[Sandro]

Just fyi, the cost I quoted above is the total hospital bill that was completely paid for by the insurance company.
This whole network thing is completely alien to me, I just walk into whichever hospital or doctors office and tell them to get to work. Then again, other than dental check ups I’ve been to a doctor twice in the past five years.

 

[dan-o]

the most likely scenario is that a lot of the roles would simply transition from private industry to a gov't job.

If the transition included medical device manufacturers, how willing would you be to become a government employee?

 

[jonKranked]

If the transition included medical device manufacturers, how willing would you be to become a government employee?

mmmmm government cheese.

in the big scheme of things, my industry is so heavily regulated there'd be negligible difference in my day to day activities.

in reality, the difference is that health insurance in america is unique in that its almost exclusively privatized with the exception of medicaid/medicare (which are limited to certain small segments of the population). the manufacturers are also privatized. however in all other countries with socialized health insurance, the manufacturers are still privatized. the EU, ASPAC, Australia, South America, Japan. Public health insurance, privatized manufacturers. the regulatory environment is, for all intents and purposes, the same globally. America is the anomaly.

 

[dan-o]

mmmmm government cheese.

in the big scheme of things, my industry is so heavily regulated there'd be negligible difference in my day to day activities.

in reality, the difference is that health insurance in america is unique in that its almost exclusively privatized with the exception of medicaid/medicare (which are limited to certain small segments of the population). the manufacturers are also privatized. however in all other countries with socialized health insurance, the manufacturers are still privatized. the EU, ASPAC, Australia, South America, Japan. Public health insurance, privatized manufacturers. the regulatory environment is, for all intents and purposes, the same globally. America is the anomaly.

Was just curious about willingness to become govt worker.

M4A is cool idea, I want to see plan to implement it at this point. The motivation for change is clear but that’s where discussion seems to stop.

 

[jonKranked]

Was just curious about willingness to become govt worker.

M4A is cool idea, I want to see plan to implement it at this point. The motivation for change is clear but that’s where discussion seems to stop.

as it stands we already have to answer to the FDA / TUV / PMDA / SFDA / TGA etc, our paycheck just doesn't come from them.

 

[dan-o]

as it stands we already have to answer to the FDA / TUV / PMDA / SFDA / TGA etc, our paycheck just doesn't come from them.

Do you feel devices will face same price scrutiny as meds?

 

[johnbryanpeters]

not unavailable, but unaffordable.

Unaffordable is effectively unavailable.

 

[jonKranked]

Do you feel devices will face same price scrutiny as meds?

prices for med device are all over the board. bandaids are classified as medical devices. so are syringes. so are replacement knees. the costs are all over the board. implants are obviously going to be more expensive, but we don't sell them to the general public, they are only sold on order of a doctor, and only provided TO a doctor. patients generally don't pay for them directly in the same manner as they do when picking up an Rx from a pharmacy.

that being said, the same question ultimately applies: do you want something safe and effective, or do you want it cheap?

 

[jonKranked]

Unaffordable is effectively unavailable.

end result yes. but its still a subtle difference.

 

[dan-o]

that being said, the same question ultimately applies: do you want something safe and effective, or do you want it cheap?

Like all the vanity drugs being prescribed, some may think replacement devices are also overprescribed.

Does rideit really need a high performance, Ti knee replacement just so he can ski and bike? He can probably function ok with a less expensive option etc?

How many hips/knees etc is a person entitled too? Especially if they live a lifestyle that exacerbates the need?

How about hearing aids? The most micro version is nice but far from necessary to hear.

Given Sandros post how his public option is no individual rooms, lesser doctor versus their private insurance (which mirrors my experience while on NL’s healthcare, it was a positive experience btw) I don’t think these questions are unreasonable to see discussed.

 

[jonKranked]

Like all the vanity drugs being prescribed, some may think replacement devices are also overprescribed.

yea, that's not how it works. at least for my industry. the majority of the business in my industry is trauma related.

Does rideit really need a high performance, Ti knee replacement just so he can ski and bike? He can probably function ok with a less expensive option etc?

the options are Ti or SS. there is no less expensive option. these materials are utilized for biocompatibility reasons.

How many hips/knees etc is a person entitled too? Especially if they live a lifestyle that exacerbates the need?

so a reasonable, pain free quality of life is an entitlement? the other option is a wheelchair and pain killers.

 

[dan-o]

so a reasonable, pain free quality of life is an entitlement? the other option is a wheelchair and pain killers.

Not my argument but one I’ve heard.
Some view willfully taking risks (action sports) as the same as smoking, drinking, shitty diet etc. I had a ER doctor tell me this when I broke myself riding.

Glad to hear your industry is immune.
The bean counters may have other ideas and rascals for all may suffer when they do.

