How to argue for universal health care

LetsGoBrandon · Nov 15, 2019

Neomalthusian said:
What about that argument? Of course it isn’t “free market,” nor is there any chance that it ever will be. Way too many conservatives (let alone liberals) need and demand their government health coverage.

Private Healthcare in the US used to be free market. That is certainly not the case under Obamacare. When by government edict, virtually everyone is forced to buy healthcare, it's a captive customer base. There is no incentive for the insurance providers or healthcare providers to compete.

jaeger19 · Nov 15, 2019

ObamacareFail said:
Private Healthcare in the US used to be free market. That is certainly not the case under Obamacare. When by government edict, virtually everyone is forced to buy healthcare, it's a captive customer base. There is no incentive for the insurance providers or healthcare providers to compete.

That's crap. Sheesh..

You realize that Obamacare never forced anyone.. ANYONE.. to buy healthcare... not one single person. (lets see how long it takes you to realize why you are wrong).

Waddy · Nov 15, 2019

jaeger19 said:
That's crap. Sheesh..

You realize that Obamacare never forced anyone.. ANYONE.. to buy healthcare... not one single person. (lets see how long it takes you to realize why you are wrong).

It forced people to buy health care of face a penalty. What it oulawed was cheap catastrophic insurance like I used to buy my grown kids when they were between jobs. That used to run $70-$90 per month. Not offered now.

bave · Nov 16, 2019

jaeger19 said:
Reimbursement is an issue..and that's does go back to debt load.

However.. yes.. often its lifestyle as well. usually from the spouses end. At least that's what we find when trying to recruit doctors to rural areas.

However..in comparison to other countries? which was the gist of Waddy's point.

Yes.. other countries pay their doctors less.. but yes..they do tend to help their doctors our more. Like for education. Now.. you are right.. in many cases employers of physicians will offer debt repayment. BUT THAT IS A COST TO THE HOSPITAL OR PRACTICE... so it ends up getting charged to the insurance companies and patient. One of the reasons that other countries can "spend less than the US on healthcare"...its because some of the cost has been shifted to public education where in the US.. that cost goes to the patient/insurance.

Wrong, yet again.

Reimbursement is the primary issue regardless of your educational debt.

Medicare reimbursement on average is 94-96% of the *cost* to provide care.
Medicaid reimbursement on average is 58% of the *cost* to provide care.

It doesn't matter what your debt load is, no one can afford customers that *cost* them money. Every time a private practice sees a medicare patient they lose 4-6%. Medicaid patients about 10x the size of the loss. The idea that reimbursement is secondary to debt is absurd, you need to be profitable to even be able to consider your debt payments first.

It isn't "spouse" lifestyle at all. No one wants to be Q2/3. No one wants to life in Mayberry. No one wants to have a census of all government payors.

Again, what kind of "physician" are you? Who are you recruiting? What's your JHACO status?

The basic fact you are missing, which is amazing even for someone pretending to be a physician on the internet, is that you are not adjusting compensation for production. Compare a British Neurosurgeon to their American counterpart. The first thing you will find is that that wRVU output of the American is going to be ~double what their british counterpart is. Suddenly they are doing twice as much work, being paid three times as much, but the cost per wRVU is actually less because of ancillary and overhead cost. A classic example of this is VA medicine. They get paid about 70% of their private sector peers, but their output is ~40% of their peers and their cost per output unit is 4x their peers. That's what central command medicine looks like.

But please, go back to pretending to being a medical professional.

LetsGoBrandon · Nov 16, 2019

jaeger19 said:
That's crap. Sheesh..

You realize that Obamacare never forced anyone.. ANYONE.. to buy healthcare... not one single person. (lets see how long it takes you to realize why you are wrong).

Nice try. They merely taxed those who refused 2% of their income. Fortunately President Trump has since managed to get the individual mandate repealed. The employer mandate is next.

James972 · Nov 16, 2019

Waddy said:
Those doctors don't come out of school with 5 times the debt load either.

Let's put or thinking cap on shall we? When your income will be $16 million student loans of $200,000 mean nothing!! 1+1=2

James972 · Nov 16, 2019

Waddy said:
I told you you were comparing apples and oranges. Look at the chart down on the page; doctors in Japan make way more than other occupations. And the government pays for their schooling.
Doctor / Physician Average Salaries in Japan 2019

you missed the point completely. There is no reason doctors in USA need to earn 2-3 times what they earn in Europe. Now do you understand??

James972 · Nov 16, 2019

Waddy said:
In every country doctors make more than most of the population; a LOT more.

so??? our issue here is that we pay 3 times what the world pays for health care, and part of the problem is the doctors earn about 3 times more than they should.

