheaper, if there's a cost at all, and are more likely to nip problems in the bud before they worsen.

 

[methylatedghosts]

The only good that will come from socialised medicine is, people who cannot afford medical care will get it. The rest of us will recieve a lower caliber of service. When we get socialised medicine there will not be one more exam room or one more doctor appointment on the books. The wait for services will increase and the quality of care will diminish.

Bollocks.

I honestly believe that we will not attract medical talent to this country if we go to socialised medicine. I truly don't believe they recieve the same caliber of care we do in a timely manner. Cheaper? Perhaps. Better? No way!

More of the same.

The reason I DON'T want to go to the U.S. once I become a doctor is because of the way your healthcare system is set up.

 

[Reverend Rick]

Anecdotes are not data. Are you aware of any research on the subject?

If you see a storm blow a house away, does research validate what has happened or not? Most research is biased and just about anyone can google anything now a days. After someone presents the data, the opposition throws rocks at the sourse.

My own friends who are doctors absolutely hate the direction their practices have taken. One gave up a private practice to work on contract in emergency rooms, because the paperwork was just too aggravating.

You doctor friends need people to handle this for them. People make careers in medical management by lifting this burden off the doctor's shoulders.

How do you think we could find out? What would be a valid measure of the quality of care?

I guess it is where your perspective is. If you have no health insurance I guess anything would be an improvement.

And as you have shown us several times, it's all about you. I will point out that with universal care, more prosperous people can still pay a little extra for more deluxe insurance, so those who can afford it will not suffer any decrease in quality. Does that reassure you?

It reassures me that people who do not have this additional insurance may not even get seen by many medical practices. They simply will not be taking on any additional patients at this time. People on medicare experience this discrimination all the time. In the doctors defense, the negotiated payment schedule medicare has is not fair payment for services rendered. A doctor would have to run a revolving door of patients to make a profit and spend less than two minutes with each patient. With time frames like this, quality of health care would be in the toilet.

Exactly. But we do it in the most costly and ineffective way possible--the emergency room. This is simply false. Actually, you're paying for their health care directly, but you're paying around ten times what you need to.

I was talking about medicade not the emergency room.

 

[methylatedghosts]

I guess it is where your perspective is. If you have no health insurance I guess anything would be an improvement.

If you can't afford it otherwise, perhaps.

But if the state is paying for you, there's nothing better

 

[Ciscokid]

I may be a little off topic here but my neighbor across from me is a Doctor who has lived in South Africa and also London. I asked him what the difference was in healthcare in Europe as opposed to America.

He stated one main difference is that in Europe, if you are older you may get put in the end of a line because the country wants to keep the young and productive healthy [vs. someone who is near the end of the rope anyway]. Also, if you have a medical concern that is not life threatening, they may not even take any action.

The reason why he moved to America is because the pay is a lot better.

 

[Reverend Rick]

The reason why he moved to America is because the pay is a lot better.

That just about says it all. Doctors went to school for a very long time and then they have to work for nothing after that as an intern. People really don't realise just how much debt a new doctor has. People don't realise how much time and expense building a practice takes as well.

After all that hard work, doctors deserve every penny they make. It is an insult to them to expect them to work harder and longer for less. Not only that, it is basically greedy to expect more from them.

 

[Shadow Wolf]

People really don't realise just how much debt a new doctor has. People don't realise how much time and expense building a practice takes as well.

I do realize that medical school is very costly. I don't think a doctor should drain a person's bank funds, or force them to starve to seek treatment though.

 

[methylatedghosts]

Originally Posted by Ciscokid

The reason why he moved to America is because the pay is a lot better.
That just about says it all. Doctors went to school for a very long time and then they have to work for nothing after that as an intern. People really don't realise just how much debt a new doctor has. People don't realise how much time and expense building a practice takes as well.

After all that hard work, doctors deserve every penny they make. It is an insult to them to expect them to work harder and longer for less. Not only that, it is basically greedy to expect more from them.

While of course conveniently avoiding my post on the same page as your one, here

The reason I DON'T want to go to the U.S. once I become a doctor is because of the way your healthcare system is set up.

 

[Reverend Rick]

I do realize that medical school is very costly. I don't think a doctor should drain a person's bank funds, or force them to starve to seek treatment though.

