Dumber than a bag of hammers
Comments
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The problem with people being directly involved with what they are paying is the vast majority of medical expenses covered by insurance are not discretionary. You want to buy a car so you shop around and find the car and the price you want or you keep your old car. The medical world isn't like that. I had a kidney stone, I can't go call around for the cheapest place to get treated to find out why it feels like my kidney is giving birth.SFGbob said:The 3rd party payer system is the biggest problem we have with our healthcare system. As government got more involved in healthcare taking on more of the costs that's when costs really started to explode. The graph that someone posted here in that other thread illustrated that fact nicely.
What I'd like to do is greatly expand the use of medical savings accounts so that people are contributing to them during all of their working years. Make the contributions pre-taxes, allow the money in the accounts to be invested and only allow healthcare expenditures to be made from the account. When the person dies the account is treated as a personal asset that can be willed to someone else.
If people were more directly involved with what they were paying for their healthcare you'd start to see some market pressure on price. There would be incentive to not just continue medical treatment when there little or no chance of success. -
So the medical world couldn't advertise the prices they charge for dealing with a kidney stone? Why not?2001400ex said:
The problem with people being directly involved with what they are paying is the vast majority of medical expenses covered by insurance are not discretionary. You want to buy a car so you shop around and find the car and the price you want or you keep your old car. The medical world isn't like that. I had a kidney stone, I can't go call around for the cheapest place to get treated to find out why it feels like my kidney is giving birth.SFGbob said:The 3rd party payer system is the biggest problem we have with our healthcare system. As government got more involved in healthcare taking on more of the costs that's when costs really started to explode. The graph that someone posted here in that other thread illustrated that fact nicely.
What I'd like to do is greatly expand the use of medical savings accounts so that people are contributing to them during all of their working years. Make the contributions pre-taxes, allow the money in the accounts to be invested and only allow healthcare expenditures to be made from the account. When the person dies the account is treated as a personal asset that can be willed to someone else.
If people were more directly involved with what they were paying for their healthcare you'd start to see some market pressure on price. There would be incentive to not just continue medical treatment when there little or no chance of success. -
Because there's no market forces needed for them to do that. The only way to make that happen is through government intervention. Which you are against.SFGbob said:
So the medical world couldn't advertise the prices they charge for dealing with a kidney stone? Why not?2001400ex said:
The problem with people being directly involved with what they are paying is the vast majority of medical expenses covered by insurance are not discretionary. You want to buy a car so you shop around and find the car and the price you want or you keep your old car. The medical world isn't like that. I had a kidney stone, I can't go call around for the cheapest place to get treated to find out why it feels like my kidney is giving birth.SFGbob said:The 3rd party payer system is the biggest problem we have with our healthcare system. As government got more involved in healthcare taking on more of the costs that's when costs really started to explode. The graph that someone posted here in that other thread illustrated that fact nicely.
What I'd like to do is greatly expand the use of medical savings accounts so that people are contributing to them during all of their working years. Make the contributions pre-taxes, allow the money in the accounts to be invested and only allow healthcare expenditures to be made from the account. When the person dies the account is treated as a personal asset that can be willed to someone else.
If people were more directly involved with what they were paying for their healthcare you'd start to see some market pressure on price. There would be incentive to not just continue medical treatment when there little or no chance of success. -
This is beyond stupid. The changes I advocated and clearly stated would create the market forces needed to that. The government wouldn't need to intervene in order make people advertise their prices any more than the government intervenes in order make lasik providers advertise their prices.2001400ex said:
Because there's no market forces needed for them to do that. The only way to make that happen is through government intervention. Which you are against.SFGbob said:
So the medical world couldn't advertise the prices they charge for dealing with a kidney stone? Why not?2001400ex said:
The problem with people being directly involved with what they are paying is the vast majority of medical expenses covered by insurance are not discretionary. You want to buy a car so you shop around and find the car and the price you want or you keep your old car. The medical world isn't like that. I had a kidney stone, I can't go call around for the cheapest place to get treated to find out why it feels like my kidney is giving birth.SFGbob said:The 3rd party payer system is the biggest problem we have with our healthcare system. As government got more involved in healthcare taking on more of the costs that's when costs really started to explode. The graph that someone posted here in that other thread illustrated that fact nicely.