James972 · Nov 16, 2019

Waddy said:
The only way to introduce "Capitalism" is to eliminate insurance companies an have people pay out of pocket. So long as insurance pays the bill most people could care less what it costs.

totally wrong of course. If people pay for medical care directly or through insurance they will shop very carefully as long as liberal govt does not prevent competition as it does in insurance now. Do you understand??

James972 · Nov 16, 2019

Waddy said:
Reimbursements for Medicare are already so low many doctors don't like to take Medicare patients.

we don't know what low or high prices are until we have had decades of Republican free market competition. Is this really over your head?? A soviet car might cost someone 10 years pay and soviet engineers would swear they could not make it cheaper. Let their livelihoods depend on it and all of the sudden you see lower prices and higher quality. Do you understand now?

James972 · Nov 16, 2019

Waddy said:
Blaming it all on doctors is just plain nuts.

no one blames it all on doctors, just the portion for which they are responsible.

James972 · Nov 16, 2019

FinnFox said:
that kind of work shouldn't be for profit

Of course that's purely insane, medical care is very important so its very important that it generate huge profits to encourage people to cure illnesses. I sure hope there is someone out there killing himself to make monopoly profits off of a cure for cancer and hearth disease before I get those diseases. Do you understand?

James972 · Nov 16, 2019

GreatNews2night said:
A board certified internal medicine physician who is married with two children, living in California and earning the median internist annual salary of $205,441 :

sure beats earning 25% of that as a average college grad!!

James972 · Nov 16, 2019

jaeger19 said:
R One of the reasons that other countries can "spend less than the US on healthcare"...its because some of the cost has been shifted to public education where in the US.. that cost goes to the patient/insurance.

So in other countries they pay more for public education and then not as much for patient/insurance so it balances out. In reality it's far cheaper in other countries because 1) they don't have as much capitalism as we do so they are poorer and can afford less and 2), they have more efficient socialist health care than we do. Now do you understand?

James972 · Nov 16, 2019

ObamacareFail said:
. There is no incentive for the insurance providers or healthcare providers to compete.

yes, imagine if auto manufactures didn't have to compete? Yet this is what the liberal imposes upon us in health care. Its insane but that is the state of the liberal mind.

James972 · Nov 16, 2019

jaeger19 said:
That's crap. Sheesh..

You realize that Obamacare never forced anyone.. ANYONE.. to buy healthcare...

it put a lot of pressure on you to buy even if you didn't want to buy and to support the elderly and sick

James972 · Nov 16, 2019

Waddy said:
It forced people to buy health care of face a penalty. What it oulawed was cheap catastrophic insurance like I used to buy my grown kids when they were between jobs. That used to run $70-$90 per month. Not offered now.

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Waddy · Nov 16, 2019

James972 said:
Let's put or thinking cap on shall we? When your income will be $16 million student loans of $200,000 mean nothing!! 1+1=2

Tell that to the young doctor trying to pay it off. You have no solutions.

Waddy · Nov 16, 2019

James972 said:
so??? our issue here is that we pay 3 times what the world pays for health care, and part of the problem is the doctors earn about 3 times more than they should.

they also work 3 times more.

Waddy · Nov 16, 2019

James972 said:
totally wrong of course. If people pay for medical care directly or through insurance they will shop very carefully as long as liberal govt does not prevent competition as it does in insurance now. Do you understand??

When you have insurance you don't have to care what it costs.

Waddy · Nov 16, 2019

James972 said:
we don't know what low or high prices are until we have had decades of Republican free market competition. Is this really over your head?? A soviet car might cost someone 10 years pay and soviet engineers would swear they could not make it cheaper. Let their livelihoods depend on it and all of the sudden you see lower prices and higher quality. Do you understand now?

So you're saying we need an open transparent medical market? Would be great if incusance didn't cover it.

James972 · Nov 16, 2019

bave said:
wRVU output of the American is going to be ~double what their british counterpart is..

interesting; love to see some documentation on that!!

Waddy · Nov 16, 2019

James972 said:
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Yeah, I went through the quote process. Best they could do was $186 per month.

bave · Nov 16, 2019

James972 said:
interesting; love to see some documentation on that!!

There is an enormity of it. MGMA has all sorts of data that compares productivity by specialty, by region, by employment method and you can see stark disparities right there. The productivity decline from private practice > employed > government employed is ~20%+ per step.

Edit: Can you guys use multi quote please, rather than a full page of single line quotes.

James972 · Nov 16, 2019

Waddy said:
So you're saying we need an open transparent medical market? Would be great if incusance didn't cover it.

yes so we need Republican capitalism in the insurance industry. Make sense??