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Free Minds & Free Markets

Free Market Health Care

Government involvement in health care drives prices up.

President Trump and Paul Ryan tried to improve Obamacare. They failed.

Trump then tweeted, "ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!"

But I do worry.

Trump is right when he says that Obamacare will explode.

The law mandates benefits and offers subsidies to more people. Insurers must cover things like:

  • Birth control.
  • Alcohol counseling.
  • Depression screening.
  • Diet counseling.
  • Tobacco use screening.
  • Breastfeeding counseling.

Some people want those things, but mandating them for everyone drives up costs. It was folly to pretend it wouldn't.

Insisting that lots of things be paid for by someone else is a recipe for financial explosion.

Medicare works that way, too.

When I first qualified for it, I was amazed to find that no one even mentioned cost. It was just, "Have this test!" "See this doctor!"

I liked it. It's great not to think about costs. But that's why Medicare will explode, too. There's no way that, in its current form, it will be around to fund younger people's care.

Someone else paying changes our behavior. We don't shop around. We don't ask, "Do I really need that test?" "Is there a place where it's cheaper?"

Hospitals and doctors don't try very hard to do things cheaply.

Imagine if you had "grocery insurance." You'd buy expensive foods; supermarkets would never have sales. Everyone would spend more.

Insurance coverage -- third-party payment -- is revered by the media and socialists (redundant?) but is a terrible way to pay for things.

Today, 7 in 8 health care dollars are paid by Medicare, Medicaid or private insurance companies. Because there's no real health care market, costs rose 467 percent over the last three decades.

By contrast, prices fell in the few medical areas not covered by insurance, like plastic surgery and LASIK eye care. Patients shop around, forcing health providers to compete.

The National Center for Policy Analysis found that from 1999 to 2011 the price of traditional LASIK eye surgery dropped from over $2,100 to about $1,700.

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  • nicmart||

    Again a "libertarian" advocates "free market" medicine without including abolition of occupational licensure and prescription drug laws. There is no free market in a profession whose main participants are educated and licensed by the state. There is no free market when people must be granted permission to self-medicate. Apparently this is damned hard for a many self-identified libertarians to grasp.

  • Bra Ket||

    Practitioner licensing has been the law for centuries, it doesn't help, but doesn't explain the recent price bubble in healthcare.

  • Enemy of the State||

    In the US, only for 100 years +/-. Barrycare is the reason for the most recent cost spikes. Medicare/Medicaid and artificial supply constraints are to blame for the long run inflation in health care costs...

  • Sugarsail||

    No one brings up frivolous litigation. Our lawyer-politicians always try to convince us it's a small cost, but I know far too many doctors and have seen their legal overhead to buy that. The courts have become an extortion racket.

  • TGoodchild||

    There are robust markets (though, to be sure, not inter-state) for legal and many other non-medical professionals which normally require that practitioners be licensed.

  • IceTrey||

    There are private medical schools.

  • BYODB||

    I understand where you're coming from Nicmart, and that's why I'm going to offer my medical services to anyone for the low, low price of $100.00.

    I should warn you though, I have no medical training and I intend to simply inject you with heroin. And when I say 'I should warn you' what I mean to say is 'I'm going to take your $100.00 and then inject you with heroin'.

    I'm pretty confident that you won't be happy with that level of service, but then again I bet you'll come back. I wager you won't be able to help yourself.

    This isn't meant to be a critique necessarily, but most people prefer that someone be examined and certified when the profession has literal control over if you live or die. I'm not saying you're wrong, but the above is simply intended to be an illustration of what 'no education or licensing' could be considered. You'll understand why non-libertarians will look at you like you're insane, yes?

  • cluskillz||

    Not taking sides here, but just to be fair, the OP did specify "licensed by the state". He did not object to licensure or accreditation by private bodies and boards.

  • jerbigge||

    I've been saying that repealing the mistake of prescription laws is one good way to bring down health care costs. See "muskegonlibertarian.wordpress.com" FDR signed the law into effect on behalf of leftist advisors who considered people too incompetent to make their own decisions for themselves. Of course the AMA loved the idea, as it was one of the objectives back when the AMA was formed in the 1840's Giving doctors a legal government enforced monopoly over access to medical drugs was something the MD's had been wishing for some time.

    Prior to this people relied more upon their neighborhood pharmacist when they had something that could be treated with a drug. Doctor visits were more reserved for broken bones and the need to have surgery for something.

  • Sugarsail||

    How exactly does requiring a license preclude a free market? That's like saying safety regulations on cars impedes the automobile market. Faulty logic, I don't think you know what "free market" means. Consumers have to have multiple choices and there needs to be competition...there is currently those things among doctors. These are product safety measures only, not impediments to free market economics. And people self-medicate all the time what do you think the illicit drug market is for? They also go to alternative medicine clinics all the time. Besides, I think if you talked to Stossel, he would agrees that making a license unnecessary for doctoring would be a good roll back of excessive government but would you want the janitor doing you heart transplant? I didn't think so.

  • nicmart||

    Again a "libertarian" advocates "free market" medicine without including abolition of occupational licensure and prescription drug laws. There is no free market in a profession whose main participants are educated and licensed by the state. There is no free market when people must be granted permission to self-medicate. Apparently this is damned hard for a many self-identified libertarians to grasp.

  • buybuydandavis||

    Seems like we are making progress with this idea in the comments section.

  • $park¥ leftist poser||

    Again a "libertarian" advocates "free market" medicine without including abolition of occupational licensure and prescription drug laws.

    The scare quotes are a nice touch.

  • Cynical Asshole||

    Meh.

    I give it a D-. Barely passable trolling. Try harder next time.

  • MichaelL||

    Yet, if we look into diabetic care, why do we not see endocrinologists caring for every diabetic instead of family doctors. They are most qualified to do it. Why would we allow others to give inferior care..........(;-P................As a past board certified general surgeon, I can pretty well assert the fact that I was trained well enough to care for my patients. It had everything to do with my education and nothing to do with the fact that I could pass some state exam required to practice medicine. In fact, I had completed graduate school and had extra time obtaining a Certificate in Pain Studies from a university program. Yet the petty politicians that control the medical boards, with much less education, are the ones that are making the decisions. It is all about control and competition and very little to do with education and knowledge. In fact education had nothing to do with their political decisions. It was more the fact that such a large portion of physicians that I was around seemed to have less of it (education and knowledge) than I did. But they drove me out before my fifty-fourth birthday. I have to admit, I never considered politics as an important part of patient care. But, I was wrong! Lack of peer support destroyed my practice!

  • buybuydandavis||

    A *Free* market would include the right to self treat and self-medicate, and get advice on how to do so from anyone willing to give it.

    "Libertarian" Reason Magazine

  • $park¥ leftist poser||

    Stossel didn't specifically mention that so he's probably against it.

  • Zeb||

    Sometimes people write articles addressing practical policy ideas. Not everything has to lay out the exactly perfect libertarian solution. We all already know what that is (more or less).

  • Redcard||

    Stossel writes to defend Republicans. Not free markets

    And he is selective

    Today, 7 in 8 health care dollars are paid by Medicare, Medicaid or private insurance companies. Because there's no real health care market, costs rose 467 percent over the last three decades.

    By contrast, prices fell in the few medical areas not covered by insurance, like plastic surgery and LASIK eye care. Patients shop around, forcing health providers to compete.

    The National Center for Policy Analysis found that from 1999 to 2011 the price of traditional LASIK eye surgery dropped from over $2,100 to about $1,700.

    Non-essential procedures of course, cost less.

    There was that free market dude bro whose AIDS drug went from $13.50 to $750 overnight.

  • Sugarsail||

    No medical procedure is essential, gotta die of something. The essentialness of the procedure is not what sets the price, unsubsidized competition in the market place does, like Stossel pointed out. Stossel's point is valid, your criticism of it isn't.

  • Karen24||

    LASIK and cosmetic surgery are not at all the same thing as, say, diabetes maintenance. I will not die or go blind without LASIK; therefore I can afford the time to wait and shop around. (And even then those things aren't exactly cheap. The prices have fallen, which is why Stossel uses them as an example, but they're still luxury services.). Compare that to, say, diabetes maintenance or cancer treatment, where delay means permanent disability or death. That's not even considering whether the condition itself impairs the patient's cognitive functions enough to make things like price comparisons for drugs possible. Finally, obtaining the information necessary to compare treatments for complicated illnesses that require long and expensive courses of treatment is expensive and difficult. Does Stossell think people should have to go to medical school?

    I am not suggesting any particular policy option for health care in this country. What I am stating, flatly, is that John Stossel has made a stupid argument. Try to write paragraphs of at least five sentences and include things like evidence next time.

  • DaveSs||

    Diabetes maintenance is something millions of people have to do daily.
    Its also something for which the most common treatment has been existence for 40+ years.

    There is no rational reason, apart from the fact that Medicare covers most diabetes care and thus price is immaterial, that its expensive today.

  • Karen24||

    I would be very interested in reading evidence in support of your opinion. My husband is an insulin-dependent diabetic and his maintenance regimen is not simple. He has monthly appointments with a primary care doctor, quarterly with an endocrinologist, annual with a kidney specialist, as well as peripheral specialists for vision and circulation issues. The basic medications may have been around for a while, but the entire course of treatment has changed since his diagnosis. (He had pancreatitis which led to this, instead of the typical pattern of discovering it in childhood.).

    The point I'm making is that health care involves a lot of separate products and services. Some treatments are quick, others involve lifetime management. No single policy can cover all aspects of it at once. We need better analysis of each category of treatment, and apply policies that way. Stossel's half-assed PowerPoint here does none of those things.

