Healthcare Question: If we don't force people to get coverage....Who pays if they get sick or injured??

Educated guy, I see you agree with my above post! Good for you brother. You are a true Liberty-minded patriot. My only criticism of your post is it's too long / wordy. Keep it simple as all real word problems are super simple and can be distilled into catchy phrases like "free market reform".

All that one needs to do is look at other countries that have cheaper medical care and better outcomes to see what the US needs to do. EVERY example of an efficient system with good outcomes is based on true free market principles. FACT!

#MAGA

TroLLminator wrote:

You forgot to include 3) Americans are fat, inactive, sick, and addicted to meds... just the way insurers and pharmas like it. This is a circular issue, but in the US the circle is just much bigger with more players.

That stuff doesn't matter. Something like the sickest 15% of the population accounts for like 85% of the costs. Those are people that need 24/7 nursing care, nursing homes, congenital conditions, etc.. You could pay for all the routine stuff, including the diseases of obesity and the pill poppers for what a few traumatic brain injuries and nursing home patients cost.

We like to think that as runners we are not just more healthy, but morally superior to those that are not active, but you can eat all the kale you want and run 100 mpw but are still going to get old and die.

HandWringingLiberal wrote:

No insurance, cant afford care; tough luck. Don't see why taxpayers have to pay for someone else's boob job or sex change or diabetes 2 care.

It's easy to say that until someone swipes you with their car while you are riding your bike or wind up with cancer.

Despite what some people would like to believe, accidents and diseases happen to healthy people.

moanswers wrote:

HandWringingLiberal wrote:

No insurance, cant afford care; tough luck. Don't see why taxpayers have to pay for someone else's boob job or sex change or diabetes 2 care.

It's easy to say that until someone swipes you with their car while you are riding your bike or wind up with cancer.

Despite what some people would like to believe, accidents and diseases happen to healthy people.

Think about the typical middle class person. Because of Medicare most of our parents do not have to liquidate their resources during their final 15 years of life. That mean ol' "socialized medicine" allows them to keep their family home, retirement savings, and SS. Often this gets passed down to their kids and grand kids.

Now imagine if it was the opposite. Your 65 yr old mother gets cancer, blows through her 401k withing 1 year, then has to sell her home, now she's living with family members, once that money gone the YOU either pay for her treatment or let mom die.

Is that the "free market" we want? Is that how people should live and die in the richest country on the planet?

As I have recently heard, healthcare is complicated.

This particular thread is about the mandate.

No matter how you slice it, it is better for society as a whole if every single person is paying into some healthcare plan or insurance policy from the very beginning, and keep paying in.

The average person's cost is equal to the total cost of care divided by the number of people paying in.

When more people pay in, cost per person goes down.

There are other elements to discuss, of course. But let's stay on subject.

You really don't understand how reducing demand and more limited funds available impact fee-for-service business models? C'mon, man.

MRI machines and the scans they perform are as expensive as they are because they CAN BE in the current system. With the use and prices the doctor can charge, the cost really isn't a big deal to him. As my link explains, doctors and hospitals can basically charge whatever they want, and the insurance company gladly pays up. There's zero accountability, and always enough money to pay. There's very little downward pricing pressure on anyone in the system, from producer of the medical equipment to the hospital to the doctor himself.

I didn't say no one needs health care. I said it should be split into basic care that has very little insurance company involvement, and catastrophic insurance that works as a risk management business truly should. It may need three divisions instead of two, but its based the same tiered concept (strive for efficient operations of the system in each tier).

So in the example you request, I'll provide one example of how the system could be set up: As I said, I'm not saying insurance doesn't exist anymore in my solution. On an increasing scale of health-related procedures, my tiered pre-paid insurance and/or health savings account (currently a lot of employers are providing this) could be tapped to cover expenses. So who do I go to? Doctor A or Doctor B? Both doctors' rates are now published. (This is critical. Pricing figures need to be out there so people can shop. Currently this does not occur. Why? Because "Who cares? I have insurance.") Anyway, Doctor A wants more MRI business, so he lowers his price. But then doctor C enters the market to undercut Doctor A. Doctor B is getting no MRI action after several months, so he decides to undercut both Doctor A and Doctor C. And so on.

And there you have a competitive, transparent pricing landscape for performing MRIs.

It's basic economics applied to the medical industry. Basic economics that NO ONE in the health care industry wants applied. Why do you think that is?

I completely agree with you. An effective leader (meaning NOT Donald Trump) could articulate a plan like this, and move it through the Congress. You have to be VERY clear on how somethings will not be covered, but how that means we can cover cardiac disease, or cancer and other horrible and very expensive procedures.

You have to hammer away that not treating ever little sniffle with insurance is a different proposal than "not covering sick people and letting them die in the street..." rhetoric you will hear from the Left.

And I'm not saying that we must have a mandate where you receive a tax penalty if you are not covered.

There can be other ways to incentivize people to get covered.

But you don't want people sitting on the sidelines.

quickndirty wrote:

TroLLminator wrote:

You forgot to include 3) Americans are fat, inactive, sick, and addicted to meds... just the way insurers and pharmas like it. This is a circular issue, but in the US the circle is just much bigger with more players.

