(02-10-2020 11:15 PM)Owl 69/70/75 Wrote:  

(02-10-2020 06:06 PM)mrbig Wrote:  I have a random idea and I'm hoping no one excoriates me if it is stupid because I haven't really thought it through. Plus, I don't have the business background to really think out all the implications.
What happens if we require private health insurance companies and private hospitals to transition to not-for-profit status with reasonably strict accounting standards (similar to a non-profit)? Thinking of this as a way to bring down costs since these industries make billions in profits that don't do anything to help with healthcare. CEO's and providers and such still make similar salaries.
Again, please don't excoriate me...

Then why would anyone invest funds to build a new hospital?

Indeed:

Quote:But man has almost constant occasion for the help of his brethren, and it is in vain for him to expect it from their benevolence only. . . . It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest. . . . Nobody but a beggar chooses to depend chiefly upon the benevolence of his fellow-citizens.

All wisdom is not new wisdom!

The same source, in the very same chapter, had a keen observation on division of labor:

Quote:The difference of natural talents in different men is, in reality, much less than we are aware of; and the very different genius which appears to distinguish men of different professions, when grown up to maturity, is not upon many occasions so much the cause as the effect of the division of labour. The difference between the most dissimilar characters, between a philosopher and a common street porter, for example, seems to arise not so much from nature as from habit, custom, and education. When they came into the world, and for the first six or eight years of their existence, they were perhaps very much alike, and neither their parents nor playfellows could perceive any remarkable difference. About that age, or soon after, they come to be employed in very different occupations. The difference of talents comes then to be taken notice of, and widens by degrees, till at last the vanity of the philosopher is willing to acknowledge scarce any resemblance.

(italics added)

(08-05-2019 11:26 AM)RiceLad15 Wrote:  A bit more digging:

Quote:Health insurance is mandatory for all citizens and permanent residents of Germany. It is provided by two systems, namely: 1) competing, not-for-profit, nongovernmental health insurance funds (“sickness funds”—there were 118 as of January 20161) in the statutory health insurance (SHI) system; and 2) substitutive private health insurance (PHI)...
There were 42 substitutive PHI companies in April 2016 (of which 24 were for-profit) covering the two groups exempt from SHI (civil servants, whose health care costs are partly refunded by their employer, and the self-employed)7 and those who have chosen to opt out of SHI. All of the PHI-insured pay a risk-related premium, with separate premiums for dependents; risk is assessed only upon entry, and contracts are based on lifetime underwriting. Government regulates PHI to ensure that the insured do not face large premium increases as they age and are not overburdened by premiums if their income decreases.

So there is the primary provider which is composed of not-for-profit healthfunds and then a secondary provider that is heavily regulated, but not regulated into not-for-profit status. However, a large minority are not-for-profit.
edit: https://international.commonwealthfund.o...s/germany/

Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

(02-10-2020 06:06 PM)mrbig Wrote:  I have a random idea and I'm hoping no one excoriates me if it is stupid because I haven't really thought it through. Plus, I don't have the business background to really think out all the implications.

What happens if we require private health insurance companies and private hospitals to transition to not-for-profit status with reasonably strict accounting standards (similar to a non-profit)? Thinking of this as a way to bring down costs since these industries make billions in profits that don't do anything to help with healthcare. CEO's and providers and such still make similar salaries.

Again, please don't excoriate me...

Not-for-Profit is the same as For-Profit with a pretty dress on. They just cross out the word 'profit" on their income statements and replace it with the word "surplus". CEOs and providers et al still make similar salaries. Smell test: how long can a NFP that never turns a "surplus" survive?

The differences are that NFPs get a tax break, and they do not pay out any dividends, usually about 5% of the profit/surplus.

(02-11-2020 03:00 AM)mrbig Wrote:  

(02-10-2020 11:02 PM)tanqtonic Wrote:  My point is that if we follow the path that big proposes, then why not toss in the entire enchilada? His proposal is a strict cost setting, government defined regimen for such an enchilada, and if that is the case, why not profit-regulate every aspect of it, such as, things *not* covered by insurance like boob mills?