  • $park¥ leftist poser||

    We need better analysis of each category of treatment, and apply policies that way.

    If by 'we' you mean you and your husband, sounds like you've got some work to do.

    The only policy 'we' need is that government stop inserting itself into health insurance and health care.

  • creech||

    I'm sorry to hear about your husband's condition. However, it isn't like, say, falling from a ladder and breaking a leg where you aren't going to shop around first to see which emergency room has the best price. It is a long term illness he must treat, and by now he should have had the opportunity to ask around about the lowest priced doctor for those monthly appointments, quarterly and etc. appointments.

  • Cynical Asshole||

    by now he should have had the opportunity to ask around about the lowest priced doctor for those monthly appointments, quarterly and etc. appointments.

    I don't know man, that sounds like a lot of effort. /sarc

  • Red Rocks Baiting n Inciting||

    It is a long term illness he must treat, and by now he should have had the opportunity to ask around about the lowest priced doctor for those monthly appointments, quarterly and etc. appointments

    Theoretically, that's how it should work, but without enforced price transparency it's pointless. Try calling up a few random hospitals and ask how much they charge for these things--I guarantee not a damn one of them will be able to give you even a ballpark figure, because healthcare providers get away with violating price discrimination laws every damn day of the year and giving you a pre-determined cost would instantly end their scam.

  • Provocateur||

    Actually, try calling doctors , hospitals, etc, and asking what their CASH price is for various services. You would be surprised how low it is (usually 50% of insured cost).

    It's only insured costs they refuse to tell you up front, so you have to get an itemized statement from your insurance co for actual treatment performed if you want to do a price comparison with cash.

  • Red Rocks Baiting n Inciting||

    It is a long term illness he must treat, and by now he should have had the opportunity to ask around about the lowest priced doctor for those monthly appointments, quarterly and etc. appointments

    Theoretically, that's how it should work, but without enforced price transparency it's pointless. Try calling up a few random hospitals and ask how much they charge for these things--I guarantee not a damn one of them will be able to give you even a ballpark figure, because healthcare providers get away with violating price discrimination laws every damn day of the year and giving you a pre-determined cost would instantly end their scam.

  • BYODB||

    With conditions like diabetes, where the patient never really gets better, you aren't paying for insurance you're paying a subscription fee.

    I find calling such a thing 'insurance' mendacious on every level. You literally can not insure against a sure thing. You can't do it. There is only one thing a person like that can ever be to any given 'insurance' system and that is a cost.

    Period.

    Insurance as a concept should be illegal except for purely catastrophic coverage. Forcing them to lose money is certainly one way to do that, but ultimately that system must result in one thing and that is every insurance company goes out of business.

    Instead of waiting for the system to implode under the weight of what they 'must do' by law, why not expedite the process. Sure, there will be a lot bad things happen in the short term but those things are unavoidable anyway and the consequences will only become worse the longer we wait. The selfishness of those in the system now will kill the people in the system tomorrow.

    Also period.

  • bartzman86||

    You should have ended your statement with "Drops Mic". More dramatic.

    Also, the way we use the term "insurance" in healthcare now drives me nuts too. Glad someone else feels the same way.

  • ||

    Add to that the term "disease"(i.e. opioid addiction, alcoholism, etc., etc., etc.).

  • JFree||

    The price of insulin at least has nothing to do with Medicare. It is entirely because of the way we grant patents on chemicals/drugs. Every time the molecule is changed, it results in a new patent on the discovery of the chemical itself - not just the invention of the process used to create it. That patent granted on the discovery kills off ALL invention of alternate processes that could be used to create that chemical - and as a side-effect a slew of alternative chemicals that might also be discovered to be therapeutic. We are rewarding discovery and punishing invention and the effect is that drug manufacturing is increasingly artisanal (and filled with patent wars) not industrial.

  • NotAnotherSkippy||

    This bullshit again. Considering insulin was purified over a century ago the notion that any attached patents are interfering with competition is ludicrous. As is typically the case other gov't interference is the cause of higher insulin prices in the US.

    And if you think your magical mystical process will result in new theraputics, then a patent on an existing compound has absolutely no bearing because it, by definition, would not apply. You might want to take the time to educate yourself on the differences between the different types of patents.

  • NotAnotherSkippy||

    And on the subject of insulin costs:http://www.medscape.com/viewarticle/841669

  • JFree||

    Jesus H Christ. Did you even read that article? It says exactly what I'm saying - those new patents on tweaked chemical structure (once per day replacing twice per day) are preventing generic insulin from being made in the US.

    The only thing that article isn't focused on is WHY. And that is because the chemical patent (discovery) precludes the process of synthesizing insulin (invention) itself from being profitable. But it does illustrate why the patents are driving prices higher - not lower. The newest patent becomes the price point that all older versions are based on (because it has the longest protection) - rather than the oldest/generic version being used as the baseline price that the market will bear.

    And yes - allowing patents on the invention (synthesizing process) rather than the discovery (chemical structure itself) will result in a ton of new therapeutics. Just like it did for the entire first generation of antibiotics - which saved hundreds of millions of lives within 20 years after WW2. All of that research (pretty much every class of antibiotics that exists today) originated in process research - finding anything therapeutic - dirt/mold/fungi/etc - that could be synthesized via the particular fermentation process that companies owned. That research occurred only because penicillin itself (the original product of different fermentations) was NOT patented.

  • BYODB||

    So what you're saying is that each new patent on what is effectively a different molecular structure prohibits people from using the molecular structure of 'original' insulin because...

    I honestly don't know what the length of time a patent lasts, but I seem to recall it's something to the tune of 90 years. Are we there with the 'original' molecular insulin or not? I honestly don't know. If so, why isn't it cheaper when the patent would have expired?

    And also, on the subject of antibiotics, I'm sure it's occurred to you that just because we discovered a lot of them over a short period of time it doesn't necessarily mean that there are infinite antibiotics, yes?

  • Myk||

    I think drug patents are 20 years. But as mentioned above they get extended by making a minor change (not even molecular changes). One when I was newly diagnosed simply put the pill into a capsule. Literally the old pill is now wrapped with a capsule so what should have generics now doesn't.

    Also there's an "orphan drug" program that is abused. If you find a rare disease use for your medicine you get exclusive rights for a time. Real purpose is to create new rare disease treatments. Actual use is to extend your rights on drugs that are already there so you can charge more longer plus get tax incentives.

  • JFree||

    prohibits people from using the molecular structure of 'original' insulin because...

    The profits of scaling a synthesizing process depend on the number of products you can push through it. The analogy is a refinery. If you can't produce gasoline or kerosene or asphalt or butane or diesel cuz those are patented, then you aren't gonna make a profit with only lubricants. Chemical/pharma processing is similar except that they have a larger variety of inputs (not just crude) and processes. And every chemical/pharma output can be produced using different processes - ranging from 'nature'/'folk' to synthetic.

    Looking at what I just wrote, this could be the difference between the German chemical industry (highly competitive and innovative) and Rockefeller's Standard Oil Trust (highly monopolistic and merger-oriented) in late 19th century. We had very different patent systems then. Germans like what I describe. US like what we (and Germany since we forced them to change) have now. Never thought about this before.

    it doesn't necessarily mean that there are infinite antibiotics, yes?

    Yes that's true. But there is not even any discovery research occurring now.

  • OldMexican Blankety Blank||

    Re: Karen24,

    LASIK and cosmetic surgery are not at all the same thing as, say, diabetes maintenance.


    The fact that you posit more value on diabetes maintenance does not mean diabetes maintenance is fundamentally different a service than LASIK or cosmetic surgery. All of those are services that require a provider who obtained a set of skills through preparation and practice. His or her labor is for SALE, whether you happen to like it or not. That means you have to trade something with that person, something you posit a lesser value on than the service you want to trade it for. The trade is voluntary on both sides, meaning the provider doesn't owe you anything. That is what everyone here means with free market medicine.

    What I am stating, flatly, is that John Stossel has made a stupid argument.


    Really? That takes some chutzpah. You are the one making a value judgment argument, not an objective argument. I don't cafe about your problems; everyone has problems. Injecting your problems on your argument is not precisely a show of rationality, so don't come here accusing someone of making a "stupid argument" so easily.

  • JFree||

    All of those are services that require a provider who obtained a set of skills through preparation and practice. His or her labor is for SALE

    Well why is Lasik and boobjobs cheaper in socialized medicine Europe than it is in justwannabefree US then? You hint at why. It is because cosmetic surgeons in Europe don't require as much money to stay in cosmetic surgery (v say general surgery) there than here. The public systems there use their market monopsony power to drive down specialist income (without driving them out of medicine altogether). Medicare here doesn't do that (the reverse actually) - but that is entirely a Medicare reform problem and Stossel is tiptoeing around that issue like every pol does too.

  • dan'o en barrel||

    The EU also enjoys a far less litigious environment for healthcare practitioners. When a GP in the US has to cough up $100k for malpractice insurance and practices defensive medicine to avoid lawsuits, it drives up cost of services dramatically.

  • JFree||

    The US spent 'in roughly the same range as everyone else' until the late 1970's. Then those countries spending flattened - and ours continued at the same growth rate. What changed? The late 1970's (specifically post-1974 recession) is precisely when those other countries expanded their socialized health systems to cover more specialist services (which were pretty new then). For a long time we could ignore that because one consequence of those expanded welfare systems was reduced job creation there. IOW - they paid the price elsewhere. But re health itself - that is no longer - and probably never was - significant and now it is our higher costs that are eliminating job creation.

