My Obamacare Taxes

[barfo]

http://www.cato.org/publications/policy-analysis/health-care-regulation-$169-billion-hidden-tax

barfo, you're making it too easy on me.

Since you can bribe a govt. official, they'll look the other way when you bill them $600 for a hammer or $1800 for a toilet seat.

Denny, Denny. That article says the net cost of healthcare regulation is $169 billion. Even if we were to accept that as fact (which it probably isn't since it was written by Cato), that's less than 10% of the cost of healthcare overall. So at best you've contradicted your own point - government isn't the biggest (much less the sole) reason for the increase in the cost of healthcare.

barfo

 

[Denny Crane]

Denny, Denny. That article says the net cost of healthcare regulation is $169 billion. Even if we were to accept that as fact (which it probably isn't since it was written by Cato and likely understated), that's less than 10% of the cost of healthcare overall. So at best you've contradicted your own point - government isn't the biggest (much less the sole) reason for the increase in the cost of healthcare.

barfo

FIFY.

And the "total cost" of health care doesn't really mean that much. If govt. didn't pay for any of it, the "total cost" would be significantly (1/3 less, $523B in medicare spending alone in 2010).

It's economics 101 that (http://en.wikipedia.org/wiki/Supply_and_demand):

1. If demand increases and supply remains unchanged, then it leads to higher equilibrium price and higher quantity.
2. If demand decreases and supply remains unchanged, then it leads to lower equilibrium price and lower quantity.

Government for medicare and medicaid alone are creating a lot of increased demand, eh?

So they're interfering in the market and it's screwed things up royally.

 

[Denny Crane]

An interesting read on WebMD.

http://blogs.webmd.com/all-ears/2012/04/why-is-medical-care-so-expensive.html

I grew up in the 1950’s. Even adjusted for inflation and the fact that I was in a rural Appalachian town, our office visits were $3. A house call was $5, and that included any medications (usually a painful penicillin shot). That was sixty years ago, when a house cost about $14,000, a car cost $1500, and gasoline was a whopping 18-25 cents per gallon (including complimentary windshield washing, and checking oil/tire pressures). My family, like many families that I care for in my practice, did not have health insurance. Of course, at those bargain prices, they just paid for it.

There were few, if any, health insurance companies in the 1950’s, but they were starting. The federal government had a commitment to care for the poor and elderly through welfare. Hospital prices doubled. By the 1960’s, there were 700 private insurance companies, and President Johnson signed the Medicare and Medicaid bills. Prices continued to climb. In 1969, I had my appendix removed. I suspect Medicaid paid for it, since our family income was around $5,000 a year at that time.

America was in a health crisis, of sorts, but nothing like what was to come. The largest problem was doctor shortages, especially in primary care. Now that insurance companies were paying the bills, doctors migrated into the more lucrative specialty areas. Over 69% of the doctors at that time were specialists, so the federal government and private institutions funded grants and scholarships to train more general practitioners (renamed, family practice physician), and of course, PAs and nurse practitioners. I received one of the healthcare shortage grants from the Commonwealth Fund.

 

[barfo]

FIFY.

And the "total cost" of health care doesn't really mean that much. If govt. didn't pay for any of it, the "total cost" would be significantly (1/3 less, $523B in medicare spending alone in 2010).

It's economics 101 that (http://en.wikipedia.org/wiki/Supply_and_demand):

1. If demand increases and supply remains unchanged, then it leads to higher equilibrium price and higher quantity.
2. If demand decreases and supply remains unchanged, then it leads to lower equilibrium price and lower quantity.

Government for medicare and medicaid alone are creating a lot of increased demand, eh?

So they're interfering in the market and it's screwed things up royally.

