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No limit on how high health care expenses may run in health care bill
scholar - 9-1-2010 at 18:19

I have just heard President Obama declare that one of the bad practices of the health insurance companies which will be eliminated in the health care bill is limits on health care expenses. Insurance companies will no longer be able to put a limit on how much your health care may cost them in a particular year, or in your lifetime.

So, if your medical condition is such that you will need millions of dollars spent on your health most years, the insurance company must pay it, endlessly.

President Obama also said that the bill will bring the cost of health insurance DOWN.

A question of logic--if the insurance companies must pay out ten times, twenty times, even fifty times as much as they used to pay, how is it that the cost will come DOWN? If they are required by law to pay endlessly (three heart transplants in the same year for a patient, for example), how will the cost be reduced? Doesn't logic say that the cost will go UP? Won't the insurance companies have to increase their rates to cover the new obligations imposed on them by the law?

Speaker Pelosi said something very similar--your health benefits will never be limited, and your premiums will never increase.

How is this possible?


giron - 9-1-2010 at 18:29

Quote:
Originally posted by scholar


How is this possible?


It isn't possible, which is why private healthcare is never a good option.


scholar - 9-1-2010 at 19:04

Quote:
Originally posted by giron
Quote:
Originally posted by scholar
How is this possible?

It isn't possible, which is why private healthcare is never a good option.
The reason it isn't possible has nothing to do with it being privately financed. You can't extract unlimited resources from limited investment in any case, private or public, individually or collectively. If more is to be taken out, more must be put in. If you put in less, there is less there to take out.


giron - 9-1-2010 at 19:22

Quote:
Originally posted by scholar
The reason it isn't possible has nothing to do with it being privately financed.


To a certain extent, it is.

Being privately financed means that they need to make a profit, in order to satisy the shareolders.

At least with a Government run scheme there are no shareholders to pay.

That's not to say that there are unlimited amounts of money to spend on the health service, obviously there isn't, but it seems to me to be a better way maximise the resources.

It also means that people on a low income have access to decent heathcare, which certainly isn't the case in America.


scholar - 9-1-2010 at 22:03

Quote:
Originally posted by giron
It also means that people on a low income have access to decent heathcare, which certainly isn't the case in America.
But, low income people do have access to health care in America!

I get my health care through a charity clinic of Catholic origin.

You seem to be confusing health care and health finance, O Giron.

In Canada, for example, everyone has health finance handled by the government. But, some of them would die because of the long wait for health services, unless they go to the U.S., where everyone has access to health care.


giron - 9-1-2010 at 22:12

Quote:
Originally posted by scholar
But, low income people do have access to health care in America!

I get my health care through a charity clinic of Catholic origin.



Yes, but I said decent healthcare, surely that's not what you get when you rely on charitable institutions?


Daz - 9-1-2010 at 23:27

Quote:
Originally posted by scholar
But, low income people do have access to health care in America!

I get my health care through a charity clinic of Catholic origin.

You seem to be confusing health care and health finance, O Giron.


So, if you had no insurance due to being poor, but were diagnosed with a condition that demanded constant medication every day for the rest of your life, how would you make sure you could get the meds, without relying on charitable contributions that may, one day, suddenly not be available...?

Over here, that would not be an issue, just curious...?


marymary100 - 9-1-2010 at 23:51

What would happen to your "charity health care" if you actually got a job scholar?


giron - 10-1-2010 at 00:00

What are the chances of that happening, eh? lips_sealed


LSemmens - 10-1-2010 at 13:23

We have a life long medical condition to deal with in our family. As long as the treatment is necessary and we are prepared to accept the "public" doctor and hospital (IOW, we cannot pick and choose who our physician will be, nor do we get a choice on the hospital or bed) then our treatment is free. If we choose to "go it alone" then either we foot the bill or we get private health insurance. There are some treatments, and medications that are not on the government's list of "acceptable" treatments although they may be valid. For those, we must pay. I fail to see how private health insurance as you describe it, scholar, can benefit anyone except the shareholders. Any insurer who, upon assessing their risk, may decline to insure a person just as Joe Public can decline to accept their offer of insurance.


scholar - 10-1-2010 at 21:43

Quote:
Originally posted by giron
Quote:
Originally posted by scholar
But, low income people do have access to health care in America!

I get my health care through a charity clinic of Catholic origin.



Yes, but I said decent healthcare, surely that's not what you get when you rely on charitable institutions?
The health care the doctors offer is the same for everyone. They don't know if you have insurance, or if you pay out-of-pocket, or if you are a charity case. (They might reasonably guess that the older people are Medicare patients.)

Health financing is disconnected from health care--the two are separate subjects.


giron - 10-1-2010 at 21:52

Quote:
Originally posted by scholar

Health financing is disconnected from health care


How can that be, surely health care needs finance? confused2


scholar - 10-1-2010 at 21:56

Quote:
Originally posted by marymary100
What would happen to your "charity health care" if you actually got a job scholar?
When I am on salary with professional employment, my employer pays for insurance under a Health Management Organization. I don't think the charity clinic is on their list, so it would be to my financial advantage to go to a doctor on the list instead.

