It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
The question is how can doctors help in a "don't offend me" world?
I've lost 50# and my doctor told me he wishes even half of his patients took it seriously.
Like most anything else, others cannot do it for you. One cannot be coached if they are not willing to be coached.
As someone said above, anyone with a 4th grade education should know to eat fewer chips(crisps) snack cakes and soda and more fruits, vegetables and drink water.
But a casual glance in the typical shopping cart will see people are spending more time in the snacks and soda aisle than they do in the produce aisle.
People have to want to make changes for any help from the doctor to become effective.
From a maintenance perspective, I wish calorie disclosure would go further. I would like to see mandatory calorie counts for all restaurants and shops selling food items, regardless of number of locations. Not to the extent of sending food to a lab for measurement, but at least calculating calories for all the ingredients and dividing by their serving size.
I would like to see doctors tell there patients all about weight loss when overweight and helping there patients before they get to obesity. Everyone usually goes to the doctor. And I think if doctors help there patients get to a healthy weight and stay at a healthy weight there would be less people getting obese and overweight. I think the food companies sell to much junk food and should be working on making nice foods that are healthy with less calories and foods that fill people up. My doctor suggested to try and lose some weight and since he said that I’ve gone from 104kgs to 77kgs. Best thing my doctor said to me because now I’m trying to lose weight and get healthy and get in good shape. I’m grateful to my doctor for helping me. Now I’m learning about weight loss walking and eating less and drinking more water and cut out most junk food and try to stick to drinking water sugar free energy drinks and coffee and bike riding and not interested in getting my license back because I’m happy walking most places and walking to public transport to go thirty minutes or more out of town by bus and train. I really think doctors should help there patients so the world can be happier and healthier and fitter.
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Do you also want to bring back debtors prison? Because the reality is those costs do normally get passed on to the person without insurance. They either pay, negotiate a discounted repayment, or declare bankruptcy when they fall behind on their payments.
It's not like hospitals go "oh you're uninsured? You're free!" They send the person bills, they attempt to collect, sometimes there are things like one-time grants available if you are super lucky. Most people who declare bankruptcy in the United States do so because of medical bills.
If hospitals can just pass along the costs of those who don't pay to others, what is their incentive to keep costs low?
Don't allow them to pass those costs along to others.
If they are really losing money, they will have far more incentive to find a way to lower costs than if they can just pass them along.
Finally, nothing prevents those from believing something needs to be done to help those who cannot pay from opening their wallets and living out their values.
It's easy to say "the rich" or "the government" or some other group should pay. That's not generosity. Spending other people's money is never generosity or caring.
Generosity and caring is what you personally do with YOUR time, YOUR talent and YOUR treasure.
It would certainly be a step in the right direction. Paying for preventative care, but if the person let something go on without getting the care, they would be on the hook for the difference.
But ultimately, a free people should never be obligated to pay.
They can volunteer to pay. But should never have the ability to force others to pay into such a system. Others may have different views on how to help those who cannot pay. A free person should never be forced to pay for another. They can do so voluntarily, but never by force of law.
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
I see this argument brought up when attempting to pitch for socialized structures, but there isn't much truth to this.
By doing this you aren't addressing the root cause of unlimited demand and decreasing supply. In fact you are making the problem considerably worse.
If you actually want to help the healthcare problem you can either address the demand problem by reducing the need for care...or increase the number of practitioners.
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
I see this argument brought up when attempting to pitch for socialized structures, but there isn't much truth to this.
By doing this you aren't addressing the root cause of unlimited demand and decreasing supply. In fact you are making the problem considerably worse.
If you actually want to help the healthcare problem you can either address the demand problem by reducing the need for care...or increase the number of practitioners.
So are you saying the reason health care is so expensive in the US is a supply/demand issue? Honest question, I know my opinions in this area involve a lot of emotion, so I try to keep my yapper shut and soak up info
Aren't the insurance companies a primary driver of the costs right now?
Aren't the insurance companies a primary driver of the costs right now?
If insurance companies were the primary drivers of cost, wouldn't it be cheaper for people to just direct pay doctors and hospitals?
I doubt there is any one thing.
Cost shifting is one part of it.
Defensive medicine is another. No doctor or hospital wants to be sued because they missed something.
