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Thread: Ill tell you why people want natl health care...

  1. #41
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    Quote Originally Posted by YVK View Post
    6) Early and persistent education, starting from elementary school, in regards to general health issues, smoking, nutrition, obesity...

    7) Incentives for active commitment to healthy lifestyle, such as reduced fees for gym memberships, swimming pools...

    8) Reduction of productivity-based reimbursement for physicians, or, at least, adjustment of productivity formulas to patient's outcomes.
    I believe that the free market should set gym prices. A direct fee for service system that has minimal 3rd party payors will fix the conflicts between physician incentives, excessive/unneeded testing, and compensation.

  2. #42
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    In central Alabama there are more hospitals than you can shake a stick at I mean literally. The best advice I have been given by a nurse that I went to college with is that they special's in different things. If you have a gun shot you got to the shitty hospital because that's were all the thugs that get shot go too. If you have a general problem you go to the other hospital that does the wide range of problems, If you are having a kid then there is another hospital for pregnancies, If your kid has a problem there is a special world renowned hospital for the little ones none of the other hospitals will not even treat kids they will automatically refer you to the children's Hospital. If you have Gastronomical problem there is even a hospital that specializes in that.
    I am probably missing one or two but you get the point.
    Now when I was 20 yrs old I did a f*cked up thing that landed me getting surgery and a 40K doctor bill for a in and out surgery and at the time no hospital stay. And I had no insurance from the job I was working at that time. Fast forward 5 yrs later I was involved in a car accident and the car I was driving had a first generation ford air bag and those bustards are known to pack a wallop. The accident was actually minor the car wasn't even totaled it was just barely enough to trip the air bag . That bitch airbag gave me a KO punch ,I woke up just when the ambulance arrived. I get to the ER I am awake and have my were fair all with me. And communicating with people fine. The ER nurse's snatches my pants off with out telling jack squat and lifts my ball sack to stick a IV in the inside of my leg WTF I couldn't even control my self my 6'2'' lanky arms was hanging in the air fixing to KO that bitch that was going to stick that needle in that spot all the while me screaming you can stick it in my neck just don't stick it there They didn't even tell me what they were up to thank God the doctor told them to stick me in the arm after he saw me raise up Any way there is a couple a stories that go along with that episode. I stayed in the Hospital 1 1/2 days and got one CAT scan and a IV [ THATS IT] which that hospital charged my insurance company almost 60k. All the doctor said was that I had a mild concussion that's it for the day and and half all I got was served was breakfast.. I didn't even get a prescription.
    Last edited by Thomas M-4; 08-12-11 at 04:08.

  3. #43
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    Quote Originally Posted by lanesmith View Post
    I believe that the free market should set gym prices. A direct fee for service system that has minimal 3rd party payors will fix the conflicts between physician incentives, excessive/unneeded testing, and compensation.
    If one looks at gyms as businesses, then, certainly, free market rules should apply. I try to look at promotion of a healthy and active life style as a public health measure.

    I am not so sure about direct fee for service simply because my field costs a lot, even if one takes out hyper-inflated fees imposed on insured patients. Last I checked, an ICD device alone was about 25K, and it was 40K few years ago.

  4. #44
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    The best public health measure would be to simply not fund diseases brought about through lifestyle choices like obesity and substance abuse.
    "Life is short, but the years are long." - Robert A. Heinlein

  5. #45
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    Quote Originally Posted by armakraut View Post
    The best public health measure would be to simply not fund diseases brought about through lifestyle choices like obesity and substance abuse.
    I don't disagree, but then you have to carry that out to the logical conclusion.

    Do we, as a society, have the stomach (no pun intended) to watch these people die in the streets in the short-term? Remember that we've grown a populace accustomed to safety nets from Uncle Sugar. The fatties and the junkies will NOT believe that it is real until they watch their friends dying around them. And when they do, who pays to scrape up the bodies?