If I get hourly employment that does not include insurance, I can continue to go to the charity clinic, but I will have to pay for services.


marymary100 - 10-1-2010 at 22:57

I was with an HMO when I was in the States and it was adequate for me as my particular needs at the time were small.

A colleague of mine became seriously ill however and the same HMO cancelled his healthcare due to the amounts of money involved as he was likely to eventually need catastrophic health care. He sued and in the meantime his wife who worked for the Pentagon's insurance covered him. Eventually things went his way legally but he had years of frustration which contributed to his untimely death.

IMO when you're really sick the last thing you should be worried about is whether you will be covered for the treatment you require.


scholar - 11-1-2010 at 04:03

In the US, Medicare (government health care for the aged) denies more than health insurance.

Someone in the medical profession told me that it is against the law to charge a Medicare patient for a procedure that the government has disallowed. So, if the person needs the procedure to save his life, he cannot get it by paying for it himself. Unless he leaves the country to get it out of reach of U.S. law, he dies.:(


LSemmens - 11-1-2010 at 13:55

Quote:
Originally posted by scholar
Someone in the medical profession told me that it is against the law to charge a Medicare patient for a procedure that the government has disallowed. So, if the person needs the procedure to save his life, he cannot get it by paying for it himself. Unless he leaves the country to get it out of reach of U.S. law, he dies.:(
I find this quite unbelievable! If the government were unwilling to provide a service, and that service is available at a cost, it would be incumbent upon them to allow that service to be performed at a rate determined by the current market. Linky?


scholar - 11-1-2010 at 14:05

This is from a conversation with a nurse who works in a doctors' office, O Leigh.


giron - 11-1-2010 at 14:18

So it might not necessarily be true.


scholar - 11-1-2010 at 16:04

Quote:
Originally posted by giron
So it might not necessarily be true.
Does that make sense to you? Medicare does not authorize a treatment or medicine that a patient needs, and will not reimburse the doctor for doing it. The patient says, "I have sufficient money, I'll pay for it myself." And the nurse FALSELY says, "No, we won't do the treatment which your are willing to pay for, because the laws don't allow it"--even though the laws do allow it?lips_sealed


marymary100 - 11-1-2010 at 17:23

If it's more than hearsay it should be simple enough to find evidence to support the assertion.


scholar - 11-1-2010 at 17:50

Quote:
Originally posted by marymary100
If it's more than hearsay it should be simple enough to find evidence to support the assertion.
You're welcome to try.

Just to be clear--she was speaking of her own, direct knowledge. It was not hearsay.

Now, if you find an article which covers it, which was written based on what a reporter was told by someone who had direct knowledge--THAT would be hearsay.


marymary100 - 11-1-2010 at 18:29

It's hearsay from you and it's not my job to prove your claims.


scholar - 11-1-2010 at 18:58

Quote:
Originally posted by marymary100
It's hearsay from you and it's not my job to prove your claims.
And no one said it was your job to prove anything.

Increase your knowledge, or don't--your choice. I have already heard it directly from the source. :)


giron - 11-1-2010 at 23:03

What it I were to tell you that I'd heard it directly from a source that the nurse is incorrect in what she said?


scholar - 12-1-2010 at 06:30

Quote:
Originally posted by giron
What it I were to tell you that I'd heard it directly from a source that the nurse is incorrect in what she said?
I would wonder how reliable a source you hear directly in Coventry would be, compared to a nurse working in a doctor's office in America, with regard to actual Medicare authorization and billing (since the American nurse deals with it every day she works).

Back to the idea of the original post: It is nonsense to promise funds will be spent without any limit, AND that the cost will go down. If you remove limits to spending, the cost will increase.


Daz - 12-1-2010 at 08:53

This seems to dispute Scholars nurse friend claims

However...

Things like the story Scholar is relaying here have happened here, but often because there is a valid reason. The PCT have a set of NICE (National Institute for Health and Clinical Excellence) guidlines and also limited resources, so it has to consider the needs as a whole for the area they are delivering to.

Example 1

Example 2

Example 3

All that said, usually they refuse certain treatments because it is A, considered to be an outdated treatment and better options are available, or B, because funds are limited, and "suits"have decided that a particular drug/treatment/whatever, despite the evidence, is too expensive... They seemingly usually back down though when people start kicking off... And eventually the guidelines are changed...

I'm sorry for my post, my bad. lips_sealed


Mary2 - 12-1-2010 at 11:05

Bad boy! :D


LSemmens - 12-1-2010 at 13:32

To use, Scholar, your report is only hearsay, try and stand up in court and say that someone told you that "a" happened when you have no first hand experience to back it up or corroborating evidence. I'm certain the opposing lawyer would chew you up and spit you out so fast your words would have not got past " I was told..."

