[ZASHAGALKA]

Originally Posted by nicurn001

I came into nursing to care for PATIENTS ,not consumers.

So long as your patients aren't the consumers of their own care, they will never have the autonomy to be the directors of their care. YOUR patients have a more vested interest in their health outcomes than the gov't does for them. Or, and don't take it personally, they have a higher stake in the outcomes than even you do.

I trust THEM to direct their own care more than anybody else.

That being the case, the power belongs with the patient. The ONLY way to ensure that power is to give them control of the spending.

He who buys it, owns it. If the gov't buys your care; IT owns your care, not you.

I'd rather my patients own their own care. That is only possible if they ARE consumers.

To do less, to design a system that does less - that's uncompassionate.

To say you can design a system that does less and still claim that patients would have any power under such a scheme: that's dishonest.

I consider CARING for my patients to include empowering them. If that makes them consumers, more power to the people.

~faith,
Timothy.

[ZASHAGALKA]

Originally Posted by HM2Viking

Ezra Klein debunks the Radical Republican argument at:
The Republicans plans don't offer that. But Ramesh knows they need to seem like they do. So he writes, for instance, of Bush's plan will "make it possible, for example, for [people] to keep their policies when they switch jobs." Yes, Bush's plan makes it possible, but not likely. Conversely, the Democrats' plans actually allow you to keep your policy when you switch jobs.
http://ezraklein.typepad.com/blog/20...l-republi.html

Until they attach so many strings to that private insurance that it either bankrupts the companies or bankrupts you to afford it.

This is what is being done now.

Do you know WHY 47 million people don't have insurance? Because, if you don't have a job to enlist the gov't's/employer's bed to help pay for it, you can't afford it.

The gov't is ALREADY in the business of pricing you out of the market. God forbid you buy your insurance directly instead of being channeled into the employer driven business that denies you a choice and shields big insurance, inc. of the trouble of having to compete for your business. Neither gov't nor employers want you to have that kind of control. To avoid it, you are priced out of the market. This isn't an accident. The gov't is in bed with financing healthcare and they aren't in bed with you.

God forbid you exercise real choice in your life. No.

Uncle Daddy is a much better 'benevolent patrician' for your life, than you are. Just trust Uncle Daddy. He knows better than you what is good for you. You do know, this is going to be a much harder sell than simple polling platitudes. Don't you?

~faith,
Timothy.

[HM2Viking]

This is how the marketplace would be able to work under single payer:

The costs are known upfront. They have already been negotiated for best price by health economist professionals.

You (the patient) choose your provider.

Providers are independent.

Providers (Hospitals, and Doctors, NPS etc) have a known fee schedule that they operate within for every service. (No gouging like the Mayo system is doing in Mankato).

To attract patients they must offer superior care at a better price.

Spending more for poorer outcomes is not efficient by any stretch of the imagination.

It is just that simple. Patients want provider choice. This is the only system that forces providers to compete on a level playing field for patients.

[nicurn001]

ZASHAGALKA , I'm not taking anything personally , I realise that Patients are consumers , in the sense that they consume that which makes up their treatment ,but how are you ( not you personally )going to enable patients to see a price list of all healthcare products and services so they can compare the prices of their care .Only once the consumer / patient can identify and quantify the costs of their care can the system you prescribe function .

So I ask how can I be a good consumer when I can't compare cost either because I didn't plan my illness , or if it is an elective procedure where are the readily available price lists or comparison bots .

Trying to clarify why I want to care for PATIENTS is because they and us ( me and you) care about their clinical care , Whilst a CONSUMER is more concerned about Haute Cuisine meals , Drapes on the windows and gowns that don't let your B*** hang out the back ( this last thing showed to me Americans have a sense of humor , you must feel bad enough without having to wear those bloody gowns)

[ZASHAGALKA]

Originally Posted by HM2Viking

The costs are known upfront. They have already been negotiated for best price by health economist professionals.

I find the concept of gov't economist to be oxymoronic. Didn't YOU just dismiss stats I cited, in another thread, about income parity BECAUSE they were compiled by the Treasure Dept, in your opinion, corrupt because of the current Administration.

But.

I'm supposed to trust those same economists to be professional?

You can't have it both ways. Either the gov't is a bureaucracy, with everything that entails, including Administration partisanship. Or, it's isn't.

I think it is.