That's right. If all those old people, sick children, disabled, and poor people would just die at the rate nature intended, instead of being kept alive by the government, you and I could get the cheap healthcare we so richly deserve. It's a travesty, it is.

barfo

 

[Denny Crane]

That's right. If all those old people, sick children, disabled, and poor people would just die at the rate nature intended, instead of being kept alive by the government, you and I could get the cheap healthcare we so richly deserve. It's a travesty, it is.

barfo

S T R A W M A N

In any case, a good read from the Association of American Physicians and Surgeons:

http://www.aapsonline.org/index.php/article/medicare_myths_and_facts/

Myth #2: Medicare pays the reasonable cost of medical services.

Government price controls have, in some cases, slashed Medicare fees to 10 cents on the dollar compared with the Medicare “allowed charge” 10 years ago. This has forced those who provide these services not only to work without payment, but actually to subsidize the cost. The harder they work, the more money they lose.

Myth #3: Without Medicare, most seniors wouldn’t have medical care.

The government used carefully doctored statistics to mislead the public into believing that nearly half of the senior population did not have medical insurance coverage prior to the passage of Medicare.

These statistics, taken from a 1964 Department of Health, Education and Welfare report, didn’t count an enormous number of people who were covered by a variety of programs including: indemnity policies that paid cash benefits, existing government programs such as the Veterans Administration, and welfare. It also didn’t count those who could afford to pay their own way-i.e. lack of “insurance coverage” is not the same as lack of access to medical care.

The fact was that 77% of seniors were eligible for the Kerr-Mills program (Medical Assistance for the Aged), which had been passed into law a full five years before Medicare. The remaining 23%-if they couldn’t afford to pay for their own care-could receive free care at their local hospital. Under the Hill-Burton Act, hospitals agreed to provide free care to anyone who needed it in return for government grants and loans.

Thus, all seniors-and everybody else-had access to medical care whether they could afford it or not. Physicians also were able to provide a substantial amount of charity care to patients who needed it, unlike today, when the physician risks accusations of fraud with accompanying prison time and ruinous fines for failing to charge a Medicare patient what the government deems the patient should pay. Charging a Medicare patient $0.0 can get a physician into a world of trouble today because of government regulations.


Myth #4: Seniors were in poorer health before Medicare.

Not so, at least not according to the seniors themselves. In a 1960 survey conducted by Emory University (i.e. 5 years before Medicare was passed into law), 10% of seniors reported that they were in poor health. Today, after 36 years of compulsory, one-size-fits-all medical care under Medicare, 26.7% of seniors report that they are in poor health.

 

[barfo]

S T R A W M A N

Not at all. You are advocating for withdrawing government from 'creating demand' for healthcare. Demand being reduced means less healthcare is provided. Less healthcare being provided by 1/3 (your number) certainly means more deaths.

Edit: now that I look at it, I see that below you claim the government only pays 10 cents on the dollar for Medicare, yet in a previous post you say Medicare amounts to 1/3rd of all healthcare spending. That must mean that Medicare actually amounts to an astounding 5/6ths of all healthcare being provided. We are almost all the way to single-payer already! Either that or the numbers you are giving me are bogus. Hmm.

Myth #2: Medicare pays the reasonable cost of medical services.

Government price controls have, in some cases, slashed Medicare fees to 10 cents on the dollar compared with the Medicare “allowed charge” 10 years ago. This has forced those who provide these services not only to work without payment, but actually to subsidize the cost. The harder they work, the more money they lose.

Yes, I was just at Burgerville and the guy behind the counter was an MD, but he said "the money is better here". It's a crying shame how many doctors are living below the poverty line today.

Myth #3: Without Medicare, most seniors wouldn’t have medical care.

The government used carefully doctored statistics to mislead the public into believing that nearly half of the senior population did not have medical insurance coverage prior to the passage of Medicare.

These statistics, taken from a 1964 Department of Health, Education and Welfare report, didn’t count an enormous number of people who were covered by a variety of programs including: indemnity policies that paid cash benefits, existing government programs such as the Veterans Administration, and welfare. It also didn’t count those who could afford to pay their own way-i.e. lack of “insurance coverage” is not the same as lack of access to medical care.

