dagblog - Comments for "John Roberts goes rogue?"

Private hospitals may be much

artappraiser — Mon, 09 Jul 2012 19:06:28 +0000

In reply to the same chief GI resident in

Private hospitals may be much more responsible for evildoings than private insurance cos:

[....] ''There's no rhyme or reason for how patients are charged or how hospitals come up with charges.

''There's no other industry where you get charged 100 times the same amount, or 121 times, for the same product,'' she said [....]

Dr. Hsia, whose research was supported by the Robert Wood Johnson Foundation and the National Institutes of Health, reviewed charges for 19,368 California adults under age 60 who had had uncomplicated emergency appendectomies in 2009 and were sent home after hospital stays of fewer than four days. She and colleagues found huge variations in price, even within the same county. In Fresno County, for instance, the researchers found the smallest range of charges, but there was still a difference of $46,204 between the highest and lowest hospital appendectomy charge.

For-profit hospitals tended to charge more than county hospitals, and charges increased with a patient's age. Charges were also higher for Medicaid patients and the uninsured, and for patients with other health problems like diabetes and congestive heart failure [....]

from

Confusion On Pricing At Hospitals Adds to Pain
New York Times, April 24, 2012

Bringing to mind the purse

jollyroger — Sun, 01 Jul 2012 23:17:12 +0000

In reply to the same chief GI resident in

Bringing to mind the purse pinching (!) blue dog who weighed in during the HCR debate that he'd be fine with expanding medicare to younger people but only of we raised the doctors' fees!

You've been incredibly lucky,

stillidealistic — Sun, 01 Jul 2012 22:16:04 +0000

In reply to No, these are people who

You've been incredibly lucky, but not everyone is. And, if you discover you have a disease, be it life threatening or not, at least now you can get coverage whereas before ACA, you could not. And what about children? People had been making the determination to IGNORE what might happen with their own children had they developed a condition that would prevent them from EVER being able to get insurance.

the same chief GI resident in

artappraiser — Sun, 01 Jul 2012 21:34:13 +0000

In reply to While getting over my neck, I

the same chief GI resident in a non VA hospital would get 750k. wherein our 17% GDP burden.

I'm with ya 100%!

But now I wanna see ya go and 'splain that to the firedoglakers without getting flamed I think most of the liberal blogsophere are where I waz like 10 years ago, they just sooo wanna scream and rant about insurance companies (not realizing that Medicare and Medicaid are just insurance, too, with many of the same attributes, perhaps more given that they are quite open to the affects of lobbying Congress.)

It's not so much that we are

EmmaZahn — Sun, 01 Jul 2012 21:25:37 +0000

In reply to I agree, except... I believe

It's not so much that we are arguing for an expensive and complicated giveaway as it is that we are trying to defend one step forward.

No, what it does is prop up a collapsing system. Plus, I do not remember reading any opinion- leading progressives or liberals even trying to promote anything different. What, no left sided think tanks could hire insurance specialists and actuaries to run the numbers, maybe figure out actual plans and premiums to quote just like private insurers do? Negotiations started where exactly where they ended with a hideously complicated giveaway. And do not even get me started on why no one ever thinks about developing a decentl healthcare system. No, it's all about insurance e.g. how to pay for the healthcare hell we have now.

While getting over my neck, I

jollyroger — Sun, 01 Jul 2012 21:18:02 +0000

In reply to I think the irony is that if

While getting over my neck, I met a nurse who just relocated from some Midwest VA hospital. She said the nurses there topped out at 100k, and the chief gastrointestinal resident pulled down 250k. I offered my opinion that this was not a life of penury. She agreed, but also said the same chief GI resident in a non VA hospital would get 750k. wherein our 17% GDP burden.

I should add that I was never

artappraiser — Sun, 01 Jul 2012 21:07:49 +0000

In reply to Sorry for my

I should add that I was never felt that arguing against a Medicare-for-anyone-who-wanted-it was worth the time and that it was just fine with me if it happened. Because I think this has to be an evolutionary process, just like it has been in virtually all other countries and just like it was with introducing Medicare, and Social Security, for that matter. And more people getting on Medicare and finding out it wasn't what they thought and not liking it, and costs continuing to rise, would bring up the same reforms as going about it the way we are now or perhaps better and faster. Or maybe not,who really knows?

I had just come to think status quo/doing nothing was the only wrong option, everything else has to be a process. All of this is trial and error, it is always a process, countries with systems that work well are always shifting what gets covered, who gets covered, what and who pay etc; there is no perfection.

There was an excellent example of the nuanced realities about CHIP that so many like to herald in this article on Texas uninsured in the Times the other day. A father turns down pay raises and even asks for pay cuts so that the little daughter with unusual illness can be on CHIP, also turns down some employer supplied health insurance because that coverage is not apparently going to cover all she needs. Meantime, he gets cancer and is not covered for that because of what he did, and now with lower income which he gave up for her to be on CHIP, has to figure out how to pay for his own treatment. But wait, there's more, lest you think government-insurance-for-all solves their problems, at the end their story continues: CHIP has just turned down paying for $17,000 of genetic tests that the little girl's doctor says he needs; they are in the process of appealing that decision.

There are winners and losers in every health care system, it is always a judgment of "less worse system than these others" and a nation's priorities. It is also a constant process of keeping a system working decently because of the constant change in medical care and technology. Like it or not, people are going to try to sell longer life because most people want that, even in a communist system capitalism will break out in this one front, it's inevitable.

I think the irony is that if

Peter Schwartz — Sun, 01 Jul 2012 18:18:52 +0000

In reply to I think the irony is that if

I think the irony is that if progressives were screaming "we want an NHS option" (instead of the "Medicare option for all" mantra that I believe many actually wouldn't like if they got it) they might actually have a chance of getting it, beee-cause enough right wingers would foolishly go along believing the option would be a massive failure with death panels, like Medicaid, and all that hokum.

It's a thought...

I agree, except... I believe

Peter Schwartz — Sun, 01 Jul 2012 18:16:09 +0000

In reply to The politics and economics of

I agree, except...

I believe liberals moved to this solution because they thought it was a compromise with the anti-big-government-ers that could get bipartisan support.

That Medicare For All couldn't have gotten through at all.

It's not so much that we are arguing for an expensive and complicated giveaway as it is that we are trying to defend one step forward.

IOW, we aren't arguing for this as a end point, but as a step along the way...and arguing against undoing this step forward because undoing it would (we believe) would be a step backwards.

Sorry for my

Peter Schwartz — Sun, 01 Jul 2012 18:11:26 +0000

In reply to wonder if it makes a

Sorry for my argumentativeness. Appreciate your slowing me down.

I agree entirely about the fee-for-service piece of what you say.