The solution to Medicare and the health care system

[Rick]

Hey, Rick, I understand what you're saying. Our health care system is a MESS. A lot of work needs to be done to get it back to where it needs to be.

You made many good points. And I also made many good points. I'm not going to provide links about the pharmaceutical industry and how they "operate". You know exactly what I am saying.

As for the definition of "greed", you're much too intelligent for me to have to explain to you what "greed" is, and what the difference between "greed" and "profit" is.

No, I don't know. "Greed" is a subjective religious/moral concept, profits are an economic concept. What does anyone REALLY NEED, except a tent, a can of beans, and one set of clothes? How much after that is "greed"? Corporations have an affirmative business law duty to maximize profits of shareholders. Really, where's the cut-off point? If they make a certain amount of money by September, should they announce they'll not sell any more for the rest of the year, because that would push their profits into the "greed zone"??

 

[Hobo1]

No, I don't know. "Greed" is a subjective religious/moral concept, profits are an economic concept. What does anyone REALLY NEED, except a tent, a can of beans, and one set of clothes? How much after that is "greed"? Corporations have an affirmative business law duty to maximize profits of shareholders. Really, where's the cut-off point? If they make a certain amount of money by September, should they announce they'll not sell any more for the rest of the year, because that would push their profits into the "greed zone"??

Greed is another word for the "desire to get rich". It is the whole motivating factor behind the capitalistic system. In classic economic terms, it drives me to make a better widget. If I can invent, market and sell a better widget, people will buy at a higher price and I will get rich. I can have a big house, a fast car, and a beautiful mistress.

But, in the wings, is a man who is working on an even better widget, called widget #2. If he succeeds, then my product will become second rate and he will be kind of the hill. So greed motivates and controls the capitalistic system.

The problem comes in when outside factors start messing with the system. Lawyers are able to say, "hey the new widget #2 is dangerous for your children to use". Or the government bureaucracy says " Our regulations require us to use widget #1". Or insurance companies say, "Hey, we cannot insure your house if you use widget #1".

I am trying to give neutral examples, but in the case of the health care system, we have lawyers, government regulations, and insurance companies all messing with the free market system. And for some reason, we (the public) are willing to let them.

Right now I am in a hotel in Malaysia. I can walk out the door and into the pharmacy across the street with a list of drugs I want to buy -- and I can buy everything except something like Valium. If I have an a broken nose because the girl I met crossed her legs, then I can go to a small local hospital and ask, how much to fix my nose? $300? too expensive I will go to the clink down the street. No one is asking about insurance - no one ever heard of health insurance... people pay out of pocket.

So I go into the doctor's treatment room which has a medical bed. I take off my shirt, he injects my nose with Novocain and fixes my nose. He tells me to come back in 5 days to take out the stitches; the nurse hands me a little plastic bag filled with generic pain medicine and antibiotics... and asks for the $200 we agreed to. Then I am out the door. No one thinks about lawyers.

That is health care in most of the world. Oh, yea, everyone is happy with the $200 because I paid too much.

Next time you go into a doctor's office, ask the nurse how much for a check up. She will looks at you kind of strange because nobody ever asks that question. She will ask you, "what kind if insurance?"... answer:"the best, cash". Eventually she will give you a price. You can ask for a discount for cash. When she says take a seat in the waiting room (always filled with people), give her your cellular phone number and tell her to call you when it is your turn. Get loud, get demanding, demand lower prices.

That is how all consumers should act if you want lower prices.

 

[Rick]

Liberals just can't get their heads around a central theme of free markets that must appear to them to be a paradox, viz, that in pursuing one's self-interest in such an economy, ("greed", etc) a person/company indirectly serves the good of all. He tries to make a better widget to win the customers of the seller of the older widget. But if he succeeds, why is it? It's because consumers got a better widget. He only succeeds if he makes life better for the consumers.

Adam Smith said it long ago:

It is not from the benevolence of the butcher, the brewer or the baker, that we expect our dinner, but from their regard to their own self interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages.

The same thing could be made to work in the healthcare system; instead, obozocare takes the worst of the current system and puts it on steroids.

 

[PLC1]

In the US, if you're paying cash for care, you will pay triple what an insurance company will pay.