The fact was that 77% of seniors were eligible for the Kerr-Mills program (Medical Assistance for the Aged), which had been passed into law a full five years before Medicare. The remaining 23%-if they couldn’t afford to pay for their own care-could receive free care at their local hospital. Under the Hill-Burton Act, hospitals agreed to provide free care to anyone who needed it in return for government grants and loans.

Thus, all seniors-and everybody else-had access to medical care whether they could afford it or not. Physicians also were able to provide a substantial amount of charity care to patients who needed it, unlike today, when the physician risks accusations of fraud with accompanying prison time and ruinous fines for failing to charge a Medicare patient what the government deems the patient should pay. Charging a Medicare patient $0.0 can get a physician into a world of trouble today because of government regulations.

So to sum up, before Medicare there was government-paid coverage that all seniors could access, up until that was replaced by Medicare, which is government-paid coverage that all seniors can access. Yes, that sure tells us that Medicare was an outrageous expansion of government powers, all right.

Myth #4: Seniors were in poorer health before Medicare.

Not so, at least not according to the seniors themselves. In a 1960 survey conducted by Emory University (i.e. 5 years before Medicare was passed into law), 10% of seniors reported that they were in poor health. Today, after 36 years of compulsory, one-size-fits-all medical care under Medicare, 26.7% of seniors report that they are in poor health.

That's hardly very convincing. Did the seniors of 1960 define poor health in the same way that the seniors of 1996 did?

barfo

 

[BrianFromWA]

Mmm...I miss Burgerville.

 

[BLAZER PROPHET]

Mmm...I miss Burgerville.

Worst burger joint I have ever been to.

Killer Burger is the best.

 

[BrianFromWA]

The last time I went I was 16. I thought it was fantastic. I would take a Burgerville burger and shake over Mickey D's anytime. Maybe that's changed.

And I've never heard of Killer Burger.

 

[MARIS61]

Which is what ACA is neither affordable, nor addresses care, or makes anyone in the business act differently.

I agree it will need to be completely socialized to improve on the first and latter points, there's simply no other system that can reign in the greed.

But ACA makes sweeping improvements in care provided and in helping the poor and the lower middle class actually being able to have healthcare at all. I'm older than you and I remember when pretty much everyone could afford healthcare. It wasn't a big deal.

 

[MARIS61]

The govt. book of regulations has gone from 800,000 pages to millions of pages. You can't regulate a market and expect it to act like a rational market.

http://www.byjustinfox.com/the-myth-of-the-rational-market.html

 

[BLAZER PROPHET]

And I've never heard of Killer Burger.

Crawl out of your cave sometime. The world has changed in the last ten years. The government is taxing us into bankruptcy, health insurance companies are being eliminated, and our total unemployment rate is going to settle in at about 15% permanently.

But we still have Killer Burger!

 

[3RA1N1AC]

anyone in here work for an insurance company?

 

[BLAZER PROPHET]

anyone in here work for an insurance company?

I do.

 

[PapaG]

anyone in here work for an insurance company?

My wife is a part of the national team for the HMO "model" for ObamaCare, and her CEO was a key adviser in structuring parts of the law. Everybody in their organization hates it, and they've had to raise rates already, because of the hidden gems in it that nobody knew about until it was passed. Even the CEO says it isn't what they were told it would be.

 

[Denny Crane]

Not at all. You are advocating for withdrawing government from 'creating demand' for healthcare. Demand being reduced means less healthcare is provided. Less healthcare being provided by 1/3 (your number) certainly means more deaths.

Edit: now that I look at it, I see that below you claim the government only pays 10 cents on the dollar for Medicare, yet in a previous post you say Medicare amounts to 1/3rd of all healthcare spending. That must mean that Medicare actually amounts to an astounding 5/6ths of all healthcare being provided. We are almost all the way to single-payer already! Either that or the numbers you are giving me are bogus. Hmm.



