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I don't understand albaby1's support for paying double the cost for half the health care.

albaby has excellent health insurance paid for by his employer. He fears he would lose that under a rational health care plan.
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To gain enough political support to pass, health care prices were set significantly higher than drafters originally hoped.

“It started out as a very aggressive effort to push down prices to Medicare levels, and ended up something quite a bit more modest,” said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation.

“The whole debate was about the rate mechanism,” said Mr. Frockt, the state senator. “With the original bill, with Medicare rates, there was strong opposition from all quarters. The insurers, the hospitals, the doctors, everybody.”


Everybody??? The health care consumers were complaining that the costs were too low?

culcha
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Everybody??? The health care consumers were complaining that the costs were too low?

LOL. It is interesting that whenever we start to have a discussion/debate about health care in the US, it always turns into a health insurance debate instead of actually addressing health care issues. And somehow, we have managed to pit both the insurance companies and the health care providers against the patient. No one seems concerned about actual health care or about actual patients. They are simply the chattle that interferes with the financial games being played by the insurance companies and care provider's billing efforts.
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Either the Washington state health care complex refuses to work for Medicare rates except for those over 65. Or the Washington state health care lobbyists rolled the states representatives.

The argument is that private insurance reimbursement rates keep the doors open for medicare & medicaid patients.

I found a link of medicare vs private insurance reimbursement rate by state. Five states were below 200%, 2 above 300%, and a ballpark average of 225% for the remainder.

Ultimately they will work for whatever is out there. Just like the rest of us. Medicare rates are quite fine. They just have to work that yet.
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Read the title of the "Medicare vs. Private Pay Prices" study.

Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely
https://www.rand.org/pubs/research_reports/RR3033.html

</snip>


No one is talking about the actual cost of delivering a medical service. They're just arguing about the level of price gouging that will be permitted.

What do you want to bet that the last couple of votes required to pass the Washington State Private Option Law were on the payroll of the American Hospital Association?

You won't fix health care until you fix money in politics and the corruption of large political campaign contributions.

intercst
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You won't fix health care until you fix money in politics and the corruption of large political campaign contributions.

Which is why I keep arguing that adopting single-payer won't address health care costs in this country. Because you're never going to "fix money in politics," and even if you did it would only make the health care lobby stronger than it is now.

Albaby
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albaby1 writes,

Which is why I keep arguing that adopting single-payer won't address health care costs in this country. Because you're never going to "fix money in politics," and even if you did it would only make the health care lobby stronger than it is now.

</snip>


Why not? Single payer for those over age 65 has delivered tremendous savings vs. the for-profit price gouging suffered by the under-65 set. You just need somebody to identify the folks who are screwing you and explain the arithmetic of how much the price gougers are costing you. If we cut every medical provider to Medicare reimbursements, which country would the provider move to so that he could keep charging double and triple the cost? There aren't any.

intercst
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Washington State has already gone through a Democratic health care plan.


Signup was initially good. Then doctor's offices and hospitals discovered they could sign up people for health care coverage who were already sick. That really marked the end of the plan, which spun into the ground as revenues dwindled and costs and subsidies exploded.


Eventually, Dems decided they wanted to spend their money elsewhere and the program was shelved.

Doing a roll out is the easy part.



Seattle Pioneer
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<<No one is talking about the actual cost of delivering a medical service. They're just arguing about the level of price gouging that will be permitted.

What do you want to bet that the last couple of votes required to pass the Washington State Private Option Law were on the payroll of the American Hospital Association?

You won't fix health care until you fix money in politics and the corruption of large political campaign contributions.

intercst>>



Every time intercst describes his work history, it's all about getting paid the most for doing the least. He just doesn't understand why doctors and hospitals think the same way he does.


Seattle Pioneer
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<<Which is why I keep arguing that adopting single-payer won't address health care costs in this country. Because you're never going to "fix money in politics," and even if you did it would only make the health care lobby stronger than it is now.

Albaby>>



I think it should be pointed out that Albaby has repeatedly proclaimed that it wasn't going to be at all easy to cut the costs paid by any health care plan the way they have been cut in Medicare and Medicaid.

The discussion in this thread vindicates Albaby's shrewd assessment of the politics of the issue.

Of course that doesn't really explain how Medicare and Medicare snuck by the health care lobbyists. As I understand it, Medicare only passed in 1965 because Lyndon Johnson promised the healthcare lobby that Medicare would pay more or less the usual charges for services.

That was the reimbursement standard until 1980, when Democrats decided they were unhappy paying retail rates. They adopted the current reimbursement system which usually makes Medicare services a loss for health care providers which must be compensated for by raising the charges for private insurance and cash customers, who are gouged as a result.



Seattle Pioneer
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<< If we cut every medical provider to Medicare reimbursements, which country would the provider move to so that he could keep charging double and triple the cost? There aren't any.

intercst>>



You might discover that doctors and nurses decide to do what you did, intercst: do the minimum amount of work absolutely required. Never work any overtime. Take all the time off you can without getting fired. Retire at age 45.