You made the assertion, it is, therefore, incubent upon you provide corroborating evidence, or it is only hearsay!


Daz - 12-1-2010 at 19:28

Quote:
Originally posted by Mary2
Bad boy! :D


I love it when you talk dirty! ;)


giron - 12-1-2010 at 19:53

If you ask her nicely, she'll give you a jolly good tawsing. ;)


Daz - 12-1-2010 at 19:54

Quote:
Originally posted by giron
If you ask her nicely, she'll give you a jolly good tawsing. ;)


I just want her to turn her web cam on... :D


Faolan - 17-1-2010 at 14:46

http://blogs.ngm.com/.a/6a00e0098226918833012876674340970c-800wi


marymary100 - 17-1-2010 at 15:10

Quote:
Originally posted by Faolan
http://blogs.ngm.com/.a/6a00e0098226918833012876674340970c-800wi
V.v. interesting.


scholar - 17-1-2010 at 20:48

Quote:
Originally posted by Faolan
http://blogs.ngm.com/.a/6a00e0098226918833012876674340970c-800wi
That is a very strange graphic, insofar as there are lines of different slopes from left to right (as if points were plotted), when, in fact, there is no function charted. The information could have been represented without bias by simply making a table or list.

A problem with the data is that it does not include information that explains dissimilarities. For example. a country that aborts babies with health problems would not have those babies count as deaths which would bring down the life expectancy, while a country whose health care is superior enough to keep those babies alive through birth and some months of life would then have them count as young deaths, thus bringing the life expectancy down. Also, a country with a higher murder rate would have a lower life expectancy than one which does not--but, that would not be because of inferior health care.


LSemmens - 18-1-2010 at 11:59

For once, I agree with you Scholar, the graphic does not really give enough information to make the graph meaningful. It's like at one side they've marked a country with 'per capita costs' and on the other side they've listed life expectancies and then drawn a line between the two rather than just write that data next to the country to which it refers!


Faolan - 18-1-2010 at 12:12

http://blogs.ngm.com/blog_central/2009/12/the-cost-of-care.html
http://blogs.ngm.com/blog_central/2010/01/the-other-health-care-debate-lines-vs-scatterplot.html

Answers some of the questions... ;)


LSemmens - 18-1-2010 at 12:51

Thanks SF, answers it all really.


scholar - 18-1-2010 at 17:35

Longevity is not a reasonable way of measuring how good a nation's health care is. It doesn't take account how many people die young because of crime, or because of drug abuse. It doesn't take account of whether one nation has more exposure to substances which promote cancer than another (including tobacco). It doesn't take account of whether a nation's diet is such as to bring on more artery disease, or heart disease, or diabetes. Some ethnic populations have a higher rate of alcoholism than others.

In the U.S., health costs are driven higher because of lawsuits. Lawyers sue for the very largest amount they might get (which may be unreasonably high), and they get a percentage of the money their client is awarded. If laws were adjusted so that suits were limited to the actual medical costs and lost wages, medical fees would not be set so high as to cover the high malpractice insurance necessary to cover the gigantic penalties that some juries award patients when doctors make honest mistakes.

Another additional cost that arises from the unlimited lawsuits are the many expensive, unnecessary tests doctors order for self-protection. They may be 99% sure that a patient has one condition, but they will order a test that costs hundreds of dollars just so they cannot be sued because they did not check the highly unlikely 1% possibility.

Sadly, the Democrat lawyers in the White House are not interested in reducing health care costs in a way that would reduce the money that lawyers get. Of the thousands of pages in the proposed law, there is not one sentence actually lowering costs by restricting what lawyers can take from people.


marymary100 - 18-1-2010 at 18:01

Lower life expectancy: drugs; tobacco; guns; fat-filled diet; less willingness to walk anywhere; poor healthcare unless one is willing to pay = America.

There's almost no need for your enemies to use terrorism against you as you seem intent on killing yourselves before your time.


giron - 18-1-2010 at 22:22

Sadly, that's all too true, as Jamie Oliver found out.


Quote:

Jamie was also left flabbergasted after he asks a group of school children to identify vegetables, mistaking tomatoes for potatoes.



shocked_yellow


LSemmens - 19-1-2010 at 12:23

IIRC, he had similar issues in England, too.


Daz - 19-1-2010 at 14:40

Quote:
Originally posted by LSemmens
IIRC, he had similar issues in England, too.


He is a pillock, that's why.

Because of him, my lad cannot have a bourbon biscuit, or penguin biscuit etc in his packed lunch box to eat after his sarnie or whatever. (Basically no chocolate, of any kind.) rolls_eyes

Nuts are also barred, but that I can understand, because of possible allergic reactions. But a choccy biccy? FFS! lips_sealed