That was a very good response, thank you. I do get the feeling that you are either a paid lobbyist or an unpaid lobbyist ; )
No, I just believe that (quoting Keith Evans, who is another Medium denizen who is definitely NOT a conservative) government is good for paying for things but terrible at running things. (And if you ask them to run something, it won’t end well.)
I believe in universal care. However, I don’t believe in rip-and-replace of large systemically important systems. Too much risk. Our problems in health care can be fixed; the problem is that you have one party has a near-sexual obsession with rip-and-replace (via single payer) and won’t consider any other system — — and they’ve been like that for nearly 30 years now.
The GOP system that was voted down and would have replaced the ACA would have been a vast improvement over both. But the GOP got cold feet at the end and decided not to fund it properly, and because the Dems are obsessed with blocking anything that doesn’t look like single payer, it died.
Both parties failed. If the Dems had been willing to discuss the GOP plan, then they could have used their votes to increase the funding and make it whole. OTOH, if the GOP wasn’t so damn prideful, they would have said “You know, this ACA thing isn’t all THAT bad, now that we’ve gotten rid of the stuff we hated most about it, so let’s work with the Dems to improve it.”
During that period I encountered numerous instances in which hospitals, small clinics and small businesses consisting of specialist surgeons were billing amounts that were 1000% of what they would eventually pay medical, which I did not qualify for because my income was too high when the medical need emerged.
Sure. The provider is going to try to recover uninsured costs from their paying customers whenever they can, leading to these nonsensical markups. That’s a key part of our “nonsystem” known as “cost-shifting”.
Just this month my daughter needed a CAT-scan. The provider said they would charge me $900 because my deductible hadn’t been met. I asked them what their walk-in cash price was. $300. Go figure.
in fact the whole of the industry is so entrenched in fraudulent practices that they have become normalized and are treated as standard operating procedures.
Sure. And what causes those fraudulent practices? The same government that now people want to give full control over the system to. The government sets reimbursement rates for uninsured care and Medicare/Medicaid/CHIPS so low that the provider has to recoup that money from the people on private plans. So, they overbill the 70% of us that have private insurance to make up the losses from the 30% who don’t.
The erosion of ethical standards in the business of medicine is so complete as to destroy any trust whatsoever that I had in the industry.
Dude. It’s not an erosion of ethical standards; it’s accounting. If as an ethical doctor I spend 70% of my time working at a loss for patients on a government plan, I need to make up those losses so I can pay my office staff and my medtechs and my rent and then pay myself. It’s inefficient as all hell, but instead of saying “let’s fix the specific problem”, we decide to burn the whole house down and let the numnuts in the government run it?
Count me out.
The entire Medicare system is run off that measly 1.6% payroll tax that the employer matches. But is there a single politician who wants to address the proximate cause of all this cost shifting and suggest raising that tax to 2 or 3%? Not a damn one. They either (GOP) grind their heels down and say “Duhhhh……no new taxes, Wilma!” or (Dem) “Let’s rip it all down and start over! It will be better! Trust us!”.
Fucking idiots, every damn one of them. The Dems would rather strike out that not hit a home run, and the GOP…..well, they think if they hide out in the dugout all these problems will go away.
And every damn one of them knows that just the CURRENT medicare/medicaid system runs out of money in 2035. BY LAW, all reimbursements out of the fund will then be cut 25% or so. And they do nothing about THAT, but they want to grandstand with “Medicare for All”.
I also believe that profit motive is an evil that corrupts almost everything it touches.
I don’t know if it’s “evil” or not. What I do know that is profit motive is the only known way to control costs. Without that, you have a government program which will be perpetually underfunded and begging for more of the taxpayer dollar.