That stuff doesn't matter. Something like the sickest 15% of the population accounts for like 85% of the costs. Those are people that need 24/7 nursing care, nursing homes, congenital conditions, etc.. You could pay for all the routine stuff, including the diseases of obesity and the pill poppers for what a few traumatic brain injuries and nursing home patients cost.

We like to think that as runners we are not just more healthy, but morally superior to those that are not active, but you can eat all the kale you want and run 100 mpw but are still going to get old and die.

Excuse me, sir, but I am going to get hit by a car and or eaten by a bear before I get old and die, thank you very much.

Hope this is not dumb question wrote:

What if these people don't have money to pay for their services? Is this cost factored into the Republican plan? Are there any estimates on this cost?

Questions of cost subsume an answer to the question "cost to who?

If you can't afford healthcare, it has no cost, because you either rely on charity or do without. You do NOT have a right to force others to pay for it!

Cold hearted? Maybe, but policy shouldn't be based on emotion.

The kindest thing we can do for people who lack the means to pay for healthcare that is currently prohibitively expensive is to abolish all subsidies, taxes, mandates, and barriers to entry (like FDA regulations and professional licensing) that make it impossible for profit-seeking doctors, scientists, and businessmen to sell it for less.

Reality, fool wrote:

Cold hearted? Maybe, but policy shouldn't be based on emotion.

7/10! Excellent, excellent.

[quote]Reality, fool wrote:[/b

If you can't afford healthcare, it has no cost, because you either rely on charity or do without. You do NOT have a right to force others to pay for it!

Cold hearted? Maybe, but policy shouldn't be based on emotion."

Well, I'll give you this.... you at least got part of your name right.... (Hint: it's the second part, not the first)

You tell 'em, Flaggy!

It's not basic economics. Because MRI scanners cost millions because they are advanced pieces of machinery that have costs tied up in research, materials and engineers. If you think Siemens is going to start flogging MRIs for $500 then you are very wrong. There is NOTHING that can bring an MRI scan into the realm of affordable for the average American. The costs of purchase have to be recovered by the hospitals or else they would not be able to offer the scan at all. The startup costs are so high that unless there is either a high demand or they charge lots for the scan then it's not financially feasible. MRI scans are expensive all over the world.

There is another factor that 'basic economics' forgets, which is the level of care. How can a person realistically know if Doctor C is just undercutting the previous two Doctors by offering worse care, untill it is too late? Same goes with the MRI scanners, you can get cheaper inferior quality/strength scanners. They are more common in Far East Asia. How can the average person know the difference between a 1.5 or 5 Tesla machine?

If you reduce the demand for healthcare artificially then you will strangle research. Drug companies only exist because they are able to get exclusive rights to sell their products at extortionate rates for the first 10 years. If they didn't, there would be no research and medicine would stall.

The innate problem with treating medical care as some other commodity is it is complex, has lots of innate costs tied up in it (length and costs of doctors studies, research costs etc)and absolutely everyone needs it at some point.

You can avoid buying a car, but you can't decide not to have cancer

zohan wrote:

Well, I'll give you this.... you at least got part of your name right.... (Hint: it's the second part, not the first)

You have no counter-argument apart from brazenly flaunted logical fallacies like "every other country has socialism, so we should, too."

What if nobody had insurance? wrote:

...

It's not basic economics. Because MRI scanners cost millions because they are advanced pieces of machinery that have costs tied up in research, materials and engineers. If you think Siemens is going to start flogging MRIs for $500 then you are very wrong. There is NOTHING that can bring an MRI scan into the realm of affordable for the average American. The costs of purchase have to be recovered by the hospitals or else they would not be able to offer the scan at all. The startup costs are so high that unless there is either a high demand or they charge lots for the scan then it's not financially feasible. MRI scans are expensive all over the world.

...

It IS basic economics. Free markets work.

A couple years back my doctor signed me up for an MRI scan. It was supposed to cost over $1,000 dollars, but of course insurance would pay for it so I was not supposed to be bothered by the cost. But I was. So I went shopping and I found a place that would do it for just over $300, but my insurance wouldn't pay for that second place because it was outside the plan. The insurance company wouldn't even let me negotiate price savings for them. Can you spot the problem in the system?

The third party payer issue is a big part of the problem, combined with government restrictions on the structure of health plans. The Educated Guy is right. If you can get the third party out of the way and let consumers drive down costs then most health care costs would snap back into line... even MRI scans.

Also, you state that nothing can bring down the cost of a scan and then immediately explain how costs could be brought down by using less powerful scanners. So the logic is confusing.

hey Disco, if you have a grandchild that gets leukemia let me know if you find leukemia drugs in the Sunday sale papers ok? Or about someone with a traumatic brain injury? Hard to shop for care for that on craigslist...

DiscoGary wrote:

Also, you state that nothing can bring down the cost of a scan and then immediately explain how costs could be brought down by using less powerful scanners. So the logic is confusing.

Less powerful = inferior. Weaker MRI scans could miss your affliction/cancer. You don't know that, because you are the average American i have been talking about. Should you be expected to know all the complexities of a medical procedure or illness or treatment and shop around taking into account all these complex factors whilst potentially dying? It is unrealistic and utopian.

I'm glad for your sake that your insurance wouldn't pay for your bargain basement MRI which could have been cheap quality and also interpreted by a guy that gave it a quick glance.

Medical services are NOT basic economics.