Posted on 10/24/2004 6:54:31 AM PDT by finnigan2
It sounds good...but it isn't true.
Certainly technological advance has improved, and in cases such as you cite, made certain kinds of health care cheaper. But if you look at the actual costs of all the elements which make up modern medical care you find they are increasing - radically.
What is actually happening is that the quality of healthcare is going up
Very true...if you can afford it.
. The problem is that w/ third party payers, people are willing to spend large sums of money for minimal improvements, so we are spending more.
Only half true. When people are self-payers do they forego minimal improvements or necessary services? The best evidence - from emergency rooms - is that the latter predominates by far.
Try looking at the cost of delivering a baby in a hospital. It's expensive. Do we really need all that stuff? I mean people can deliver babies at home by themselves. The answer, I think, is a metaphor for what we face.
Or look at the cost of treating cancer, or some of the diseases of age. In the past most people just dropped dead earlier. Do you want to consider modern treatment of such things as frivolities?
The middle class are the ones getting all that elective surgery
In Los Angeles most elective surgeons, like most lawyers, are located in the wealthiest parts of the city. I think that's true most everywhere.
drug use among the poor probably causes a signifigant part of their health problems
Poverty is the cause of the health problems of the poor - now and always. Drug use in the middle and upper classes is treated and not compounded by bad diets and overwhelming stress.
Oh please. You can repeat this bilge all you want and nobody here is buying.
If you are unable to prioritize and make rational decisions, all the money in the world won't help you.
Just did :0)
We can treat a lot of stuff (like AIDS) that we couldn't used to. That is an improvement, not an increase in cost.
If people are paying, they make more rational choices. For instance, if a generic is 10% cheaper, they might still get the brand name. But, if it is 90% cheaper they will probably go with the generic.
I know lots of middle class people here in the midwest who have gotten elective surgery. Maybe you guys out in LA are paying too much of your $$$ for housing...
Poverty doesn't cause health problems, a poor lifestyle does. Go to a Sam's and you can buy a huge sack of rice + some veggies for minimal $$$. It costs more to get a big bag of Dorito's. You are practicing the soft bigotry of low expectations. Shame on you.
I thought you liberals were supposed to be compassionate? You don't think the middle class has stress?
True.
But the reverse is also true. If you don't have any money all the prioritizing and rational decisions in the world won't help you.
There's something else for you to consider.
People are fundamentally and inherently different. Not everyone can be wealthy or successful...or rational and clever. When times are really hard, like during the depression, great numbers of people are really poor. Do you think they're suddenly rendered stupid and irrational as well?
During the dot-com bust I was amazed at the number of "geniuses" who post to this board who started blaming others for their losses and demanding that the "gubmint" do something.
You can repeat this bilge all you want and nobody here is buying.
Now there's a statement that's real bilge...and I would hope that most people aren't buying it.
No. It's an improvement AND an increase in cost. Is it a frivolity to be foregone by a rational self-payer? Only if you don't have cancer (or AIDS) and know for sure you won't get it.
If people are paying, they make more rational choices
Is it rational to choose to die or get really sick because you can't pay for treatment? Is it rational to drive around in a ratty old car because you want your kids to go to a good school? Is it rational to pay for medical treatment for your kids rather than for yourself? Many people face really hard choices.
I know lots of middle class people here in the midwest who have gotten elective surgery. Maybe you guys out in LA are paying too much of your $$$ for housing...
Yes, middle class people get elective surgery too.
No, people in LA are paying market price for their housing.
Wonderful article.
bump!
No. I'm just being realistic.
Not every poor person has a bad diet, or a drug problem, or AIDS. Not every rich person is free of these things. But there is a relationship...because the poor generally have less ability and less intelligence of all kinds...and, by definition, far less resources to use to recover from their errors.
Of course, the middle classes have stress...but do you think it increases or decreases when they lose their jobs and can't pay their bills?
Behavior is going to be affected at the margins. For instance, would you saddle your familiy with millions of debt for one more week of life? You are much more likely to do that to my family!
Actually you point about market prices in LA is 100% correct. And it kinda illustrates my point. My lifestyle would be much enhanced to have your weather, but I am not willing to give up other things in order to get it.
Your notion that healtcare is unaffordable for the middle class is not borne out by reality. Who do you think is paying for it now (including the tab for the poor)?
I'm not playing games here. I'm talking about real hospitals facing real costs.
For instance, would you saddle your familiy with millions of debt for one more week of life? You are much more likely to do that to my family!
That's the heart of the problem. Basic health care - the entitlement part of it which is paid by someone else - must be limited and defined. Obviously it should include vaccination against communicable diseases.