    A graph of that comparative spending from Mercatus (which damn these ideologues starts at 1980) - http://bit.ly/2oaP6vU
    Same data from NYT (from 1960 on - which shows the flattening of others better) - http://bit.ly/2nh4NwO

  • BYODB||


    "The public systems there use their market monopsony power to drive down specialist income...Medicare here doesn't do that (the reverse actually)"

    Let me see if I understand because this seems too stupid to be what you mean:

    You are essentially saying that we should get rid of the physicians ability to make up lost cost from accepting government plans that pay below-market rates by setting the market rate itself below the market rate?

    What that would mean is there would no longer be a healthcare system in the United States, but rather a system of making us a slightly more comfortable while we die system provided at 'only' half your paycheck each month.

  • JFree||

    No I'm not saying that. Using monopsony power would be - Medicare says this [lower number than now] is what we are going to pay for specialist services. Either accept that or lose your Medicare customer base. There's been legislation in Congress to do this for 25 years. It never goes anywhere. There are other ways countries do it as well - move away from fee-for-service. Specialists become high-salaried employees (say 200k or whatever) of a hospital - and the state pays hospitals X for Y ops/year. This is the way Mayo Clinic runs itself - and prob HMO's like Kaiser as well.

    This is prob why cosmetic surgery is cheaper in Europe. The boobjob dr compares what they earn doing private market boobjobs to what they would earn doing surgery in the public medical system.

    By Medicare doing the reverse I mean that Medicare DOES drive GP's out of business here. They can't survive here on a 1000-patient practice (with followup and longer visits and preventive care and such like Europe) unless they milk 'testing' fees or somesuch. So new doctors become specialists rather than generalists - and we have a serious GP shortage. The private market can't fix that - cuz the doctor no longer exists in medicine.

  • Fatty Bolger||

    What's stupid about it? Insulating consumers from costs drives prices up, that's all he is saying.

  • JFree||

    Seems like a rather silly argument since the US has the highest medical prices (and it ain't close) in the world and we actually force MORE people to face those costs on their own than anywhere else.

    Like it or not, other systems do a far better job at driving those costs down - regardless of the means by which they do that. Positing a solution of tax credits bullshit and interstate insurance sales is - wind pissing.

  • Red Rocks Baiting n Inciting||

    Seems like a rather silly argument since the US has the highest medical prices (and it ain't close) in the world and we actually force MORE people to face those costs on their own than anywhere else.

    We also don't enforce price transparency, which is a primary driver in why we force more people to face those costs on their own.

    In other countries, medical care is highly regulated in the sense that healthcare providers have to accept caps on their salaries and services in order to operate, but because most of the population save for the very wealthy don't supplement the state system with private plans, the hospitals have little choice but to accept the model that's being enforced on them. That kind of model doesn't exist here except in bastardized versions like Medicare and Medicaid, and because these programs tend to under-pay the actual costs, they're made up elsewhere via over-charged services for other insurance plans. And good luck getting doctors here to agree to salary caps when they've taken out $200K for a medical degree paid for with government-backed student loans that have also contributed to exponential increases in tuition.

    The point is that we shouldn't need a "public option" from our already dysfunctional government in the US system when we have existing tools to lower healthcare costs, using price transparency and anti-monopoly laws via 15 USC.

  • JFree||

    My point is that Stossel's basic premise/headline here - govt involvement drives prices up - is flat-out erroneous. So his conclusions are irrelevant/meaningless.

    Even what you are describing as occurring elsewhere - state-run monopsonies driving prices down and de-incenting new supply isn't actually happening. They have lower current prices (purely a result of monopsony state power) -- AND higher supply of physicians and hospitals (which would keep prices down there even IF they abandoned their state systems).

    The only exceptions are UK/Canada (and only re specialist physicians - not generalists or hospitals). The only two single-payer systems too. Why that is the model that American progs want to follow is - a question for progs.

    I just find it mindboggling that Americans are uniquely avoiding anything productive/humane because we are dividing ourselves into stupid prog ideologues and irrelevant free-market ideologues.

  • NotAnotherSkippy||

    And many of them subsidize the education of said doctors. What's really stupid is handwavong away price controls with the magic word "monopsony."

  • Red Rocks Baiting n Inciting||

    My point is that Stossel's basic premise/headline here - govt involvement drives prices up - is flat-out erroneous. So his conclusions are irrelevant/meaningless

    Except in the US, government involvement--from FDR's wage controls all the way up through Obamacare--actually has contributed to exponential increases in the cost of healthcare. Since the early 1980s, federal payments on Medicare/Medicaid have gone up at about a 8-9% annual clip, which roughly mirrors private sector cost increases.

    You can blame that on the US not immediately implementing a "monopsony" after WW2 like most other countries did, and instead executing an incrementalist approach, but the root of the matter is that rather than enable market forces to mitigate these exponential cost increases, the US government implemented policies over the decades that actually made the increases worse. No discussion ever took place regarding the basic supply/demand question--if you're going more than double your country's population from 1950-2010, this would seem like a no-brainer--nor were existing anti-monopoly measures enforced that would have reduced most healthcare costs by 50 to 80 percent of what they are today.

  • BYODB||


    "My point is that Stossel's basic premise/headline here - govt involvement drives prices up - is flat-out erroneous."

    I'm curious to hear about how regulations reduce prices JFree. Please, enlighten us.

  • JFree||

    Are you disputing that medical prices are much higher in the US than everywhere else on Earth - like 50% higher than the 2nd highest (Switzerland or Norway?)? I'm not advocating govt regulation for its own sake. Realistically our system is just seriously cronyist and rewards rent-seeking - like our entire economy now. But simply shouting 'free market' and advocating nonsense like 'tax deductions for everyone' ain't gonna fix that.

  • Rebel Scum||

    Does Stossell think people should have to go to medical school?

    Do you think everyone needs to go to auto technician school to have a basic understanding on how to interpret a techs suggestions for service and make an informed decision?

    It appears that 1) you are disingenuous, and 2) reading comprehension is not your strong point.

  • JFree||

    An auto tech doesn't charge a year's income for their services. And if their fee is higher than the known cost of replacing the car (also lower than one years income); then you walk. And guess what - they charge a boatload more to fix an expensive car than they do a cheap car. That is differential pricing.

    One big reason our system is broken is because we insist that all cars (lives) are valued identically and that their owners must therefore pay the same price for fixing them. IOW - Gates/Buffet pay the same price as everyone else for open-heart surgery. Despite the reality that they would willingly pay a freakload more.

    Implementing a form of differential pricing is actually what 'socialized systems' do - by basing much of their spending as a % of income rather than our fixed-price system. And back in the old days, our own free market had that sort of differential pricing - which is why it worked then. But there is nothing in Stossel's suggestions that shows how differential pricing can return (indeed he makes it even worse).

  • NotAnotherSkippy||

    Ok, so from everyone according to their ability, to everyine according to their needs. I think that pretty much sums up your thesis. Clearly we will needs means tested pricing for food as well. And shelter. Oh, let's not forget transportation, and internet access should be in there too.

    The disconnect on health care costs came about due to two key government fuckups: tax exemption of employer provided healthcare and the great society. Once medicare came in with all these goodies prices jakced up almost overnight. So what was the enlightened government's response? Why we'll just create all these procedure codes and set up a reimbursement schedule for each RVU. And lo the magic of price discovery was forever fucked.

    But I'm sure that if we only allowed ppl to patent broad process patents like, say, recombinant DNA, and not the specific products of said process that things will be MUCH cheaper.

  • JFree||

    I think that pretty much sums up your thesis.

    And I think you are a twit. Charging different prices to different customers is exactly how marginal price discovery works and it is exactly how the medical system worked way back when. Some patients paid cash (and different prices). Some paid in chickens/bread/handywork. Some paid in IOU's (and were often not collectable). Those folks who paid cash knew they were subsidizing the folks who paid in chickens or IOU's. In return, they got a doctor/dentist/surgeon who lived nearby and had plenty of actual experience - and maybe the psychic satisfaction that they were part of a community.

    Your system of same fixed price for everybody is - central planning.

    The disconnect on health care costs came about blahblahblah

    Except that that doesn't comport with - reality - anywhere else on Earth.

  • Red Rocks Baiting n Inciting||

    Some patients paid cash (and different prices). Some paid in chickens/bread/handywork. Some paid in IOU's (and were often not collectable). Those folks who paid cash knew they were subsidizing the folks who paid in chickens or IOU's.

    Comparing a barter system like what you describe to what we have now is patently absurd.

    Your system of same fixed price for everybody is - central planning.

    LOL at this goonfiction. You really think an auto mechanic charging $80 for an oil change or $600 for a brake job to every customer is "central planning"? Get the fuck out of here with that nonsense.

  • JFree||

    Comparing a barter system like what you describe to what we have now is patently absurd.

    Some form of barter system is ALWAYS going to occur when doctors earn much more than their patients and their services are mostly time-based. Lawyers do 'barter' as well. For them it's called 'take a case on contingency' - and they paid by the object of the lawsuit (the bigger pocket than they are) not by the client. I doubt that model works for doctors.

    You really think an auto mechanic charging $80 for an oil change or $600 for a brake job to every customer is "central planning"?

    An auto mechanic bases his prices on the cars that drive by his garage. Nice neighborhood, higher prices. The difference is that the mechanic can estimate his customers income by the car they drive. Not so doctors.

  • BYODB||

    What you're saying is that the only price consideration should be the persons ability to pay rather than the difficulty of their case. This is absurd at face value. It means that someone with, say, ten million dollars could expect to pay $100,000 for a tooth cleaning at the Dentist whereas a homeless guy off the streets who needs a mouth full of implants could expect to pay nothing or be paid for showing up at all.

