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Posted by Kris Krieger on November 27, 2007, 4:30 pm
>
>>
>>
>>> Health-care.
>>> Here's my 2 takes on it.
>>> 1) People should *pay* for what they want. Period.
>>> No insurance,
>>
>> This is nonsense because you need to pool risk and you cannot do this
>> on a personal level.
>
> What risk?
> And why does it need to be pooled?
More to the point, when I used to pay my doctors directly, they didn't
overcharge - they cwertainly didn't starve <LOL!>, but they couldn't get
away with overcharging, because then, people would just go to a differnt
doctor.
The whole HOMo nonsense caused a price inflation.
ALso, there is a difference between having helath insurance, and being
forced to go through this halfasses HMO crap system that they invented
during, what was it, the Nixon years? Doctors are manipulated into over-
charging by the HMO system. Now, it's called "health insurance", but
what it actually is, is a series of gigantic HMOs.
We used to pay the physician directly, and the insurance was there for
"the big stuff". As above, it helped keep costs down. Now, everyone is
forced into this bureaucratic nightmare - rather than paying th
ephysician, we have to pay the bureaucracy, which then pays the
physician, so the doc almost *has* to overcharge just to get what s/he
*should* get. It's lunacy.
>
> Further, with the AMA limiting doctors and choices to what
>> they want to provide, the individual has no choice at all, even to
>> purchase
>> drugs at will.
>
> My recent understanding, from an insider, is that doctors are limited
> in their practices by the cost of malpractice insurance, and thats why
> you now see groups of doctors associated.
Yup. As far as I know, the AMA has nothing to do with it, unless what
he's going on about is specialist training - and that's just common
sense; you don't want a family practice doc, or an orthopedist, doing
brain surgery - you want someone who has trained, and continues to train,
in the methodologies of brain surgery.
> For example, if a doctor wants to specialize in 4 seperate things he
> must pay $250k per year for malpractice insurance for each specialty
> (x 4 specialties = $1mil per year) and its very hard for one doctor
> to justify that cost. So he associates himself 3 other doctors that
> specialize in 3 of those things and they occupy the same building.
> Spreading the costs.
Well, it's also dang hard to cope with more than one or maybe two
specialties - there isjust so much knowledge... But malpractice
insurance *is8 a killer. What it is, is that the good physicians are
forced to pay for the few bad apples, plus those people who do consider
lawsuits a form of retirement plan, and *everyone* suffers because of it.
> Further, the current system simply gives those with their
>> limited access the ability to charge three times what they do in
>> Europe....wages are out of sight.
>
> I think you're mistaken.
> What the doctors *charge* is not the same as what they *earn*.
Exactly. THe determiner is the HNMO/"Insurance" groups. THey decide
what is considered a "fair and customary" price, I think that's the term.
But ifthe Doc charges you that price, they don't get it all from the HMO
- they get a percentage. So they charge more, so that they get the fiar
price doled out to them by the HMO.
ALso, salary is one thing, the cost of doing business is another. In
some places, obstetritians have become an extict species because they
have to pay out *more* (in insurance, and business costs) than they earn.
>
> You simply are pushing for sky-high
>> costs, limited availability and bad results, all of which we now have
>> in the
>> USA.
>
> OK then, why are the costs sky high, availability limited and the
> results bad?
The worst is socialized medicine. I lived in Canada for 10 years, and
between the waiting times to see specialists, the fact that you couldn't
get any testing that wasn't approved (meaning, common and average, IOW,
if you had an unusual condition, you were prob out of luck), and so on -
well, if there is one thing that makes me shudder, it's the talk of
socializing the US system. I'd prefer to see vouchers given to low-
income folks...
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