Single Payer

[pinstripers]

Honestly, when most Democrats are crying for "single payer," they are hopin Charles Koch is the guy pickin up the tab.

[Jamar Howard 4 President]

These people make me sick, masquerading as ethical and concerned with other's "best interests".

The guidance, drawn up by the Nuffield Council, is not compulsory but advises doctors that medical intervention for very premature children is not in the best interests of the baby, and is not 'standard practice'.

http://www.dailymail.co.uk/news/article-1211950/Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care-limit.html

[ShockCrazy]

My position isn't that single payer is best, but I think it could work. What I am certain of is what is currently being done does not work for a lot of people. A lot of people go down this rabbit hole of thinking single payer is you ultimately paying for someone else's medical care, but unless the benefits you draw in a given year exceed what you and/or your employer and/or government subsidies are currently paying, then you are already doing that, and you are also lining the pockets of shareholders in insurance companies. I know for me at least I don't draw as many benefits as I pay in being a younger professional and for me, I'd rather that excess money definitely go to someone else's care rather than the pocket book of some holding company or random high level investor.

[ShockCrazy]

These people make me sick, masquerading as ethical and concerned with other's "best interests".



http://www.dailymail.co.uk/news/arti...are-limit.html

I am actually curious as to how often doctors would pursue care before 23 weeks here anyways, survival rate without serious defects is incredibly rare, lungs at that state still have a lot of developing to do. This seems a bit sensationalists because I imagine there are similar stories here. While we've seen improvements in premature care, it hasn't been in babies born before 23 weeks.

Edit to add a scenario to consider: Imagine you are a NICU doctor and you receive this premature baby, but you say already have 2 other(number doesn't matter) premature babies born after 23 weeks to care for. You as a doctor know that by adding this baby to the load of both you and the hospitals resources, this decreases the survival rate of the other(high risk) babies by some amount, maybe in some cases significant. You also know that even with all your time, best efforts and all the hospital's resources, it would be incredibly unlikely for this baby to survive. What do you do? It's a hard decision right? And it sucks, but ultimately hospitals and doctors have to make tough calls and it's not always with respect to an individual patient's needs because they have other responsibilities.

[Boss1786]

I specced out an accounting system for a CPA firm that specialized in working with hospitals over a 3-state area. The amount of detail they had to be able to provide to justify costs to Medicare and Medicaid was insane. As I recall everythoing was based on a cost-plus basis, and incredibly nit-picking detail was required for every cost. Without the documentation to back up a cost, the cost was denied.

Perhaps the reason for this would be because of a situation I personally experienced:

My daughter had a traffic accident, her billing initially did not get billed through insurance to the tune of $28k in treatment. (I freaked out). Once insurance was filed as it should (which it had had not), l learned that insurance paid $13k and I paid $100 deductable and my problem went away.

Two questions:
1) Why did the hospital bill so much more than they could justify to insurance for payment?

2) How can anyone argue that health Care is affordable to the the uninsured when they have to pay twice as much for the same service?

[Jamar Howard 4 President]

1) Why did the hospital bill so much more than they could justify to insurance for payment?

http://www.npr.org/sections/health-shots/2014/11/15/364064088/they-paid-how-much-how-negotiated-deals-hide-health-cares-cost

Every hospital has its own master list of charges for different services. Those charges are different from hospital to hospital.

But insurance companies don't pay those listed charges. The listed charges are almost fiction. Instead, each insurer negotiates for lower prices with each hospital and doctor on every plan. The negotiated prices even can vary within an insurance company depending on which plan a patient has.
All of this means there are about as many price tags for that hypertension checkup as there are insurers and providers

If you are paying the hospital directly, you are paying full price, unless you attempt to negotiate too. Unfortunately for those who go this route, you don't have the leverage of a large insurance company.

We really need more people covered with insurance for large scale claims ($1,000+, $10,000+, ???) and way less insurance coverage for regular doctor visits.

[Boss1786]

http://www.npr.org/sections/health-s...lth-cares-cost



If you are paying the hospital directly, you are paying full price, unless you attempt to negotiate too. Unfortunately for those who go this route, you don't have the leverage of a large insurance company.

We really need more people covered with insurance for large scale claims ($1,000+, $10,000+, ???) and way less insurance coverage for regular doctor visits.

But that's the irony. No coverage for doctor visits reduce preventative medicine which leads to larger claims later.

[shockmonster]

Thank you. Thank you. Thank you.

I've been reading this thread just waiting for this to be said. Statistics are not kept the same way from country to country. For all the ugliness that is abortion in the U.S., we often forget that we do some things really well when it comes to babies prior to reaching full term. If a baby is going to be born multiple months early, the U.S. is absolutely the best place for it's chances. I fully admit that I can't back up the following statement with stats, but I'm convinced that culturally, the U.S. places MUCH more value on the life of a premie baby than most of these other "developed, civilized" countries that are being praised.

To put it bluntly, other countries are effectively saying "look at these freaks, they don't count", and then following that with pats on the back for how well they do with "normal" births. I mean, seriously, I'm a pretty good golfer if you excuse all those imperfect lies in the rough I get from time to time.

Some days, I just hate politics because it seems all the data is biased and there isn't any common ground set of good data to even begin honest discussions with.

This has nothing to do with child birth, but does with Single Payer Health Insurance. I visited the doctor today, and we were talking about knee replacement surgeries because at some point, I will need one. Medicare is in my not too distant future (close enough to discuss but significantly far enough away not to be a real concern yet). I asked because bad knees are debilitating and painful for those who have to suffer with them. When I asked whether medicare covered it, he said that supplemental (we all have to buy a supplemental insurance in addition to paying for medicare) insurances were all different. He added that other countries who have single payer plans like Sweden don't allow for knee replacements after (somewhere the age of 50). I did not research it, but according to my Doctor, he said that they prescribed canes, pain medications, and even wheel chairs to those who were in bad shape. If this is true, aging sounds more like suffering may be a "way of life" for you after you reach a certain age under Socialized Medicine.