    So really, yeah. You're a socialist. You'll have to come to terms with that somehow, but it's what you're advocating for.

  • JFree||

    Like it or not - differential pricing is exactly how free markets work. It is the ONLY way free markets work. And it is how our system worked before FDR - and probably before Marx as well. But hey if sloganeering makes you feel good, then who am I to stop you.

  • Red Rocks Baiting n Inciting||

    Some form of barter system is ALWAYS going to occur when doctors earn much more than their patients and their services are mostly time-based.

    Please. People trading chickens for a throat exam isn't anywhere close to a system where doctors "earn much more than their patients." You're just pulling shit out of thin air with these assertions.

    An auto mechanic bases his prices on the cars that drive by his garage.

    AHAHAHAHAHAHAHAHAHAHAHA!

  • JFree||

    You're just pulling shit out of thin air with these assertions.

    No I'm not actually. My greatgrandfather was a dentist - in the Dust Bowl area during the entire Depression. Moved to Wichita only after the war started and after most of his patients had left for CA. Obviously his practice was more barter-based after the crash/drought than before. But it always had pure barter patients and too many IOU's. His family was always better off than most people in town - though I'm sure poverty-stricken compared to a dentist on the Upper East Side.

    What is 'just pulling shit out of thin air' is your belief that doctors are nothing more than market animals with Randian ethics. They take an oath now. They took an oath then. And they've taken a professional oath since Hippocrates. And churches created most hospitals in the US (and medical schools for that matter since they created most universities too) to fulfill ethical/religious/charitable obligations as well.

  • Red Rocks Baiting n Inciting||

    But it always had pure barter patients and too many IOU's. His family was always better off than most people in town - though I'm sure poverty-stricken compared to a dentist on the Upper East Side.

    So basically, you're basing your entire thesis that differential pricing lowers healthcare costs on your great-grandfather's experience. Sorry, but that's not even close to being an accurate indicator of what the entire healthcare industry was like 70-80 years ago, nor does it prove your assertion that a doctor charging the same price for a service will result in higher costs for everyone.

    We HAVE differential pricing RIGHT NOW in how providers accept payment for medical services. So your claim that this mechanism would lower healthcare costs here is already proven false.

    What is 'just pulling shit out of thin air' is your belief that doctors are nothing more than market animals with Randian ethics

    Maybe you should look at what they charge for their services before asserting that they're doing this out of nothing more than altruism.

  • JFree||

    you're basing your entire thesis that differential pricing lowers healthcare costs on your great-grandfather's experience.

    That's not my thesis. Differential pricing provides access to the market for the marginal customer. And yes the free market is going to have to solve that issue - just like it did back in the day.

    Sorry, but that's not even close to being an accurate indicator of what the entire healthcare industry was like 70-80 years ago

    Oh? Well please tell me how wonderful things were back in the day then - when apparently we had fixed transparent prices and controlled costs by letting those who couldn't pay that just die in the streets. Yeesh - no wonder you Austrian twits can't sell the idea of free markets. Your imagined world sounds so - wonderful.

  • Red Rocks Baiting n Inciting||

    That's not my thesis. Differential pricing provides access to the market for the marginal customer

    No, affordable pricing provides access to the market for the marginal customer. And that happens when the free market is allowed to function in a manner where it isn't crippled by excessive government interference in that market. Arguing that a doctor charging everyone the same price to set a broken arm is what causes sheer question-begging.

    Well please tell me how wonderful things were back in the day then - when apparently we had fixed transparent prices and controlled costs by letting those who couldn't pay that just die in the streets.

    Lefties love to use this "die in the streets" trope, but it's sheer bullshit. A normal live birth and two days in a private room that cost $1,000 inflation adjusted 60 years ago now has a $10K cost just for the procedure. Were we a third-world country 60 years ago that it now supposedly costs ten times the amount it did to simply pull a baby out of a woman's vagina?

    And guess what? EMTALA's only been in force since the 80s. Were we a third-world country in the 60s and 70s?

    Yeesh - no wonder you Austrian twits can't sell the idea of free markets. Your imagined world sounds so - wonderful.

    Not nearly as wonderful as you proglydytes selling the idea that someone else is going to cover the cost of your annual checkups and flu antibiotics by charging them 1000% more for the same services.

  • JFree||

    And that happens when the free market is allowed to function in a manner where it isn't crippled by excessive government interference in that market.

    Thanks for the theory. But the FACT remains that the US has the highest healthcare prices and also the most people who are facing the market on their own. And no I am obviously not defending our walking cluster$%^& of a govt.

    Were we a third-world country 60 years ago

    No. Many parts of the country are worse off now than then. And while idiots like you obsess about insurance, the fact is that many counties do not even have a hospital/specialists and have fewer family doctors/capita than the Third World does. For those places, the family doctor is the only health system - just like 100 years ago. There's roughly 80 counties in Texas alone with lower family doctor coverage than Thailand/Botswana. http://bit.ly/2mTnACL

    The need is no more complicated than then (get generalist physicians to move there to improve people's health) and cheap too. No need for insurance at all. AJ Nock knew what went wrong - social power (churches, Masons, school boards, etc) was displaced by state power - and thus how to right it. Randians, Rothbardians, and libertarians are positively harmful babblers who undermine actual solutions cuz they are such assholes.

  • Red Rocks Baiting n Inciting||

    But the FACT remains that the US has the highest healthcare prices and also the most people who are facing the market on their own.

    Since this isn't a free market for healthcare, this is beside the point.

    And while idiots like you obsess about insurance

    Lol at this strawman nonsense. Insurance costs are pointless if you don't lower the overall cost of healthcare.

    There's roughly 80 counties in Texas alone with lower family doctor coverage than Thailand/Botswana

    Which doesn't have anything to do with a free market healthcare system.

    Randians, Rothbardians, and libertarians are positively harmful babblers who undermine actual solutions cuz they are such assholes.

    More lol--your only solution here has been "implement differential pricing"--which ALREADY happens with different insurance companies and Medicare/Medicaid providing different payouts, and entirely different costs for people who simply pay in cash. So don't smug out about not offering solutions when yours has so clearly failed here.

  • Redcard||

    to have a basic understanding

    Fuckwad Rebel Scum slipped that in. Get your appendix removed by someone who has a basic understanding of how vestigial organs do nothing

  • Myk||

    Amen. It's the typical healthy people with plenty of money telling the sick how things are instead of shutting up and listening to how things actually are.

    Insurance does try to shop around for biologics. Their deny/delay tactic results in people becoming immune to the few medicines available and results in higher costs for a worse outcome. But yes healthy people, tell us how it really is to be sick for a lifetime.

  • Red Rocks Baiting n Inciting||

    It's the typical healthy people with plenty of money telling the sick how things are instead of shutting up and listening to how things actually are.

    It's the "typically healthy people" subsidizing the sick's goddamn healthcare, so yeah, they should have a say in how things are. Fuck off with your "shut up and color" attitude, slaver.

  • Azathoth!!||

    You would be right except for one crucial fact

    When the processes Stossel was talking about ARE covered--when patients wind up medically needing them for some reason--such as reconstructive procedures--the prices skyrocket. Same procedure, same hospital, same doctor--but if it's done by choice the patient gets better service and a cheaper cost.

    If that doesn't tell you we're incentivizing the wrong thing, nothing will.

  • MichaelL||

    Yet, if we look into diabetic care, why do we not see endocrinologists caring for every diabetic instead of family doctors. They are most qualified to do it. Why would we allow others to give inferior care..........(;-P................As a past board certified general surgeon, I can pretty well assert the fact that I was trained well enough to care for my patients. It had everything to do with my education and nothing to do with the fact that I could pass some state exam required to practice medicine. In fact, I had completed graduate school and had extra time obtaining a Certificate in Pain Studies from a university program. Yet the petty politicians that control the medical boards, with much less education, are the ones that are making the decisions. It is all about control and competition and very little to do with education and knowledge. In fact education had nothing to do with their political decisions. It was more the fact that such a large portion of physicians that I was around seemed to have less of it (education and knowledge) than I did. But they drove me out before my fifty-fourth birthday. I have to admit, I never considered politics as an important part of patient care. But, I was wrong! Lack of peer support destroyed my practice!

  • MichaelL||

    Yet, if we look into diabetic care, why do we not see endocrinologists caring for every diabetic instead of family doctors. They are most qualified to do it. Why would we allow others to give inferior care..........(;-P................As a past board certified general surgeon, I can pretty well assert the fact that I was trained well enough to care for my patients. It had everything to do with my education and nothing to do with the fact that I could pass some state exam required to practice medicine. In fact, I had completed graduate school and had extra time obtaining a Certificate in Pain Studies from a university program. Yet the petty politicians that control the medical boards, with much less education, are the ones that are making the decisions. It is all about control and competition and very little to do with education and knowledge. In fact education had nothing to do with their political decisions. It was more the fact that such a large portion of physicians that I was around seemed to have less of it (education and knowledge) than I did. But they drove me out before my fifty-fourth birthday. I have to admit, I never considered politics as an important part of patient care. But, I was wrong! Lack of peer support destroyed my practice!

  • Roscoe BoDeen||

    I believe one of his points is allowing free market principles, laws, and forces to play a substantial role in determining prices for health care products and services. I also know that many chronic illnesses, including some types 2 diabetes cases, are caused by individual behavior and could be eliminated by changes or modifications to behavior. Why should I have to subsidize others that smoke, drink alcohol excessively, make poor diet choices, etc. If insurance is going to be part of solution, then why doesn't health insurance function like insurance is designed to...cost based upon risk to the insurer. Lastly, if government is going to be deeply involved in health care, I think I should have the freedom to opt in or out of a government solution, including medicare.