Now, if that situation were turned around, and cash for service became the norm, then no doubt prices for ordinary care would go down. A system like that could work for broken noses.

However, what about cancer treatment? Heart surgery? Emergency surgery? Is the patient who is passed out and hours from death without treatment going to go to the hospital and say, "No, too expensive. I'll go down the street."

 

[Hobo1]

In the US, if you're paying cash for care, you will pay triple what an insurance company will pay.

Now, if that situation were turned around, and cash for service became the norm, then no doubt prices for ordinary care would go down. A system like that could work for broken noses.

However, what about cancer treatment? Heart surgery? Emergency surgery? Is the patient who is passed out and hours from death without treatment going to go to the hospital and say, "No, too expensive. I'll go down the street."

I was at a doctor's office and ask how much for a check-up with the doctor. And she looked through her stack of papers, and asked "what insurance", I said, "cash, why?" She said insurance companies get a cheaper price, and I said I wanted the cheaper price.

To make a long story short, we almost called the police. I was so mad the nurse manager would not give me the insurance company's rates. The people in the waiting room stood up and agreed with me and were mad too. The doctor came out and asked what's up. After he heard the situation, he said he would do the check up for free. I said I would pay and he said something about his malpractice insurance,etc.

I said, ok - free is a good price. After the check up, and all my prescriptions were written, I put $30 in an envelope and said "Here is an early Christmas present for your kids". Put the envelope on the desk and walked out.

I have had a LOT of battles with doctors. We need to fight for our rights.

I have a $10,000 deductible for the big stuff, like a heart attack. But if even when I am in a hospital and had an operation (about 8 years ago), I will not sign anything - even if the insurance pays for it- unless I agreed to it in advance. They didn't tell me in advance I had to pay $100 for the bed pan, and I sure was not going to sign a piece of paper saying I agree to pay $1500 for some little stuff like that.

I do battle whenever I am cheated.

 

[TruthSeeker]

Liberals just can't get their heads around a central theme of free markets that must appear to them to be a paradox, viz, that in pursuing one's self-interest in such an economy, ("greed", etc) a person/company indirectly serves the good of all. He tries to make a better widget to win the customers of the seller of the older widget. But if he succeeds, why is it? It's because consumers got a better widget. He only succeeds if he makes life better for the consumers.

Adam Smith said it long ago:

The same thing could be made to work in the healthcare system; instead, obozocare takes the worst of the current system and puts it on steroids.

I don't believe that you can treat health care as a COMMODITY. I don't believe that health care should be a for-profit enterprise.

My definition of "greed" as it pertains to economics is when companies, no matter what they make and sell, use their profits to pad the bank accounts of their top executives or do an assortment of other things to WASTE money, while at the same paying their workers lower wages, minimal benefits, and charging the same or more for their products and services to their customers.

My definition of "greed", as it pertains to the corporate world, is when companies who are near insolvency, and companies who have received loans from the federal government, still pay their top executives millions of dollars in salaries and bonuses and lavish luxuries.

I just don't buy into this "companies must answer to their stockholders" thing. Companies need to learn to answer to their EMPLOYEES and their CUSTOMERS first, and the stockholders finish third.

What about privately-owned companies who obviously aren't publicly-traded? Who do they "answer" to? Their consciences? That's a good one!

Hobo, I am fully aware that non-profit companies are not always on the "up and up". That's where the word "greed" comes into play, again.

 

[Hobo1]

I don't believe that you can treat health care as a COMMODITY. I don't believe that health care should be a for-profit enterprise.

My definition of "greed" as it pertains to economics is when companies, no matter what they make and sell, use their profits to pad the bank accounts of their top executives or do an assortment of other things to WASTE money, while at the same paying their workers lower wages, minimal benefits, and charging the same or more for their products and services to their customers.

My definition of "greed", as it pertains to the corporate world, is when companies who are near insolvency, and companies who have received loans from the federal government, still pay their top executives millions of dollars in salaries and bonuses and lavish luxuries.

I just don't buy into this "companies must answer to their stockholders" thing. Companies need to learn to answer to their EMPLOYEES and their CUSTOMERS first, and the stockholders finish third.

What about privately-owned companies who obviously aren't publicly-traded? Who do they "answer" to? Their consciences? That's a good one!