You want to trust gov't economists with MY healthcare? How very noble of you. My hero. Just please, point that gun of the police state somewhere else while you're trying to help me so much.

(If you want me to trust your 'professional' economist, I submit that they must have at least 20 yrs experience in the real world, actually earning money as an economist before they get to call themselves 'professional' just because they mooch off my tax dollars).

Gov't economists as our collective hero. What a role. I look forward to your party trying to sell that.

~faith,
Timothy.

[ZASHAGALKA]

Originally Posted by HM2Viking

You (the patient) choose your provider.

Providers are independent.

Providers (Hospitals, and Doctors, NPS etc) have a known fee schedule that they operate within for every service. (No gouging like the Mayo system is doing in Mankato).

To attract patients they must offer superior care at a better price.

Spending more for poorer outcomes is not efficient by any stretch of the imagination.

It is just that simple. Patients want provider choice. This is the only system that forces providers to compete on a level playing field for patients.

Providers are not independent of the gov't if they are DEPENDENT on the gov't for payment. Life isn't that Polly Anna. The buyer is the customer. The buyer is the consumer.

This is JUST THE PROBLEM with HMOs. The HMO (the buyer of services) is the customer, not the patient.

Health Insurance? Your employer (the buyor of services) is the customer, not the patient. (How responsive is your employer-based insurance to you? Oh, you can bet, they are EXTREMELY responsive to the needs and demands of their customers. That's just not you.)

Single payor restricted gov't care? The gov't (the buyer of services) is the customer, not the patient.

It is outright disingenuous to state that you are going to take the purchasing power away from the patient and yet, they get to keep all the rights that come with being the buyer. That is a lie. That is dishonest.

How well do gov't fee schedules work, now? This is the key. If the gov't wants to discourage a service, it reduces the fee below return on investment, and poof, the service dries up. If it wants to encourage a service, it makes it profitable and poof, the service explodes.

If dialysis becomes too expensive, cut the reimbursment and watch the number of new dialysis patients fall.

If you want to get more people to use brand x drug, raise the reimbursement of it.

It's just this simple: making the gov't single payor means that all the decisions YOU should be making about your best care is made by a team of 'professional economists' backed by an elected class that has tons of lobbyists just itching to change this reimbursement detail, or that.

Want a powerchair at no cost to you? All it takes is for the powerchair lobby to push it through that the gov't will supply you one.

Where are YOU in all of this? Why, you are an afterthought. YOU are just you. You aren't an actuarial table and you CERTAINLY aren't a lobbyist. You're a nobody. Dang you and your complaining. You should be THANKFUL the gov't is providing you such wonderful care. After all we do for you, you want a say, too? How ungrateful can you be.

Stupid American. We know what's better for you than you do. We've always known.

FREE MARKET healthcare? The patient (the buyer of the services) is the customer. Amen.

~faith,
Timothy.

[ZASHAGALKA]

Originally Posted by HM2Viking

To attract patients they must offer superior care at a better price.

Monopolies, even gov't run ones, are not known for quality or thrift.

The best mix of quality and price is very possible with healthcare. The same way such a combination always results: the free market.

Any other promise of quality at best cost is either a delusion or a deception.

~faith,
Timothy.

[ZASHAGALKA]

Originally Posted by nicurn001

ZASHAGALKA , I'm not taking anything personally , I realise that Patients are consumers , in the sense that they consume that which makes up their treatment ,but how are you ( not you personally )going to enable patients to see a price list of all healthcare products and services so they can compare the prices of their care .Only once the consumer / patient can identify and quantify the costs of their care can the system you prescribe function .

So I ask how can I be a good consumer when I can't compare cost either because I didn't plan my illness , or if it is an elective procedure where are the readily available price lists or comparison bots .

Trying to clarify why I want to care for PATIENTS is because they and us ( me and you) care about their clinical care , Whilst a CONSUMER is more concerned about Haute Cuisine meals , Drapes on the windows and gowns that don't let your B*** hang out the back ( this last thing showed to me Americans have a sense of humor , you must feel bad enough without having to wear those bloody gowns)

Name me ONE thing you buy in the open market that doesn't list its price, up front. Do you go to the counter with a gallon of milk just HOPING it won't be too expensive, today?

No.

You know the price of EVERYTHING YOU BUY.

Why don't you know the price of the healthcare you consume? Simply put, because you are not the buyer; it's not YOUR concern.

