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Started by ghYHZ, September 22, 2016, 06:33:54 AM

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ghYHZ

I'm not familiar  with healthcare in the US.....but thought I'd post my experiences here in Canada over the past couple of months.

Other than the occasional doctor & ER visits......I hadn't used Healthcare until vision problems and a MRI the end of July revealed a tumour (totally benign :) ) ....... that just had to go!

When I visited the specialist and neurosurgeon, had lab tests and MRIs,....then my surgery and hospital stay and now post op follow-ups....... they just swipe my Provincial Health Card. There are no bills arriving from doctors or hospitals, forms to complete for insurance, co-pays or deductibles.

A quick google search shows my surgery if in the US would be in the $100,000.00 range and this has to be paid  somehow..... whether it be through taxes, insurance or retirement savings. But here....I just go home, relax and recover with no worries of "how will I ever pay for this?" ......and another nice thing.....Joe Doe down the street, who's on welfare would receive the exact same care I did.

I also have supplemental healthcare through work. A premium of $12/week gets me 80% coverage of prescription drugs, private room, vision, dental, home care, physio etc plus out of country medical.




Max Rockatansky

But how's your wait for an appointment or finding a doctor in the first place?  I have a lot of Canadian family and they all complain about what I just described in addition to their taxes on health care.  I have a cousin who couldn't a new doctor in Quebec City until literally someone had a patient die, it was something like a 3 month wait she was on with several offices.

Rothman

It's not like wait times in the U.S. are all that great, either.  I've had places tell me they couldn't accept me as a new patient for six to eight weeks, just to see a general practitioner or internist.  I suppose once you get it, things go smoother.

But, you cancel with some types of specialists and you're looking at waiting another couple of months no matter what.

Please note: All comments here represent my own personal opinion and do not reflect the official position(s) of NYSDOT.

ghYHZ

Quote from: Max Rockatansky on September 22, 2016, 09:50:52 AM
But how's your wait for an appointment or finding a doctor in the first place?  I have a lot of Canadian family and they all complain about what I just described in addition to their taxes on health care.......

No problem getting an appointment. From the time the tumour was discovered the end of July, I had appointments scheduled  with the neurosurgeon within a week....then surgery the first of September. If it were life/death...surgery would have been scheduled faster.

I guess you have to equate what I pay in taxes verses what someone in the US has to pay for heir  Health Insurance coverage.

Rothman

Quote from: ghYHZ on September 22, 2016, 01:11:20 PM
I guess you have to equate what I pay in taxes verses what someone in the US has to pay for heir  Health Insurance coverage.

Therein lies the rub.  Not all Americans pay the same rate for their health coverage and all receive differing levels of coverage.  It's absurd, really.

For what it's worth, I pay about $385/mo for family coverage (four people, but family coverage is family coverage); copays usually run $20 a visit (seeing the doctor) and/or test (i.e., blood drawn at a lab).  Includes vision and dental (another fun note:  orthodontia is only covered for one set of braces.  Orthodontists around here are now prescribing two).

Please note: All comments here represent my own personal opinion and do not reflect the official position(s) of NYSDOT.

vdeane

I think wait times in the US are affected by how much one is willing to pay.  Of course, someone who currently pays a lot to minimize the wait would not like a system that forces everyone to go through the same queue absent medical necessity.

I would LOVE to have the Canadian system extend down here.  It's one of many reasons I wish I had been born on the other side of the border.

Quote from: Rothman on September 22, 2016, 01:46:27 PM
For what it's worth, I pay about $385/mo for family coverage (four people, but family coverage is family coverage); copays usually run $20 a visit (seeing the doctor) and/or test (i.e., blood drawn at a lab).  Includes vision and dental (another fun note:  orthodontia is only covered for one set of braces.  Orthodontists around here are now prescribing two).
And the vision only covers an eye exam every other year when most eye doctors want you to visit annually (and one is legally required to for contacts (which the plan will only pay for a six month supply)).