  • Myk||

    You subsidize other's high risk choices because they subsidize yours. You don't get to point at everyone else while ignoring yourself.
    It doesn't matter if govt is involved or not, if you are rich you are going to subsidize someone else's healthcare unless you avoid getting healthcare. It is how Dr's are, just like when many Dr's go to Africa to donate their time you pay for that. I guarantee you eventually you will need healthcare. It's because of that nearly assured need that you don't get to opt out until you do need it. Whether I agree with it or not, that is the rational of the ACA mandate.
    Opting out hoping you don't need it, losing that bet and sticking everyone else with your bill is why the previous American way wasn't working and is one reason why our prices are higher.

    Look at it this way: You're paying all those guinea pigs today to advance medical knowledge so when you need it tomorrow you won't have to be the guinea pig and suffer as much as they did. The way my aunt suffered dying from cancer in the 70s cancer patients today owe her billions. What I went through with early gastro testing is worth millions. Do you want to pay my $180K/yr medical bills or do you want to pay me $1,000,000/yr in higher medical costs to be a test subject? Paying the test subjects is a free market ideal.

  • Red Rocks Baiting n Inciting||

    You subsidize other's high risk choices because they subsidize yours. You don't get to point at everyone else while ignoring yourself.

    Stupid assertion. A 350 pound diabetic fatass SHOULD pay more in healthcare costs because they consume more in healthcare services than a 180-pound jogger who watches what they eat. And quite frankly, insurance companies should be free to reject them if they think they're going to be a financial burden to the rest of the insurance pool. You're "healthcare is a RIGHT!" nonsense is why these landwhales think they're entitled to stuff themselves with fried meats and receive heroic medical treatment until they gracelessly expire.

  • ||

    Funny, did I detect the faint smell of a eugenicist?

  • ||

    Funny, did I detect the faint smell of a eugenicist?

  • eyeroller||

    The catch-22 is that government interference causes prices to go way up, and then when you suggest getting the government out of it, people say "But then nobody could afford it!"

    Government interference creates its own justification. It's kind of magical that way.

  • Stilgar||

    Unfortunately, just like the donkeys and elephants, libertarian "thinkers" are also painting a very black and white picture of something that is not. One reason why some of those items are included in base policies is that they are for things you will be unlikely to use if not already there - ie, drug/alcohol counseling, depression screening. Just like you can't order collision on your car insurance after an accident, its not going to work if you try to do that with, say, alchol counseling. And insurance itself is premised on spreading the cost of coverage among a large pool with the expectation that many people will not use it (how often do you wreck your car?)

  • NotAnotherSkippy||

    I'm pretty sure that a 50 yr old male can reasonably expect to not need maternity services.

  • See.More||

    ... One reason why some of those items are included in base policies is that they are for things you will be unlikely to use if not already there - ie, drug/alcohol counseling, depression screening...

    I've had a vasectomy and my wife has had a hysterectomy. We're never getting pregnant again.

    So, why must I pay higher premiums for birth control and maternity coverage?

  • Myk||

    That is how risk spreading insurance works. Women won't need a prostate exam either.

    I don't and won't have kids. Why do I have to pay so much in property taxes to schools I'll never use while those with kids get deductions and are wanting vouchers? Libertarians are all for those vouchers but no vouchers for me and the schools I don't use.

  • Red Rocks Baiting n Inciting||

    That is how risk spreading insurance works. Women won't need a prostate exam either.

    Well, Obamacare didn't actually result in lowered healthcare costs by mandating comprehensive coverage, so it looks like you understand how insurance works about as well as Obama did. There's a reason that 16-year-old boys pay more for car insurance rather than 40-year-old women despite them drawing from the same pool of insurance money, but maybe one day that reason will cross your dim, entitled mind.

  • bartzman86||

    1. On behalf of your non-existent children, thank you for not pro-creating. You don't appear to be very nurturing.
    2. I'm not really of fan of you paying for my kids school either (or to be more clear, I paid for private school on top of my taxes, so it feels like a waste of your money). I'd be happy to not pay for lots of stuff with my taxes as well, so I believe we are in a general agreement on that :).

  • Myk||

    I didn't like kids when I was one. Not nurturing is on target.

    I'd be much happier with less socialism. I just don't know how to unring the bell without screwing over 3-4 generations of living people to end the ponzi scam.
    Even the schools. We've convinced people kids they can't afford are affordable so you can't tell me I can pay a few thousand less every year with a generation relying on it to not be stupid (although presently one could argue the schools are creating planned stupidity).

    But for healthcare I don't see how a free market would have us as advanced as we are or treat anything but injuries. Even if you can afford multi-millions for disease care if few others paid the price before you the knowledge won't be there to treat you when you need it.
    Free market sounds good but when you break the percentages down by disease and then rule out affordability to each individual the market isn't there for the research.

  • See.More||

    That is how risk spreading insurance works.

    Uhm, no. There is absolutely nothing in risk sharing that requires that I have coverage I will never use (e.g. birth control and maternity care).

    Indeed, risk sharing worked just fine before birth control and maternity care were mandated for all policies. They were mandated for purely political reasons, not for market reasons.

  • Myk||

    Birth control is there because it's not just for keeping babies from happening. There's a thing called endometriosis for one other use.
    Maternity care is because the cost of it has exceeded the average income's ability to pay and for some dumb reason we seem to think everyone needs to breed. But the fact is poor people breed a lot so one way or another you will pay.

    If it worked just fine before it works just fine now.

    I'm sure you're not against covering those two things for political reasons. And pacifists shouldn't pay for bombs. Atheists shouldn't pay for Christmas displays. Amish shouldn't pay for roads. Anti-gmo shouldn't pay for biologic med research. Unmarried shouldn't pay for marriage benefits. Anarchists shouldn't have to pay for government at all. Eventually we'll find the handout you like.

  • Jerryskids||

    Armchair quarterbacking. It's easy enough to criticize the guy who built a perpetual-motion machine that didn't work quite right and criticize the guy who's attempting to fix the perpetual-motion machine, but unless you've got a plan for a perpetual-motion machine that actually works I'd suggest you shut up. Try to offer helpful advice on how to build a successful perpetual-motion machine rather than bad-mouthing the attempts of those who are at least trying.

  • Curt||

    Awesome analogy... because perpetual-motion machines are impossible since they violate the laws of thermodynamics. Similarly, effective healthcare at reasonable cost while the government wrecks the market is also impossible.

    So, yes, the responsible thing is to criticize the guy trying to use a crapload of taxpayer money to build a perpetual motion machine. The reasonable thing is to point out the folly of his attempts and stop that guy from receiving/spending money.

  • Len Bias||

    Free market health care: the top 1% get tax breaks, everyone else dies.

  • Rebel Scum||

    Free market health care: the top 1% get tax breaks, everyone else dies.

    Free Market food production: The top 1% get tax breaks, everyone else starves.
    Free Market clothing production: The Top 1% get tax breaks, everyone else freezes.
    Free Market tech dev.: The Top 1% get tax breaks, everyone else is stuck in the stone age.

    Wait, something's wrong. None of these are true. It's almost like "free market" means something: the sum of the innumerable and incalculable decisions made by individuals on a routine basis, perhaps? Perhaps people making their own choices drives competing businesses to provide the best product for the lowest cost to the consumer so as to remain in business? Why, it's almost as if competition breeds excellence and your comment demonstrates a severe lack of understanding of that which you are criticizing.

  • IceTrey||

    I'm not listening to a guy who killed himself with cocaine.

  • Len Bias||

    sniff

  • Len Bias||

    Free market health care: the top 1% get tax breaks, everyone else dies.

  • Eric Bana||

    Don't forget certificate of need laws that make it extremely difficult for new hospitals and clinics to open up, thus restricting their supply.

  • Ron||

    If I go to the local hospital for my yearly blood test the price is $400.00+/- due to regulations for how hospitals will charge. When I went to the independent open market lab it cost $37.00. Sonogram at the hospital $1200,00 min. the independent lab cash $470.00.

  • Myk||

    Odd how universal coverage with even more coverage & rules works in many other countries. Lies about other countries doesn't change that it does work, is cheaper & they love it.

    Maybe if we'd stop giving money to those other countries and took care of our own first it would work here. Maybe if we'd stop voting for politicians owned by healthcare corporations our prices wouldn't be 3x more than those other countries. Odd how those non-free market issues are never mentioned only denying care to those who aren't rich.

    If you've ever tried to shop around for healthcare you'd know it is impossible. Nobody knows the prices and you don't always have the time to shop around. That is why the insurance companies shop around for you, before you need it.

    It's not the lack of shopping around that fueled prices. I have a non-working finger because I couldn't get pricing answers. It's "How much is your life (or finger) worth to you?"
    Groceries and elective surgery are strawmen. Life & death or chronic illness that will cost more if treatment is delayed are the issues but free market healthcarers avoid those issues.

    With a free market we would be stuck in 1950's healthcare. That is all the majority making $50K/yr could afford. Simple free market what the market will bear math.

  • Rebel Scum||

    If you've ever tried to shop around for healthcare you'd know it is impossible. Nobody knows the prices and you don't always have the time to shop around.

    You don't know what anything costs because of the insurance system combined with gov't regulation.

  • Myk||

    That and healthcare is big business. The Dr or nurse doing the procedure doesn't know the price, billing is in another city or even state and they don't know until they get the procedure code.
    It's no longer the days of your Dr is the one deciding how much he's going to charge you to fix your broken bone so you can haggle at the point of care.