Big has the stomach for strong government intervention, actually strict economic regulation, of the area with his proposal, I am exploring how far does he have the stomach to cover the field?

I didn’t propose a path you big boob. I asked a question. I acknowledged that this is a topic where I know very little. Next time I won’t bother asking. Jeeze, what is your deal?

Big has the stomach for Big asked a question that proposed very strong government intervention, actually strict economic regulation, of an area. I am exploring how far does he have the stomach to cover the field?

My point is that if we follow the path that big proposes posits in his question, then why not toss in the entire enchilada?

Better phrased?

Just trying some Socratic here as a return question, sir.

(02-11-2020 08:28 AM)georgewebb Wrote:  

(02-10-2020 11:15 PM)Owl 69/70/75 Wrote:  [quote='mrbig' pid='16669222' dateline='1581376000']
I have a random idea and I'm hoping no one excoriates me if it is stupid because I haven't really thought it through. Plus, I don't have the business background to really think out all the implications.
What happens if we require private health insurance companies and private hospitals to transition to not-for-profit status with reasonably strict accounting standards (similar to a non-profit)? Thinking of this as a way to bring down costs since these industries make billions in profits that don't do anything to help with healthcare. CEO's and providers and such still make similar salaries.
Again, please don't excoriate me...

Then why would anyone invest funds to build a new hospital?

If the government steps in and limits *any* return from *any* source to 4%, then hospitals would be a winner. But, I dont think there is any confusion about what form of economic and political system that is.

(02-11-2020 09:32 AM)tanqtonic Wrote:  

(02-11-2020 08:28 AM)georgewebb Wrote:  

(02-10-2020 11:15 PM)Owl 69/70/75 Wrote:  [quote='mrbig' pid='16669222' dateline='1581376000']
I have a random idea and I'm hoping no one excoriates me if it is stupid because I haven't really thought it through. Plus, I don't have the business background to really think out all the implications.
What happens if we require private health insurance companies and private hospitals to transition to not-for-profit status with reasonably strict accounting standards (similar to a non-profit)? Thinking of this as a way to bring down costs since these industries make billions in profits that don't do anything to help with healthcare. CEO's and providers and such still make similar salaries.
Again, please don't excoriate me...

Then why would anyone invest funds to build a new hospital?

If the government steps in and limits *any* return from *any* source to 4%, then hospitals would be a winner. But, I dont think there is any confusion about what form of economic and political system that is.

The farther left one is, the more confusion there is.

(02-10-2020 09:30 PM)ruowls Wrote:  Hospitals are "capped" as well as providers and ancillary services in the current system.

As to free standing surgery centers, they are exploiting differences in regulatory requirements regarding health care facilities. Hospitals have to offer a greater array of services with many that are unprofitable but required due to regulatory standards. The surgery centers are able to exclude these revenue draining requirements so they are more profitable. Unfortunately, they don't have the resources to treat some of the severe unexpected consequences of surgery. What do they do? They transport the patient to the nearest hospital that has to maintain these higher standards and capabilities. It is another example of gaining the system for profit by shifting costs to someone else who is more regulated.

Which is what was most interesting to me about the recent arguments about abortion clinics. Surgery centers 'save money' over hospitals by limiting services and thus to a degree, safety. Groups like Kaiser or Kelsey Siebold similarly do so... Even their ERs can turn people away, not be open 24/7 or not offer all services.... using hospitals as a back-up.

The AMA, insurers and hospitals are all against Medicare for All. AMA and Hospitals for opposite reasons from insurers... because they don't pay enough for (mostly) primary care to cover the costs.

Another physicians group recently began supporting it, but with the often missed or limited proviso that they must pay a lot more than they currently do for primary care

(02-11-2020 08:55 AM)Owl 69/70/75 Wrote:  

(08-05-2019 11:26 AM)RiceLad15 Wrote:  A bit more digging:

Quote:Health insurance is mandatory for all citizens and permanent residents of Germany. It is provided by two systems, namely: 1) competing, not-for-profit, nongovernmental health insurance funds (“sickness funds”—there were 118 as of January 20161) in the statutory health insurance (SHI) system; and 2) substitutive private health insurance (PHI)...
There were 42 substitutive PHI companies in April 2016 (of which 24 were for-profit) covering the two groups exempt from SHI (civil servants, whose health care costs are partly refunded by their employer, and the self-employed)7 and those who have chosen to opt out of SHI. All of the PHI-insured pay a risk-related premium, with separate premiums for dependents; risk is assessed only upon entry, and contracts are based on lifetime underwriting. Government regulates PHI to ensure that the insured do not face large premium increases as they age and are not overburdened by premiums if their income decreases.