Regarding the dental, my boss goes to New Jersey for his implants because they're not covered, and paying out of pocket is expensive here.

About $108/month for an individual plan, at least until the next union contract... rumor is an across the board (premium, copays, etc.) 50% cost increase.

And all this is regarding a plan that is extremely good compared to many others in the US.  Most Americans have a multi-thousand dollar deductible before the plan will cover anything.
Please note: All comments here represent my own personal opinion and do not reflect the official position of NYSDOT or its affiliates.

briantroutman

I don't think there's any disagreement–from hard-right free market types who want a laissez-faire, cash-paying, wild west of healthcare on one side...to the most ardent leftists who demand 100% socialized medicine on the other side–that the American system is completely and utterly broken and dysfunctional. Of course the righties and lefties that I mentioned above will have entirely different conceptions of how to fix the situation.

In a sense, we already have socialized medicine in that no one in a medical emergency will ever be refused treatment. Sure, the hospital can bury you in debt, but if you're penniless, that debt is uncollectible anyway and will be eventually spread among other patients in the hospital though higher charges, across insurance policyholders through higher premiums, and to all taxpayers through government subsidies. The difference is that in the American "socialized"  system, we're reactive instead of proactive–paying higher tabs for medical crises exacerbated by a lack of preventative care–and we bear other increased costs through the inefficiency of attempting to collect uncollectible debts.

You'll see claims of absurdly high prices for medical procedures ($100,000 for an MRI), but this is useless and incorrect information. Almost no one pays these prices. My wife and I welcomed an infant daughter in January, and the total "cash price"  for the labor, delivery, and related treatments was in excess of $70,000. In reality the insurance company paid about 1/10 of that and we paid $1,200.

I've been told that the high prices are there for two reasons. One is that, if a wealthy foreigner has a heart attack in America, the hospital has "won the lottery"  and can collect the ridiculous full retail price. The other is that the insurance companies demand that they'll only pay a steeply discounted rate–so providers artificially inflate their prices so that they can offer fictitious 80% discounts.

But if you believe many economists, there's a heavy dose of doe-eyed naïveté about the Canadian system. The Canadian single payer health system, these economists argue, is able to negotiate lower prices on drugs, medical equipment, etc., and the big pharma establishment is willing to offer these prices only because they've already gorged themselves on obscene profits at the expense of the American consumer. And the argument continues that without gouging the Americans, there would be no deep discounts for the Canadians, the Brits, the Norwegians...and less incentive to create new drugs without the prospect of winning the "Rape American Consumers"  jackpot.

Scott5114

Going to let this one run as it seems to be going well so far, but let's try to keep this thread from getting political.
uncontrollable freak sardine salad chef

chays

Quote from: Rothman on September 22, 2016, 01:46:27 PM
Quote from: ghYHZ on September 22, 2016, 01:11:20 PM
I guess you have to equate what I pay in taxes verses what someone in the US has to pay for heir  Health Insurance coverage.

Therein lies the rub.  Not all Americans pay the same rate for their health coverage and all receive differing levels of coverage.  It's absurd, really.

For what it's worth, I pay about $385/mo for family coverage (four people, but family coverage is family coverage); copays usually run $20 a visit (seeing the doctor) and/or test (i.e., blood drawn at a lab).  Includes vision and dental (another fun note:  orthodontia is only covered for one set of braces.  Orthodontists around here are now prescribing two).

That seems like a great price.  Who are you with if you don't mind my asking?

vdeane

Quote from: chays on September 23, 2016, 03:37:56 PM
Quote from: Rothman on September 22, 2016, 01:46:27 PM
Quote from: ghYHZ on September 22, 2016, 01:11:20 PM
I guess you have to equate what I pay in taxes verses what someone in the US has to pay for heir  Health Insurance coverage.

Therein lies the rub.  Not all Americans pay the same rate for their health coverage and all receive differing levels of coverage.  It's absurd, really.

