(04-22-2016 10:37 PM)Tom in Lazybrook Wrote:  The economics never worked for providers. That's why the friggin' state has to provide most of the expensive assets for them. We subsidize the s**t out of medical demand. But without any requirement that the recipients of that subsidy actually serve the public, we're flushing much of that money down the drain.

State's provide stadiums as well and that's not because the NFL and MLB are not profitable.

State's provide airports, that's not because airlines economically don't work. State's provide roads and bridges does that mean the economics of taxi's auto companies, and bus lines don't work?

(04-22-2016 10:28 PM)Owl 69/70/75 Wrote:  

(04-22-2016 10:26 PM)Tom in Lazybrook Wrote:  

(04-22-2016 10:23 PM)Owl 69/70/75 Wrote:  

(04-22-2016 10:22 PM)Tom in Lazybrook Wrote:  

(04-22-2016 10:12 PM)Bull_In_Exile Wrote:  I'm sure Tom works for free because he loves what he does..

The difference is that i don't go to work in an expensive government subsidized or owned building with lots of expensive government paid for equipment.

Nor do most docs.
Your greed and envy are beyond belief.

And I also didn't need the state to pay to build a half billion dollar hospital for me to be trained in my residency either. How many doctors use the state for their residencies.
I drive right past a public friggin' hospital where I cannot access services every day.

Greed and envy.

You seem to forget, the economics have to work for providers, or else you will have no providers.

I told you that no amount of discussion/explanation will move his needle. Total leftist that demands total government control..............because government has proven to be so efficient and altruistic........... SMH.

(04-22-2016 06:32 PM)Tom in Lazybrook Wrote:  I've had to pay for plans for my employees when I had employees. I was in discussions at a corporate level when we were reviewing health care plans.

Did you comparison shop? Or did you just take whatever the greedy insurers offered you? Why didn't you self-insure? Those are serious questions. They would go a long way towards educating you on the issues, if you cared to be.

Quote:First the GOP said it was 'runaway' lawsuits. So now you can't sue (for any real amount) in most places. Did healthcare costs go down? No. They kept climbing 20 percent or more per year while coverage fell.

Funny, that's not what ANY measure of healthcare costs says. Only for very limited portions of the population was that the case... and those people were those who had the biggest bills, and a HUGE part of the reason for that is that more and more people found ways to get insurance (like in an economy hard up for employees, people with PECs went to work for larger companies with group policies that took them) leaving an increasingly expensive cohort.

Quote:Now they're blaming Obamacare.

1) obamacare was supposed to fix it and didn't It deserves blame for that 2) most of the problems you mention are actually the result of government, not insurance. You are actually the one blaming Obamacare when you describe your complaints... you just don't know enough about the issues to see it.

Quote:I do agree in one area. Since Obamacare never fixed the problems of skyrocketing pharma costs (and by fixed, I'd argue that the fix is to prevent Americans from being overcharged, not by limiting access to those drugs), skyrocketing exec packages, and ridiculous expenses on medical advertising, then there are areas to fix.

So the price of Prozac has gone up where you live? For everyone else, it has gone down. Now they certainly have new meds that cost more, but they cost more because they work differently and supposedly better. If they don't work better, why is your doctor (who REALLY just wants to be a doctor and doesn't care about the money) prescribing them to you?

A 2016 Corvette costs a lot more than a horse and buggy, but i don't thing anyone wouldn't admit that there are other differences between the two other than cost. The cost of surgeries is actually down, and the treatment for things like Cancer in 2016 IS significantly higher than in 1976, but so too is the efficacy of the treatments. The cost of an MRI is down (using the same technology). The newest and latest DOES costs more... but it is better. If you want 1976 treatments, you can save a lot of money.

But you just IGNORE that.

Quote:Of course the solution is to just end the taxpayer support of private healthcare. Put everyone on Medicare, ban any payments from the government to any facility or hospital that doesn't take Medicare, require every hospital that ever had a Cert of Need or any other government benefit to do the same, and require that any person receiving any benefit from the state (such as a student loan, attending a state supported med school, or performing a residency in a state supported institution) accept Medicare in their practices.