What I'd like to do is greatly expand the use of medical savings accounts so that people are contributing to them during all of their working years. Make the contributions pre-taxes, allow the money in the accounts to be invested and only allow healthcare expenditures to be made from the account. When the person dies the account is treated as a personal asset that can be willed to someone else.
If people were more directly involved with what they were paying for their healthcare you'd start to see some market pressure on price. There would be incentive to not just continue medical treatment when there little or no chance of success.
Sometimes you need to just keep your mouth shut Hondo. -
This commentary on the Physicians for a National Health Program website tracks some of my own thoughts on healthcare and free-market theory:Fundamentally, the degree of information asymmetry between the buyer (the patient) and the seller (the provider) prevents health care from conforming to the theoretical tenets of free-market economics. Kenneth Arrow famously contended that the uncertainty intrinsic to health care makes it unique from other goods and services. The health economist Bob Evans has argued that not only has there never been a pure free market in health care but that “inherent characteristics of health and health care make it impossible that there ever could be.” On the contrary, he argues, attempts to inject market mechanisms into health care are fundamentally about redistribution. As health-care costs are shifted from public to out-of-pocket sources, those with higher incomes invariably benefit.
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First off the argument about a "pure free market" is a red herring that's not what I'm advocating and you could never achieve it on account of the number of poor and disabled people that would still need some kind of public care option.Squirt said:This commentary on the Physicians for a National Health Program website tracks some of my own thoughts on healthcare and free-market theory:
Fundamentally, the degree of information asymmetry between the buyer (the patient) and the seller (the provider) prevents health care from conforming to the theoretical tenets of free-market economics. Kenneth Arrow famously contended that the uncertainty intrinsic to health care makes it unique from other goods and services. The health economist Bob Evans has argued that not only has there never been a pure free market in health care but that “inherent characteristics of health and health care make it impossible that there ever could be.” On the contrary, he argues, attempts to inject market mechanisms into health care are fundamentally about redistribution. As health-care costs are shifted from public to out-of-pocket sources, those with higher incomes invariably benefit.
Yes, people with higher incomes would benefit. Just like they benefit now. They get to live in bigger houses, drive nicer cars and take better vacations but they also improve the goods and services for the non-wealthy over time. It's not as if the wealthy don't have better access and healthcare right now.
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No there are no market forces causes medical providers to advertise prices because they are not elective. Elective procedures like invisiline and plastic surgery, prices are up front and open. There's no need to advertise Cancer Care or the cost of a CT scan or whatever. Cause if you need one you need it. Now.SFGbob said:
This is beyond stupid. The changes I advocated and clearly stated would create the market forces needed to that. The government wouldn't need to intervene in order make people advertise their prices any more than the government intervenes in order make lasik providers advertise their prices.2001400ex said:
Because there's no market forces needed for them to do that. The only way to make that happen is through government intervention. Which you are against.SFGbob said:
So the medical world couldn't advertise the prices they charge for dealing with a kidney stone? Why not?2001400ex said:
The problem with people being directly involved with what they are paying is the vast majority of medical expenses covered by insurance are not discretionary. You want to buy a car so you shop around and find the car and the price you want or you keep your old car. The medical world isn't like that. I had a kidney stone, I can't go call around for the cheapest place to get treated to find out why it feels like my kidney is giving birth.SFGbob said:The 3rd party payer system is the biggest problem we have with our healthcare system. As government got more involved in healthcare taking on more of the costs that's when costs really started to explode. The graph that someone posted here in that other thread illustrated that fact nicely.
What I'd like to do is greatly expand the use of medical savings accounts so that people are contributing to them during all of their working years. Make the contributions pre-taxes, allow the money in the accounts to be invested and only allow healthcare expenditures to be made from the account. When the person dies the account is treated as a personal asset that can be willed to someone else.
If people were more directly involved with what they were paying for their healthcare you'd start to see some market pressure on price. There would be incentive to not just continue medical treatment when there little or no chance of success.
