doubt it. RG is stuck in the strawmannish "many say" or "typical conservatives say" mode. any reply not fitting fit the contours of the cookie cutter gets tossed aside as scrap and ignored.
and yet, the flip-flopping, lying, slandering extremist Mormon bishop has the gall to claim:
Romney on Obama: 'Talk is cheap'
http://www.latimes.com/news/politics...,5169355.story
I haven't put words in anybody's mouth, thank you very little.
I just can't remember hearing any real purely-free market approach, TB's protestations to the contrary notwithstanding.
No, I dimly remember you putting forth something, and thinking it sounded reasonable enough, but can't remember the specifics.
I would have to spend a bit of time searching to really ferret it out.
(unless of course, you were gratious enough to spell it out for the 10,001st time)
Ok...10,001.
The existing conventional wisdom's basic reasoning is that 3rd party payers (both insurance companies and medicare) allow consumers to overuse and abuse healthcare services, and thus the American consumers are spending so much on healthcare, well...because they can. The argument continues that the existence of this guaranteed market fuelled by 3rd party payers in turn fuels all kinds of companies to step up for part the pie by creating all kinds of gadgets, tests and drugs that may or may not be evidenced based (i.e. effective). In turn, doctors oblige as consumers gobble up all this supposed innovation, and round and round we go. Everyone, the argument goes, from provider to patient to durable supply companies, are trapped in this happy web of gravy and en lement.
Lots of conservatives make this argument. (it is hardly an all inclusive argument but nevertheless partly true). However, the "remedy," they propose is foolish because it is predicated on the fantasy that after these third party payers are removed or curtailed consumers will go head-on with the industry and doctors, start "shopping" harder when they have to pay for more things out of pocket and then make wiser healthcare choices, selecting cheaper care and/or consuming only what they need.
An irony here is that the same people making the above argument instantly become alarmists as soon as an evidenced based recommendation is made to consumers to forgo any type of test. The U.S. Preventive Task Force 2009 recommendation against routine breast cancer screenings for women under fifty comes to mind. Worries were abound that 3rd party payers would start denying claims for the routine procedure. They would equally freak out if a guideline established that the prostate specific antigen test was largely useless, as is the case with the established guidelines in many countries (the UK, Australia to name two) But, isn't that exactly what they wanted? The theory goes that fewer consumers would get the unnecessary test in the first place since they would have to pay out of pocket for this procedure and the remainder would go shopping, and both these results would drive prices down, the screening equipment companies would not have that "guaranteed" market. etc.
This just illustrates the truth that consumers are not capable of navigating a "free market" for healthcare. On the one hand, they are not knowledgeable enough to decide they do not need a medicine or procedure that a professional recommends (e.g. breast cancer screening), and certainly not equipped to make sense of conflicting recommendations by professionals who do not always know what is actually evidenced based even themselves. Even if they were equipped, consumers bragging about the half-price triple bypass they got, would most likely send their friends running in the other direction from that doctor rather than flocking to him/her to get one of those "discount bypasses" for themselves.
All this combines to illustrate that the healthcare market does not and cannot operate like other "free-er" markets with better information symmetry than healthcare and it is worth noting that American consumers still find ways to make stupid choices in those less complicated markets with (hopefully but probably not) less dire outcomes.
We like to pretend this problem is super complicated but, at its core, it really isn't. We only pretend it is because we really, really do not want to take the simple steps to correct it. The only real answer involves what you (and the rest of America) does not want to hear. The "tough pill" is that meaningful cost containment is only possible if the government controls even more (not less) aspects of healthcare than it already does. The evidence is abound the world over: This madness will never end unless the authority steps in and starts drawing hard and fast lines for both healthcare professionals and consumers to follow.
Step 1. Healthcare records need to be nationalized, put in a data base and analyzed to truly determine what practices are evidenced based. From this, better Guidelines need to be developed by government bodies made of healthcare professionals with the specific task of sorting through the mess- like but not necessarily the U.S. preventive services task force, MedPAC or IPAB .
Step 2. Based on the guidelines, the 3rd party payers (ideally, one single payer) need to start limiting access to care (i.e. rationing) more than they already do, but intelligently like in many other countries that achieve equal or better health outcomes while spending less. I'm sorry, but the doctors are not going to stop the madness. The patients aren't going to stop the madness. That leaves the government to step in and say, we aren't paying either of you for x, y and z because the evidence for it is . Then, if Americans still want to overconsume dubious patches, pill and potions, they can just buy some supplemental plan or pay out of pocket. But, most won't. Failing this, healthcare costs in this country will never be controlled. The rest is just a pipe dream.
Step 3. Create a Fed single payer HMO...this would handle all routine visits/vaccinations/exams.... , routine checkup exams represent about 8% of the total outlay for healthcare alone! Realize that the vast majority of these patients that come in for an "annual exam" have already seen their doctor multiple times the preceding year. A single, governing body can identify and prevent unneeded exams like these by dint of a layer of guidelines/filters. This is something the current model has failed miserably at.
Step 4. Allow insurance companies to be...well, insurance companies. Their original purpose was to leverage risk across time. So, let them handle the specialist stuff and subsequent surgeries. The fed would have to impose a do entation/coding standard so that the outcomes can be included in a master medical database. That standard should be exactly what the single payer/fed system would use. Freed of the need, and administrative burden of functioning as an HMO, Insurance companies would significantly reduce their overhead. Policy premiums should be required to reflect this. Participation should be mandatory (which is not ideal, but a needed caveat to make this even feasible from a political standpoint).
"Healthcare records need to be nationalized,"
the latest doctor fraud discovered where records were electronic is that the docs upgrade the coding from a $40 code to a $120 code.
Medicare/medicaid/VA/single-payer docs must be govt employees and on a strict salary, not fee-for-service.
Yes.
This election will be the lesser of two losers.
At least one of those losers has real world executive experience making money, instead of going in debt!
I see.
One size fits all.
Can you wear anybody's shoes?
I don't know about Random, but I don't know what future date to go to to see it.
devastating, perceptive, informative analogy
I swear, you two hacks bring nothing to any discussion.
TB, bringin it down hard
Well, that was better than your typical altnet/thinkprogress.borg bull link.TB, bringin it down hard
TB
always expressing his bull opinion supposedly to refute facts and direct quotes
lol at boutons getting repeatedly slapped into oblivion.TB
always expressing his bull opinion supposedly to refute facts and direct quotes
TB
soza and TB bringin it hard n fast. such little es
take your slapping like the little hack you are, .
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