Meantime hospitals would quit investing in new technology and fixing the roof and sweeping and mopping the hall, hoping to use their limited revenues to keep the lights on.

Meanwhile, a lot of talented people would quit going to nursing and medical schools in favor of careers where they can get paid a good living.


For a smart guy, intercst, you have some blind spots about things that you yourself were very shrewd about.


And if Washington State had adopted the reimbursement rates you wanted, I imagine that a lot of doctors and other health care professionals would move out of state or not move to Washington State to practice, creating huge shortages within a very few years.


Seattle Pioneer
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Every time intercst describes his work history, it's all about getting paid the most for doing the least. He just doesn't understand why doctors and hospitals think the same way he does.

You sure about that?
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<<Every time intercst describes his work history, it's all about getting paid the most for doing the least. He just doesn't understand why doctors and hospitals think the same way he does.

You sure about that?>>


intercst's attitude is like the cheap wage employer who is ALWAYS interested in cheapening wage rates by another nickel.


In economics, that's the concept of monopsony power, the purchaser of goods and services who has effective market control over price and is always angling to cut down on the price paid.

That results in less labor and less product being created because a shortage of labor is created by holding down wage rates.


That's an economic argument in favor of labor unions, which may be able to use their own power to force increases in the amount paid for labor or goods. If that happens, there will be both higher wages AND an increase in employment, since enough people will be attracted to fill the actual demand desired.

Medicare reimbursement rates are just that kind of monopsony power used by the Federal government to pay less than is fair and just for the services the government purchases. It works primarily because the health care providers can gouge private insurance and private paying customers, charging them excessively high prices in order to subsidize the cheap prices paid by the government.

If intercst had a chance to impose his health care system on the country as a single payers system, he would torpedo the heath care system as we know it now, impoverishing suppliers and providers by failing to compensate them in a just and fair manner.

Of course, he wouldn't actually get what he wants. What he would do would be to have declared WAR on doctors and health care providers, and they would wage war on the government health care system in turn. They would not surrender quietly or without a fight, and I am very sure they could fight VERY effectively.


Seattle Pioneer
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SP analyzes,

If intercst had a chance to impose his health care system on the country as a single payers system, he would torpedo the heath care system as we know it now, impoverishing suppliers and providers by failing to compensate them in a just and fair manner.

</snip>


I'm only advocating that capitalism and market pricing be applied to health care services. That's not a novel concept when applied electric utility pricing or the cost of computer chips. Only in health care do we allow market participants to refuse to disclose pricing to customers (patients) in exchange for massive bribes to politicians.

If voters follow the money and vote out those taking it, the problem can be fixed.

intercst
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If intercst had a chance to impose his health care system on the country as a single payers system, he would torpedo the heath care system as we know it now, impoverishing suppliers and providers by failing to compensate them in a just and fair manner.

I've been going to the same doctor for about 15 years or so. Back in the day, he worked a small-ish clinic. I remember they used a balance beam scale in the hallway for the weigh-in prior to check up. He got bought out by the MegaClinic, and now they have fancy digital scales in each examination room. I'm 100% certain having digital scales in each examination room provides zero health care benefit over the single balance beam scale in the hallway.

If we go just across the border to Canada, we find health care per capita costs less than half, yet heath care outcomes for most conditions are actually superior in Canada. Yes, you might have to wait longer to see a specialist, but by almost every objective measure their specialists do a better job than our specialists, and at lower cost.

I know you are of a frugal nature, so why would you enjoy paying double for worse results?
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My doc still has the scale in the entrance way - but it's a digital scale.......

He works for a large collection of doctors...... I think that is becoming the only way that docs can survive these days with all the electronic records and other BS imposed upon them by the government. About 40-50 docs in the practice.

The admin spends 10 minutes typing in answers to questions she has to ask for an annual health checkup.....

the doc spends all of ten minutes .....

I get my blood test results about 10 days later in a 'secure' email where I have to log onto the doc's site and get my results with his comments......

t.
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<<SP analyzes,

If intercst had a chance to impose his health care system on the country as a single payers system, he would torpedo the heath care system as we know it now, impoverishing suppliers and providers by failing to compensate them in a just and fair manner.

</snip>

I'm only advocating that capitalism and market pricing be applied to health care services. That's not a novel concept when applied electric utility pricing or the cost of computer chips. Only in health care do we allow market participants to refuse to disclose pricing to customers (patients) in exchange for massive bribes to politicians.

If voters follow the money and vote out those taking it, the problem can be fixed.

intercst>>


What I see is that you advocate applying Medicare prices to a national single payer health care system, which would use the monopsony power of the Federal government to impose, or try to impose, reimbursement levels that substantially fail to reimburse costs.


I say "try," because such an effort would surely cause health care providers to wage political and economic war on that health care system, roiling the health care system in dramatic ways as strikes, lockouts, rationing and other methods are used to retaliate against the imposition of such a system.