How does this address the cost issue? Oh yeah... it doesn't. You just pretend that it does. You act as if the government can simply decide that cancer treatments should cost $x and no more. that's precisely what 'bundled payments' is trying to do... pay a hospital system a fixed amount of money to take care of a population without regard to how much it actually costs to care for that population/how much they need. If the cost they want to pay doesn't cover the actual cost, exactly where is the extra money going to come from? You act like Medicare guarantees to cover the costs... when you know very well that they don't even cover 100% of what they THINK things should cost. I don't know what you think hospital's margins are, but with Medicare leaving 20% of the cost up to the patient, it won't take a lot of people who can't afford their 20% to turn them negative.

Quote:Right now, I'm subsidizing the "private" healthcare system while I have no access to it.

you sound like you don't like paying for other people's healthcare... which essentially admits that the only reason why you support what you support is because you KNOW that you are (or will be) a 'taker' from the system and don't want to pay for it. I'm paying into social security and will never see a dime of it. I'm also subsidizing the 'public' system and have no access to it either. I make too much money. That's why the ACA is a tax. If you were me, a father of two in college in relatively good health who makes more than 4X the FPL, you wouldn't want the ACA OR single payer.

(04-22-2016 09:10 PM)Tom in Lazybrook Wrote:  There's plenty of demand to be a doctor. A doctor that doesn't serve the public probably shouldn't be in that field. I'm sure that Neurosurgeons make plenty of money off Medicare.

I suppose that depends on what you mean by 'plenty'. Neurosurgeons are a very small cohort of the doctor population with something like 16 years of POST-GRADUATE study and specialization, and are needed by a very small part of the patient population. More significantly, Neurosurgeons WOULD make more except that their services are often denied by Medicare based on other health factors of the patient. On the other end, the average PCP working 40 hours a week makes closer to 140k (off the top of my head) and most pediatricians make less. That sounds great until you factor in their 7-12 years of post-graduate training and education (both cost AND time) and the overhead of an office.

Quote:And if someone wants to be a 'private doctor' then let them not use taxpayer assets to be a doctor. I paid for that damn hospital. I paid for that medical school. I paid to subsidize those loans. I paid to subsidize that bond issuance. Why the hell should we subsidize the careers of people who aren't going to serve the public?

hahaha Maybe because you need them to save your life???

You realize that the entire reason why you have part a and b of your beloved medicare is because doctors reimbursement is ENTIRELY separate from the hospital? The hospital exists for YOUR comfort, not the Physicians. The physician spends very little time in your room. You spend all day there. The BUILDING you subsidized houses rooms for YOU, and labs to run YOUR tests, etc etc etc. Your doctor doesn't get a DIME of that money. He gets a (relatively) fixed amount.

I'm betting you don't know any lawyers who charge less than your hospital doctor... and THEY use publicly funded courthouses... and taxpayer subsidized law schools. Your plumber probably attended a publicly funded trade school, as did your barber. Your clothing store probably got a city tax break and uses public sewer facilities.

Your complaints are foolish

Quote:I'm good with having a truly private system that can do whatever they want. But lets make the private system truly private. But don't ask me to build the assets they use for the careers and then deny me the benefit of that investment. My guess is that the private system would be very small. Because few could really afford 'private' healthcare that was truly 'private'.

Only because you don't understand the finances, and obviously don't care to become informed because educated people have tried to inform you

Funny, my office isn't government owned, nor is any of our equipment or our hospital.

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

One actually did his residency at a private catholic hospital after attending medical school at a private university, but I digress.

The whole "you didn't build that" slogan is just garbage that you lefties throw around to try and justify anything. Y'all say it to make it seem like the government is some benevolent parent, or to justify anyone's success.

"You went to public schools so you owe everyone everything you'll ever make in your lifetime." That's basically what you are saying, and it is dumb.