Yes, I was just at Burgerville and the guy behind the counter was an MD, but he said "the money is better here". It's a crying shame how many doctors are living below the poverty line today.



So to sum up, before Medicare there was government-paid coverage that all seniors could access, up until that was replaced by Medicare, which is government-paid coverage that all seniors can access. Yes, that sure tells us that Medicare was an outrageous expansion of government powers, all right.




That's hardly very convincing. Did the seniors of 1960 define poor health in the same way that the seniors of 1996 did?

barfo

Just wow. I've never seen so much drivel on your part, apart from the rest of your drivel.

There's no link, whatsoever, between increased government spending on health care and the outcome (other than the skyrocketing prices). People live longer today than in 1960, but less people smoke cigarettes. And in spite of our massive spending (per person) on health care, we're not the healthiest of nations in the world.

You're the one infatuated with % of overall spending (like the cost of regulations). Medicare is $500B, or 1/3 of all health care spending in the USA, no matter how you slice it.

Have any more drivel to offer?

 

[barfo]

Just wow. I've never seen so much drivel on your part, apart from the rest of your drivel.

I accept your less-than-gracious surrender.

There's no link, whatsoever, between increased government spending on health care and the outcome (other than the skyrocketing prices).

So, if you have no money to pay for (some lifesaving treatment) and you die, that's not a different outcome than if the government pays for that lifesaving treatment and you live?

Ok...

People live longer today than in 1960, but less people smoke cigarettes. And in spite of our massive spending (per person) on health care, we're not the healthiest of nations in the world.

Agreed on both of those statements, but are you trying to make some point, or just mentioning those things because they sound somewhat related to the topic?

You're the one infatuated with % of overall spending (like the cost of regulations).

Yes, that must be why I claimed that the cost of birthing went up due to government. Oh wait, that was you.

Medicare is $500B, or 1/3 of all health care spending in the USA, no matter how you slice it.

Then I guess your 10 cents on the dollar figure was, how do you say, "drivel"?

barfo

 

[barfo]

In related news:

In 1790, the very first Congress—which incidentally included 20 framers—passed a law that included a mandate: namely, a requirement that ship owners buy medical insurance for their seamen. This law was then signed by another framer: President George Washington. That’s right, the father of our country had no difficulty imposing a health insurance mandate.

That’s not all. In 1792, a Congress with 17 framers passed another statute that required all able-bodied men to buy firearms. Yes, we used to have not only a right to bear arms, but a federal duty to buy them. Four framers voted against this bill, but the others did not, and it was also signed by Washington. Some tried to repeal this gun purchase mandate on the grounds it was too onerous, but only one framer voted to repeal it.

Six years later, in 1798, Congress addressed the problem that the employer mandate to buy medical insurance for seamen covered drugs and physician services but not hospital stays. And you know what this Congress, with five framers serving in it, did? It enacted a federal law requiring the seamen to buy hospital insurance for themselves. That’s right, Congress enacted an individual mandate requiring the purchase of health insurance. And this act was signed by another founder, President John Adams.

barfo

 

[MARIS61]

FIFY.

And the "total cost" of health care doesn't really mean that much. If govt. didn't pay for any of it, the "total cost" would be significantly (1/3 less, $523B in medicare spending alone in 2010).

It's economics 101 that (http://en.wikipedia.org/wiki/Supply_and_demand):

1. If demand increases and supply remains unchanged, then it leads to higher equilibrium price and higher quantity.
2. If demand decreases and supply remains unchanged, then it leads to lower equilibrium price and lower quantity.

Government for medicare and medicaid alone are creating a lot of increased demand, eh?

So they're interfering in the market and it's screwed things up royally.

This is only true if your definition of "demand" for healthcare is "sick or injured wealthy people" rather than "all sick or injured people".