Liberals have been waging war on the interests and incomes of the working class for half a century, and produced Donald Trump as a result.

I can only imagine what waging war against Doctors, nurses, hospitals and millions of health care providers might look like when their fundamental interest are under attack and they are motivated to organize to counter those attacks.



Seattle Pioneer
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<<I know you are of a frugal nature, so why would you enjoy paying double for worse results?>>



You have already seen the answer that occurred when Washington State tried tom impose cheap reimbursement rates. The health care providers beat it down. They beat it down in a blue state with a Dem legislature and governor.

That's political reality.


Washington State has already had experience with a "Medicare for all" type plan. After being started with great political fanfare, it went bust after a few years.


California Democrats have proposed a "medicare For All" plan. Why haven't THEY passed it?


Seattle Pioneer
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My doc still has the scale in the entrance way - but it's a digital scale.......

He works for a large collection of doctors...... I think that is becoming the only way that docs can survive these days with all the electronic records and other BS imposed upon them by the government. About 40-50 docs in the practice.

The admin spends 10 minutes typing in answers to questions she has to ask for an annual health checkup.....

the doc spends all of ten minutes .....

I get my blood test results about 10 days later in a 'secure' email where I have to log onto the doc's site and get my results with his comments......

t.


So, you forgot to mention ... What's your problem? Electronic records? Seems like an odd complaint in 2019. You preferred a rollodex?

CNC
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You have already seen the answer that occurred when Washington State tried tom impose cheap reimbursement rates. The health care providers beat it down. They beat it down in a blue state with a Dem legislature and governor.

That's political reality.


I understand why the entrenched interests oppose it. I don't understand why you oppose it. Do you like taking a blow torch to your money?
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So, you forgot to mention ... What's your problem? Electronic records? Seems like an odd complaint in 2019. You preferred a rollodex?

Part of Obama's stimulus package of was money for providers to move to electronic records. Conservatives are still angry that medical records aren't kept in filing cabinets like our grandfathers used.
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syke6 writes,

<<SP: You have already seen the answer that occurred when Washington State tried tom impose cheap reimbursement rates. The health care providers beat it down. They beat it down in a blue state with a Dem legislature and governor.

That's political reality.>:>

I understand why the entrenched interests oppose it. I don't understand why you oppose it. Do you like taking a blow torch to your money?

</snip>


I understand why SP likes taking a blow torch to his money. He's innumerate.

I don't understand albaby1's support for paying double the cost for half the health care.

intercst
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I know you are of a frugal nature, so why would you enjoy paying double for worse results?

Because the right wing echo chamber has convinced Trump culters that inexpensive and effective health care is something that would be good for Democrats, minorities and immigrants. If cult members shun decent, cost effective health care, it will hurt those terrible liberals and teach them a lesson.

I'm not joking.
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Do you like taking a blow torch to your money?

When you hate liberals, minorities and immigrants the way Trump culters do, the expense of supporting Big Insurance price gauging is worth the pain of having to pay those prices.
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I don't understand albaby1's support for paying double the cost for half the health care.

albaby has excellent health insurance paid for by his employer. He fears he would lose that under a rational health care plan.
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"You have already seen the answer that occurred when Washington State tried tom impose cheap reimbursement rates. The health care providers beat it down. They beat it down in a blue state with a Dem legislature and governor.

That's political reality.

I understand why the entrenched interests oppose it. I don't understand why you oppose it. Do you like taking a blow torch to your money? "

-----------------------------------
SP, like a few people I know, is a hard core right winger who votes against what is in the best interest of the working class. I get the impression SP is a pretty smart guy, but he has bought into the right wing elite's propaganda hook,line,and sinker. ( for all of you non fisherman out there, that means he's swallowed the whole enchilada, if that helps, lol ).

They are entitled to their view and opinion, but I know more than a few of the "water carrier's for the right wing elite" who will be singing a whole different tune if some of these policies/reforms are enacted. I actually know someone who is on SS Disability as his only source of income who is hard core right wing. He doesn't seem to comprehend that he is on government assistance. He hates the ACA. And he will be living in a box if there are any cuts to the social safety net. But to each their own.
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But to each their own.

But it's not "to each their own" for the right. The right won't leave it to others. They know what religion you need to be. They know that white is the only acceptable skin color. They lie about the conditions of the country, then demand that we spend public funds to address their lies. There is no border crisis, but they have spewed lies about it for so long that now they demand billions of public funds be spent on a silly wall. The wealthy are not doing poorly. They are making more money every year while the working class stagnates. But the right has lied about taxes for so long that they can't think of anything else to do with public funds but give it to the wealthiest people on the planet. The list goes on.

Anyone who is smart and isn't a greedy billionaire should see through the lies of the right.
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<<You have already seen the answer that occurred when Washington State tried tom impose cheap reimbursement rates. The health care providers beat it down. They beat it down in a blue state with a Dem legislature and governor.

That's political reality.