For what it's worth, I pay about $385/mo for family coverage (four people, but family coverage is family coverage); copays usually run $20 a visit (seeing the doctor) and/or test (i.e., blood drawn at a lab).  Includes vision and dental (another fun note:  orthodontia is only covered for one set of braces.  Orthodontists around here are now prescribing two).

That seems like a great price.  Who are you with if you don't mind my asking?
Assuming he uses Empire Plan instead of one of the HMOs, it's the employee share of NY's state government coverage, which is a conglomeration of multiple plans (one for emergency, one for mental health, etc.).
Please note: All comments here represent my own personal opinion and do not reflect the official position of NYSDOT or its affiliates.

CNGL-Leudimin

From what I know, the US health care system is just insane. I won't give up a mostly free (though taxpaid, and we still have to pay for drugs anyway) system like we have in Spain. Despite budget cuts, the professionals are working hard to keep this up. That is one of the reasons I won't never move to the US (but that didn't stop me to make up an April fool :sombrero:).

I once befriended a little child who unfortunately suffered from the ultra-rare Pearson syndrome, and as result he needed a blood transfusion every few weeks. This would have been costly in the US, but since we have the mostly free health care system he received the transfusion when needed, and his family could raise funds for investigation only. Otherwise he looked like any other toddler, and I made a brilliant move. That explains why I'm a bit reluctant to anything named Pearson, and why I have the I-41 shield as my avatar (41 is the number of the bus route that took me to meet him).
Supporter of the construction of several running gags, including I-366 with a speed limit of 85 mph (137 km/h) and the Hypotenuse.

Please note that I may mention "invalid" FM channels, i.e. ending in an even number or down to 87.5. These are valid in Europe.

J N Winkler

The high cost basis is one of the biggest problems with healthcare in the US and probably also one of the oldest and most stubborn.  Doctors in the US, for example, were more expensive than in the UK even back in the late 1940's when the NHS was being established.  Big Pharma adds another layer:  besides the gouging pharmaceutical companies engage in (profit margins of 30% supported by government-funded basic research into drugs), Medicare's no-negotiation policy effectively substitutes for a generous foreign-aid budget, with the added absurdity that it is typically wealthy nations (not poor ones) that can afford to have a broad selection of in-patent drugs in their formularies.

In regard to the OP, there was not even any scanning of insurance cards when I was a NHS patient in Britain.  On initial registration with the NHS you receive a printed paper card that indicates you are a NHS patient, but this does not have to be shown at a doctor's or dentist's office except when you first sign up as a patient with that practice.
"It is necessary to spend a hundred lire now to save a thousand lire later."--Piero Puricelli, explaining the need for a first-class road system to Benito Mussolini

slorydn1

My wife and I are both employed by our county, we don't pay a dime for our insurance, which sounds like a really great deal, right? Keep reading:

It does cost us $250/month to have our son added to my wife's insurance thanks to Obamacare. It was cheaper for us to just pay for his yearly check up out of pocket, which the insurance doesn't pay for because it doesn't meet the deductible, so now we have to pay out of pocket AND pay the $250.00 a month for, well, nothing!

Now, back to our insurance. We are on the hook for the first $400.00, then the insurance kicks in, but only at 80%, we have to pay the other 20%. Think about that for a moment. That is $400 for me, $400 for my wife, and $400 for my son before insurance only covers part of it.

Add to that the fact that I was diagnosed with Hodgkins disease in 1993, and ran up a $250,000 bill in just 1 year, with no insurance. I am still paying that off and will be for the rest of my life (I still owe close to $90,000). Needless to say my wife and I don't go to the doctor unless we absolutely have too. My son has to have a yearly physical because of his participation in JROTC (the same physical required of high school athletes in our state) so he goes every year. All told that only costs about $125 according to my wife, so no big deal.