So there is the primary provider which is composed of not-for-profit healthfunds and then a secondary provider that is heavily regulated, but not regulated into not-for-profit status. However, a large minority are not-for-profit.
edit: https://international.commonwealthfund.o...s/germany/

Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

I'm guessing you mean The Netherlands, and not Holland, right? I assume the region of Holland doesn't has a separate healthcare model as compared to the rest of the country.

Speaking from personal, second-hand experience, my wife was a big fan of the Dutch healthcare system when she lived there for two, non-consecutive years. She found it quick, efficient, and incredibly inexpensive as compared to ours.

(02-11-2020 09:49 AM)RiceLad15 Wrote:  

(02-11-2020 08:55 AM)Owl 69/70/75 Wrote:  

(08-05-2019 11:26 AM)RiceLad15 Wrote:  A bit more digging:

Quote:Health insurance is mandatory for all citizens and permanent residents of Germany. It is provided by two systems, namely: 1) competing, not-for-profit, nongovernmental health insurance funds (“sickness funds”—there were 118 as of January 20161) in the statutory health insurance (SHI) system; and 2) substitutive private health insurance (PHI)...
There were 42 substitutive PHI companies in April 2016 (of which 24 were for-profit) covering the two groups exempt from SHI (civil servants, whose health care costs are partly refunded by their employer, and the self-employed)7 and those who have chosen to opt out of SHI. All of the PHI-insured pay a risk-related premium, with separate premiums for dependents; risk is assessed only upon entry, and contracts are based on lifetime underwriting. Government regulates PHI to ensure that the insured do not face large premium increases as they age and are not overburdened by premiums if their income decreases.

So there is the primary provider which is composed of not-for-profit healthfunds and then a secondary provider that is heavily regulated, but not regulated into not-for-profit status. However, a large minority are not-for-profit.
edit: https://international.commonwealthfund.o...s/germany/

Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

I'm guessing you mean The Netherlands, and not Holland, right? I assume the region of Holland doesn't has a separate healthcare model as compared to the rest of the country.

Speaking from personal, second-hand experience, my wife was a big fan of the Dutch healthcare system when she lived there for two, non-consecutive years. She found it quick, efficient, and incredibly inexpensive as compared to ours.

Holland

(02-11-2020 09:56 AM)OptimisticOwl Wrote:  

(02-11-2020 09:49 AM)RiceLad15 Wrote:  

(02-11-2020 08:55 AM)Owl 69/70/75 Wrote:  

(08-05-2019 11:26 AM)RiceLad15 Wrote:  A bit more digging:

Quote:Health insurance is mandatory for all citizens and permanent residents of Germany. It is provided by two systems, namely: 1) competing, not-for-profit, nongovernmental health insurance funds (“sickness funds”—there were 118 as of January 20161) in the statutory health insurance (SHI) system; and 2) substitutive private health insurance (PHI)...
There were 42 substitutive PHI companies in April 2016 (of which 24 were for-profit) covering the two groups exempt from SHI (civil servants, whose health care costs are partly refunded by their employer, and the self-employed)7 and those who have chosen to opt out of SHI. All of the PHI-insured pay a risk-related premium, with separate premiums for dependents; risk is assessed only upon entry, and contracts are based on lifetime underwriting. Government regulates PHI to ensure that the insured do not face large premium increases as they age and are not overburdened by premiums if their income decreases.

So there is the primary provider which is composed of not-for-profit healthfunds and then a secondary provider that is heavily regulated, but not regulated into not-for-profit status. However, a large minority are not-for-profit.
edit: https://international.commonwealthfund.o...s/germany/

Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

I'm guessing you mean The Netherlands, and not Holland, right? I assume the region of Holland doesn't has a separate healthcare model as compared to the rest of the country.