In the real world which I realize you don't visit very often, the demand for healthcare is fairly constant, but the "suppliers" have acted as a monopoly and manipulated the prices for obscene profits. Meanwhile, Real Americans are dying for lack of healthcare.

HAPPY INDEPENDENCE DAY!

 

[Denny Crane]

Then I guess your 10 cents on the dollar figure was, how do you say, "drivel"?

barfo

LOL

I told you that "liberals" don't get economics and then you go on to prove it with your post.

S T R A W M A N

Not at all. You are advocating for withdrawing government from 'creating demand' for healthcare. Demand being reduced means less healthcare is provided. Less healthcare being provided by 1/3 (your number) certainly means more deaths.

Edit: now that I look at it, I see that below you claim the government only pays 10 cents on the dollar for Medicare, yet in a previous post you say Medicare amounts to 1/3rd of all healthcare spending. That must mean that Medicare actually amounts to an astounding 5/6ths of all healthcare being provided. We are almost all the way to single-payer already! Either that or the numbers you are giving me are bogus. Hmm.

Myth #2: Medicare pays the reasonable cost of medical services.

Government price controls have, in some cases, slashed Medicare fees to 10 cents on the dollar compared with the Medicare “allowed charge” 10 years ago. This has forced those who provide these services not only to work without payment, but actually to subsidize the cost. The harder they work, the more money they lose.

See the words price controls in the paragraph above? What, exactly, do you think that cutting Medicare fees (you know, amounts paid to people providing health care) have to do with Medicare spending somehow being 5/6ths of all health care spending?

LOL

If it's such a good thing, how about your company pay you ten cents on the dollar for your paycheck?

LOL indeed.

 

[BLAZER PROPHET]

Careful Denny, it'll go from lies to barfoisms pretty soon.

 

[barfo]

LOL

I told you that "liberals" don't get economics and then you go on to prove it with your post.

You say that, but you don't even seem to be able to post coherently today, much less understand economics.

See the words price controls in the paragraph above?

Yes.

What, exactly, do you think that cutting Medicare fees (you know, amounts paid to people providing health care) have to do with Medicare spending somehow being 5/6ths of all health care spending?

Huh? You are mangling the language and the argument. I said that IF it were true that medicare providers were paid 10 cents on the dollar, and IF it were true that medicare payments were 1/3rd of the total healthcare spending, THEN it would be the case that medicare was 5/6th of all healthcare provided. I didn't suggest that Medicare spending was 5/6ths of all health care spending.

If it's such a good thing, how about your company pay you ten cents on the dollar for your paycheck?

LOL indeed.

Who said it was a good thing? I was saying your claim of 10 cents on the dollar was bullshit.

barfo

 

[Denny Crane]

You say that, but you don't even seem to be able to post coherently today, much less understand economics.





Yes.



Huh? You are mangling the language and the argument. I said that IF it were true that medicare providers were paid 10 cents on the dollar, and IF it were true that medicare payments were 1/3rd of the total healthcare spending, THEN it would be the case that medicare was 5/6th of all healthcare provided. I didn't suggest that Medicare spending was 5/6ths of all health care spending.





Who said it was a good thing? I was saying your claim of 10 cents on the dollar was bullshit.

barfo

I can only LOL at your logic lately.

Seriously.

If you got paid $.10 on the $1 at your job, you'd demand a 10x wage increase to at least take home the same pay.

Similarly, the doctors and hospitals are charging 10x to get their fair pay. And they're charging EVERYONE that 10x so it doesn't look like they're gauging just the government.

No matter how you slice it, medicare is 1/3 the demand for the doctors' services.

Oddly, most of the hospitals are non-profit, yet they charge $800 for a central line kit that costs $20. You'll figure it out one day.

 

[barfo]

Government price controls have, in some cases, slashed Medicare fees to 10 cents on the dollar compared with the Medicare “allowed charge” 10 years ago. This has forced those who provide these services not only to work without payment, but actually to subsidize the cost. The harder they work, the more money they lose.