I understand why the entrenched interests oppose it. I don't understand why you oppose it. Do you like taking a blow torch to your money?>>


If you are going to have a government health care service, it needs to pay fair and just reimbursement levels to everyone, just as it pays fair and just wages and benefits to government employees.

The idea of using government economic power to pay health care provider cheap and inadequate levels of reimbursement is a vile and disgusting thing to even talk about.

Fortunately, we have seen the recent effort by liberals and Democrats to do just that in Washington State has been a failure.


Seattle Pioneer
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SeattlePioneer analyzes,

If you are going to have a government health care service, it needs to pay fair and just reimbursement levels to everyone, just as it pays fair and just wages and benefits to government employees.

The idea of using government economic power to pay health care provider cheap and inadequate levels of reimbursement is a vile and disgusting thing to even talk about.

</snip>


There's nothing in the Federal Medicare legislation or the WA State Public Option program that requires a doctor or hospital to participate. They are perfectly free to forgo accepting the 60 million people on Medicare as patients, or the 100,000 plus employees of the WA State Gov't and the Public Universities if they think focusing on other parts of the health care market will be more profitable for them.

Of course, about 97% of doctors and hospitals do accept Medicare and I suspect a similar number would accept the WA State public option at Medicare reimbursements rather than Medicare plus 60% as the legislation allows.

intercst
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If you are going to have a government health care service, it needs to pay fair and just reimbursement levels to everyone, just as it pays fair and just wages and benefits to government employees.

The idea of using government economic power to pay health care provider cheap and inadequate levels of reimbursement is a vile and disgusting thing to even talk about.


Who says it is cheap and inadequate? You go right across the border and the costs are less than half and the outcomes are objectively better by most metrics. If it works in Canada it will work here too.

I've mentioned this a number of times, but bears repeating. Here in Seattle health provider Virginia Mason found that by reducing tests and procedures they improved outcomes and lowered costs.

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2011....

Our current system is designed to maximize tests and procedures and there is little to no incentive to maximize health care outcomes. Only people who enjoy high taxes and favor government waste think this is smart.
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syke6: Here in Seattle health provider Virginia Mason found that by reducing tests and procedures they improved outcomes and lowered costs.

I have a skin cancer on my right hand, middle knuckle. After jumping through several hoops, I was sent (By my primary MD, aka gate keeper) to an allergist. He nodded his head wisely, took a sample and sent it out for analysis. Gee! It's cancer! So I was referred to a plastic surgeon. Why? I have no idea. The insurance declined this request, so I an finally referred to an oncologist in another 1 1/2 weeks*. If I am still alive. I think I prefer the British (or French) systems. Our system of having everything screened through insurance "underwriters" (Now there's a useless waste of resources) before being allowed to actually see the person able to take action. No wonder our system is so expensive! It's filled with drones!

CNC
*But wait! It gets better. The oncologist won't actually do anything! He will refer me to a surgeon!
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CountNoCount writes,

I have a skin cancer on my right hand, middle knuckle. After jumping through several hoops, I was sent (By my primary MD, aka gate keeper) to an allergist. He nodded his head wisely, took a sample and sent it out for analysis. Gee! It's cancer! So I was referred to a plastic surgeon. Why? I have no idea. The insurance declined this request, so I an finally referred to an oncologist in another 1 1/2 weeks*. If I am still alive. I think I prefer the British (or French) systems. Our system of having everything screened through insurance "underwriters" (Now there's a useless waste of resources) before being allowed to actually see the person able to take action. No wonder our system is so expensive! It's filled with drones!

</snip>


You must have a GOP-approved, for-profit Medicare Advantage plan.

Traditional, fee-for-service Medicare allows you see any specialist you like without the Primary Care physician gate keeping. And to add insult to injury, Medicare Advantage costs Taxpayers 12% more than traditional Medicare.

Who would have guessed that putting a for-profit health insurer between you and your doctor would make health care more expensive and reduce its quality?

Anyone who understands arithmetic.

intercst
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Our current system is designed to maximize tests and procedures and there is little to no incentive to maximize health care outcomes.

The insane part about Western medicine is that it is supposedly built upon evidence based science. Not true. Au contraire.

https://endeavors.unc.edu/win2005/hadler.php

Do you need surgery for your back pain? Should you have a colonoscopy once you reach age fifty? Is bypass surgery the answer for heart disease?

According to today’s medicine, the answer to those questions often is yes. But Nortin Hadler says that all too often, this answer is wrong. Hadler maintains that many standard procedures and tests carry more risks than benefits. “I firmly believe,” he says, “that the institution of medicine, not the practitioners, has lost its way.”

Most statistical studies of colon-cancer screening consider the most important result to be whether the screening reduced the number of people dying from colon cancer. But Hadler argues that the most important question should be, does screening for colon cancer enhance my longevity? “If screening spares you death by colorectal cancer but you die at about the same time from something else,” he writes, “was the screening valuable?”