Now for the "absolutely have to" part of it: My wife had to go the the ER by ambulance 3 times this year. She is extremely allergic to peanuts-she only has to enter a space where someone has consumed peanuts or their derivatives recently and it's 2 Epi-Pens and an ambulance ride to the hospital for her. Even with insurance we are approximately $2,500 in the hole for those 3 ER visits. We really could have used that $3,000 a year we are forced to pay for my son's useless insurance (he's 17 and healthy as an ox) to help pay for my wife's ER visits, but hey I don't want to stray into the political realm so I'll keep my trap shut when it comes to how I feel about Obamacare. Oh and did I mention it now, all of a sudden, costs $600.00 to replace an Epi-Pen? Luckily our insurance covers most of that (we have to pay the full amount up front but then are reimbursed all but $50 of that when we present the receipt to the county-kinda touch and go when the car payment is due right that week).
Please Note: All posts represent my personal opinions and do not represent those of any governmental agency, non-governmental agency, quasi-governmental agency or wanna be governmental agency

Counties: Counties Visited

Duke87

Quote from: briantroutman on September 22, 2016, 02:34:50 PM
But if you believe many economists, there's a heavy dose of doe-eyed naïveté about the Canadian system. The Canadian single payer health system, these economists argue, is able to negotiate lower prices on drugs, medical equipment, etc., and the big pharma establishment is willing to offer these prices only because they've already gorged themselves on obscene profits at the expense of the American consumer. And the argument continues that without gouging the Americans, there would be no deep discounts for the Canadians, the Brits, the Norwegians...and less incentive to create new drugs without the prospect of winning the "Rape American Consumers"  jackpot.

Correct me if I'm wrong but I am under the impression that most countries which have single payer healthcare have government price controls on medications and treatments - the regulators say "we're going to pay you this", and the providers can complain but ultimately their options are take what the regulators offer or walk away and don't sell their products in that country.

It therefore stands to reason that if the US were to implement similar price controls, providers would have to either suck it up and accept significantly lower profits (and their stock prices subsequently tumbling), find ways to cut costs internally, push their products harder in developing countries where there are no price controls, or some combination of the above. Of course, that's if the US implements such. The reality is that the US will never do that because the impacted companies would lobby insanely hard against it and get their way because the lobbyists are the ones actually running the show here.

All that said, part of the reason costs are so high in the US definitely has to do with there being no real history or culture of cost control in the system. Healthcare services are often vital such that consumers don't really have the option of saying "that's too expensive, I'm not paying for that". And for many services there really is not a significant amount of competition in the marketplace that might help keep prices down, especially since most consumers don't actually pay for things directly, their insurance does - and competition in the insurance marketplace is abysmal since most people get insurance through their employer and are stuck with using whichever insurance company their employer has a contract with unless they want to purchase insurance on their own, which is almost always more expensive because you on your own can't negotiate a group rate.

This lack of cost control manifests itself in many ways - hospitals often have have well paid board members and a large number of administrative staff members compared to hospitals in other countries, hospitals and drug companies have large advertising budgets because they can and do advertise directly to consumers, hospitals and drug companies will fund all sorts of boondoggles like sending staff to conferences all expenses paid or having fancy dinners for their high level staff, doctors make more money compared to other countries, etc. There is a lot of room to bring healthcare costs down in the US simply by running a leaner system, but there is little incentive for the folks who would have to make and accept the fat trimming to do so.

Also not insignificant is the fact that for providers, needing to deal with a whole multitude of insurance companies, all of whom will find excuses to try and not pay up and make you fight them for the money, creates a large amount of administrative overhead that would not exist if they only had one standard place to send all their bills to.


One other aspect of the American system which makes it different from healthcare elsewhere is that because patients (through their insurance) are the ones paying for things, doctors treat them like paying customers and are more or less willing to give them whatever they want. It is very normal in the US for people to walk into a doctor's office and demand a specific drug or treatment, which the doctor will then go ahead and write them a prescription for so long as the patient actually has some condition that warrants it and it won't actively harm them.