Sometimes you need to just keep your mouth shut Hondo.
But keep calling me stupid. Weren't you just arguing for an end to the name calling and wanting actual discussion? -
Fair enough. And along the lines of your point, in the Canadian system, the wealthy are still free to obtain healthcare from a parallel private system.SFGbob said:First off the argument about a "pure free market" is a red herring that's not what I'm advocating and you could never achieve it on account of the number of poor and disabled people that would still need some kind of public care option.
Yes, people with higher incomes would benefit. Just like they benefit now. They get to live in bigger houses, drive nicer cars and take better vacations but they also improve the goods and services for the non-wealthy over time. It's not as if the wealthy don't have better access and healthcare right now.
Health savings accounts are interesting. I see some problems that may or not be solvable:
1. They create financial disincentives for people to obtain preventative care, which has been shown by research to be the best way to reduce costs and improve outcomes.
2. They siphon funds away from insurance funds. Less money would be available to pay for care for the sick people using healthcare.
3. A disproportionately large amount of healthcare is devoted to a small percentage of the population. (I've seen 69% goes to 10%.) For sick people, HSAs wouldn't be enough.
4. In many rural areas, there is not much choice of healthcare provider. There's one local doctor, one nearby hospital, etc.
I agree with the other arguments here (PDF). -
I need to figure out why this board eats a number of my posts when I try to edit the content.
Oh well.
I want actual discussion and I don't give a crap if you call me a name. I'm just going to respond in kind. How about this, what you're saying is stupid.
There are literally thousand of medical procedures that are entirely elective. My youngest just had his tonsils taken out. The entire thing was elective. I had no incentive to search for someone to do it for a cheaper price because I wasn't paying for it and I never saw a bill.
Hip replacement, Achilles tendon repair, knee replacement, you name it. Hell I used to take my kid in for strep throat, (thus the tonsil removal) all the time to see the doctor. I never cared about what that doctor was charging the insurance company because I wasn't paying the bill directly. All of these are elective. And of course there is a need to advertise the cost of a CT scan, it people were actually paying the cost out of their own Medical Savings Account. If you needed a CT scan and you were paying for it why wouldn't you go to the place that was $300 less than the place across town? There is no need to advertise now, because most people aren't paying directly for their medical care. -
I'll keep calling you stupid2001400ex said:
No there are no market forces causes medical providers to advertise prices because they are not elective. Elective procedures like invisiline and plastic surgery, prices are up front and open. There's no need to advertise Cancer Care or the cost of a CT scan or whatever. Cause if you need one you need it. Now.SFGbob said:
This is beyond stupid. The changes I advocated and clearly stated would create the market forces needed to that. The government wouldn't need to intervene in order make people advertise their prices any more than the government intervenes in order make lasik providers advertise their prices.2001400ex said:
Because there's no market forces needed for them to do that. The only way to make that happen is through government intervention. Which you are against.SFGbob said:
So the medical world couldn't advertise the prices they charge for dealing with a kidney stone? Why not?2001400ex said:
The problem with people being directly involved with what they are paying is the vast majority of medical expenses covered by insurance are not discretionary. You want to buy a car so you shop around and find the car and the price you want or you keep your old car. The medical world isn't like that. I had a kidney stone, I can't go call around for the cheapest place to get treated to find out why it feels like my kidney is giving birth.SFGbob said:The 3rd party payer system is the biggest problem we have with our healthcare system. As government got more involved in healthcare taking on more of the costs that's when costs really started to explode. The graph that someone posted here in that other thread illustrated that fact nicely.
What I'd like to do is greatly expand the use of medical savings accounts so that people are contributing to them during all of their working years. Make the contributions pre-taxes, allow the money in the accounts to be invested and only allow healthcare expenditures to be made from the account. When the person dies the account is treated as a personal asset that can be willed to someone else.
If people were more directly involved with what they were paying for their healthcare you'd start to see some market pressure on price. There would be incentive to not just continue medical treatment when there little or no chance of success.
Sometimes you need to just keep your mouth shut Hondo.
But keep calling me stupid. Weren't you just arguing for an end to the name calling and wanting actual discussion?
