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Desc:Oliver finds yet another sector of the american healthcare system that is a massive scam
Category:Crime, News & Politics
Tags:HBO, john oliver, Last Week Tonight, dialysis, blame the insurance companies
Submitted:SolRo
Date:07/11/17
Views:497
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Comment count is 23
Bort
Haven't watched this yet, but isn't this the fault of DaVita and not the insurance companies? Even Medicare got scammed by DaVita apparently (that seems to be what is happening around 14:10), surely they aren't colluding with DaVita.

I realize it is still in vogue to blame insurance companies for everything that goes wrong, but the ACA was passed seven years ago. Insurance companies have largely been reined in, and the bulk of our remaining problems are on the medical provider side.
Old_Zircon
Insurance companies have largely been reined in





Insurance companies have largely been reined in

Bort
Yes, O_Z. insurance companies have largely been reined in. Thanks to Obamacare they actually have to deliver value for premium dollars, they can't nail you for pre-existing conditions, they can't practice rescission, and on and on. You know, all the stuff the Left never learned because they were too busy shouting about how Obamacare was a corporate giveaway and a Betrayal Of All That Is Good And Decent.

Bobonne
Insurance companies have largely been reined in

jfcaron_ca
Profiting from disease and injury is an abomination.

Bort
Well then doctors should have their income capped. Which coincidentally brings us to the reality that, if we want to actually make health care affordable, we need to regulate medical providers, who charge 50% overall more in America than in Canada, and 100% more than in much of Europe.

Anaxagoras
"Profiting from disease and injury is an abomination."

I don't mean to be too harsh, but this is a really dumb thing to say. If your profession is "doctor", (or "nurse", or "biotechnician", or any number of similar jobs), and you've spent time & money training to become qualified for that profession, and you spend 8-10 hours a day doing that profession, of course you should be able to "profit from disease and injury". That's how you make your living!

Once you acknowledge that profit in this arena isn't an inherently bad thing, only *then* can you realistically start looking at how best to limit the profits, to make sure the *right* people profit appropriately, and to start having an honest discussion about when & where the government should pick up the tab. (Or if the government doesn't pick up the tab, how can those services be made affordable to most people.)

Bort
Yep. Insurance companies may contribute the least to patients' welfare, and as such are the most parasitic element in the process. But if our goal is to make health care affordable, they are also the least of our problems at this point. We regulate insurance companies and cap their profits. We don't similarly regulate hospitals, doctors, or pharmaceutical companies.

Single payer keeps turning up unworkably expensive in the US because oversized medical bills are going to be a strain no matter what payment mechanism you use. Green Mountain Single Payer failed in Vermont in December 2014 on precisely those grounds, and the Left hasn't even noticed.

jfcaron_ca
On this matter I take a deliberately absolutist (and admittedly obtuse) position.

Even if individual doctors & nurses (etc) "deserve" to be paid for their work, if they are withholding their work for lack of payment, they are basically holding sick people hostage against their own diseases. Pay up or you die.

Obviously they don't see it this way. I've noticed that hospitals and clinics purposely separate the medical bits from the paying bits, so much that the doctors don't even know what the bill might be. I wonder if the doctors would be as willing participants if they had to face the icky transaction themselves.

The solution is obviously to pay these skilled & noble humans regardless of delivery of services, then use a mechanism not related to the sick & ill's ability to pay to motivate them to work (they are already pretty motivated, I've noticed.)

Bort
If we take direct that train of thought at ourselves and not at those people over there who aren't being good enough people, YOU are obligated to do anything and everything in your power to alleviate suffering to the very best of your ability. Among other things, that means that every penny not essential to your bare survival is a penny you owe to someone in need. Same goes for all your resources.

Obligations you're willing to shoulder yourself are principles. If it's an obligation you demand the other person shoulder, I'm not sure what I'd call it, but it's not principles.

jfcaron_ca
I don't think that follows from what I said. Maybe I don't see the path you're taking to get from "withholding care from the poor is immoral and we need non-payment ways to motivate those with the skills to care for them" to "you personally need to sacrifice everything to save the world".