If you got paid $.10 on the $1 at your job, you'd demand a 10x wage increase to at least take home the same pay.

Similarly, the doctors and hospitals are charging 10x to get their fair pay. And they're charging EVERYONE that 10x so it doesn't look like they're gauging just the government.

So which is it Denny? Are doctors losing money because medicare only pays 10 cents on the dollar, or are they charging everyone 10x? You are all over the map here. "The harder they work, the more money they lose" is not consistent with "the doctors and hospitals are charging 10x to get their fair pay. And they're charging EVERYONE that 10x".

barfo

 

[Denny Crane]

So which is it Denny? Are doctors losing money because medicare only pays 10 cents on the dollar, or are they charging everyone 10x? You are all over the map here. "The harder they work, the more money they lose" is not consistent with "the doctors and hospitals are charging 10x to get their fair pay. And they're charging EVERYONE that 10x".

barfo

They're charging 10x. The government is asking them to take $.10 on the dollar, expecting them to work harder and lose more money.

It's because the market is distorted by govt. intervention.

Like I said, you'll figure it out sooner or later.

 

[barfo]

They're charging 10x. The government is asking them to take $.10 on the dollar, expecting them to work harder and lose more money.

It's because the market is distorted by govt. intervention.

Is it? Or is it because they are greedy bastards who are charging the most they can get away with? Just like they would in your fantasy of a completely unfettered market?

If we did away with Medicare (which I guess is what you are arguing for - you certainly can't be arguing that the taxpayers should pay more for the current level of Medicare, can you?) then what is your plan?

barfo

 

[Denny Crane]

Is it? Or is it because they are greedy bastards who are charging the most they can get away with? Just like they would in your fantasy of a completely unfettered market?

If we did away with Medicare (which I guess is what you are arguing for - you certainly can't be arguing that the taxpayers should pay more for the current level of Medicare, can you?) then what is your plan?

barfo

Hospitals are, for the most part, non-profit. Without that profit motive, it's hard to see how you can call them greedy bastards. But they do have to employ an army of attorneys and people to fill out the bureaucratic paperwork to get paid.

What I think is best for health care and all markets is that they're free markets. One of the biggest issues with health care costs now is that the consumer isn't the one paying for the products and services. If the consumer did pay, he'd shop for lower prices and competition for the consumer dollars would drive prices down. Like has already been pointed out, health care basically cost $5 before govt. got involved; there were no big insurance companies involved, etc. People would get their care for free (doctors did 33% of their work pro-bono) if they couldn't afford it, or traded livestock (chickens, pigs, etc.) with doctors for the care. It worked just fine.

Insurance for automobiles or homes or anything else doesn't cover tune ups, oil changes, and that sort of thing. It's absurd that health care insurance covers those same sorts of things (maintenance). Maintenance and the vast majority of what people go to the doctors for is still rather cheap in the current environment.

A clinic near my house charges cash customers $100 for the first office visit and $70 for other visits for the calendar year. About the price of a tank of gas. The urgent care clinic a few blocks away might be even cheaper. As a cash paying customer, I'd choose the cheaper of the two (the care is comparable), or other factors might drive me to choose the other (I like the doctor better). But with my insurance, I pay $35 or whatever, either place I go, so there is no competition driving the overall prices down. Instead of paying $35 for a flu shot where my health insurance is good, I could easily go to Walmart and get a cheap one there.

Insurance is exactly meant to be there for the situations everyone hates about the current system. A $10,000 deductible policy costs $50/month, and you're a LOT less likely to go bankrupt if you need brain surgery, cancer treatment, heart surgery, or other really expensive procedures. Insurance is supposed to cover CATASTROPHES, not pay your ordinary bills.

You can see the lack of competition and the decline of quality of service in education, too. I'm not sure you've figured that one out yet, either.