    The Mexican street market haggling of whatever price you ask for will be met with a offer of 20% between insurance and medical is part of what drives the cost up. Cash payers often get screwed in big systems.

    Post above mine talks of $400 blood tests that are $37 elsewhere. $400 billed, my insurance pays $5. Obviously the hospital can afford to do them for $5 not $37 or $400.

  • BYODB||

    Healthcare is 'big business' because small healthcare providers are being driven out of business by regulations and shitty government reimbursement rates. Only the large systems can afford the compliance & eat the cost by passing it on, and thus you cause the very thing you appear to dislike.

  • wrytersview||

    THIS.

  • IceTrey||

    Sure it works if you don't mind waiting 6 months for an MRI or a year for knee surgery.

  • Myk||

    You mean like my roommate just burned through FMLA plus extension (that's 6 months) and his surgery will be the day his extension runs out? And this is a bit more important than a knee.
    Like I waited 4 months to get a colonoscopy with a Crohn's stricture?
    Like I waited 3 months to get into a Rheumatologist with a suspected inflamed aorta, and another 3 months to get his report on the MRI? But I was told to call if symptoms got worse. You know, that symptom of death in minutes when your aorta blows out?
    I forget how long my cancer scare biopsy wait was but it was months unlike someone I know on NHS waited to have her kidney removed for cancer last week.

    People who think US doesn't wait don't use our healthcare. People who think everyone in other countries all wait only read scare stories. Nobody's healthcare is perfect, ours certainly isn't.

  • bartzman86||

    Months for a biopsy? Mine took a week to schedule and do. Your facilities must SUCK (and I was poor as shit and not Medicare/Medicaid when it happened).

    But I must agree, no country is perfect. It's all about trade offs (as usual).

  • Myk||

    It was surgical and before everything was done by scope.
    I thought the aorta wait was inexcusable. In the 3 month wait what they originally saw wasn't there. Dr's didn't want to say glitch so now I wait with a possible ticking time bomb or not. At least it's a quick death.

  • Red Rocks Baiting n Inciting||

    Nobody knows the prices and you don't always have the time to shop around.

    You have time to shop around for a fucking television set or a new iPhone, but not something that you'll actually need? Lazy asshole.

    Insurance is for EMERGENCIES, not basic, routine services. Imagine how much an oil change would cost if your insurance had to cover it and every other car repair instead of what it covers now, you don't get a bill for the service until about two weeks after it's performed, and what you're charged is entirely arbitrary. That's equivalent to how the medical industry in this country works now.

    "Nobody knows the prices"--gee, you think price transparency might actually contribute to solving this little problem?

  • Myk||

    Slash your wrists and spend your time calling around to see who has the best prices for what you need. Get back to me on that, brainiac.

    Insurance is for what insurance says it's for. My insurance says it's for everything as long as I go certain places for care. I didn't use it for anything for quite a while. Now that I need it I have it.

    I do recall paying for insurance on electronics that covered basics like lens cleaning so not only do you use a strawman it's a false strawman.
    If someone wanted to sell oil change insurance it won't drive the cost up, it would likely drive the cost down. You paying $30 for a single oil change has no negotiating power. Them paying for a million oil changes does.

    Price transparency would be good but medicine has grown beyond that. The people you'd ask about prices are too busy with the issue of trying to save your freakin' life to be bothered with prices.

  • Red Rocks Baiting n Inciting||

    Slash your wrists and spend your time calling around to see who has the best prices for what you need. Get back to me on that, brainiac

    Right, because slashing your wrists and getting an annual checkup or shopping for a knee surgery are the exact same fucking thing. Take your progtard argumentum ad absurdum and shove it, you dumb bitch.

    Insurance is for what insurance says it's for. My insurance says it's for everything as long as I go certain places for care.

    And because it's for EVERYTHING, overall costs aren't mitigated. Welcome to Supply/Demand 101.

    I do recall paying for insurance on electronics that covered basics like lens cleaning so not only do you use a strawman it's a false strawman

    Uh, that insurance is optional, not mandatory, and is rarely used so you're claims of "strawman" don't even apply here. It can cover everything cheaply because very few people actually bother to purchase it and actually use it. That doesn't apply to healthcare insurance.

    If someone wanted to sell oil change insurance it won't drive the cost up, it would likely drive the cost down.

    Bullshit. 50 years ago, a normal live birth and two days in a private room cost about $1,000, inflation-adjusted. Today, that charge is $10K for the procedure and about $15K for the two days in the room plus other expenses. Tell me again how comprehensive insurance coverage drives the actual cost of a service down.

  • Myk||

    Oh, so now that it's your life on the line you don't want to shop around for the best prices. I see how this works. Of course that's nothing new, I already knew that was how this works. As long as you're killing me to save money that's good, but when it's killing you your suggestions become bad.

    The costs my insurance has negotiated are insanely low. I haven't had a hospital stay yet but if they pay for an Advil at the hospital you can bet it's not going to be $20.

    I never said I was for the insurance mandate either. I can see how it is needed because of what insurance has been allowed to do for decades.

    Actually I think a birth is averaging $75K. That is more salesmanship than anything. You "need" a private room with all the accommodations for your "special time". If I made the rules all those extras wouldn't be covered at all. You get a ward and life saving measures.
    But 50 years ago your preemie was probably going to die now it's not so of course prices have gone up.

  • Red Rocks Baiting n Inciting||

    Oh, so now that it's your life on the line you don't want to shop around for the best prices. I see how this works.

    Jesus, talk about erecting a strawman.

    Actually I think a birth is averaging $75K.

    That's because you can't be bothered to do basic research with this fancy online tool called "Google." Do the world a favor and end your shitposting.

  • Red Rocks Baiting n Inciting||

    Price transparency would be good but medicine has grown beyond that.

    No, it hasn't. You just don't give a shit because the thought of paying for a broken arm completely out of pocket terrifies you, even if it was offered at a price you could afford.

    The people you'd ask about prices are too busy with the issue of trying to save your freakin' life to be bothered with prices.

    You're seriously arguing that in this age of modern technology, a hospital can't set up a page on their website listing the cost of various services? Get real.

  • Myk||

    Actually no, a $300 broken arm out of pocket is no problem. I made my last PCP do an Xray to make sure there was a reason to have an MRI and go to a neurologist. And I do refuse things I think are unnecessary.
    I delayed about 3 years of having the kitchen sink throw at me to try lesser treatments, that's about half a million billed costs I saved insurance.

    In spite of your attempt to paint me as someone to hate I do try to keep my costs low even though nearly everything is covered 100%. I have enough high risk meds and doctors sticking things everywhere there's a hole or making one where there isn't.

    We've already established that you're not willing to price shop when it's your life on the line. Prices for cleaning your ears isn't what is driving costs up. It is those "how much is your life worth?" issues.

  • Red Rocks Baiting n Inciting||

    We've already established that you're not willing to price shop when it's your life on the line

    Because that's what INSURANCE is for--catastrophic events. Not for everyday items like an annual physical or even occasional accidents like a broken arm.

    We haven't established what you've claimed, but we've certainly established that you're a dishonest, obtuse moron.

  • Myk||

    Obtuse and moron? I don't think you've read your posts.

    Insurance is for what insurance or regulations say it's for. Insurance bases this on charts that tell them what saves money in the long run. They have decided that "wellness" care saves them money so your annual exam is covered 100% to encourage you to get them (I don't get that freebee BTW so bite me, slaver).

    Insurance has always been for broken arms. Insurance has fraudulently not been for catastrophic illness. They made the bet and lost, the government which should've made them pay allowed them to kick people off so everyone could pay while they raked in the profits.
    It was that profiteering that had them not caring about prices, until prices got so high they did, and now they do.

  • ||

    You're one of those "living document" advocates I see.
    "It was that profiteering that had them not caring about prices, until prices got so high they did, and now they do"
    This makes no sense by the way.

  • Red Rocks Baiting n Inciting||

    (I don't get that freebee BTW so bite me, slaver).

    Uh, you claimed you had an insurance plan that covered everything--so now we can chalk up "congenital liar" to your list of personality defects.

    Insurance has always been for broken arms. Insurance has fraudulently not been for catastrophic illness.

    Another lie. Between this and your idiotic claim that normal live births average $75K in costs, we can now safely place your health issues as shitthatdidnthappen.txt.

  • pan fried wylie||

    The people you'd ask about prices are too busy with the issue of trying to save your freakin' life to be bothered with prices.

    You're seriously arguing that in this age of modern technology, a hospital can't set up a page on their website listing the cost of various services? Get real

    No, it's seriously arguing that division of labor doesn't apply and that doctors don't work in an organization with accountants and management.

  • blondrealist||

    No health care financing (including insurance) system is perfect - they all ration care, including ours. We just do it differently than Canada, etc. Plenty of horrific stories about sick people in the USA, so the story about the "screaming in pain for nine hours" is bullshit in that it happens here too.

    It's very true that because of employer-provided health insurance and Medicare (primarily) that we have not had much of a free market for health care for decades. I don't argue that a lot more free market forces would help - but health care isn't like buying a car or a computer, at least not in many instances. As to insurance companies - government regulation is needed to a certain extent because insurance companies have no interest in keeping unprofitable customers - and as we age, the odds of any of us being unprofitable go up significantly.

  • afk05||

    The young and healthy are naive if they don't have any health insurance, as they are more likely to take risks and be in more accidents, and are more likely to get pregnant unexpectedly, be in an MVA, have an injury on the job, etc. It is still cheaper to be insured even when you don't use it than to risk medical bills that can bankrupt you earlier in your adult life due to a poor estimation of risk.