From what friends and relatives in other countries have told me, this is not how it works there. I know someone who used to do this sort of thing all the time in the US and then moved to Canada and got rebuffed by his doctor when he attempted it there. The doctor told him "no, I'm not going to write you a prescription for this drug right now just because you come in here asking for it, let's wait a couple weeks and see if this goes away on its own. If you're not feeling better after a couple weeks, come back and I'll prescribe you something then". You can't be a doctor in the US and attempt to assert authority over a patient like this, your patients will leave you for someone else that says yes when they ask for things. Your patients will also sue you for lots of money if god forbid something happens to them that the treatment you just denied them may have prevented. But when the doctors are in the mindset that they work for the government, not for their individual patients, they are much more emboldened to deny patients things they want but do not need.

The upshot to all this is that in the US, you can pretty much get as much care as your heart desires and while your insurance company may start refusing to pay for things, if you have the money to pay for things yourself, doctors won't cut you off and say "no, you don't need that". The downside is that Americans are generally overmedicated which is not cost effective and can cause other problems since drugs do after all have side effects.
If you always take the same road, you will never see anything new.

english si

#14
Quote from: Duke87 on September 24, 2016, 01:46:26 PMCorrect me if I'm wrong but I am under the impression that most countries which have single payer healthcare have government price controls on medications and treatments - the regulators say "we're going to pay you this", and the providers can complain but ultimately their options are take what the regulators offer or walk away and don't sell their products in that country.
I believe that, in the UK at least, it functions that the patients have a co-pay on prescriptions (a fixed cost for those who don't get exemptions who pay a lower fixed cost (eg those living in Wales pay £0), even if the drug is cheaper without prescription) and then the government tops up the difference.

The key difference between the US and many other countries is that the FDA is very strong at protecting intellectual property - they understand that, while the second pill costs $1 to produce, the first cost $1bn and clamp down on cheap knock-offs so that R&D can be funded.

Drugs are cheaper in, say, Canada as the government pays some of the price, and because the market is less monopolyous due to less robust patent law. In Sudan, say, it's as the market can be flooded with cheap product and/or the drug companies are deciding to not make a profit for charitable reasons.

Until the EU's Clinical Trial Directive, the UK, despite having the most socialist healthcare system outside Cuba and North Korea, was punching well above its weight in pharmaceutical research. The US's corporatist system isn't necessary to invent drugs or for drug companies to make money.
QuoteAll that said, part of the reason costs are so high in the US definitely has to do with there being no real history or culture of cost control in the system. Healthcare services are often vital such that consumers don't really have the option of saying "that's too expensive, I'm not paying for that".
So does the UK, with the 'Tory cuts' to the NHS being simply not increasing spending as fast as Gordon Brown promised before the 2010 election (though still above inflation) causing demonstrations about the "nasty party harming our ill people" because they aren't matching an election promise of someone who had spent 13 years massively increasing Government spending and debt and knew he was fighting an uphill battle to stay in Downing Street.

The US doesn't really have the complaint that they aren't spending enough on healthcare - in the UK, to express anything other than that will make it pretty much to obtain high office politically. And to say that we're spending too much (especially if you mention the free market or competition, even if only talking about supply-side contracts for things like catering or construction) is to risk not even being elected in a safe seat for your party.

J N Winkler

Quote from: Duke87 on September 24, 2016, 01:46:26 PMCorrect me if I'm wrong but I am under the impression that most countries which have single payer healthcare have government price controls on medications and treatments - the regulators say "we're going to pay you this", and the providers can complain but ultimately their options are take what the regulators offer or walk away and don't sell their products in that country.

It therefore stands to reason that if the US were to implement similar price controls, providers would have to either suck it up and accept significantly lower profits (and their stock prices subsequently tumbling), find ways to cut costs internally, push their products harder in developing countries where there are no price controls, or some combination of the above. Of course, that's if the US implements such.