Hobo, I am fully aware that non-profit companies are not always on the "up and up". That's where the word "greed" comes into play, again.

You need to take a course in accounting. I have had corporations all my life - the largest an engineering company of about 100 people. Engineering is not a commodity either? Some years we paid very high bonuses to our top executives, who were also partners, who were also shareholders. But our poor company had almost no profit!

So what's going on here? We were trying to keep our top engineers happy (including me), and at the same time show the government zero profit. Should I hang my head in shame for being so greedy?

Bookkeeping is a "funny-money" world. In accounting, profit doesn't the mean same thing as making big money. Profit is Income minus Expenses - that's all! The expenses may be fancy cars or junkets to Mexico. Heck, our company bought a nice car for the secretary because her car was always breaking down and she was late to work. When the secretary was not behind her desk, the company was loosing money. Buying the secretary a car was a smart company decision. But the car also was an expense to that brought down the company profit.

The point is a healthy company must keep everybody happy. If anybody, the employees or the stock holders or the executives are unhappy and not getting a fair share of the pie, they will leave.

And another thing, a good executive is hard to find. Ask Yahoo as they change CEO's faster than most people change underwear. Yahoo, a huge company, is sinking fast! It is kind of hard for most people to understand how an executive can be worth so much money - until they see a perfectly good company (like Yahoo) getting beaten out of the market. Why? Because their top executives didn't see Skype coming. Yahoo Messenger was on top of that people-to-people chat market but the execs fell asleep on the job as technology advanced.

Private companies don't intentionally make stupid decisions with their money. It may look stupid to you - and you can call it greed. But NOBODY in the private sector just throws away money or allows some fat guy in a nice suit just take the money because he is greedy. Apparently most people think he earned his money.

Throwing away money only happens in the government!

 

[TruthSeeker]

You need to take a course in accounting. I have had corporations all my life - the largest an engineering company of about 100 people. Engineering is not a commodity either? Some years we paid very high bonuses to our top executives, who were also partners, who were also shareholders. But our poor company had almost no profit!

So what's going on here? We were trying to keep our top engineers happy (including me), and at the same time show the government zero profit. Should I hang my head in shame for being so greedy?

Bookkeeping is a "funny-money" world. In accounting, profit doesn't the mean same thing as making big money. Profit is Income minus Expenses - that's all! The expenses may be fancy cars or junkets to Mexico. Heck, our company bought a nice car for the secretary because her car was always breaking down and she was late to work. When the secretary was not behind her desk, the company was loosing money. Buying the secretary a car was a smart company decision. But the car also was an expense to that brought down the company profit.

The point is a healthy company must keep everybody happy. If anybody, the employees or the stock holders or the executives are unhappy and not getting a fair share of the pie, they will leave.

And another thing, a good executive is hard to find. Ask Yahoo as they change CEO's faster than most people change underwear. Yahoo, a huge company, is sinking fast! It is kind of hard for most people to understand how an executive can be worth so much money - until they see a perfectly good company (like Yahoo) getting beaten out of the market. Why? Because their top executives didn't see Skype coming. Yahoo Messenger was on top of that people-to-people chat market but the execs fell asleep on the job as technology advanced.

Private companies don't intentionally make stupid decisions with their money. It may look stupid to you - and you can call it greed. But NOBODY in the private sector just throws away money or allows some fat guy in a nice suit just take the money because he is greedy. Apparently most people think he earned his money.

Throwing away money only happens in the government!

Yeah, I need a course in accounting. LMAO! Whether you realize it or not, you just verified my previous posting by talking about "your" company. Thanks.

It is OBSCENE that corporate executives make millions and millions of dollars because they "can", while the corporations they supposedly "manage" are going bankrupt and/or cutting "worker bee" salaries and benefits, and raising the prices on their goods and services.

Corporate greed is never going to go away, unless it becomes VERY uncomfortable for the fat cats who take advantage of the loopholes and all of the other illegal accounting practices they use.

There is the free enterprise system, and the laws of supply and demand, and then there is the ABUSE of both. There is no excuse for the latter.

 

[Centrehalf]

In the US, if you're paying cash for care, you will pay triple what an insurance company will pay.