Tort reform is probably a part of it too. How much is malpractice insurance for this business. Daytime TV is full of law firms saying they will "get you what you deserve" from your doctor, hospital or whomever may have "harmed" you.
How much of the cost to treat me is to actually treat me, and how much is defense of the doctor or hospital from those who don't pay and those who sue?
If hospitals can just pass along the costs of those who don't pay to others, what is their incentive to keep costs low?
Don't allow them to pass those costs along to others.
If they are really losing money, they will have far more incentive to find a way to lower costs than if they can just pass them along.
Finally, nothing prevents those from believing something needs to be done to help those who cannot pay from opening their wallets and living out their values.
It's easy to say "the rich" or "the government" or some other group should pay. That's not generosity. Spending other people's money is never generosity or caring.
Generosity and caring is what you personally do with YOUR time, YOUR talent and YOUR treasure.
So what happens to people who actually can't afford to pay?
So what happens to people who actually can't afford to pay?
Make the case to their family, neighbors, friends, community, church or other worship group they are affiliated with.
If those closest to them see they've been spending what would have been an insurance premium on toys as I've described above, they may not be so willing to fund their bill.
If their story is one that is truly one that is bad luck, such as they did have insurance until the plant closed, they were doing the right things, not being the grasshopper by living for today without regard to tomorrow, I can't imagine people would be so callous as to not help.
Having observed how people generously respond to natural disasters it's hard for me to buy the idea that people are not compassionate towards those who are really in need.
One death is a tragedy. One million deaths are a statistic.
One person in need of a lifesaving operation they can't afford is a community fundraising project. Ten thousand people in a low-income area dealing with the rigors and ailments of aging, appealing to other communities dealing with their own issues... It's not a pretty picture. And going around appealing for aid can be a daunting prospect for people dealing with anxiety. Or people who always prided themselves on not needing charity. Or introverts.
It's one thing for me to send $25 for flood relief every year or so. It's another for me to be asked repeatedly to assist elderly relatives, friends and neighbors while trying to hang onto enough to cover my own medical needs and those of my family. It's not callousness. It's recognizing that there's only so many times I can contribute.
It's all well and good to say that healthcare providers will have an incentive to lower costs but people don't always agree to forgo lucrative income simply because "they no longer have to worry about other costs". They worry about what might be down the road. They think about increased cost of living. And some (not all, but let's agree that there are a fair number) are just plain greedy.
Government-funded healthcare may not be the best option. But what you're suggesting sounds a lot worse.
So what happens to people who actually can't afford to pay?
Make the case to their family, neighbors, friends, community, church or other worship group they are affiliated with.
If those closest to them see they've been spending what would have been an insurance premium on toys as I've described above, they may not be so willing to fund their bill.
If their story is one that is truly one that is bad luck, such as they did have insurance until the plant closed, they were doing the right things, not being the grasshopper by living for today without regard to tomorrow, I can't imagine people would be so callous as to not help.
Having observed how people generously respond to natural disasters it's hard for me to buy the idea that people are not compassionate towards those who are really in need.
So basically, anyone who a) doesn't have connections wealthy enough to have tens of thousands spare, b) isn't well loved by those connections, or c) is insufficiently convincing about their own past decisions, just gets to die?
Presumably they need to raise the money prior to treatment; how do you expect them to do that if they're for example, unconscious?
If you're just going to hit them with a bill after treatment, how does that differ from today?
Even if wealthy and philanthropic connections were as plentiful as you imagine (which they're clearly not, or the US would have socialised healthcare by now), I don't see any practical way to implement this.
It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
I see this argument brought up when attempting to pitch for socialized structures, but there isn't much truth to this.
By doing this you aren't addressing the root cause of unlimited demand and decreasing supply. In fact you are making the problem considerably worse.
If you actually want to help the healthcare problem you can either address the demand problem by reducing the need for care...or increase the number of practitioners.
So are you saying the reason health care is so expensive in the US is a supply/demand issue? Honest question, I know my opinions in this area involve a lot of emotion, so I try to keep my yapper shut and soak up info
Aren't the insurance companies a primary driver of the costs right now?
I agree and find that emotional response usually ends up badly. There are several issues at play and what is needed is a balanced approach.