  • wrytersview||

    Here's how the insurance system & government regulation obscure the true cost of healthcare.

    At our clinic, if I have someone call & ask, "How much to treat my ankle sprain?" I can't offer a simple answer because it depends on:

    1. What is their insurance carrier? Each carrier has their own fee schedule.
    2. What are the terms (deductible, co-pay, co-insurance, etc) of the person's policy?
    3. Thanks to fee-for-service pricing, at best I can only give an estimate of what the person might pay per unit (essentially 15 min blocks) of treatment, not what the cost will be for an episode of care.
    3. If the person has a high deductible policy or no insurance policy at all, we can negotiate cash pay rates BUT...
    4. If the person has Medicare, we are not allowed to do cash pay with the patient, so we can only treat things that Medicare considers to be "medically reasonable & necessary," & that standard often doesn't align with what the patient's goals are.

  • wrytersview||

    Without these rules, we could implement any number of possible ways for people to pay for treatment - flat rate cash pay, sliding scale cash rates based on income, exchange of goods & services (sure, we can treat your kid's elbow tendinitis, & in exchange, he'll mow our lawn this summer), whatever. It would give us the flexibility to work with people as individuals & come to mutually beneficial arrangements.

    Granted, we don't offer emergency services, & judging by the other comments on this thread, that seems to be people's main hang up with free market healthcare. But I at least don't think we should dismiss the idea entirely just because it wouldn't function perfectly for every individual in every conceivable instance.

  • Myk||

    My main issue is chronic and catastrophic issues. Median US income is and has been $50K/yr. It has floated around there for decades. Medical costs have gone way up. Sick people probably earn less but need more care.
    Paying for a $10K-$30K ER visit for a broken bone on $50K isn't fun but workable. Paying $180K/yr forever in meds even at the negotiated price of $90K on $50K doesn't work. There's no amount of free market to make that work. With a free market we simply don't have those treatments, not even for those who can afford them because the market wasn't there for the guinea pigs before them. Cancer, chronic illness, rare disease, too bad for you.

    Then we can get into the part where you go to the $10K ER who sends you to the $10K specialist for a $100K surgery for what used to be a $300 broken arm. Maybe I was exposed to people with simple breaks and am exposed to more complex issues but I don't see ER set bones any more, and those $300 ER set arms have worked just fine for 40 years.
    PCPs and ERs have become nothing but expensive triage who sends you to a specialist.

    There is an osteo here that advertises to avoid the ER for broken bones, come to them directly.

  • Red Rocks Baiting n Inciting||

    My main issue is chronic and catastrophic issues.

    Except your side demands that EVERYTHING be covered, which DRIVES UP the costs! Do you really not understand how basic supply/demand works?

  • Myk||

    I don't recall demanding everything be covered.
    If I would've demanded anything, which I didn't, it would be that doctors do the doctoring, insurance does the insuring like works in the Netherlands. I have no idea what they require insurance covers, just that a general nurse at insurance doesn't overrule a highly qualified specialist's treatment and they don't get to kick people off insurance for getting sick like goes (or went) on in the US.

  • Red Rocks Baiting n Inciting||

    I don't recall demanding everything be covered.

    Except you admitted up above that you have a plan that covers everything, depending on where you go for care. And I said "your side," meaning progressives, not you specifically.

    If I would've demanded anything, which I didn't, it would be that doctors do the doctoring, insurance does the insuring

    None of this actually confronts the issue of price discrimination and opacity, which is the root cause of our exponential healthcare cost growth.

  • Myk||

    So I have good ins. I once had bad ins. Neither means that's what I think the solution is. It's what I need, it's what I can afford.

    There is no one cause. It's not even limited to medical or ins, there are false economy issues too.
    If I didn't have ins I would get worse until it became a life or death issue, the hospital would have to (by law, or want to because they're Drs) treat me costing more, I couldn't pay, you would pick up my tab with a $500 bandaid.
    We've tried denying care & it is one of the reasons our costs are so much higher. It's the major reason ACA hasn't worked out as planned. Generations of sick denied coverage until they were sick enough to take on as a charity case & the cost passed on.
    Whether you like it or not you're going to pay one way for those who can't. That is what medical does, even back when the community had their community Dr & they "took care of them" the guy who could pay a chicken got care, they guy who paid money paid.

    The solution of kill the sick isn't going to happen, get over it. And that is the progressive's eugenics program taken to extremes which makes your side more progressive than "mine".

    Instead of trying to magically go back to the 1800's & expect the same advances if we paid Dr's with livestock until now I'm looking at the reality of the present situation. Incomes are too low, prices are too high. How do we get them more in line with each other without murdering half the population to drive the prices down.

  • Red Rocks Baiting n Inciting||

    It's what I need, it's what I can afford.

    Sorry, you can't claim that you're not demanding that everything be covered and then admit that you've in fact purchased a plan that covers EVERYTHING. Claiming that it's what you "need" is simple question-begging.

    We've tried denying care & it is one of the reasons our costs are so much higher.

    Once again you fail to get how basic supply/demand systems work.

    Whether you like it or not you're going to pay one way for those who can't.

    That's hardly an excuse for a government-run healthcare system, but progressives have been using it as a false dilemma for decades.

  • Myk||

    Insurance was free to offer a PPO. I was free and able to buy it. You want it regulated away. So now you're against the free market?
    I think many would be wise to pay for a PPO but that doesn't mean I think they should be forced.

    Once again you fail to realize healthcare isn't a supply and demand business. Remember when they taxed luxury items and killed business? Healthcare is the opposite.

    If you don't want govt run healthcare you should be happy with insurance based healthcare like we have. So why are you whining and wanting govt to regulate insurance away? Except the insurance type that you want of course, which is everyone accept the risks you want but you accept nobody what nobody else wants.

    It's not a false dilemma to point out average income can not afford average healthcare. It is a fact. One that making more people not afford healthcare isn't going to solve without serious unintended consequences. One will be less private research and medical advances because you've destroyed the customer base that has new research profitable. It is precisely the socialist nature of medicine that has medical knowledge expanded beyond our average means to pay.

  • Red Rocks Baiting n Inciting||

    Insurance was free to offer a PPO. I was free and able to buy it. You want it regulated away. So now you're against the free market?

    That strawman you torched was so massive that NASA satellites picked up its heat signature.

    If you don't want govt run healthcare you should be happy with insurance based healthcare like we have.

    No, I want cash-based healthcare with insurance as the last resort. Proglydytes like you claim it should only be one or the other.

    It's not a false dilemma to point out average income can not afford average healthcare. It is a fact.

    It's a false dilemma to argue that this situation requires a government-run healthcare system.

    It is precisely the socialist nature of medicine that has medical knowledge expanded beyond our average means to pay.

    Here we see proglydyte clever-silliness rearing its head.

  • wrytersview||

    I think the point many people are trying to make is that if you get rid of obscure pricing via insurance & government regulation, then the ER visit should no longer be $10k, the specialist should no longer be $10k, & the surgery should no longer be $100k. For example, I'll use CPT code 97110 (the code for therapeutic exercise).

    Our state workers compensation fee schedule pays one unit of this code at $45.
    Insurance company A pays it at $36.12.
    Medicaid pays it at $25.27.
    Insurance company B pays it at $23.22.
    So naturally our clinic bills $45. We don't get paid $45 for it every time (every insurance co will only pay the amount listed on their fee schedule), but we will get it sometimes.

    Now imagine if our clinic was a large medical group capable of seeing hundreds of thousands of patients in a year. That would give us the clout to negotiate our OWN rate with Insurance company A & B rather than the contract rate offered to all other providers. Now the prices go up, but the patients don't see it, at least not directly, because it's obscured by coding & terminology that they have no hope of deciphering.

  • Myk||

    I would like to do away with all the price haggling. You charge what you need, one price to everybody. Insurance doesn't have preferred providers or HMOs they've worked out deals with.
    The problem is where conservatives and libertarians look to unring that bell tells me to die. My life becomes their price negotiation tool.

  • wrytersview||

    And maybe a free market system isn't appropriate for all healthcare. Maybe some insurance is necessary for big emergencies & cancer & other conditions of that sort. But by the same concession, there are some areas of healthcare where the govt & insurance cos are not helping things by being so involved. I mean, if your kid develops tendinitis in his elbow from playing baseball, we must have a doctor's permission before we can treat him, then we have CMS, AMA, OSHA, OIG, & a whole alphabet soup of regulator agencies that tell us how we can & cannot treat this elbow tendinitis, & each of these agencies comes with hundreds or even thousands (not an exaggeration) of regulations that we must abide by or face crippling fines &/or jail time. Not to mention the insurance cos, each with their own hundreds of pages of regulations. So in the case of our clinic & others like it, if all these Top Men would just get out of our way & let us treat your son's elbow, we could get him back to his baseball team faster, cheaper, & much more efficiently.

  • Myk||

    I see the regulation problem, including how other countries get meds faster and cheaper because of our over-regulation. We don't need the regulation, the delay itself has the patients in other countries using the meds way before we get them. Real life use > RCT.

    Even within insurance companies there's stupid wasteful policies that cost more trying to save. I paid a ton in co-pays for PT I knew would make me worse to get durable equipment. Insurance paid thousands trying to save a couple hundred (I actually bought exact same item for $30 on Amazon while I waited & returned the one from insurance when I saw what it was).
    Friend has a bone spur, obviously needs ground off. Nope, can't do that, need to fail PT first before doing the obvious.
    I understand their charts say PT saves money overall but that doesn't mean they should ignore the obvious cases where it won't.
    But this is what you get when business gets too big and in the case of the US, when insurance who doesn't see the patient rules how the Dr who does can treat.