Speaking from personal, second-hand experience, my wife was a big fan of the Dutch healthcare system when she lived there for two, non-consecutive years. She found it quick, efficient, and incredibly inexpensive as compared to ours.

Holland

Thank you for posting why I asked my question.

Quote:Holland is a region and former province on the western coast of the Netherlands. The name Holland is also frequently used informally to refer to the whole of the country of the Netherlands.

(02-11-2020 10:05 AM)RiceLad15 Wrote:  

(02-11-2020 09:56 AM)OptimisticOwl Wrote:  

(02-11-2020 09:49 AM)RiceLad15 Wrote:  

(02-11-2020 08:55 AM)Owl 69/70/75 Wrote:  

(08-05-2019 11:26 AM)RiceLad15 Wrote:  A bit more digging:
So there is the primary provider which is composed of not-for-profit healthfunds and then a secondary provider that is heavily regulated, but not regulated into not-for-profit status. However, a large minority are not-for-profit.
edit: https://international.commonwealthfund.o...s/germany/

Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

I'm guessing you mean The Netherlands, and not Holland, right? I assume the region of Holland doesn't has a separate healthcare model as compared to the rest of the country.

Speaking from personal, second-hand experience, my wife was a big fan of the Dutch healthcare system when she lived there for two, non-consecutive years. She found it quick, efficient, and incredibly inexpensive as compared to ours.

Holland

Thank you for posting why I asked my question.

Quote:Holland is a region and former province on the western coast of the Netherlands. The name Holland is also frequently used informally to refer to the whole of the country of the Netherlands.

Yet most of us recognized that Holland was used by #s as referring to the country, as the term is used quite frequently although informally.

(02-11-2020 10:07 AM)tanqtonic Wrote:  

(02-11-2020 10:05 AM)RiceLad15 Wrote:  

(02-11-2020 09:56 AM)OptimisticOwl Wrote:  

(02-11-2020 09:49 AM)RiceLad15 Wrote:  

(02-11-2020 08:55 AM)Owl 69/70/75 Wrote:  Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

I'm guessing you mean The Netherlands, and not Holland, right? I assume the region of Holland doesn't has a separate healthcare model as compared to the rest of the country.

Speaking from personal, second-hand experience, my wife was a big fan of the Dutch healthcare system when she lived there for two, non-consecutive years. She found it quick, efficient, and incredibly inexpensive as compared to ours.

Holland

Thank you for posting why I asked my question.

Quote:Holland is a region and former province on the western coast of the Netherlands. The name Holland is also frequently used informally to refer to the whole of the country of the Netherlands.

Yet most of us recognized that Holland was used by #s as referring to the country, as the term is used quite frequently although informally.

From the wikipedia link"

Holland is a region[2] and former province on the western coast of the Netherlands.[2] The name Holland is also frequently used informally to refer to the whole of the country of the Netherlands.[2] This usage is commonly accepted in other countries,[3] and sometimes employed by the Dutch themselves

69/70/75 - if you can do this without getting overly political, I'd really appreciate it (and I would absorb the information better). What are the primary differences between the Dutch health care system and Obamacare? I ask because I read this and this and this I'm trying to figure out where you think Obamacare went wrong. I mean, Lou Dobbs seems to be a fan (or have been a fan) of the Dutch system (based on the 1st link).

What would be really helpful for me to understand what needs improvement over what we have now is a quick bullet-point list of the major differences between what we have now and the Dutch system and then a separate bullet-point list of the major ways in which our current system falls short of the Dutch system. Hopefully my brain can match the two lists to determine cause-and-effect, but feel free to provide your thoughts as well.

And before tanq accuses me of proposing a government takeover of healthcare with this inquiry, I'm just asking 69/70/75 some questions.

