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Author: erikinthered100 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 4272  
Subject: Denial of Care Date: 10/2/2012 12:02 PM
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Here's a good article about how government denies medical care through central planning. The article specifically discusses "certificates of need (CON's)"

http://reason.com/archives/2012/09/26/denial-of-medical-choi...

CON's are basically a method that many states use to restrict the supply of health care. A CON is a permit that must be acquired from the state before a new health care facility is built, a healthcare facility is expanded, a new lab is built or new imaging machines (CT's and MRI's for instance) are bought. The idea is that the state can control health care costs by limiting the supply of health care facilities.

Of course, it's plainly obvious to any economist that limiting supply through central planning has the perverse result of inappropriately limiting supply and driving up the price. The decisions are predictably often driven by politics rather than the best interests of patients(I personally know of one example where this occurred). Even in the best case, the policy causes huge delays and adds significant costs. Sometimes, an application can be delayed for months if one signature is missing.

CON's are a microcosm of what is likely to occur on a larger scale through Obamacare. The Independent Payment Advisory Board ("death panel") appears to be the main tool that will be used. But I suspect there are other ways the two thousand page law will deny care.

dave
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Author: pauleckler Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3913 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 1:04 PM
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But it is also well documented that when a region has over capacity in some test facility, say MRI, costs in that area also rise. Often prescribe-rs over use the facility in an effort to support it. And all too often the physician forwarding patients has a financial position in the facility.

There also seems to be the problem of over concentration of services in a few desirable big cities leaving other areas under served.

Again the medical community seems to need govt assistance to do the obvious to provide good care.

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Author: fleg9bo Big funky green star, 20000 posts Top Recommended Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3914 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 1:41 PM
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There also seems to be the problem of over concentration of services in a few desirable big cities leaving other areas under served.

Again the medical community seems to need govt assistance to do the obvious to provide good care.


There is an over-concentration of quality food in affluent areas while poor parts of some cities suffer from a lack of grocery stores. Perhaps the government should determine where grocery chains can and cannot locate new stores and what items they should be selling in which locations. That would no doubt result in lower food costs for everyone.

--fleg

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Author: erikinthered100 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3915 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 4:45 PM
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But it is also well documented that when a region has over capacity in some test facility, say MRI, costs in that area also rise. Often prescribe-rs over use the facility in an effort to support it. And all too often the physician forwarding patients has a financial position in the facility.

This is primarily a problem created by government due to a predominance of third party payers. In a patient-focused free market system, this entire issue would be irrelevant.

There also seems to be the problem of over concentration of services in a few desirable big cities leaving other areas under served.

This is a natural result of human nature. In an efficient economy, those who choose to live in sparsely populated areas will pay more for certain services or do without. There is no way to fix this problem without massive inefficiencies or massive misuse of resources.

Again the medical community seems to need govt assistance to do the obvious to provide good care.

No. Government has created a problem (predominance of third party payers with associated incentives for fraud or overbilling) and now is trying to fix the problem. It does so by denying health care to people.


dave

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Author: pauleckler Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3917 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 5:02 PM
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Perhaps the government should determine where grocery chains can and cannot locate new stores and what items they should be selling in which locations. That would no doubt result in lower food costs for everyone.

Yes, it would be nice if market forces caused innovative entrepreneurs to open stores where the customers are rather than concentrating their efforts where everyone else has their stores.

And yes, it is ok for govt to provide incentives to build in under served areas, and even to limit new stores (where everybody else has theirs) usually through zoning laws.

Do we really need the glut of vacant big box stores? Do business men need common sense? Or do they need help from outside forces?

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Author: erikinthered100 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3919 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 5:53 PM
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Yes, it would be nice if market forces caused innovative entrepreneurs to open stores where the customers are rather than concentrating their efforts where everyone else has their stores.

It is nice since that is exactly how market forces operate.

And yes, it is ok for govt to provide incentives to build in under served areas, and even to limit new stores (where everybody else has theirs) usually through zoning laws.