This has not been true in my case. I do contract work and currently only have insurance for catastrophic care. Last month I had to get 2 X-rays. I paid $110 for the two of them. When I still had BC/BS I would have only paid $10, for the office visit. But, my doctor would have been paid $250 for the same two X-rays by BC/BS. I asked him about this, and he told me that even though he only charges a cash price of $55 for an X-ray, he has to accept the $125 per X-ray that BC/BS pays out. If he tried to only charge the insurance company his price, they wouldn't pay him. They only pay out whatever they deem to be the price of any given procedure, so if you're a doctor and you bill the insurance company an amount for a procedure that doesn't match the amount on the providers fee schedule, you won't get paid even if you're asking for less money.

In February I had some very basic outpatient surgery. My cash price was $95, BC/BS would have paid the doctor $550 for that procedure.

In March I had some blood work done. My cash price was $85, BC/BS would have paid out $220 for the same lab work.

My doctor told me that the reason this happens is because the insurance companies , or more accurately some of the big ones, overpay on purpose in order to keep doctors on their list of approved providers, and in some cases to keep them as exclusive providers. I know this is just my personal experience so take it however you will.

The only problem I'm running into is that some of the non-generic drug prices are just absolutely brutal if you don't have some sort of presciption plan.

 

[TruthSeeker]

This has not been true in my case. I do contract work and currently only have insurance for catastrophic care. Last month I had to get 2 X-rays. I paid $110 for the two of them. When I still had BC/BS I would have only paid $10, for the office visit. But, my doctor would have been paid $250 for the same two X-rays by BC/BS. I asked him about this, and he told me that even though he only charges a cash price of $55 for an X-ray, he has to accept the $125 per X-ray that BC/BS pays out. If he tried to only charge the insurance company his price, they wouldn't pay him. They only pay out whatever they deem to be the price of any given procedure, so if you're a doctor and you bill the insurance company an amount for a procedure that doesn't match the amount on the providers fee schedule, you won't get paid even if you're asking for less money.

In February I had some very basic outpatient surgery. My cash price was $95, BC/BS would have paid the doctor $550 for that procedure.

In March I had some blood work done. My cash price was $85, BC/BS would have paid out $220 for the same lab work.

My doctor told me that the reason this happens is because the insurance companies , or more accurately some of the big ones, overpay on purpose in order to keep doctors on their list of approved providers, and in some cases to keep them as exclusive providers. I know this is just my personal experience so take it however you will.

The only problem I'm running into is that some of the non-generic drug prices are just absolutely brutal if you don't have some sort of presciption plan.

Centrehalf, I've been there and done that. I was a contractor working in the nuke power plant industry for many years. Great money, but I was pretty much on my own as far as health insurance went. It was definitely a trade-off,

 

[PLC1]

This has not been true in my case. I do contract work and currently only have insurance for catastrophic care. Last month I had to get 2 X-rays. I paid $110 for the two of them. When I still had BC/BS I would have only paid $10, for the office visit. But, my doctor would have been paid $250 for the same two X-rays by BC/BS. I asked him about this, and he told me that even though he only charges a cash price of $55 for an X-ray, he has to accept the $125 per X-ray that BC/BS pays out. If he tried to only charge the insurance company his price, they wouldn't pay him. They only pay out whatever they deem to be the price of any given procedure, so if you're a doctor and you bill the insurance company an amount for a procedure that doesn't match the amount on the providers fee schedule, you won't get paid even if you're asking for less money.

In February I had some very basic outpatient surgery. My cash price was $95, BC/BS would have paid the doctor $550 for that procedure.

In March I had some blood work done. My cash price was $85, BC/BS would have paid out $220 for the same lab work.

My doctor told me that the reason this happens is because the insurance companies , or more accurately some of the big ones, overpay on purpose in order to keep doctors on their list of approved providers, and in some cases to keep them as exclusive providers. I know this is just my personal experience so take it however you will.

The only problem I'm running into is that some of the non-generic drug prices are just absolutely brutal if you don't have some sort of presciption plan.

I'm not sure how you get X rays for that price. I've seen some of the EOMB (explanation of medical benefits) papers that the insurance company sends. There will be a fee of $2,000 charged for a procedure, with $100 to be paid for by the patient, $400 by the insurance, and the rest "written off", meaning that $500 is what they expected in the first place.