 

[jonKranked]

Not my argument but one I’ve heard.
Some view willfully taking risks (action sports) as the same as smoking, drinking, shitty diet etc. I had a ER doctor tell me this when I broke myself riding.

it's a pretty ill informed argument. while there might be some basis, sports injuries are low on the list of what we treat. the 2 biggest categories of what we treat are vehicle accidents & degenerative diseases.

 

[slyfink]

For services that are effectively unavailable for a significant portion of the population in the United States.

How so?

I was on a generic BCBS PPO plan through my employer. It was a very expensive plan, about $520/mo for a family, but when I needed it, it worked.

Unaffordable is effectively unavailable.

fwiw, my 1-week stay in the post-op wing of the local children's hospital with my son, and his three trips to the OR over three weeks cost me $0 out of pocket. (well, I think I paid about $50 in parking to be fair). And we got what I would consider world class care.

I have private insurance through my work that would cover me for upgrades (such as a private room at the hospital) but I didn't need it. It costs me $10/month for the family and covers prescription meds too. Our deductible is $75/year.

 

[slyfink]

Not my argument but one I’ve heard.
Some view willfully taking risks (action sports) as the same as smoking, drinking, shitty diet etc. I had a ER doctor tell me this when I broke myself riding.

Glad to hear your industry is immune.
The bean counters may have other ideas and rascals for all may suffer when they do.

it's a pretty ill informed argument. while there might be some basis, sports injuries are low on the list of what we treat. the 2 biggest categories of what we treat are vehicle accidents & degenerative diseases.

I've read somewhere, that the cost of broken bones and "high risk" sports to the health care system are orders of magnitude smaller than treating "lifestyle" diseases. I can't confirm or deny this, maybe others on here have data?

 

[jonKranked]

I've read somewhere, that the cost of broken bones and "high risk" sports to the health care system are orders of magnitude smaller than treating "lifestyle" diseases. I can't confirm or deny this, maybe others on here have data?

i don't have the data handy but yes, this is accurate.

 

[jonKranked]

there are more trauma cases due to vehicular accidents than sports accidents by a very large margin.

 

[jonKranked]

there are more trauma cases due to vehicular accidents than sports accidents by a very large margin.

bear in mind, i'm saying this from a perspective of cases that require orthopedic surgery. this *does not* include cases which *DO NOT REQUIRE* orthopedic correction

 

[jonKranked]

a google turned up this:

Facts + Statistics: Sports injuries | III

top ranking sports injuries:
1 - exercise
2 - basketball
3 - bicycling (all)

 

[mykel]

I just don't (maybe can't?) understand any reluctance to go to a universal system.

After my accidents in 2013, I have had more doctors, doctors visits, tests, imaging scans, pokes and prods than I can stand or count. I currently have 4 doctors, a GP and 3 specialists, one of whom is the head of department. I see the specialists every 3 months and my GP when required.

My total out of pocket for everything (excluding drugs) has been $4.00 parking per visit for one of the specialists - the other three have free parking.

 

[jonKranked]

I just don't (maybe can't?) understand any reluctance to go to a universal system.

because bootstraps

 

[SkaredShtles]

Also: "I love my insurance plan - you can't take it away."

Fortunately this one is going to quickly go the way of the dodo bird, because every employer is moving inexorably towards shittier and shittier insurance plans.

 

[jonKranked]

Also: "I love my insurance plan - you can't take it away."

Fortunately this one is going to quickly go the way of the dodo bird, because every employer is moving inexorably towards shittier and shittier insurance plans.

won't happen. they'll contract nearly all functions out first. this process is already underway.

 

[SkaredShtles]

won't happen. they'll contract nearly all functions out first. this process is already underway.

Not sure what you mean...? I was just talking about the attitude of "I love my plan" going away, as employers offer shittier and shittier plans to employees.

 

[jonKranked]

Not sure what you mean...? I was just talking about the attitude of "I love my plan" going away, as employers offer shittier and shittier plans to employees.

my point is that it's gonna be moot what kind of healthcare a given employer offers as they contract out more and more functional areas. because few contract agencies offer health insurance.

Companies are contracting out more jobs—that’s not great for workers

Companies' obsession with efficiency hasn't always been good for workers.

arstechnica.com

 

[Nick]

I have nothing against any individuals who happen to work in/for the insurance industry. That said, fuck the insurance industry. Upset the whole fucking apple cart as far as I'm concerned. We'll all adapt and we'll all be just fine in the long run.

the fact we can't talk about health care withOUT talking about insurance shows it's an albatross.

 

[jonKranked]

the fact we can't talk about health care withOUT talking about insurance shows it's an albatross.

it is important to differentiate between them tho

 

[SkaredShtles]

my point is that it's gonna be moot what kind of healthcare a given employer offers as they contract out more and more functional areas. because few contract agencies offer health insurance.