The counterfactual of concern is that if the US implements a price-negotiation policy, prices go up overseas because profit has to be sought from overseas patients on socialized-medicine systems as well as patients from the mostly-private US system.

My main concern is that there is little public policy justification for Big Pharma to average 30% profit margins, especially when a considerable amount of their expenses come from marketing, such as direct-to-consumer advertising that is legal in no other country besides New Zealand, or a person-to-person sales infrastructure that reflects retrograde sexual norms (young attractive female drug reps visiting male doctors, samples in hand).

Quote from: Duke87 on September 24, 2016, 01:46:26 PMAll that said, part of the reason costs are so high in the US definitely has to do with there being no real history or culture of cost control in the system. Healthcare services are often vital such that consumers don't really have the option of saying "that's too expensive, I'm not paying for that". And for many services there really is not a significant amount of competition in the marketplace that might help keep prices down, especially since most consumers don't actually pay for things directly, their insurance does - and competition in the insurance marketplace is abysmal since most people get insurance through their employer and are stuck with using whichever insurance company their employer has a contract with unless they want to purchase insurance on their own, which is almost always more expensive because you on your own can't negotiate a group rate.

There is also a considerable lack of price transparency due to the medical billing industry, which evolved organically as a form of economic specialization that allowed doctors to focus solely on providing medical services rather than diverting their energies collecting the money they are owed.  It has now become part of the problem.

Quote from: Duke87 on September 24, 2016, 01:46:26 PMOne other aspect of the American system which makes it different from healthcare elsewhere is that because patients (through their insurance) are the ones paying for things, doctors treat them like paying customers and are more or less willing to give them whatever they want. It is very normal in the US for people to walk into a doctor's office and demand a specific drug or treatment, which the doctor will then go ahead and write them a prescription for so long as the patient actually has some condition that warrants it and it won't actively harm them.

From what friends and relatives in other countries have told me, this is not how it works there. I know someone who used to do this sort of thing all the time in the US and then moved to Canada and got rebuffed by his doctor when he attempted it there. The doctor told him "no, I'm not going to write you a prescription for this drug right now just because you come in here asking for it, let's wait a couple weeks and see if this goes away on its own. If you're not feeling better after a couple weeks, come back and I'll prescribe you something then". You can't be a doctor in the US and attempt to assert authority over a patient like this, your patients will leave you for someone else that says yes when they ask for things. Your patients will also sue you for lots of money if god forbid something happens to them that the treatment you just denied them may have prevented. But when the doctors are in the mindset that they work for the government, not for their individual patients, they are much more emboldened to deny patients things they want but do not need.

In Britain, as a NHS patient, I experienced several variations of parsimony not just in prescribing but also in providing services.  In some cases a conservative approach to prescribing can save the health care system money, but in others (such as when lab tests are ordered to confirm the necessity of a drug), they can actually increase costs.

*  I used to have upper back pain from long hours spent looking at a computer monitor.  I was referred to a physical therapist, who evaluated me and determined I did not need services, and suggested some exercises I could do on my own to relieve the discomfort.  These helped, and the problem eventually went away completely when I realized that, in spite of my efforts to position it correctly in the first instance, my monitor needed to be even higher.

*  For years I had problems with sinus infections following colds.  As a NHS patient I was given antibiotic prescriptions a few times, but after a few years I was advised that the condition would likely clear up on its own without antibiotics.  I was still given a prescription and told to fill it only if symptoms persisted after a few days.  I suspect I still have unfilled antibiotic prescriptions filed somewhere.  Eventually I started irrigating my sinuses with a neti pot.  While I still get colds and often still have drainage for a few days after cold symptoms go away, I have never had a sinus infection since.

*  In 2009, I decided to have toenail fungus eradicated once and for all.  Since I have had this before, with the same treatment each time, I requested terbinafine (Lamisil).  In the US the prescription would have been written right away, possibly accompanied by instructions for a liver function test a month later, but in Britain my NHS doctor wanted a test done to ensure that the fungus in my toes was the kind that terbinafine actually treats.  I told him I would play along though I was pretty certain the lab findings were a foregone conclusion.  Sure enough, I was prescribed terbinafine once the results came in.