Hadler names coronary artery bypass surgery as an example of “Type II medical malpractice” — performing a treatment very well, but on people who do not need it in the first place. Most coronary artery bypass graft surgery, he says, does not significantly increase survival or even decrease the chance of a heart attack.
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I don't understand albaby1's support for paying double the cost for half the health care.

I don't "support" it. I just think that it is a naive fantasy to think that single-payer will cut the cost of health care in half. Or cut it at all, actually.

You asked upthread what country medical providers would move to in order to escape lower rates. They wouldn't move. They would organize. Which is exactly what happened in Washington state (and which has happened every time that Medicare rates were scheduled to be cut, resulting in the "doc fix"). Medical providers used their political clout to make sure that rates didn't get cut in half.

Think about it - one of the most prominent supporters of a single-payer system in California is the nurse's union. That's a trade group of medical service providers. There is no way they would be supporting single-payer if they felt there was any chance it would result in their members' compensation being cut in half (or cut at all). They know they have enough political power to make sure that doesn't happen. They know that if compensation rates are set in the political arena they will be able to make sure they stay high.

The political constituency for a trade group of medical service providers (much less a union) is enormous - more than enough to keep Congress from reducing health care costs, and probably strong enough to pressure Congress to increase health care spending. And single-payer converts that constituency from a group that is somewhat interested in federal medical policy to a group that is intensely and overwhelmingly focused on federal medical policy to the near exclusion of anything else.

What you want to result from single-payer will never result from single-payer in this country.

Albaby
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<<I've mentioned this a number of times, but bears repeating. Here in Seattle health provider Virginia Mason found that by reducing tests and procedures they improved outcomes and lowered costs.>>



What you will discover is that as cheap reimbursement rates stress health care providers they will reduce tests and procedures that are vital to improved outcomes and lowered costs.

When people seek bids from contractors, they are usually told not to generally accept the cheapest bid. The cheapest bid may provide inadequate levels of quality and experience in performing a job.


What cheap reimbursement levels provide is to impose the cheapest bid on everyone, for everything.

I don't doubt that is the cheapest thing for government. It is not in the interests of patients.

Rather than using new sterile bandages, we'll just reuse bandages, if they don't look too bloody, as an example. That starts to become the medical norm when shortages of supplies becomes chronic, and I would expect it to happen when health care providers receive inadequate levels of reimbursement.

Inadequately trained and experienced doctors, nurses and other professionals will be used to do procedures when chronic shortages of staff become the norm. Training of new staff will be shortchanged, and doctors and nurses trained in 3rd world countries of doubtful quality will be recruited for American hospitals to make up shortages

But thanks for illustrating why I oppose government health care.

You guys are exactly like cheap wage employers who are always looking for the way to put extra money in your pockets.




Seattle Pioneer
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Hadler names coronary artery bypass surgery as an example of “Type II medical malpractice” — performing a treatment very well, but on people who do not need it in the first place. Most coronary artery bypass graft surgery, he says, does not significantly increase survival or even decrease the chance of a heart attack.


Chilling article in the Seattle Times about how a prominent neurosurgery hospital was performing huge numbers of unnecessary surgeries and procedures, sometimes resulting in death. Unnecessary spinal fusions were very popular because they made the most money for doctors. One doctor was making two million a year.

https://projects.seattletimes.com/2017/quantity-of-care/hosp...
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Hadler names coronary artery bypass surgery as an example of “Type II medical malpractice” — performing a treatment very well, but on people who do not need it in the first place. Most coronary artery bypass graft surgery, he says, does not significantly increase survival or even decrease the chance of a heart attack.

Another example I just thought of is mammography. It is far less frequent in the UK, yet US and UK women have nearly identical breast cancer mortality rates.
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<<I don't understand albaby1's support for paying double the cost for half the health care.

I don't "support" it. I just think that it is a naive fantasy to think that single-payer will cut the cost of health care in half. Or cut it at all, actually.>>


Look at the effects of unions on public employee pensions. While private employer pensions have been routinely cut or eliminated, those of public employees have been expanding in costs at dramatic rates, protected by laws which make cutting them difficult or impossible.


How much of government student loans have been siphoned off by colleges and universities for more staff, newer buildings and such?


Government programs often add money to finance goal A, but it winds up in the pockets of B and C so regularly that you's imagine that even liberals would observe that happening. But you don't.



Seattle Pioneer
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<<Another example I just thought of is mammography. It is far less frequent in the UK, yet US and UK women have nearly identical breast cancer mortality rates.>>


I would suspect that US malpractice law places a definite premium on performing such procedures. Just imagine the lawsuit against a doctor whose judgement it was that mammography was not needed, perhaps for good reason, only to discover that cancer was there despite his best judgement.

Extreme malpractice laws no doubt increase unnecessary tests and procedures, but you wont find many liberals who want to eliminate such bias. You guys TALK a lot about eliminating unnecessary procedures, but you have spent half a century building unnecessary procedures into medical practice.



