We already means test for numerous subsidies based, essentially, on tax returns. Would it be much different?
We already means test for numerous subsidies based, essentially, on tax returns. Would it be much different?Totally against it. That would mean you have to means test everybody in the country.
Like I've said multiple times unpaid hospital bills are a tiny part of the whole pie, like 6% of hospital budgets small. That isn't going to significantly raise prices.While I would love to support your assertion that "you can't subsidize bad decisions," it's just not realistic. My libertarian core would love that we could practice in such a way, but we can't because it some point, the government will be picking up the check because we have agreed that we are not going to allow people to starve and die in the streets.
As I mentioned earlier, what if charity doesn't cover the bill, or there is no charity? Who pays? The hospital just takes the loss? We can't exactly require providers to treat, and then expect them to do it for free, can we?
How do you define a bad decision? What about the 19 year old type 1 diabetic that is finally realizing the gravity of his condition after poorly controlling it for the past decade and now living with permanent health issues because of it? Too bad? Your 10 year old self made bad choices, deal with it? Blame the parents perhaps?
I agree with you (earlier in this thread) that health insurance is not really insurance, and that's a huge part of problem. The entire system is set up for failure, unless of course you're a large hospital system, pharmaceutical company, or medical device maker in which case you're making tons of money privatizing gains and socializing losses.
Do you know anybody on public assistance? I do. They have to report income changes whenever they occur. Maybe you wouldn't need to do that for just deductibles now that I think about it more.We already means test for numerous subsidies based, essentially, on tax returns. Would it be much different?
Like I've said multiple times unpaid hospital bills are a tiny part of the whole pie, like 6% of hospital budgets small. That isn't going to significantly raise prices.
Geekbabe was telling me that her treatment was negotiated down from 30k to 10k by her insurance company. If the hospital can charge 10k for the service but is charging 30k then there aren't enough restraints on them for pricing.
An example of a bad decision is to not have any health insurance when you think you don't need it.
Many many people directly and indirectly. It's certainly not an easy thing with all the bureaucracy, especially for people with variable incomes and always having to estimate/correct.Do you know anybody on public assistance? I do. They have to report income changes whenever they occur. Maybe you wouldn't need to do that for just deductibles now that I think about it more.
The pricing constraints I'm talking about are market based, not government. But we're not going to get the government 100% out of health care, we do need some regulations. I agree with your first point, that 6% isn't going to be eaten by the hospitals, prices will go up elsewhere. Its simply not a large problem was my point.If we suggest that charity care is 6%, prices would rationally rise by 6%, right? This is capitalism and that cost is going to be passed on to the other consumers. Again, socializing losses, so then perhaps taxpayers aren't paying through taxes, but they're paying in their own health care costs.
I absolutely agree with your second point. On fact, in general we need to stop focusing on what "health coverage" costs to consumers, and focus on the cost of Healthcare delivery. The former will follow the latter.
We absolutely need to more restraint/regulation when it comes to pricing from hospitals, medical device companies, and pharmaceuticals. All the profit they reap comes from somewhere, I wonder where. It's hard to argue we need less government in Healthcare, and then say we need more government regulation in Healthcare.
The reason I support single payer (with some private industry on top) is that it simplifies the system and gives the government the ability to tell the aforementioned sector to collectively "fuck off" as CMS currently does.
Fair. Now how do we get government to intervene where we actually need it in Healthcare?The pricing constraints I'm talking about are market based, not government. But we're not going to get the government 100% out of health care, we do need some regulations. I agree with your first point, that 6% isn't going to be eaten by the hospitals, prices will go up elsewhere. Its simply not a large problem was my point.
Totally against it. That would mean you have to means test everybody in the country.
I don't know.Fair. Now how do we get government to intervene where we actually need it in Healthcare?
Huge increases of the federal budget is the other problem.Again 10,000 foot overview Medicare for all with some deductibles lower income whom can't afford deductibles get a prepaid debit card to cover deductibles
Or
Medicare for all zero to minimal deductibles, plus tort reform to allow Drs to say fuck off to ones who are abusing coverage
Keep it at the 10,000 foot overview please
Centralized government is going to eventually need to make care decisions for people. Why do you want this?
Can they? Yes, but should they be making these decisions? No.Rhetorical point (to some degree); can (second question would be should) government make "better" decisions than the people?
Why not? If they end up having to foot the bill (and by they I mean us, the tax payers) for people's poor health decisions (disability, etc etc entitlements that follow downstream), shouldn't they be allowed to contain costs? Additionally, if my costs are going up because non profits are providing charity care (also known as passing the buck to those who can pay, again, us), couldn't the government protect me?Can they? Yes, but should they be making these decisions? No.
Like I've said multiple times unpaid hospital bills are a tiny part of the whole pie, like 6% of hospital budgets small. That isn't going to significantly raise prices.
Geekbabe was telling me that her treatment was negotiated down from 30k to 10k by her insurance company. If the hospital can charge 10k for the service but is charging 30k then there aren't enough restraints on them for pricing.
An example of a bad decision is to not have any health insurance when you think you don't need it.
You're making my point. The government is going to be picking and choosing who gets "a pill" and who gets actual treatment that could help them. There would be no reason "why not" if the government was totally in control of the system.Why not? If they end up having to foot the bill (and by they I mean us, the tax payers) for people's poor health decisions (disability, etc etc entitlements that follow downstream), shouldn't they be allowed to contain costs? Additionally, if my costs are going up because non profits are providing charity care (also known as passing the buck to those who can pay, again, us), couldn't the government protect me?
You're making my point. The government is going to be picking and choosing who gets "a pill" and who gets actual treatment that could help them. There would be no reason "why not" if the government was totally in control of the system.
You're making my point. The government is going to be picking and choosing who gets "a pill" and who gets actual treatment that could help them. There would be no reason "why not" if the government was totally in control of the system.
Some bureaucrat in DC shouldn't be making that decision. All you want is that the disparate outcomes come from being well connected in the bureaucracy instead of being wealthy.You merely argue that such decisions should be made strictly on the ability to pay.
Some bureaucrat in DC shouldn't be making that decision. All you want is that the disparate outcomes come from being well connected in the bureaucracy instead of being wealthy.
Yes.I'm not entirely sure I follow. What exactly are you suggesting? That the government would not treat some people and treat others?
Yes.
Why do you think that? What criteria do you suppose the government would use? Why do you believe the government would not adhere to the latest medical guidelines? Would it surprise you that it's actually much easier to get things paid for by Medicare than it is private insurers? The private payers are saying "no" a hell of a lot more than Medicare.Yes.
Yeah, I'm sooo much more comfortable with my health care decisions being made by executives at AEtna and the like where their income is directly related to how far down they can squeeze what what is spent on my health care. For years private insurers would not cover expensive treatments like heart transplants, deeming them "experimental surgery."Some bureaucrat in DC shouldn't be making that decision. All you want is that the disparate outcomes come from being well connected in the bureaucracy instead of being wealthy.