(02-11-2020 10:07 AM)tanqtonic Wrote:  

(02-11-2020 10:05 AM)RiceLad15 Wrote:  

(02-11-2020 09:56 AM)OptimisticOwl Wrote:  

(02-11-2020 09:49 AM)RiceLad15 Wrote:  

(02-11-2020 08:55 AM)Owl 69/70/75 Wrote:  Although Bismarck originated in Germany (from Chancellor Otto von Bismarck, the same guy the battleship was named for), I don't like the German system as much as some of the rest, and I don't think it works as well as some of the rest, because it still has excessive government regulation.

Holland and Switzerland are less regulated, and Holland is generally regarded as the best. They are both small countries, but Bismarck is the one approach that seems to scale up well. In the 2000 WHO study, the top three countries with 60 million population or more were all Bismarcks, and the best single-provider systems were all small countries.

Also, for the record, Commonwealth Fund is basically a group that lobbies for single-payer health care. So they tend to slant their analyses in favor of single-payer and against any alternative approaches.

I'm guessing you mean The Netherlands, and not Holland, right? I assume the region of Holland doesn't has a separate healthcare model as compared to the rest of the country.

Speaking from personal, second-hand experience, my wife was a big fan of the Dutch healthcare system when she lived there for two, non-consecutive years. She found it quick, efficient, and incredibly inexpensive as compared to ours.

Holland

Thank you for posting why I asked my question.

Quote:Holland is a region and former province on the western coast of the Netherlands. The name Holland is also frequently used informally to refer to the whole of the country of the Netherlands.

Yet most of us recognized that Holland was used by #s as referring to the country, as the term is used quite frequently although informally.

I haven't heard anyone use "Holland" to refer to the country itself in years, but have heard Holland used as a reference to the region many, many time. I have been spending a lot of time with Dutch folks for the past 5 years, so that's why I wanted clarification.

Sorry if you and OO are offended for asking for clarification.

(02-11-2020 10:33 AM)RiceLad15 Wrote:  Sorry if you and OO are offended for asking for clarification.

Not offended at all. I guess you see offense where there is none. Is it just me? I sometimes think I could knock on a door and you would hear me trying to break in.

You and 69 were about to get caught in a petty distinction. I quoted the Wiki to show the differences. I would do the same for a European who called me a Yank.

You're welcome.

I feel like my joke of calling tanq a "big boob" after he randomly injected "boob mills" and "boob jobs" into the healthcare discussion was not properly appreciated. Please take a moment to appreciate my wit. One more moment. Ok thanks, you can move back to screaming at each other about Holland (which incidentally, is my son's middle name) and The Netherlands (which incidentally, is a country where I spent a month one summer in law school).

(02-11-2020 10:42 AM)mrbig Wrote:  I feel like my joke of calling tanq a "big boob" after he randomly injected "boob mills" and "boob jobs" into the healthcare discussion was not properly appreciated. Please take a moment to appreciate my wit. One more moment. Ok thanks, you can move back to screaming at each other about Holland (which incidentally, is my son's middle name) and The Netherlands (which incidentally, is a country where I spent a month one summer in law school).

Does your son have his own health insurance system? I'm confused.

(02-11-2020 10:40 AM)OptimisticOwl Wrote:  

(02-11-2020 10:33 AM)RiceLad15 Wrote:  Sorry if you and OO are offended for asking for clarification.

Not offended at all. I guess you see offense where there is none. Is it just me? I sometimes think I could knock on a door and you would hear me trying to break in.

You and 69 were about to get caught in a petty distinction. I quoted the Wiki to show the differences. I would do the same for a European who called me a Yank.

You're welcome.

I asked for clarification because it wasn't clear what Owl#s was talking about. Instead of responding that you think he is talking about the country, you just provided a link that offered no clarity into the situation. All your link did was indicate that Holland was a region in the Netherlands AND a common term for the country. Which is why I asked him to clarify...

I'm not familiar with the nuances of Dutch healthcare, outside of knowing that my wife was very happy with the service she received. So I wasn't sure if Owl#s was talking about a system that serves the entire country, or just a specific region within the country. If the latter, I was starting to wonder how such a small country that is incredibly well-connected managed to offer services on a regional basis, that other Dutch citizens from outside the region couldn't use.

Anyways, I've said my part and I'll let Owl#s respond, and my guess is he was talking about the country, not the specific region.