Restore the free market to healthcare, and just like everything else in the marketplace, competition will lead to price cutting and the low price leader will advertise. Come to hospital X for your ER care. OUR CT scanners are the cheapest in town!

You see, it is the FREE MARKET itself that creates the need for business to quantify and qualify their products. They simply MUST do so, in order to effectively COMPETE for your business.

You can't name me a single thing that you actually pay your money to buy that you don't know or can't know the cost, up front. The same would be true of healthcare. It is only not true now because, get this, YOU AREN'T THE CUSTOMER. Your employer and the gov't are big insurance, inc.'s customers.

You may not plan your illness, but without employer-plan restrictions on where you can seek care, you can make the biggest decision up front: where to go for service. (Catastrophic care is different. If you are in a car wreck, and can't direct where to be sent, that is covered by insurance). You can bet, in a free market environment, the hospitals would begin to advertise differently to you: Come to US - we ARE THE LOW COST LEADER IN QUALITY.

For routine care, the costs is only relevant to the buyer. If you want that price consciousness, then you have to make the system such that YOU are the buyer. Getting the gov't out of the business of making healthcare so danged expensive means you could be the direct buyer for less than what you are paying, now.

~faith,
Timothy

[HM2Viking]

Except the evidence on the world stage indicates that you are the one with the naive faith in the market. The evidence favors single payer. Saying the opposte doesn't make it so.

(BTW my criticism of the Treasury department was based on the ideological nature of the Bush Administration in regards to science.)

My comment was also based on a local example of anticompetitive behavior in a market system:

I can cite one local example of anticompetitive behaviors in a health care market that (if allowed to happen) would actually drive up costs.

Immanuel St Joseph's Hospital in Mankato MN is controlled by the Mayo Health System. There are 2 clinics attached to the hospital. ISJ is owned by Mayo, Mankato clinic is a clinic owned by local doctors. ISJ charges Mankato clinic more for surgical equipment sterilization than it charges ISJ clinic. (I have a friend who works in the department so I have the inside information.) Because of these and other price gouging behaviors Mankato Clinic has submitted a proposal to build a second hospital. What is the net result duplication of services such as additional CT machines which will lead to additional (and probably unnecessary) tests. This will drive health care expenditures up rather than down for the local area. These shenanigans can be prevented with a well designed single payer system. Mayo should not be able to favor its own clinic through these kinds of anticompetitive behaviors. If it charges x dollars for a service. It should charge the same price to competitors.

[ZASHAGALKA]

Originally Posted by HM2Viking

Except the evidence on the world stage indicates that you are the one with the naive faith in the market. The evidence favors single payer. Saying the opposte doesn't make it so.

The evidence on the world stage is that everywhere socialism has been thrown off for competitive markets, prosperity has risen, dramatically.

The world's prosperity is exploding, thanks to the free market.

I'm the one naive? Let me point out that 'access to a waiting list is NOT access to healthcare'. That is the ruling of the Supreme Court. Not the American Supreme Cabal. No. The Canadian one.

Single payor creates dramatically increased taxation, dramatically increased wait times, dramatically less service providers, dramatically less access to cutting edge treatments and dramatically less quality care.

ALL this, and, it's unsustainable, to boot. Ask the NHS in Britain how it plans to maintain sub-par care, for even the next decade. They have no idea.

Canada, France, Great Britain - all your wonderful models of single payor - ALL OF THEM are rushing to re-privatize as much of their systems as possible. It is the only solution available to ward off the impending disaster inherently built into these socialists system.

Australia was at least smart enough not to completely ditch their private system in the first place. (at least, if America can approximate THAT, then I will still be able to get quality care even if the average person won't be able to do so.)

Just like SS and Medicare, you can prop up a house of cards, for a little while. Don't call dumping this debt on our children compassionate. It is anything BUT compassionate.

See, this is what I HAVE FAITH IN: the American people will not vote to go down this road, The EVIDENCE is in - socialized medicine is a wait-list, sub-par failure to private healthcare.

The free market brings to bear the best mix of enlightened self-interest, for both the buyer and the seller.

Single payor is an utter failure. Taxation is ruining the economies of these nations. Waits are up, care is down. Trading opportunity for a fair share in a dismal outcome might be an improvement if you are measuring only "fairness". It's a disaster if you measure outcomes.

Single payor is socialism; just as with all other forms of socialism, it is destined for the ash heaps of history.

~faith,
Timothy.