  • afk05||

    Yes! They are penny wise and pound foolish. Insurance companies dictate the treatment rather than physicians, and deny coverage and appeals in order to try to save money, when the approval and appeals process takes more time, requires more administrators on both ends, and doesn't save nearly as much money as one would expect.

    People have much more respect and involvement for things they pay for directly. This goes for the providers, insurers and the patients. Instead of just screaming free market as the solution to everything, we need more accountability and less middlemen. If physicians had to accept money from insurers and pay directly for services and meds, they would be more discerning in which meds they prescribe and what treatments they order. If patients/customers were required to allocate their insurance dollars, shop around and have full price transparency, they could shop for the best deals in elective situations/procedures. Insurers could be more proactive in encouraging patients to get preventative care and offer better incentives to customers to make healthy choices that save money. This is closer to free market, but regulations are still required in order to prevent price gouging and price fixing, and to require cost transparency.

  • American Memer||

    Wow, the trolls are out in full force today.

    Dunno why people insist that the people who have the most insight into how money works are wrong about how to make a thing cheaper.

  • Redcard||

    Dunno why people insist that the people who have the most insight into how money works are wrong about how to make a thing cheaper.
    Probably because they are the sort of people who think that climate scientists who have the most insight into how the earth is warmed by greenhouse gases are wrong, and the dude holding a snowball on the Senate floor got it right.

    "How money works" though is laughable

  • PTKANE||

    "the media and socialists (redundant?)". Nicely done...

  • trudybeauty||

    Does anyone know of any "free market" national healthcare systems that are successful at ANYTHING?
    Nope. You're right. There aren't any. The rest of the advanced democratic economies operate on the scientific principle that if it doesn't ever work, then don't do it. We in 'Murrkah, .... well, we just sucker people.

  • ||

    A comprehensive set of Chamber of Commerce lies and dreamy infantile credulity.

  • MikeyB||

    A system needs to be designed where customers (i.e. the sick people) get $$ back for choosing a less expensive alternative.
    #1 All health provides must charge the same $$ to EVERYBODY (may have to carve out an exception for Medicare though as that would drive costs for Medicare through the roof since their reimbursement rate is extremely low). No more insurance companies negotiating prices which obfuscates costs. Health providers must also advertise on their website and have a price list available for those without web access. This allows develope of 3rd party services for comparision shopping.
    #2 When your doctor recommends a procedure you can look it up and find the least expensive choice that makes sense for you. If you pick a service less then 2 sigma above average you get back 50% of the difference. So imagine you're going to have a baby. Hospital #1 says standard cost is $8000. Baby center #1 says their standard cost is $6000. 2 sigma boundary of reimbursements is $7500. So you pick the Baby center at $1500 less than then 2 sigma point and you get $750 cash back. This will encourage specialty centers with low overhead costs like the cash places that exist now.
    Seems to me would should be able to get something like this to work regardless of what insurance you are on.

  • afk05||

    Great suggestions. I am convinced that no one wants to actually solve the problem because too many are profiting from the current system.

  • Myk||

    Bingo!
    That's why Hillarycare was something nobody in the US would accept and even Canada ruled against. It's why ACA doesn't place the same regulations on insurance as other countries with insurance based systems. It's why everyone talks about cutting costs but nobody actually proposes anything that would cut the costs.
    Free market? Not while our politicians are owned by the highest bidder.

    My insurance already tells me where to go for best prices they've negotiation. I'm covered or I'm not is the incentive. But if it was coverage everywhere I wouldn't even need 50% to go cheaper. A place would have to be bad for me to turn down $50, or if it was a longer drive, $50 plus gas and hotel. Well except for colonoscopy, I know people who've done cleanouts in hotels, I want the comfort of home for that.

  • MichaelL||

    Yet, if we look into diabetic care, why do we not see endocrinologists caring for every diabetic instead of family doctors. They are most qualified to do it. Why would we allow others to give inferior care..........(;-P................As a past board certified general surgeon, I can pretty well assert the fact that I was trained well enough to care for my patients. It had everything to do with my education and nothing to do with the fact that I could pass some state exam required to practice medicine. In fact, I had completed graduate school and had extra time obtaining a Certificate in Pain Studies from a university program. Yet the petty politicians that control the medical boards, with much less education, are the ones that are making the decisions. It is all about control and competition and very little to do with education and knowledge. In fact education had nothing to do with their political decisions. It was more the fact that such a large portion of physicians that I was around seemed to have less of it (education and knowledge) than I did. But they drove me out before my fifty-fourth birthday. I have to admit, I never considered politics as an important part of patient care. But, I was wrong! Lack of peer support destroyed my practice! That is what I get for moving south! Damned Yankee wouldn't go home!

  • AD-RtR/OS!||

    When did it ever not?

  • afk05||

    Drug prices are not regulated by the government. Per Medicare Part D, negotiated by George W, the government is not even allowed to negotiate pricing. I worked in the pharma industry. They set the prices, and negotiate with the insurers and distributors. There is not a great deal of regulation or transparency in how the healthcare industry does business, and it's much closer to free market than many realize. There is no regulation forcing hospitals or providers to publish their prices, and there is no tort reform that would decrease med mal lawsuits. Free market will certainly not solve the issues of price gouging of pharmaceuticals, and it will not solve our rapidly increasing cost of healthcare (neither does the ACA, but no one wants to seem to actually address the elephant in the room).

  • loveconstitution1789||

    The government absolutely regulates drug prices. Epi-Pen is an example of many examples of pricing not fitting what government "thinks" the price should be- then hearings....
    Conressional hearings on Epi-Pen

  • loveconstitution1789||

    Government absolutely regulates drug prices. Epi-Pen is an example of regulation of drugs. Congressmen holding hearings on what they "think" the price of the drug should be, then....
    Epi-Pen Congressional hearings

  • loveconstitution1789||

    SQUIRRELS!!!!!

  • MikeyB||

    We need a market based approach which incentivizes consumers.
    #1 All health provides must charge the same to all customers and publish costs for each insurance-coded item. We may have to carve out an exception for Medicare and Medicaid otherwise their costs will explode since their current reimbursements rates are so low. So that may have to be a more gradual change.
    #2 Consumers should get cash back for taking a solution less than two sigma of the average cost. For example, Hospital#1 standard charge for baby delivery is $8000. Baby Center#1 is $6000. Two sigma cost is $7500. Consumer chooses the $6000 solution with the $1500 price difference and gets back say 50% of the difference or $750. Insurer saves whatever the difference is from their average cost which could still include losing money if their costs are typically low. Overall this will drive down average reimbursements since consumers will tend to pick less expensive solutions and will encourage competition amongst providers including advertising like "Get $750 back on your baby delivery" or "Get $200 back on setting your broken arm", etc..... Websites and apps will be created automatically (no government needed) by people to allow you to find the least expensive solution in your area.

  • laportama||

    Since the mid-80's I've been saying there will NEVER be a cap on costs until there is a social and societal consensus and convention on what constitutes reasonable and necessary medical care. Translate: rationing.
    And since we can't even define "quality" except by government fiat, we're a ways away. We've been off a rational path for at least decades, and more intervention is not going to fix it.

  • Dan At Law||

    It is important for the Health Insurance industry to change and innovate. I suggest that health insurance be structured the same way that use auto insurance. When I have an accident, they evaluate the damage and the value of the car and write me a check. If I choose to have the car repaired, I then use the money for that purpose. I can shop for the best price, quality and value. I can also choose not to have the car repaired and use Uber.

    The differences between auto claims and health care are obvious and dramatic. But if the company can use historical experience to establish the amount to be paid for each type of condition (obviously I don't know that they can) they will be able to more accurately predict their future exposure. If this could be applied to end of life conditions, then the patient might sit down with his/her loved ones and choose between comfort care and treatment. This is where we incur most of our Medicaid and Medicare expenses.

    Innovation is impossible under our current Medicaid and Medicare system.

  • ||

    To answer your second paragraph, actuaries. Obamacare along with its destructiveness made them useless; because why do you need to predict something when the past is treated as the future?

  • aajax||

    Sure, you can shop around for procedures you don't need right away, like cosmetic surgery and lasik. Try that when you have a heart attack.

  • Heraclitus||

    Sure, I'll shop around for an ambulance while I'm dying on the side of the road. I just hope I get a 4g signal on my cellphone when it happens so I can compare prices online. But oh snap! Coverage often sucks in hospitals. How the heck am I going to get online and compare prices right before the anesthesiologist comes to my room to knock me out before the big surgery?

    The next time my kid breaks his leg I'm sure he will understand why I delay taking him to the hospital. Hold on son! I'm searching for a groupon. Maybe I can get a free cholesterol test when I purchase an x-ray for you! I'm sure he won't mind that I get an x-ray in one hospital and then drive him across town to get the cast put on. With the money I save I will buy him a new Xbox game!

  • Migrant Log Chipper||

    Troll gibberish FTW....back to DU, dipshits.

  • gentlelad||

    To improve on The ACA, people should be able to choose medical care that they want. Anyone who believes they will never need maternity care should not have to buy it. The ACA does not have to be all or nothing.

    Another idea is a medicare type plan, with Medicaid as a backup program for doctor visits and medication. Insurance companies can offer supplementary policies based on income and a government subsidy.

    I am black and a democrat. I hope they will be smart enough to study the proposed budget and come up with an infrastructure plan that includes a money source, including higher taxes on millionaires and billionaires. They made their money because people paid to see them perform or work for the minimum wage to sell their products. They should be willing to share their wealth.

  • Motivation Quotes||

    i like this topic ...
    family quotes

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