Companies are contracting out more jobs—that’s not great for workers

Companies' obsession with efficiency hasn't always been good for workers.

arstechnica.com

Ah - gotcha. Thought you meant the insurance companies were going to contract out their shit. Which, I suppose, is probably also happening.

 

[slyfink]

I just don't (maybe can't?) understand any reluctance to go to a universal system.

After my accidents in 2013, I have had more doctors, doctors visits, tests, imaging scans, pokes and prods than I can stand or count. I currently have 4 doctors, a GP and 3 specialists, one of whom is the head of department. I see the specialists every 3 months and my GP when required.

My total out of pocket for everything (excluding drugs) has been $4.00 parking per visit for one of the specialists - the other three have free parking.

where do you live that parking at a hospital is only $4?!?! It was $12/day for me.

 

[SkaredShtles]

where do you live that parking at a hospital is only $4?!?! It was $12/day for me.

GODDAM CANADIAN BASTARDS.

 

[StiHacka]

Just fyi, the cost I quoted above is the total hospital bill that was completely paid for by the insurance company.
This whole network thing is completely alien to me, I just walk into whichever hospital or doctors office and tell them to get to work. Then again, other than dental check ups I’ve been to a doctor twice in the past five years.

Our doctors are greedy, that's the bottom line. If they think an insurance vendor pays them too little, they'll refuse to sign a contract with them and are "out of network" for all patients coming with that insurance, meaning they will skin you alive. fuckers.

 

[SkaredShtles]

Our doctors are greedy, that's the bottom line. If they think an insurance vendor pays them too little, they'll refuse to sign a contract with them and are "out of network" for all patients coming with that insurance, meaning they will skin you alive. fuckers.

And, fortunately, nobody will know that they are out of network until the bill arrives. CAPITALISM!!

 

[johnbryanpeters]

not unavailable, but unaffordable.

Unaffordable is effectively unav

Our doctors are greedy, that's the bottom line. If they think an insurance vendor pays them too little, they'll refuse to sign a contract with them and are "out of network" for all patients coming with that insurance, meaning they will skin you alive. fuckers.

Since health care, under Nixon, became for profit, doctors as well as patients have gotten worked over. It has pretty much gotten to the point at which doctors can't afford to operate their own practice. They have been forced into group practices which, in turn, have become bureaucratic nightmares.

 

[slyfink]

Unaffordable is effectively unav

Since health care, under Nixon, became for profit, doctors as well as patients have gotten worked over. It has pretty much gotten to the point at which doctors can't afford to operate their own practice. They have been forced into group practices which, in turn, have become bureaucratic nightmares.

I'm curious. What was health care like in the US before Nixon? Did he introduce a new bill that privatized it or something?

 

[jonKranked]

I'm curious. What was health care like in the US before Nixon? Did he introduce a new bill that privatized it or something?

History of health care reform in the United States - Wikipedia

en.wikipedia.org

 

[slyfink]

History of health care reform in the United States - Wikipedia

en.wikipedia.org

I haven't read it all, but it sounds like it was the Democrats who fuxxored any attempts at reform?!?!

e.g.: "In December 1977, President Carter told Kennedy his bill must be changed to preserve a large role for private insurance companies, minimize federal spending (precluding payroll tax financing), and be phased-in so not to interfere with balancing the federal budget".

 

[SkaredShtles]

I haven't read it all, but it sounds like it was the Democrats who fuxxored any attempts at reform?!?!

e.g.: "In December 1977, President Carter told Kennedy his bill must be changed to preserve a large role for private insurance companies, minimize federal spending (precluding payroll tax financing), and be phased-in so not to interfere with balancing the federal budget".

Yeah - pretty sure the private insurers have had almost ALL the politicians in their back pocket since pretty much the beginning.

It's one of the reasons that I think it may be too late to *actually* figure out/implement a universal plan.

 

[dan-o]

Unaffordable is effectively unav

Since health care, under Nixon, became for profit, doctors as well as patients have gotten worked over. It has pretty much gotten to the point at which doctors can't afford to operate their own practice. They have been forced into group practices which, in turn, have become bureaucratic nightmares.

A lot of this is due to malparactice.........wait for it............insurance costs.
My SIL closed her practice because the MP Insurance was too expensive to float alone.

 

[jonKranked]

A lot of this is due to malparactice.........wait for it............insurance costs.
My SIL closed her practice because the MP Insurance was too expensive to float alone.

my aunt left a practice she helped start, and MPI was a major reason. she actually went back to an ER.

 

[johnbryanpeters]

A lot of this is due to malparactice.........wait for it............insurance costs.
My SIL closed her practice because the MP Insurance was too expensive to float alone.

Insurance as now operated is taxation by corporations. I would completely phase out for-profit insurance over a period of two decades.