Is it ok? This is restriction of trade. There is a loss of freedom and a cost to these policies. Shouldn't free people (customers and businesses) make these decisions? Aren't a few hundred million people making daily decisions with their own hard-earned money more capable of making better decisions than a few bureaucrats (insulated from the cost and consequences of their decisions)? Moreover, is it moral for government bureaucrats to arbitrarily impose these costs on people and take away their freedoms?

Do we really need the glut of vacant big box stores? Do business men need common sense? Or do they need help from outside forces?

Why can't the customers decide? Why would businessmen need help from outside forces? If they build a business where they have customers, the company will survive and prosper. If they build the business where they don't have customers, they will fail. This process selects for businessmen with better business skills ("common sense") and against those without. Allowed to work efficiently, this process produces a more efficient and prosperous society,a society where people have more and better goods and services.

When outside forces in the form of government intervene in this process through bailouts or incentives/payoffs, inefficient or unnecessary businesses survive at the expense of stronger and necessary ones. This is often called corporate cronyism. Well-intentioned "incentives" typically just become an avenue for corruption - favors or payoffs to those who are politically well-connected. This is immoral and decreases overall prosperity.


dave

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Author: Donna405 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3922 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 6:32 PM
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Dave, glad you brought this up. We had a situation where a hospital in another county, across the river from Columbia, SC wished to open a Heart wing. The CON said it was not needed. The other two hospitals, one which specializes in heart care and the other which had just opened a new heart wing/building in the last 10 years would have none of it due to competition. They both fought the other hospital from opening its Heart Hospital, no holds barred. I joined in the fray. I live on the side of town with the two existing heart hospitals, but I had a friend many years ago, who succumbed due to the lack of knowledge at the hospital across the river. He was rushed to the hospital across the river, and was not properly diagnosed until he was airlifted to the Heart Hospital near me. He had an aneurysm in his stomach area, which had burst. He died, far before he should have. The MD's at the heart hospital on my side of town stated that he if had been taken directly there, he would more than likely be alive today. They knew the symptoms for that particular occurrence, whereas the ER in the other hospital did not.

I e-mailed the State Health Department (Department of Health and Environmental Control), attended hearings, etc. The request was turned down twice. FINALLY, after plugging along, that side of town now has a well-equipped Heart Hospital in association with Duke University, and is doing very well. The residents in that county now should find comfort in the fact that, if they have cardiac problems, they will be well taken care of.

Donna

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Author: SeattlePioneer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3923 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 10:06 PM
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There is an over-concentration of quality food in affluent areas while poor parts of some cities suffer from a lack of grocery stores. Perhaps the government should determine where grocery chains can and cannot locate new stores and what items they should be selling in which locations. That would no doubt result in lower food costs for everyone.

--fleg


Oh dear, fleg! There little minds are starting to whir already about how to implement your idea I'm afraid!



Seattle Pioneer

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Author: Donna405 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3924 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 10:08 PM
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SP, many urban areas are already trying to combat the problem, including our little city of Columbia, SC. Empty urban lots are being turned into food gardens, which is a great benefit for those who cannot find a nearby grocery store selling fresh veggies.

Donna

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Author: pauleckler Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3926 of 4272
Subject: Re: Denial of Care Date: 10/2/2012 10:21 PM
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Empty urban lots are being turned into food gardens

I'm all for these gardens, but I wonder how big an army it takes to protect them from thieves. And if the gardeners get much yield.

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Author: Donna405 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 3931 of 4272
Subject: Re: Denial of Care Date: 10/3/2012 10:20 PM
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Detroit has several of these gardens, as does NYC (Queens, Brooklyn, Harlem, etc.) all of which appear to produce quite well. The surrounding neighbors are the ones caring for the gardens, so I doubt much theft is evident. (I certainly would not want the neighbors after me.) This is the first year for Columbia, SC as far as I know, so I don't have any info for this area.

By the way, Columbia, SC passed an ordinance allow 3 chickens (no roosters) in urban backyards. (I have a friend with 3 - used to have 6 with a rooster, until the neighbors raised holy terror. He was instrumental in getting the ordinance passed.)

Donna

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