 

[barfo]

Hospitals are, for the most part, non-profit. Without that profit motive, it's hard to see how you can call them greedy bastards. But they do have to employ an army of attorneys and people to fill out the bureaucratic paperwork to get paid.

Greed doesn't necessarily have to be about profits. Greed can be about expansion and domination. Or nice offices for the administration.

What I think is best for health care and all markets is that they're free markets. One of the biggest issues with health care costs now is that the consumer isn't the one paying for the products and services. If the consumer did pay, he'd shop for lower prices and competition for the consumer dollars would drive prices down. Like has already been pointed out, health care basically cost $5 before govt. got involved; there were no big insurance companies involved, etc. People would get their care for free (doctors did 33% of their work pro-bono) if they couldn't afford it, or traded livestock (chickens, pigs, etc.) with doctors for the care. It worked just fine.

Yes, unfortunately, today's doctor lives in the city and doesn't have anywhere to put a pig, so he wants to be paid in cash.
Government didn't cause medical insurance companies to exist. That's baloney.
The point about the consumer not having a motivation to seek efficient care is a good one. However your solution to that is an awful one. The 19th century might look real nice to you but the rest of us don't want to go back there.

Insurance for automobiles or homes or anything else doesn't cover tune ups, oil changes, and that sort of thing. It's absurd that health care insurance covers those same sorts of things (maintenance). Maintenance and the vast majority of what people go to the doctors for is still rather cheap in the current environment.

A clinic near my house charges cash customers $100 for the first office visit and $70 for other visits for the calendar year. About the price of a tank of gas. The urgent care clinic a few blocks away might be even cheaper. As a cash paying customer, I'd choose the cheaper of the two (the care is comparable), or other factors might drive me to choose the other (I like the doctor better). But with my insurance, I pay $35 or whatever, either place I go, so there is no competition driving the overall prices down. Instead of paying $35 for a flu shot where my health insurance is good, I could easily go to Walmart and get a cheap one there.

Insurance is exactly meant to be there for the situations everyone hates about the current system. A $10,000 deductible policy costs $50/month, and you're a LOT less likely to go bankrupt if you need brain surgery, cancer treatment, heart surgery, or other really expensive procedures. Insurance is supposed to cover CATASTROPHES, not pay your ordinary bills.

You can see the lack of competition and the decline of quality of service in education, too. I'm not sure you've figured that one out yet, either.

So, you want a free market for the inexpensive part of care, but want to preserve the current situation for the expensive part of care? So someone who needs a $20 treatment will shop around and get the best deal, but someone who needs $20,000,000 of treatment will seek the best, highest price treatment available? Seems like sort of a half-ass solution, if you don't mind me saying so.

I guess if flu shots and the like make up the majority of healthcare spending, your plan could work. Do they? I've not seen data on the ratio of current spending on maintenance vs. non-maintenance.

My understanding is that HMOs came about because the health insurance companies decided it might be cheaper for them to pay for maintenance so that they would get stuck with fewer major medical bills. Apparently you think that somehow the insurance companies are being forced by the government to pay for maintenance?

I don't know of any regulation that says that individual insurance companies can't just drop all their plans except catastrophic coverage. So if they thought that was a good business model, I guess they probably would.

The auto insurance analogy doesn't work because auto insurance doesn't cover blowing up your engine because you never changed the oil. If health insurance companies could deny you coverage for a heart transplant because you are fat and lazy and didn't exercise, then they'd have no interest in covering maintenance. Likewise, if auto insurance companies had to pay for a new engine if you ran it out of oil, you can be sure that regular oil changes would be covered.

barfo

 

[barfo]

You can see the lack of competition and the decline of quality of service in education, too. I'm not sure you've figured that one out yet, either.

There is probably more competition in education today than there ever has been. So I'm not sure how you are connecting lack of competition to a decline in quality.

barfo

 

[EL PRESIDENTE]

Burgerville.