You really need to take a long, hard look at why the VA can't keep physicians, and why the only ones who do work there are either semi-retired or barely speak English. According to you it is the ideal and how medicine in this country should be run, but I can give you real world examples of how it is a train wreck courtesy of American bureaucracy.

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.
You didn't build that.

You didn't either.

That's where the whole "you didn't build that" argument goes completely dishonest and disingenuous. To the extent that taxpayers did pay for it, that was done by all taxpayers for the purpose that having that hospital was sufficiently good for the community as a whole to justify the spending. And since 300 million taxpayers share that expense, you probably didn't pay for so much as a brick. Your problem is that somebody else used that hospital for its intended purpose, providing the intended benefit to society in the process, but in that process helped himself/herself become richer than you think he/she should have, and your greed and envy don't allow you to stand that. That hospital was there for you and any of those 300 million taxpayers to use for that purpose. He/she did, you didn't.

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

And you didn't build the airports you fly out of and a lot of those pilots did their "residencies" in the Air force, and ....

You're an Fing hypocrite so often it's funny.

(04-24-2016 04:56 AM)dfarr Wrote:  

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

One actually did his residency at a private catholic hospital after attending medical school at a private university, but I digress.

The whole "you didn't build that" slogan is just garbage that you lefties throw around to try and justify anything. Y'all say it to make it seem like the government is some benevolent parent, or to justify anyone's success.

"You went to public schools so you owe everyone everything you'll ever make in your lifetime." That's basically what you are saying, and it is dumb.

You really need to take a long, hard look at why the VA can't keep physicians, and why the only ones who do work there are either semi-retired or barely speak English. According to you it is the ideal and how medicine in this country should be run, but I can give you real world examples of how it is a train wreck courtesy of American bureaucracy.

Don't waste your time and energy on him by peppering him with facts. If this thread is any indication, whatever facts you use will be "debunked" using his very large script full of the latest and greatest talking points.

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

Also, as you continue to ignore, folks doing their residencies are paid about 15$ an hour for 40-80 hours providing care at hospitals for years.... It seems to me, Tom, that the residency system works out better for the tax payers than med school graduates.

Keep in mind 15 an hour is what leftists are pushing for burger flippers. You are getting doctors for that fee as they start their career.

And they only work those hours, for that money, after years of education so that they can make more later. The smaller you make their "later" pay then the fewer of them will bother and supply will dwindle.

This will lead to wait times in the US like those in the UK and Canada where it can take weeks or months to see your primary care doctor. If I called my doctors office tomorrow morning there is an 80% chance I could be seen before Wednesday (if not by him by another dr in his office) and a 100% chance I could be seen by Friday.

So how, again, is this some kind of scam?

(04-24-2016 09:15 AM)Bull_In_Exile Wrote:  

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

And you didn't build the airports you fly out of and a lot of those pilots did their "residencies" in the Air force, and ....

You're an Fing hypocrite so often it's funny.

The difference is that I'm not subjected to price discrimination at airports. Unlike at hospitals.

(04-24-2016 12:04 PM)Tom in Lazybrook Wrote:  

(04-24-2016 09:15 AM)Bull_In_Exile Wrote:  

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

And you didn't build the airports you fly out of and a lot of those pilots did their "residencies" in the Air force, and ....

You're an Fing hypocrite so often it's funny.

The difference is that I'm not subjected to price discrimination at airports. Unlike at hospitals.

You're not? every flight that flys out from your airports has the exact same ticket price? That's amazing! My airports have a ton of variability depending on the day, time, destination, airline, and class of ticket I want to buy.. I mean right now I have three different prices from MSP to Orlando... Where is your magical no price discrimination airport?

Just stop Tom... You're talking out of both sides of your mouth here... The "You didn't build that" was a push by the left to say that everything we all have and built was really provided by the collective.

Now you want to pick and choose..

BTW do you acknowledge that resident doctors are working for about 15$ an hour to provide health care?