Seattle Pioneer
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Chilling article in the Seattle Times about how a prominent neurosurgery hospital was performing huge numbers of unnecessary surgeries and procedures, sometimes resulting in death.

2 doctors in Redding California were involved in Heart by surgery fraud. Performing operations on patients who did not even have a heart problem. They used fear to obtain consent. They performed so many operations the Redding hospital built a whole new wing for the doctors operation. And of course hired many support staff.

https://www.latimes.com/archives/la-xpm-2003-aug-07-fi-settl...

Tenet Healthcare Corp., California’s largest hospital chain, agreed Wednesday to pay $54 million to settle government allegations that two doctors at its hospital in Northern California performed numerous unnecessary heart surgeries.

Tenet also agreed to cooperate with the government’s investigations of individuals involved in the alleged fraud at the 238-bed facility.

An FBI affidavit accused Dr. Chae Hyun Moon, formerly the hospital’s director of cardiology, and Dr. Fidel Realyvasquez, the ex-chief of cardiac surgery, of performing invasive and unnecessary catheterizations and open-heart surgeries on healthy patients.
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Another example I just thought of is mammography.

And another is the PSA test.
https://healthbeatblog.com/2010/03/the-doctor-who-invented-p...
Last year, The New England Journal of Medicine published results from the two largest studies of the screening procedure, one in Europe and one in the United States. The results from the American study that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over. The European study showed a small decline in death rates, but also found that 48 men would need to be treated to save one life. “That’s 47 men who, in all likelihood, can no longer function sexually or stay out of the bathroom for long,”

Dr Ablin, the inventor of the PSA test:“the test is hardly more effective than a coin toss. As I’ve been trying to make clear for many years now, P.S.A. testing can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t.“
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The idea of using government economic power to pay health care provider cheap and inadequate levels of reimbursement is a vile and disgusting thing to even talk about.

This seems like a serious concern for Trump culters . . . I guess because they see so many doctors and care providers living in poverty and they worry about their well being. I just don't understand why they do not have similar concerns about the people actually living in poverty. "Let 'em die" was how they expressed their concern for actual patients living in poverty.
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What you want to result from single-payer will never result from single-payer in this country.

So you seem to be saying that because change is difficult, you've just given up and accepted your own excellent employer paid insurance as the best we can do. Or is it just that it's the best you can do so who cares about the rest of us?
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One doctor was making two million a year.

Yet one of our board trolls is concerned that adapting a health care system that contains costs might leave doctors financially unsound. Those poor doctors.
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<<2 doctors in Redding California were involved in Heart by surgery fraud. Performing operations on patients who did not even have a heart problem. They used fear to obtain consent. They performed so many operations the Redding hospital built a whole new wing for the doctors operation. And of course hired many support staff.>>



I guess I don't understand.


One liberal complains that his managed care provider requires him to see his designated physician before seeing specialists. He complains that he has been walked from through several specialists, and he expects to ultimately see a surgeon for an operation.

intercst gloats that under Medicare, patients can see whatever health care provider they wish.

The we have liberals such as here, who complain that unethical physicians are exploiting the ignorance of patients in order to perform unnecessary operations.


So I'm supposing that the patients exploited by this surgeon were perhaps Medicare patients who did not require screening by a physician who might steer them away from such surgeons.

Patients who did get screened by their regular physicians were probably told they didn't need further care, and would presumably be referred to some other surgeon should an operation be needed.


Do you suppose that medical care could be too complex to fit within the confines of a political ideology?


Seattle Pioneer
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<<. The European study showed a small decline in death rates, but also found that 48 men would need to be treated to save one life. “That’s 47 men who, in all likelihood, can no longer function sexually or stay out of the bathroom for long,” >>



Heh, heh! So.... just like other men, then?



Seattle Pioneer
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<< I just don't understand why they do not have similar concerns about the people actually living in poverty. "Let 'em die" was how they expressed their concern for actual patients living in poverty.>>




I hired Donald Trump to kick out illegal immigrants who are holding down working class wage rates and build up the economy. He's doing the best job he can over the furious opposition of liberals.



Seattle Pioneer
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So I'm supposing that the patients exploited by this surgeon were perhaps Medicare patients who did not require screening by a physician who might steer them away from such surgeons.

Per the article, this specific settlement was based on unnecessary surgeries that were billed to Medicare; but also that it was expected that an equal amount of unnecessary surgeries were billed to private insurance as well, and that those claims would be quickly filed now that liability had been established for the Medicare surgeries.

Albaby
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<<What you want to result from single-payer will never result from single-payer in this country.

So you seem to be saying that because change is difficult, you've just given up and accepted your own excellent employer paid insurance as the best we can do. Or is it just that it's the best you can do so who cares about the rest of us?>>



So why didn't the Washington State legislature, or the California legislature, bothe states held by dems, do your bidding for you?


After all, it's as easy as that you guys keep saying. But even when you have power, therre is no frontal assault on the incomes of doctors hospitals nurses, and all the other parts of the health care industry.