The US system took on the worst points of both worlds. Heavily regulated on price (via insurance and government) and supply (regulations and education). The only thing keeping the system going is innovation, which is on the decline.
Insurance is a primary driver because it has too much control over the process. To address this you simply remove the influence on the system. ...but change brings fear and few people have the stomach to change even if it means things will likely be better.
Compare the cost of medical treatments outside of insurance coverage - eye correction and cosmetics/aesthetics medicine. These industries must evolve and adapt as they have no insurance or government safety net. The cost of goods is continually driven down via innovation and follows consumer price index. Medicine covered by insurance however exceeds this index by a monumental margin.
So basically, anyone who a) doesn't have connections wealthy enough to have tens of thousands spare, b) isn't well loved by those connections, or c) is insufficiently convincing about their own past decisions, just gets to die?
News flash, we all die.
Why does someone get to reach into my pocket, without my permission and demand that I pay for everyone to get treatment because others have some form of guilt or other motivation to help using the fruits of my labor?
That's the real question. Because that happens far more frequently than does the person with no connections, etc.
At least here in the US, before the ACA, 85% of people already had insurance. The ACA increased that to 90% without the promised $2500/year savings for the average family.
So it missed 2/3rds of the population targeted and still didn't bring down costs for the typical family. Instead of the $2500 / year in savings, the typical family pays $2200/year MORE since the ACA was implemented.
Even NPR, not a right wing news source indicates all the ACA did was to shift costs. It did nothing to actually make care affordable.
Not sure we can afford any more government solutions to the problem.
Replies
Only if the walking and reduction in eating are brought about by government intervention.
Hopefully a lot, considering how much ice cream it drives me to eat.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
The question is how can doctors help in a "don't offend me" world?
I've lost 50# and my doctor told me he wishes even half of his patients took it seriously.
Like most anything else, others cannot do it for you. One cannot be coached if they are not willing to be coached.
As someone said above, anyone with a 4th grade education should know to eat fewer chips(crisps) snack cakes and soda and more fruits, vegetables and drink water.
But a casual glance in the typical shopping cart will see people are spending more time in the snacks and soda aisle than they do in the produce aisle.
People have to want to make changes for any help from the doctor to become effective.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
You just pass the costs on to those who choose to take a more proactive approach.
Stop passing along costs to others and the costs for those no longer having the costs of others passed to them will go down.
If people wish to voluntarily take on those costs, I'm all for it.
I'm not in favor of someone, especially those who buy votes with other people's money, choosing to pass costs on to me and my family.
That is not equal to not wishing to help. I simply think using government fiat is the worst way to make any real, lasting, and meaningful change.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
Do you also want to bring back debtors prison? Because the reality is those costs do normally get passed on to the person without insurance. They either pay, negotiate a discounted repayment, or declare bankruptcy when they fall behind on their payments.
It's not like hospitals go "oh you're uninsured? You're free!" They send the person bills, they attempt to collect, sometimes there are things like one-time grants available if you are super lucky. Most people who declare bankruptcy in the United States do so because of medical bills.
If hospitals can just pass along the costs of those who don't pay to others, what is their incentive to keep costs low?
Don't allow them to pass those costs along to others.
If they are really losing money, they will have far more incentive to find a way to lower costs than if they can just pass them along.
Finally, nothing prevents those from believing something needs to be done to help those who cannot pay from opening their wallets and living out their values.
It's easy to say "the rich" or "the government" or some other group should pay. That's not generosity. Spending other people's money is never generosity or caring.
Generosity and caring is what you personally do with YOUR time, YOUR talent and YOUR treasure.
But ultimately, a free people should never be obligated to pay.
They can volunteer to pay. But should never have the ability to force others to pay into such a system. Others may have different views on how to help those who cannot pay. A free person should never be forced to pay for another. They can do so voluntarily, but never by force of law.
I see this argument brought up when attempting to pitch for socialized structures, but there isn't much truth to this.
By doing this you aren't addressing the root cause of unlimited demand and decreasing supply. In fact you are making the problem considerably worse.
If you actually want to help the healthcare problem you can either address the demand problem by reducing the need for care...or increase the number of practitioners.
