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  1. #61
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    Quote Originally Posted by Coriolis View Post
    I did go first in laying out one way to get significant cost savings in the area of health care.
    Yeah, but I never asked for that.

    And I did subsequently ask for your opinion on the drawbacks of a single-payer system.

    Quote Originally Posted by Coriolis View Post
    I want to see what your thoughts are on what I have already said before going to the next level/layer of detail. If you haven't thought about it enough to have an opinion, are you aware of alternative ideas for reducing overall medical costs?
    I've thought about it enough to have an opinion, albeit not one I'm ready to call final, and one which I feel still has room to grow, as I learn more about the various options we have before us, and the full litany of costs and benefits associated with each. Along those lines, I'd like to see to what extent you independently come up with the same issues I foresee affecting it.

    Quote Originally Posted by Coriolis View Post
    Others can reply, too.
    Not that I would discourage others from participating, but I do think this discussion could stay more on topic, and more good could be done, if we kept it just you and me (or at least just INTJ).

    Quote Originally Posted by Coriolis View Post
    I just don't want to get stuck down the rabbit hole of one idea, when the topic deserves a broader treatment.
    Well, I was planning on bringing in the other two options, as I see them, after you gave your treatment.


  2. #62
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    Quote Originally Posted by SD45T-2 View Post
    We both have lots of pre-existing conditions. We could theoretically get insurance, but it would be prohibitively expensive.

    My mom does not get health coverage through her job, and I am not employed or looking for work because I'm struggling with a bunch of chronic health problems. The last 5 years have been like a really long episode of House, except none of the things I have are life threatening (as far as anyone can tell) and there aren't any attractive women involved.

    My dad (who is generally pretty healthy) had health insurance for just him through his job, but he got laid off a couple weeks ago.
    I'm sorry to hear the tough news...

    Not to seem too callous, but, for the sake of knowledge (as I really don't fully understand these things), why can't you just get on Medicaid?

  3. #63
    Sweet Ocean Cloud SD45T-2's Avatar
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    Quote Originally Posted by Zarathustra View Post
    I'm sorry to hear the tough news...

    Not to seem too callous, but, for the sake of knowledge (as I really don't fully understand these things), why can't you just get on Medicaid?
    IIRC, we're not poor enough.
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  4. #64
    Analytical Dreamer Coriolis's Avatar
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    Quote Originally Posted by SD45T-2 View Post
    IIRC, we're not poor enough.
    Exactly. Just like the tile layer, the roofer, and the electrician I know, plus most of the grad students I ever worked with. The new Affordable Care Act will address some of this once fully implemented, by removing exclusions for preexisting conditions, and allowing students to remain on their parents' insurance longer.

    Quote Originally Posted by Zarathustra View Post
    Yeah, but I never asked for that.
    You asked for it indirectly by presenting a view of the current health care system which was at odds with my experience and information.

    Quote Originally Posted by Zarathustra View Post
    Not that I would discourage others from participating, but I do think this discussion could stay more on topic, and more good could be done, if we kept it just you and me (or at least just INTJ).
    I am always happy to discuss with you, but discussion on the open forum is just that - open. We should take this to VM or PM if you really want otherwise (though I agree with your assessment).

    Quote Originally Posted by Zarathustra View Post
    I've thought about it enough to have an opinion, albeit not one I'm ready to call final, and one which I feel still has room to grow, as I learn more about the various options we have before us, and the full litany of costs and benefits associated with each. Along those lines, I'd like to see to what extent you independently come up with the same issues I foresee affecting it.

    Well, I was planning on bringing in the other two options, as I see them, after you gave your treatment.
    Well, I'll assume you are not bluffing and carry on, if only for the sake of demonstration. This will be rather cursory, as my time is limited tonight.

    First, by "single-payer health care", I mean a system in which the government pays for medical services delivered by the private sector, NOT a system in which all medical providers essentially become government employees. I am discussing this as one way to reduce overall health care expenditures, irrespective of who actually pays for what. Drawbacks of such a system in this context would thus be those factors likely to lead to increased overall costs. So far, I have identified the following three:

    1. Overall costs may go up initially, since such a system would cover everyone, regardless of how much medical care they need. It would take some years before this was offset by the cost savings of universal access to preventive care, and more efficient, needs-based purchasing of high-cost capital equipment.

    2. In such a system, the government would specify what services must be included in the plan, and what payment would be given for each. This would give incentive to lobbyists to try to influence those in charge of setting the services and payment schedules. To the extent that they succeed in increasing either of these beyond medical efficacy, that would inflate costs.

    3. A major concern of government involvement in anything is rampant, inefficient, and costly bureaucracy. Limiting this involvement to specifications and payment rather than actual delivery of services should reduce this considerably. I'm not sure how it would compare with the plethora of existing insurance company bureacracies, whose administrative costs are typically listed as ~30% of total expenditures. Also, we already have substantial government involvement in health care, from regulation of the industry overall, to medicare/medicaid payment, to the military and VA systems which actually provide services. In other words, a bureaucracy is already in place, so it might not increase that much. Public accountability and bureaucratic manageability might also be enhanced by having the states administer the system.

    Your turn.
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