Nor do I. They should have to make a small payment each month though right?

 

[methylatedghosts]

Nor do I. They should have to make a small payment each month though right?

Or you could solve the whole problem by getting the state to pay the full cost, then the doctors get payment immediately, the patients aren't bankrupt, and there's no need for an insurance company to rake in millions of dollars out of those who haven't needed it

 

[Shadow Wolf]

I honestly believe that we will not attract medical talent to this country if we go to socialised medicine.

Or it may set a trend that doctors, while they deserve good salaries, shouldn't have such outrageous bills.

Nor do I. They should have to make a small payment each month though right?

My brother racked up over 200 thousand dollars worth of medical bills from one wreck, three surgeries, and a shortened hospital stay because he had no insurance. And not only was his care shorter than someone who would have had insurance, he needs more surgery now because even just shortly after his initial surgeries the screws put in his leg started to come out.

I guess it is where your perspective is. If you have no health insurance I guess anything would be an improvement.

If it wasn't for my sister being a P.A., I would have had racked up same hefty bills. But since she is able to get me basic antibiotics, samples of various medicines, and a big enough needle to remove a deep abscess, I've avoided serious illness so far.
But if I had insurance, I could get my carpal tunnel and knees taken care of, both of which cause me alot of pain every day, and I wouldn't have to risk getting caught with prescription pills that I don't have a prescription for because OTC pain pills don't do much.

 

[PureX]

The most definable characteristic of free market capitalism is the price system. The price system allocates scarce resources in the most efficient uses. And the price system goes along the profit and loss system. Enterprises that produce something or provide a service are rewarded for providing it in an efficient manner. Those that operate inefficiently record losses and are punished. This spurs innovation and ingenuity as industries compete at being the most efficient at their given task.

This is an unrealistically narrow view of commerce. The market reaction to a product or service that is considered a luxury is far different from those that are considered necessities. In fact the dynamics run opposite for each of these. In the case of luxuries, if the provider demands too much compensation, the user/buyer can simply go without. But in the case of necessities, the user/buyers cannot go without, so the compensation is no longer set by their desire, but by the provider and his competitors. And because these all have the same goal (maximum profits) they will inevitably raise the required compensation until they "break" the buyers.

]Socialism does away with the price system which then means that socialism does away with the profit and loss system.

Most forms of socialism only eliminate the free market price system regarding necessities, because the free market system does not work regarding these in many cases.

So, the question invariably arises; how will the best types of healthcare be rewarded under socialized healthcare? Under socialism there is no incentive to be more efficient because there is no calculation system. For example, under socialized healthcare how would treatment X be regarded as more efficient than treatment Y? Under the free market system the treatment that produced the best results at the cheapest cost would be rewarded with profits whereas the treatment that was less efficient would be punished with losses.

Please watch this documentary. It is free on line and explains how 5 of the other major industrialized nations handle health care, and how we might model our own system after them. Frontline: Sick Around The World

 

[Ciscokid]

Or you could solve the whole problem by getting the state to pay the full cost, then the doctors get payment immediately, the patients aren't bankrupt, and there's no need for an insurance company to rake in millions of dollars out of those who haven't needed it

Oh you want the State to pay for it....you might as well just say 'me'. So I don't just have to take care of my family I now have to take care of yours?

I have no problem with helping the desolate or the disadvantaged....but if you are healthy and functional...be a big boy or girl and help yourself.

 

[methylatedghosts]

but you see.. I'm also taking care of YOU!

We all take care of each other, so that we all pay less!!

How does that concept escape people? 0.o

 

[Ciscokid]

but you see.. I'm also taking care of YOU!

We all take care of each other, so that we all pay less!!

How does that concept escape people? 0.o

You aren't taking care of me.....I pay for my own insurance, my company pays for part of it too. Who pays for my deductible and doctor visits?? ME.

 

[Valjean]

You aren't taking care of me.....I pay for my own insurance, my company pays for part of it too. Who pays for my deductible and doctor visits?? ME.

Don't you realize more of your tax money is already going for healthcare than that of the countries that have "socialized" medicine?

No, you're not hearing me wrong. For what we're already paying in federal taxes we could have single-payer, universal coverage. Everyone would be covered and no-one would have to worry about Dr's bills, insurance premiums or pharmaceutical costs.