Ishmael
Literotica Guru
- Joined
- Nov 24, 2001
- Posts
- 84,005
This thread;
Obamacare, NOT so affordable after all !!
Prompted me to start this thread.
First of all there were some good posts in there. Not entirely on the mark, but good posts none the less. Everyone seemed to have a handle on the cause, at least in their own mind. And many had solutions of one sort or another.
Let me start with the observation that there is NO single simple answer. The Health care system is a tangled web of competing interests all looking out for their own financial interests. And any government solution has, and is, merely exasperating the problem.
Starting with just one piece of the puzzle. The AMA, and other organizations, has actively limited the number of medical school students since the 1960's. The counter-argument is that once the shortage of physicians became acutely apparent they, the AMA, increased the quota by 30%. Unfortunately they are behind in filling that quota. Shortages of anything increase the prices charged.
Add to that the insane cost of medical school on top of that. Doctors are virtually forced into high return specialties for no other reason that to pay off their student loan debt. Further driving costs up and exasperating the shortage of Primary Care physicians.
Then there is another choke point in the system, that being the 3 year residency requirement in a 'teaching' hospital. The slots available have NOT substantially increased and teaching hospitals, which traditionally have treated the indigent, are being punished under "Schuck'N'JiveCare." (Number of patients returning with the same complaints.) While the intent was to increase 'quality' of care by rewarding the hospitals with the lower number of return cases, the results have been to punish those hospitals that provide care for the lowest rung of society.
Then there is the digital record aspect of "Schuck'N'JiveCare" that forces physicians to invest in highly expensive software that requires the services of equally pricey specialty IT firms to maintain the integrity of the systems while protecting against hacking. With all of the patients information ending up in a unified government database that is itself subject to being hacked. And if you think the government is a safe repository of your personal information, I refer you to the recent OPM hack. The complete personal data of 21.5 million current and former government employees, not including their relatives, hacked. The point being the government can't even protect itself. (That hack has cost the government billions of dollars with no end in sight as I type this.) And all of this is at a cost to the patient.
Everything that we were told about "Schuck'N'JiveCare" has essentially turned out to be false. Yes, some 9 million more Americans are insured, but what about the other 37 million that we were told would be insured as well? It's obvious that they have either opted out, or just can't afford the premiums.
The insurance companies are the favored fall guys for the price increases, and to a limited extent there is some truth in that. But it must be remembered that all they do is write the checks. And with the advent of "managed care" they've had to hire a great many more employees to oversee this managed care. And that increased their management overhead, which drives prices upwards as well.
Then there is the new tax on medical devices. (Did you know that applies to your veterinarian as well? Anyone with a pet has seen the effects.) It's folly to think that that hasn't had an impact on costs to the patient.
Layer upon layer of new bureaucratic rules all designed to "fix" things while "things" just get worse and more expensive. The rule of unintended consequences run amok.
Ishmael
Obamacare, NOT so affordable after all !!
Prompted me to start this thread.
First of all there were some good posts in there. Not entirely on the mark, but good posts none the less. Everyone seemed to have a handle on the cause, at least in their own mind. And many had solutions of one sort or another.
Let me start with the observation that there is NO single simple answer. The Health care system is a tangled web of competing interests all looking out for their own financial interests. And any government solution has, and is, merely exasperating the problem.
Starting with just one piece of the puzzle. The AMA, and other organizations, has actively limited the number of medical school students since the 1960's. The counter-argument is that once the shortage of physicians became acutely apparent they, the AMA, increased the quota by 30%. Unfortunately they are behind in filling that quota. Shortages of anything increase the prices charged.
Add to that the insane cost of medical school on top of that. Doctors are virtually forced into high return specialties for no other reason that to pay off their student loan debt. Further driving costs up and exasperating the shortage of Primary Care physicians.
Then there is another choke point in the system, that being the 3 year residency requirement in a 'teaching' hospital. The slots available have NOT substantially increased and teaching hospitals, which traditionally have treated the indigent, are being punished under "Schuck'N'JiveCare." (Number of patients returning with the same complaints.) While the intent was to increase 'quality' of care by rewarding the hospitals with the lower number of return cases, the results have been to punish those hospitals that provide care for the lowest rung of society.
Then there is the digital record aspect of "Schuck'N'JiveCare" that forces physicians to invest in highly expensive software that requires the services of equally pricey specialty IT firms to maintain the integrity of the systems while protecting against hacking. With all of the patients information ending up in a unified government database that is itself subject to being hacked. And if you think the government is a safe repository of your personal information, I refer you to the recent OPM hack. The complete personal data of 21.5 million current and former government employees, not including their relatives, hacked. The point being the government can't even protect itself. (That hack has cost the government billions of dollars with no end in sight as I type this.) And all of this is at a cost to the patient.
Everything that we were told about "Schuck'N'JiveCare" has essentially turned out to be false. Yes, some 9 million more Americans are insured, but what about the other 37 million that we were told would be insured as well? It's obvious that they have either opted out, or just can't afford the premiums.
The insurance companies are the favored fall guys for the price increases, and to a limited extent there is some truth in that. But it must be remembered that all they do is write the checks. And with the advent of "managed care" they've had to hire a great many more employees to oversee this managed care. And that increased their management overhead, which drives prices upwards as well.
Then there is the new tax on medical devices. (Did you know that applies to your veterinarian as well? Anyone with a pet has seen the effects.) It's folly to think that that hasn't had an impact on costs to the patient.
Layer upon layer of new bureaucratic rules all designed to "fix" things while "things" just get worse and more expensive. The rule of unintended consequences run amok.
Ishmael