So are you saying the reason health care is so expensive in the US is a supply/demand issue? Honest question, I know my opinions in this area involve a lot of emotion, so I try to keep my yapper shut and soak up info
Aren't the insurance companies a primary driver of the costs right now?
If insurance companies were the primary drivers of cost, wouldn't it be cheaper for people to just direct pay doctors and hospitals?
I doubt there is any one thing.
Cost shifting is one part of it.
Defensive medicine is another. No doctor or hospital wants to be sued because they missed something.
Tort reform is probably a part of it too. How much is malpractice insurance for this business. Daytime TV is full of law firms saying they will "get you what you deserve" from your doctor, hospital or whomever may have "harmed" you.
How much of the cost to treat me is to actually treat me, and how much is defense of the doctor or hospital from those who don't pay and those who sue?
So what happens to people who actually can't afford to pay?
Make the case to their family, neighbors, friends, community, church or other worship group they are affiliated with.
If those closest to them see they've been spending what would have been an insurance premium on toys as I've described above, they may not be so willing to fund their bill.
If their story is one that is truly one that is bad luck, such as they did have insurance until the plant closed, they were doing the right things, not being the grasshopper by living for today without regard to tomorrow, I can't imagine people would be so callous as to not help.
Having observed how people generously respond to natural disasters it's hard for me to buy the idea that people are not compassionate towards those who are really in need.
One person in need of a lifesaving operation they can't afford is a community fundraising project. Ten thousand people in a low-income area dealing with the rigors and ailments of aging, appealing to other communities dealing with their own issues... It's not a pretty picture. And going around appealing for aid can be a daunting prospect for people dealing with anxiety. Or people who always prided themselves on not needing charity. Or introverts.
It's one thing for me to send $25 for flood relief every year or so. It's another for me to be asked repeatedly to assist elderly relatives, friends and neighbors while trying to hang onto enough to cover my own medical needs and those of my family. It's not callousness. It's recognizing that there's only so many times I can contribute.
It's all well and good to say that healthcare providers will have an incentive to lower costs but people don't always agree to forgo lucrative income simply because "they no longer have to worry about other costs". They worry about what might be down the road. They think about increased cost of living. And some (not all, but let's agree that there are a fair number) are just plain greedy.
Government-funded healthcare may not be the best option. But what you're suggesting sounds a lot worse.
So basically, anyone who a) doesn't have connections wealthy enough to have tens of thousands spare, b) isn't well loved by those connections, or c) is insufficiently convincing about their own past decisions, just gets to die?
Presumably they need to raise the money prior to treatment; how do you expect them to do that if they're for example, unconscious?
If you're just going to hit them with a bill after treatment, how does that differ from today?
Even if wealthy and philanthropic connections were as plentiful as you imagine (which they're clearly not, or the US would have socialised healthcare by now), I don't see any practical way to implement this.
I agree and find that emotional response usually ends up badly. There are several issues at play and what is needed is a balanced approach.
The US system took on the worst points of both worlds. Heavily regulated on price (via insurance and government) and supply (regulations and education). The only thing keeping the system going is innovation, which is on the decline.
Insurance is a primary driver because it has too much control over the process. To address this you simply remove the influence on the system. ...but change brings fear and few people have the stomach to change even if it means things will likely be better.
Compare the cost of medical treatments outside of insurance coverage - eye correction and cosmetics/aesthetics medicine. These industries must evolve and adapt as they have no insurance or government safety net. The cost of goods is continually driven down via innovation and follows consumer price index. Medicine covered by insurance however exceeds this index by a monumental margin.
News flash, we all die.
Why does someone get to reach into my pocket, without my permission and demand that I pay for everyone to get treatment because others have some form of guilt or other motivation to help using the fruits of my labor?
That's the real question. Because that happens far more frequently than does the person with no connections, etc.
At least here in the US, before the ACA, 85% of people already had insurance. The ACA increased that to 90% without the promised $2500/year savings for the average family.
So it missed 2/3rds of the population targeted and still didn't bring down costs for the typical family. Instead of the $2500 / year in savings, the typical family pays $2200/year MORE since the ACA was implemented.
Even NPR, not a right wing news source indicates all the ACA did was to shift costs. It did nothing to actually make care affordable.
Not sure we can afford any more government solutions to the problem.