(04-24-2016 12:13 PM)Bull_In_Exile Wrote:  

(04-24-2016 12:04 PM)Tom in Lazybrook Wrote:  

(04-24-2016 09:15 AM)Bull_In_Exile Wrote:  

(04-24-2016 01:29 AM)Tom in Lazybrook Wrote:  

(04-23-2016 08:41 PM)dfarr Wrote:  Funny, my office isn't government owned, nor is any of our equipment or our hospital.

And where did the doctors in your office do their residencies? Oh, at a 500 million dollar hospital filled with millions of dollars of equipment paid for by....the American taxpayers, most likely.

You didn't build that.

And you didn't build the airports you fly out of and a lot of those pilots did their "residencies" in the Air force, and ....

You're an Fing hypocrite so often it's funny.

The difference is that I'm not subjected to price discrimination at airports. Unlike at hospitals.

You're not? every flight that flys out from your airports has the exact same ticket price? That's amazing! My airports have a ton of variability depending on the day, time, destination, airline, and class of ticket I want to buy.. I mean right now I have three different prices from MSP to Orlando... Where is your magical no price discrimination airport?

Just stop Tom... You're talking out of both sides of your mouth here... The "You didn't build that" was a push by the left to say that everything we all have and built was really provided by the collective.

Now you want to pick and choose..

BTW do you acknowledge that resident doctors are working for about 15$ an hour to provide health care?

While everyone on the plane might be paying a different price, those prices are not segmented by the type of person. When a sale happens, they don't say "because you don't work for a group or you have Diabetes, you have to pay 10000 times more than everyone else", they just sell the tickets to all comers.

With my local public hospital, I can't get served unless I pay 10000 times the Shell rate.

---

That being said, I'm fully in favor of making non-commercial airports pay 100 percent of the cost of their construction, maintenance, and upkeep.

---

What they pay the doctors is irrelevant. They're getting hundreds of thousands of dollars in free training at facilities paid for by the taxpayers. Its what the doctors do after I've paid for their training at those hospitals.

(04-24-2016 01:14 PM)Tom in Lazybrook Wrote:  While everyone on the plane might be paying a different price, those prices are not segmented by the type of person.

And I'm pretty sure the price for a Hernia operation does not depend on the type of person. It may depend on pre arranged fees with large groups that aggregate the risk on individuals into large pools but that's not a "type" of person.

Quote:When a sale happens, they don't say "because you don't work for a group or you have Diabetes, you have to pay 10000 times more than everyone else", they just sell the tickets to all comers.

Not quite. "Frequent flyers" and people who get corporate discounts may end up spending less than you do for your ticket. So once again your analogy fails completely.

I can go on my company portal right now to get a cheaper flight rate than I would get at the ticket counter or online. Because my company has made arrangements for a large number of people with the providers..

Sound familiar?

Quote:What they pay the doctors is irrelevant. They're getting hundreds of thousands of dollars in free training at facilities paid for by the taxpayers.

Are you actually this obtuse or just reaching to justify your position? If they are underpaying residents for the services they provide than the *difference* between the rates means the training is not "free".

If you eliminated the concept of residents then you would have to pay at least twice as much for the work being done which would of course increase the cost to the consumer or you could accept fewer doctors working in the hospitals and longer wait times.

(04-24-2016 02:06 PM)Bull_In_Exile Wrote:  

(04-24-2016 01:14 PM)Tom in Lazybrook Wrote:  While everyone on the plane might be paying a different price, those prices are not segmented by the type of person.

And I'm pretty sure the price for a Hernia operation does not depend on the type of person. It may depend on pre arranged fees with large groups that aggregate the risk on individuals into large pools but that's not a "type" of person.

Quote:When a sale happens, they don't say "because you don't work for a group or you have Diabetes, you have to pay 10000 times more than everyone else", they just sell the tickets to all comers.

Not quite. "Frequent flyers" and people who get corporate discounts may end up spending less than you do for your ticket. So once again your analogy fails completely.

I can go on my company portal right now to get a cheaper flight rate than I would get at the ticket counter or online. Because my company has made arrangements for a large number of people with the providers..

Sound familiar?

Quote:What they pay the doctors is irrelevant. They're getting hundreds of thousands of dollars in free training at facilities paid for by the taxpayers.