Maybe if you negotiate ahead of time, you can get around that price difference.

As for pills, no wonder they are so expensive. They must spend a ton of money on TV ads. "shouldn't you ask your doctor?" Hell, no, my doctor better know more about medications than I have learned from some dumb ads!

 

[Rick]

I don't believe that you can treat health care as a COMMODITY. I don't believe that health care should be a for-profit enterprise.

Interesting assertion - give me your reasons.

My definition of "greed" as it pertains to economics is when companies, no matter what they make and sell, use their profits to pad the bank accounts of their top executives or do an assortment of other things to WASTE money, while at the same paying their workers lower wages, minimal benefits, and charging the same or more for their products and services to their customers.

Perhaps you can offer a specific documented example of when this has ever happened?

My definition of "greed", as it pertains to the corporate world, is when companies who are near insolvency, and companies who have received loans from the federal government, still pay their top executives millions of dollars in salaries and bonuses and lavish luxuries.

The boards of directors aren't insane - they pay for PERFORMANCE. If you're talking about banks which were nearly crashed in 2008 by the distorted housing market caused by the leftwing, the LAST thing the board would want to do is fire an experienced CEO by blaming him for events external to the company. The FIRST thing they want to do, if they want to survive, is pay top money for skilled people who can pull them from the wreckage and survive.

I just don't buy into this "companies must answer to their stockholders" thing. Companies need to learn to answer to their EMPLOYEES and their CUSTOMERS first, and the stockholders finish third.

Absolutely false. Companies owe employees and customers
nothing, and the reverse is true. If employees and customers don't like the company, they can go elsewhere. But stockholders are the >>OWNERS<<.
Of course, companies try to please customers and valued employees too, since it's a free country and they can and will go elsewhere.

What about privately-owned companies who obviously aren't publicly-traded? Who do they "answer" to? Their consciences? That's a good one!

What do you mean - "answer to"? Answer what? They provide a good or service, and if people like it, they'll buy it, otherwise they won't.

Hobo, I am fully aware that non-profit companies are not always on the "up and up". That's where the word "greed" comes into play, again.

"Upandup"?? What does that mean? You keep using vague phrases. If you mean they break the law, then of course tghey should go to jail.

 

[Centrehalf]

I'm not sure how you get X rays for that price. I've seen some of the EOMB (explanation of medical benefits) papers that the insurance company sends. There will be a fee of $2,000 charged for a procedure, with $100 to be paid for by the patient, $400 by the insurance, and the rest "written off", meaning that $500 is what they expected in the first place.

I'll ask him. I have an appointment with him on Saturday morning. He knows more than I do about this. I've tried to read through a lot of the health care laws and regulations, and it's just mind-numbing.

As for pills, no wonder they are so expensive. They must spend a ton of money on TV ads. "shouldn't you ask your doctor?" Hell, no, my doctor better know more about medications than I have learned from some dumb ads!

LOL. I hate those commercials. Everytime I see one of those pharmaceutical commercials I can't help but thinking that their product must really suck if they have to resort to marketing directly to the patients. If the doctors thought the drugs were worth a damn and wanted to prescribe them, why spend all of the money to buy ad time?

 

[GenSeneca]

I don't believe that you can treat health care as a COMMODITY.

Healthcare is a service, all the products necessary to perform that service are commodities. So I too would like to hear you expand on your thought about HC not being a commodity.

There is the free enterprise system, and the laws of supply and demand, and then there is the ABUSE of both. There is no excuse for the latter.

The US doesn't use the free enterprise system, that would require a free market in which the government guards against force and fraud. Our system is Corporatism, where we operate on a mixed market and the government usually participates in, rather than guarding against, force and fraud.

 

[PLC1]

LOL. I hate those commercials. Everytime I see one of those pharmaceutical commercials I can't help but thinking that their product must really suck if they have to resort to marketing directly to the patients. If the doctors thought the drugs were worth a damn and wanted to prescribe them, why spend all of the money to buy ad time?

in general, the more a thing has to be advertised, the less useful it is. If people already want a thing, why spend millions to create a market? That goes for pharmaceuticals and political candidates alike.