[wufan]

But that's the irony. No coverage for doctor visits reduce preventative medicine which leads to larger claims later.

Maybe...in order for this to work, you have to assume that preventive care works in that by going to the doctor now, a short term and/or low cost alternative can be put in place to reduce the chance of expensive care later. That probably isn't always the case. Yes, diet, exercise, and medication can reduce the risk of a heart attack or bypass surgery, but you need compliant patients. A medical visit ensures knowledge and access, but not compliance and treatment. A vehicle accident will not be prevented by a doctor visit, nor will it prevent accidents of other types. Is discovering type I diabetes and treating it for life cheaper than not discovering it early? Maybe. I don't know the stats on it, but it is clear to me that routine check-ups are not always effective in reducing cost.

[ShockCrazy]

This has nothing to do with child birth, but does with Single Payer Health Insurance. I visited the doctor today, and we were talking about knee replacement surgeries because at some point, I will need one. Medicare is in my not too distant future (close enough to discuss but significantly far enough away not to be a real concern yet). I asked because bad knees are debilitating and painful for those who have to suffer with them. When I asked whether medicare covered it, he said that supplemental (we all have to buy a supplemental insurance in addition to paying for medicare) insurances were all different. He added that other countries who have single payer plans like Sweden don't allow for knee replacements after (somewhere the age of 50). I did not research it, but according to my Doctor, he said that they prescribed canes, pain medications, and even wheel chairs to those who were in bad shape. If this is true, aging sounds more like suffering may be a "way of life" for you after you reach a certain age under Socialized Medicine.

Frequently cited and false, many people say these things of Canada or UK but here's the truth:http://www.politifact.com/truth-o-me...uldnt-get-hip/ Or actual data of the age of knee replacements in Canada: https://secure.cihi.ca/free_products..._Report_EN.pdf Ages specifically for Sweden(study focuses on the type of replacement but ages are there): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2856209/ The AVERAGE age is over 60.

[Aargh]

This has nothing to do with child birth, but does with Single Payer Health Insurance. I visited the doctor today, and we were talking about knee replacement surgeries because at some point, I will need one. Medicare is in my not too distant future (close enough to discuss but significantly far enough away not to be a real concern yet). I asked because bad knees are debilitating and painful for those who have to suffer with them. When I asked whether medicare covered it, he said that supplemental (we all have to buy a supplemental insurance in addition to paying for medicare) insurances were all different. He added that other countries who have single payer plans like Sweden don't allow for knee replacements after (somewhere the age of 50). I did not research it, but according to my Doctor, he said that they prescribed canes, pain medications, and even wheel chairs to those who were in bad shape. If this is true, aging sounds more like suffering may be a "way of life" for you after you reach a certain age under Socialized Medicine.

This pretty much comes down to what are "we" willing to pay for. There is going to be a lot of disagreement among "we" on that issue.

My mother has had a hip replacement and a knee replacement within the last 5 years and she still ended up in a whell chair - probably because she's 97 years old. She was in pain before the surgeries, so the doctors prescribed them. She was still in pain after the surgeries, but was able to walk a little better - with a walker. It didn't decrease her instances of falling.

However, Medicare would pay for the surgeries, and my mother will do absolutely anything a doctor recommends. Of course her doctor is going to recommend the surgeries. He probably gets a referral fee for that.

[Kung Wu]

A lot of people go down this rabbit hole of thinking single payer is you ultimately paying for someone else's medical care, but unless the benefits you draw in a given year exceed what you and/or your employer and/or government subsidies are currently paying, then you are already doing that, and you are also lining the pockets of shareholders in insurance companies.

The average margin for a health insurance company is only 3.3%. That is a VERY thin margin! There is absolutely NO WAY a government health insurance service can operate that efficiently. Not. Even. Close.

[Cdizzle]

But that's the irony. No coverage for doctor visits reduce preventative medicine which leads to larger claims later.

You don't buy home insurance to pay for painting your house either. You buy it for a 90-mph wind blowing an oak tree through the living room.

[shockmonster]

You don't buy home insurance to pay for painting your house either. You buy it for a 90-mph wind blowing an oak tree through the living room.

I'm not a big governmental health care supporter, but his point is a good one. If you have some minimal annual costs that can be controlled, it may be better to pay for it up front, and reduce higher costs by finding health weaknesses prior to the weaknesses becoming serious illnesses which requires expensive treatments.

Yearly co-paid preventative Physicals and pre-natal care with bloodwork, colonoscopies, etc. may be less expensive than cancer treatments/heart treatments/stroke treatments found after the fact (some for a short time that may result in death). I don't have a problem with high deductibles, but preventative treatments may save money in the long view.

[RoyalShock]

While we're sharing anecdotes (and I realize this is small potatoes), I paid a $70 co-pay to a podiatrist who took 3 minutes to say, "The nail will eventually fall off. Come back when it does and I'll cauterize what's underneath so it doesn't grow back."

I pay a high insurance premium for high deductible insurance so I have the "privilege" of a $70 specialist co-pay, that would probably cost me $50 if they billed me directly at a reasonable cost-plus rate.

I can't wait to pay them another $70 plus whatever inflated amount they hit me with to torch my toe for 30 seconds.

I also wonder how many paper-pushers handled my claim? All because I have to give them my insurance or else they'll charge me the fictional price.