    Who makes the call? I know of more than a few "skinny" people that are only so because of a very high metabolism. I was one of them for years until I hit 30. So without a good diet and exercise they will still appear "healthy" but may not be so. And is alcohol included? Smoking? If so does a pipe or cigar count? How many? If I get lung cancer will the fact that I smoked when I was 16 count? Or the fact that I have a cigar a week? What panel of government nincompoops makes that call?

    and why stop at intake, what about dangerous activities? Ride a motorcycle to work? Speed in your car? skydive? Bungie jump? Hell if you cook a lot you are more likely to cut yourself than someone who has their meals prepared.

    Ultimately the only solution that makes sense is to do away with insurance entirely, or at least phase it out. In this way everyone becomes master of their own destiny, and debt. Want to smoke and get lung cancer? Awesome, I hope you have a good savings plan to cover the costs of your cancer when you're 70, if you get there. If not, that cancer is going to run it's course damn quick.
    Last edited by rob_s; 08-12-11 at 12:36.

  6. #46
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    Quote Originally Posted by armakraut View Post
    The best public health measure would be to simply not fund diseases brought about through lifestyle choices like obesity and substance abuse.
    That's an over-simplification. For example, we have a threatening epidemic of childhood obesity - 100% responsibility of parents, not kids. That fat kid is gonna grow and develop obesity-related health issues in his 20s or 30s - and you are going to penalize him for something his parents are responsible for?
    Last edited by YVK; 08-12-11 at 12:38.

  7. #47
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    Quote Originally Posted by YVK View Post
    That's an over-simplification. For example, we have a threatening epidemic of childhood obesity - 100% responsibility of parents, not kids. That fat kid is gonna grow and developed obesity-related health issues in his 20s or 30s - and you are going to penalize him for something his parents are responsible for?
    I don't buy that either. A fat 12 year old has only his parents to thank for it, a fat 30 year old has only himself. While it's going to be harder for him because he learned from a bad example, it is still his choice.

  8. #48
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    Quote Originally Posted by rob_s View Post
    Ultimately the only solution that makes sense is to do away with insurance entirely, or at least phase it out. In this way everyone becomes master of their own destiny, and debt.
    I fail to see how getting rid of insurance would be a good idea. Insurance is not the problem. It is the government meddling in insurance that is the problem: mandated coverages, not allowed to sell across state lines, a system that encourages work provided insurance, etc.

    Insurance sold as real insurance, not a maintenance plan, is a useful way for someone to become master of their own destiny.
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  9. #49
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    Quote Originally Posted by chadbag View Post
    I fail to see how getting rid of insurance would be a good idea. Insurance is not the problem. It is the government meddling in insurance that is the problem: mandated coverages, not allowed to sell across state lines, a system that encourages work provided insurance, etc.

    Insurance sold as real insurance, not a maintenance plan, is a useful way for someone to become master of their own destiny.
    Disagree.

    What is the incentive to stay healthy, when people at least have the perception that there are no repurcussions for their bad choices? now if you want to charge the fatbodies more for their insurance I'm ok with that. Or adopt a model like car insurance where rates increase as "accidents" (or in this case, visits) increase but with discounts for preventative care, then I'm ok with that.

    Making people pay their own way makes them responsible for their own destiny. Whether it's insurance companies or the government, the core concept is socialist in nature in that I pay for other people's bad decisions.

  10. #50
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    Quote Originally Posted by rob_s View Post
    I don't buy that either. A fat 12 year old has only his parents to thank for it, a fat 30 year old has only himself. While it's going to be harder for him because he learned from a bad example, it is still his choice.
    There is nothing here to buy, Rob. We see early coronary disease in patients age 18; in fact, we have seen it in these age groups in Western societies for at least 40 years, when rates of obesity were half of what they are now. If one is fat since childhood, by the time he/she is 18, they are already behind the curve - blood pressure, lipids, etc. Then you're 18, you have no money, you need to go through college and juggle a job on the side, then you need to work your ass off to get a reasonable permanent job. Reality checks in and it is not pretty. I see these people in my office nearly on daily basis and while some of them have made their own poor choices, many have been dealt a bad card from a get-go.

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