Are you actually this obtuse or just reaching to justify your position? If they are underpaying residents for the services they provide than the *difference* between the rates means the training is not "free".

If you eliminated the concept of residents then you would have to pay at least twice as much for the work being done which would of course increase the cost to the consumer or you could accept fewer doctors working in the hospitals and longer wait times.

Hospitals charge people who are UNABLE to join a certain group many multiples of the price for the same procedure.

---

Whatever the 'savings' those residents get at MD Anderson (a public hospital, built and owned by the state) don't help me or anyone else who works for themselves at all.

All the subsidies that Tom decries have the ultimate effect of making services cheaper to patients and consumers. Take away the subsidies and prices would rise. Tom seems to think that you can take away the economic incentives and the same quality of providers will continue to provide the same range and quality of services at an economic loss. Won't happen. Cheaper means lower quality and/or longer queues. It can't happen any other way.

(04-24-2016 02:45 PM)Owl 69/70/75 Wrote:  All the subsidies that Tom decries have the ultimate effect of making services cheaper to patients and consumers. Take away the subsidies and prices would rise. Tom seems to think that you can take away the economic incentives and the same quality of providers will continue to provide the same range and quality of services at an economic loss. Won't happen. Cheaper means lower quality and/or longer queues. It can't happen any other way.

When you make it impossible or very difficult for an entire segment of the population to access that 'better quality service', your argument rings hollow.

My 'line' at my local public hospital for service is of infinite legnth.

(04-24-2016 02:38 PM)Tom in Lazybrook Wrote:  Hospitals charge people who are UNABLE to join a certain group many multiples of the price for the same procedure.

No, hospitals charge people the cost of the procedure with no discount...

Quote:Whatever the 'savings' those residents get at MD Anderson (a public hospital, built and owned by the state) don't help me or anyone else who works for themselves at all.

And the discounts I get out of a publicly built airport are not available to someone who just walks up to the gate..

"me me me" you are I think the most greedy self centered man I have ever crossed paths with..

This all started because you think doctors working for burger flipping wages are somehow screwing you and the other tax payers.

(04-24-2016 03:35 PM)Tom in Lazybrook Wrote:  

(04-24-2016 02:45 PM)Owl 69/70/75 Wrote:  All the subsidies that Tom decries have the ultimate effect of making services cheaper to patients and consumers. Take away the subsidies and prices would rise. Tom seems to think that you can take away the economic incentives and the same quality of providers will continue to provide the same range and quality of services at an economic loss. Won't happen. Cheaper means lower quality and/or longer queues. It can't happen any other way.

When you make it impossible or very difficult for an entire segment of the population to access that 'better quality service', your argument rings hollow.

My 'line' at my local public hospital for service is of infinite legnth.

So if you walk into the ER with a broken arm and I walk in 20 minutes later they will not only mend my arm first but leave you waiting forever..

Interesting..

(04-24-2016 04:17 PM)Bull_In_Exile Wrote:  

(04-24-2016 03:35 PM)Tom in Lazybrook Wrote:  

(04-24-2016 02:45 PM)Owl 69/70/75 Wrote:  All the subsidies that Tom decries have the ultimate effect of making services cheaper to patients and consumers. Take away the subsidies and prices would rise. Tom seems to think that you can take away the economic incentives and the same quality of providers will continue to provide the same range and quality of services at an economic loss. Won't happen. Cheaper means lower quality and/or longer queues. It can't happen any other way.

When you make it impossible or very difficult for an entire segment of the population to access that 'better quality service', your argument rings hollow.

My 'line' at my local public hospital for service is of infinite legnth.

So if you walk into the ER with a broken arm and I walk in 20 minutes later they will not only mend my arm first but leave you waiting forever..

Interesting..

If you walk into a public hospital in Houston, you will be served so long as you have a PPO (I can't get a PPO). I will not. Unless I can come up with 10000 times what you have to pay.

A broken arm doesn't subject someone to financial ruin for a lifetime. Chemo isn't dispensed at the ER. They also don't do transplants