The underlying truth is that, no matter what type of health care system your country has, it is primarily your responsibility to do the research, determine what it takes to maintain a healthy lifestyle, and then actually do it, if only because it is all but impossible to find someone else to whom that task can safely be entrusted.

The great unfairness of the US healthcare system is that if you are unlucky--e.g., through having a chronic disease like Crohn's disease (which my mother had for 35 years, and was probably the major contributor to her eventual death from metastatic colon cancer 40 years after the initial Crohn's diagnosis)--then your life chances and indeed the whole trajectory of your life are bent far more in the US than they would be in another affluent country with medical services that are essentially free at the point of use.  No other rich country even comes close to the US in its rate of bankruptcies due to medical bills.
"It is necessary to spend a hundred lire now to save a thousand lire later."--Piero Puricelli, explaining the need for a first-class road system to Benito Mussolini

bandit957

Quote from: ghYHZ on September 22, 2016, 06:33:54 AM
I'm not familiar  with healthcare in the US

Then you're very lucky.
Might as well face it, pooing is cool

bandit957

Quote from: Rothman on September 22, 2016, 01:46:27 PM
For what it's worth, I pay about $385/mo for family coverage (four people, but family coverage is family coverage); copays usually run $20 a visit (seeing the doctor) and/or test (i.e., blood drawn at a lab).  Includes vision and dental (another fun note:  orthodontia is only covered for one set of braces.  Orthodontists around here are now prescribing two).

Maybe that's part of the problem. Why would an orthodontist prescribe braces TWICE unless there's some underlying condition? I wonder if they're just trying to make money off people. I am 99% certain I've never been to one in my entire life, so I'm not sure why it's different now, unless it's to make money.

And why would insurance even cover it? Basically, it's cosmetic, unless there's some underlying condition.
Might as well face it, pooing is cool

bandit957

In addition, I can name one field of medicine that I know firsthand is a complete scam: psychiatry.

I could rant for days on end about this scam. But my experience was always that junk insurance covered psychiatry, but not stuff that was necessary.
Might as well face it, pooing is cool

Max Rockatansky

Quote from: bandit957 on September 24, 2016, 09:59:51 PM
In addition, I can name one field of medicine that I know firsthand is a complete scam: psychiatry.

I could rant for days on end about this scam. But my experience was always that junk insurance covered psychiatry, but not stuff that was necessary.

Not saying I hold an opinion...or care in that regard for that matter but that sounded an awful lot like this:



One step towards zapping Oprah with Force Lightning:


briantroutman

Quote from: Duke87 on September 24, 2016, 01:46:26 PM
..the regulators say "we're going to pay you this", and the providers can complain but ultimately their options are take what the regulators offer or walk away and don't sell their products in that country.

It therefore stands to reason that if the US were to implement similar price controls, providers would have to either suck it up and accept significantly lower profits (and their stock prices subsequently tumbling), find ways to cut costs internally, push their products harder in developing countries where there are no price controls, or some combination of the above.

Again, I'm not saying that I necessarily believe this, but...

Those economists that I referenced would suggest another outcome to add to the ones you listed: Companies and medical professionals subject to price controls would de-invest–put their capital, their time, their educations elsewhere. In other words, get out of the medical business. And as a result, the logic continues, innovation in medical treatment would stagnate.

I'm not sure that I believe that entirely; I think some people are intrinsically motivated to find a cure for cancer or help the blind see again–regardless of whether or not they'll make a killing financially. But the economists would likely say that in the cold, dispassionate world of publicly held corporations, a cap on profits from medical treatments for human consumption would drive the pharma companies to shift their R&D dollars toward veterinary drugs or agricultural biotech, markets that aren't regulated.



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