Easier to pick on Facebook perhaps? That seems to be Albaby's contention.



Seattle Pioneer
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<<One doctor was making two million a year.

Yet one of our board trolls is concerned that adapting a health care system that contains costs might leave doctors financially unsound. Those poor doctors.>>



Oh dear me! ALL that ABUSE and you say the government machinery that licenses and regulated doctors DIDN'T NOTICE THAT?


If government regulation of professions can't protect people from that kind of abuse, what good are they?



Seattle Pioneer
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<<So I'm supposing that the patients exploited by this surgeon were perhaps Medicare patients who did not require screening by a physician who might steer them away from such surgeons.

Per the article, this specific settlement was based on unnecessary surgeries that were billed to Medicare; but also that it was expected that an equal amount of unnecessary surgeries were billed to private insurance as well, and that those claims would be quickly filed now that liability had been established for the Medicare surgeries.

Albaby>>



I wonder how many such surgeries were avoided because those greedy insurance companies required patients to be referred by a primary care physician before having surgery?


I'm sure intecrst will boast about the ability of Medicare patients to refer themselves directly into the hands of such surgeons.

And it's still a mystery to me how such unscrupulous surgeons could get away with this with all the government regulations of their profession and industry. If they can't prevent, catch and deter such behavior, what good are they?



Seattle Pioneer
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And it's still a mystery to me how such unscrupulous surgeons could get away with this with all the government regulations of their profession and industry. If they can't prevent, catch and deter such behavior, what good are they?

Well, that's like asking what good the police are, since they can't prevent, catch, and deter all crime.

People violate the law. The purpose of regulatory oversight and investigation is to both catch the ones who do it and provide deterrence to dissuade others from trying.

Unless we are willing to allocate nearly unlimited resources to those regulators, then it is certain that some lawbreaking will occur - some of which will get caught, and some of which won't.

Just like the police.

Albaby
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Another example I just thought of is mammography. It is far less frequent in the UK, yet US and UK women have nearly identical breast cancer mortality rates.

Same could be said for C-sections. We do about 300% more in the US last I read.

But then on the flip side, we also have about 100% more people obese and with diabetes (which is often the #1 or #2 most expensive preventable illness and accounts for roughly 20% of all healthcare spending).
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I would suspect that US malpractice law places a definite premium on performing such procedures. Just imagine the lawsuit against a doctor whose judgement it was that mammography was not needed, perhaps for good reason, only to discover that cancer was there despite his best judgement.

Your suspicions are incorrect. This is routine screening, not in special cases. US health care organizations generally recommend annual or biennial mammograms starting around age 40, and almost all recommend annual screening after age 50.

In the UK, the recommendation is biennial starting at age 50. As I mentioned the mortality rates are virtually identical. The reason is breast cancer is rare and hard to detect in women younger than 50, and false positives can also cause harm. So there is no pubic health benefit in doing all those extra tests.
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I get my blood test results about 10 days later in a 'secure' email where I have to log onto the doc's site and get my results with his comments......

I have our doc order the labs a week or 2 before our annuals. That way if there's something interesting, we discuss it at the appointment. My docs use MyChart, so I log in anytime to see test results, upcoming appoints, send/receive messages, see/pay bills, etc. It's great to be able to compare each lab test to previous years, even look at a charted version.
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So I'm supposing that the patients exploited by this surgeon were perhaps Medicare patients who did not require screening by a physician who might steer them away from such surgeons.

Patients who did get screened by their regular physicians were probably told they didn't need further care, and would presumably be referred to some other surgeon should an operation be needed.


You would suppose wrongly. The patients were of all ages and sent to Dr Moon for evaluation. I guess you haven't been paying attention to the thread; private insurers pay 200 to 300 percent more than medicare. Dr Moon & the other physician, the perpetrators, were cardiologists & surgeons. One stop shop. He'd would tell the patient was in serious shape & rush them to the OR occasionally on the same day.


https://www.sfgate.com/health/article/A-heart-surgery-scanda...
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I hired Donald Trump to kick out illegal immigrants who are holding down working class wage rates and build up the economy. He's doing the best job he can over the furious opposition of liberals.

In 1932 they blamed the Jews, gypsies and other non Aryan races for all of Germany's problems, and they had a good solution for this problem, no?

CNC
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Uriah Heep: I guess I don't understand. Non sequitur.
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<<I hired Donald Trump to kick out illegal immigrants who are holding down working class wage rates and build up the economy. He's doing the best job he can over the furious opposition of liberals.

In 1932 they blamed the Jews, gypsies and other non Aryan races for all of Germany's problems, and they had a good solution for this problem, no?

CNC>>>>



Haven't you open border types got any new ways to try and guilt people into your schemes?


Seattle Pioneer
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Haven't you open border types got any new ways to try and guilt people into your schemes?

Seattle Pioneer


Has the racist sentiment changed?

CNC
... btw why do you think I am for open borders? Reading comprehension problem?
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<<Haven't you open border types got any new ways to try and guilt people into your schemes?