Outside of the basics all medical services should be market priced and paid for. If you can't pay for it you don't get it.
It's at bottom a political problem, with definitions and advice provided by specialists. But I can tell you that the first place I'd cut would be in medical services to the aged and retired.
My lifestyle would be much enhanced to have your weather, but I am not willing to give up other things in order to get it.
It's a lot worse than that. Big city people with means are moving to smaller, poorer places to get more value for their money. They drive up prices and the locals get angry and bitter. It's happening all over the world.
Your notion that healtcare is unaffordable for the middle class is not borne out by reality. Who do you think is paying for it now (including the tab for the poor)?
Well, is it affordable?
You state what should be obvious to everyone. The solution to health care is competition, which is as simple as one, two, three:
1. Do away with third-party payments. All insurance payments (including Medicare) go to the insured so the insured has an incentive to shop for the lowest priced services.
2. Make health-care providers quote their prices as part of their service contract like any other professional. There can be no competition without a price.
3. The price should preferably be an hourly rate. Procedure-based reimbursement (promoted by the government, naturally) has allowed doctors to unbundle their services and charge for practically every flick of the wrist. Hourly rates are at least limited by the number of hours in the day.
As simple as this is in principle, I've yet to hear any sense from a politician.
If the hospital gets paid, then so what? Yeah, GM complains when someone buys a caddy -- "Look at our costs!".
Well, is it affordable?
Yes.
Hospitals aren't getting paid. That's why they're closing.
Yes
Ok. Then health care's not your problem.
bttt
**medical costs are INHERENTLY EXPENSIVE. There's NO WAY a society can afford to provide needed and wanted services to everyone.**
This is true and this is what people like to complain about with the "I can go to the discount store and get a huge bottle of aspirin for $5, why does the hospital charge that much?" question. BECAUSE the hospital has to pay for heating and cooling and replacement parts on all the equipment, laundry, the janitor and supplies, the water bill, and a host of little 'insignificant' items which keep a hospital functioning. No one thinks about that when they go to the hospital. All that paperwork isn't 'free' for the taking.
WHILE we're talking about infections, let me add a tidbit I just learned: it takes 20 seconds of hand washing with soap to remove the germs. Water should be either tepid or can be cool. The key is making sure you're scrubbing your hands with the soap for 20 seconds. I'm told that singing 'happy birthday' though twice is 20 seconds (YMMV). One thing I have noticed is that 'flavored' soaps release their perfume at about 20 seconds.
**in Canada and I have been in contact with the health care system several times. the entire system was surly, unpolished, slow and disorganized. (For example, I had bleeding behind my retina and the only specialist I could contact could not see me for four months!)**
I may have already mentioned this, but my parents located distant cousins living in England and visited them a few times. He was the Dean of one of the Horticultural Colleges that teaches the gardeners of the Queens various gardens. He needed an MRI and was given the number 19, meaning there were 18 ahead of him. His number came up too late. He was still waiting to be called for his MRI about a month later when he died.
My parents were livid. Socialized Medicine is NOT the way to go. Had he needed the MRI in the USofA, he'd have gone to the emergency room for the initial medical problem and then been sent to Xray while his wife was signing the papers down in Admitting. AND HE WOULD STILL BE ALIVE.
I love the USofA. It's not perfect, but I do know that if I have a heart attack or a stroke, I'll be taken to the ER in an ambulance and will receive the treatment I need. With all its problems, the USofA health system is still the best one going or coming.
**in Canada and I have been in contact with the health care system several times. the entire system was surly, unpolished, slow and disorganized. (For example, I had bleeding behind my retina and the only specialist I could contact could not see me for four months!)**
I may have already mentioned this, but my parents located distant cousins living in England and visited them a few times. He was the Dean of one of the Horticultural Colleges that teaches the gardeners of the Queens various gardens. He needed an MRI and was given the number 19, meaning there were 18 ahead of him. His number came up too late. He was still waiting to be called for his MRI about a month later when he died.
My parents were livid. Socialized Medicine is NOT the way to go. Had he needed the MRI in the USofA, he'd have gone to the emergency room for the initial medical problem and then been sent to Xray while his wife was signing the papers down in Admitting. AND HE WOULD STILL BE ALIVE.
I love the USofA. It's not perfect, but I do know that if I have a heart attack or a stroke, I'll be taken to the ER in an ambulance and will receive the treatment I need. With all its problems, the USofA health system is still the best one going or coming.
If everyone saw this as clearly as you we'd be able to solve many of our problems.
sigh...
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