Seattle Pioneer

Has the racist sentiment changed?

CNC
... btw why do you think I am for open borders? Reading comprehension problem?>>



I smear liberals with beibng..... liberals and also for open borders, just as liberals smear patriotic nationalists as racists.


Don't like it? Even steven!



Seattle Pioneer
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The biggest difference between European health care costs and US healthcare costs is the price Americans pay for labor. Healthcare workers (nurses, doctors, pharmacists, etc) make significantly more in the US than they do on average in the EU.

This actually is a good test of politicians. A politician is not seriously considering reducing health care costs in the US unless he or she is advocating to drastically cut the salaries of US health care workers.


c
I say this as the husband of a pharmacist.
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The biggest difference between European health care costs and US healthcare costs is the price Americans pay for labor. Healthcare workers (nurses, doctors, pharmacists, etc) make significantly more in the US than they do on average in the EU.

Western European universities have low tuition cost to the student. This is possible because education is heavily subsidized by national governments. National governments also heavily control costs & pay in their nations in effect spreading the cost of education & healthcare to the entire national population.

Doctors can work for less as they do not have a huge education debt. The respective nation incur a 8 to 10 year education debt but reap a 30 year lower doctor wage. A greater good argument which would be anathema to a libertarian or free marketer.

We must remember the history of Europe-2 massive world war involvements. Massive infrastructure & economic devastation as a result of nationalism reflected in large militaries. Nationalistic fervor also resulted in the imposition of the punitive Versaille Treaty upon Germany.

I believe one result of their experience was a move toward socialism diverting government tax monies to education & health care & mass transit etc. They could do this because they had a US defense shield from Soviet aggression. And now they even spend less on defense.

The US Industrial-Military-Congressional Complex had to look for new dragons to slay after the collapse of the Soviet Union. The defense industry & it's political dependents were in jeopardy! 9/11 was the perfect opportunity to foment an enduring voter-terrifying threat and unending small wars to justify the money flow needed for the MICC’s survival. An added benefit was a vast expansion of intelligence private contractor workforce adding more rice bowls dependent on perpetual war and more lobbyist support for perpetual war.
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I smear liberals with beibng.

What's a beibng?

CNC
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Uriah Heep: Don't like it? Even steven!


It's not even. You FA posts willy nilly and they are removed. Your posts, otoh, seem to be protected (By some malevolent force?)

CNC
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<<This actually is a good test of politicians. A politician is not seriously considering reducing health care costs in the US unless he or she is advocating to drastically cut the salaries of US health care workers.


c
I say this as the husband of a pharmacist.>>



Having done a hatchet job on the working class, liberals are now coming for health care professionals.



Seattle Pioneer
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Don't like it? Even steven!

Seattle Pioneer


OTOH, I don't come into your house to slander you. You are trespassing in our house.

CNC
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Haven't you open border types got any new ways to try and guilt people into your schemes?

Seattle Pioneer


The rhetoric and behavior is almost identical, so no "new way" is needed. Nazis are Nazis. They even flaunt their swastikas and Nazi salutes. Brown shirts will be next.

Surely, as a fellow liberal, you are not supporting Nazis, are you?

CNC
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liberals smear patriotic nationalists as racists.

"patriotic nationalists" is a pseudonym for Nazis. Think about it. It's not a hidden message any more.

CNC
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<<Don't like it? Even steven!

Seattle Pioneer

OTOH, I don't come into your house to slander you. You are trespassing in our house.

CNC>>



You are telling me to go back where I came from, eh?


Seattle Pioneer
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<<Haven't you open border types got any new ways to try and guilt people into your schemes?

Seattle Pioneer

The rhetoric and behavior is almost identical, so no "new way" is needed. Nazis are Nazis. They even flaunt their swastikas and Nazi salutes. Brown shirts will be next.

Surely, as a fellow liberal, you are not supporting Nazis, are you?

CNC>>


You guys lost the election.

Your collusion charges have gone no where.


Ditto your obstruction of justice accusations.


It appears that all you have left is smearing those who have defeated you politically, over and over again (we'll exclude the 2018 elections, where you won a modest victory based on your continuing fake charges).

Charges of Trump being a Nazi are just ignorant.


But that's all you have left. It is a long way from enough.



Seattle Pioneer
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<<liberals smear patriotic nationalists as racists.

"patriotic nationalists" is a pseudonym for Nazis. Think about it. It's not a hidden message any more.

CNC>>



Patriotic nationalists are what every US President was before Jimmy Carter. Since Carter, every Democrat has been a liberal internationalist.


Carter was probably the first liberal internationalist elected, but that's a little too close to call, although I'd be glad to hear opinions on the subject.


Patriotic nationalist doesn't quite say it all, because personal responsibility is perhaps also a core part of that political outlook.


And of course patriotic nationalism is spreading around the world rather rapidly, displacing the out of fashion liberal internationalists


Seattle Pioneer
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