Bort
If doctors are obligated to use their talents to save lives / alleviate suffering whether or not they are paid, why is that an obligation that rests only with doctors? Why would it be tied to medical training and nothing else? What if you, with your ability to do whatever you do, could save lives / alleviate suffering whether or not you were paid; wouldn't you be equally obligated?

Remember, you're the one with the admittedly absolutist position on this. It's not my fault that your position would apply equally well to ANY profession, or any abilities a person has for that matter.

If you do not consider it reasonable to apply your own absolutist stances to yourself, why would they be reasonable to apply to anyone else?

Now me, I take a more nuanced view. I figure that a person has few absolute obligations to other people; we have laws to cover certain basic standards of behavior, but beyond that we have a great deal of latitude to help others, or not. I will respect a person more for helping others, but I also understand that people have to determine for themselves what they can afford to do.

jfcaron_ca
You're inverting the logic. I never said anyone should be obligated to do anything. It's not a dichotomy between "charge user fees for your livelihood" and "be obligated into working".

Currently we primarily motivate doctors & such to do their work by making their personal income depend on the prices they charge & the clients paying those prices (through insurance, sure).

I could imagine a system where doctors & such are primarily motivated by other reasons. In fact I'm pretty sure a lot of people go into medicine for non-financial reasons and would continue to work - willingly - if their personal income wasn't tied to a sick or ill person being able to pay.

SolRo
if the medical profession is expected, and apparently encouraged, to extract maximum profit from tasks required for a functioning society, why aren't we applying the same crazy capitalist ideals to other vital social services?

Surge pricing for 911.

Book your camping spot now on Kayak.com!

Scaled pricing for firefighting depending on size of fire.

Sorry Little Johnny, the FBI wont look into your parents murder unless you cough up $10k per day.

Life Guard On Duty - Pictures $20, Shark watch $100/hr, Rescue $500 per 10 meters out.

betabox
This discussion results from a society where people think that corporations are people.

Bort
"I could imagine a system where doctors & such are primarily motivated by other reasons. In fact I'm pretty sure a lot of people go into medicine for non-financial reasons and would continue to work - willingly - if their personal income wasn't tied to a sick or ill person being able to pay."

I could see that too. And perhaps we ought to be looking into reforms of that type, for example buying out student loans and covering malpractice insurance in exchange for a fixed (modest) salary. Like I say, the big problem at this point is bloated medical costs, and this would help.

We ought to subsidize pharmaceutical research too, so that pharmaceutical companies no longer have to pay for R&D before their products hit market, which is the root of why our pharmaceutical policies are messed up. Take away the justification for a captive US market, regulate profits, and pharmaceutical prices start coming into line too.

I GOT OPINIONS

15th
Do doctors' salaries really drive up healthcare costs substantially? I always assumed it was the insurance/pharma industries. I haven't watched the clip though.

Good doctors should be payed very well, but maybe a cap isnt unreasonable. I can't imagine topping out, at say, 200-250k a year would deter many med students interested in bettering society.

SolRo
They're certainly contributing.

For example, salaries (median) for surgeons range from about 350,000 at the low end to 600,000 (median). And there are surgeons that earn close to or more than a million in salary.

And the 10th -lowest- percentile for orthopedic surgeons is 270,000.

Really, everyone in the healthcare industry is very well paid (or overpaid).


Though, I guess one could argue that the medical field has just been better at offering their employees wages that actually grow over time (unlike the rest of us troglodyte peasants with wages that have been stagnant for FOURTY GOD DAMN YEARS), but that argument is stupid, because medical costs have been increasing way higher than inflation for a long time.

It's an unregulated system that has a captive market. Realistically there is no competition, transparency or options. Aside from big pharma it's probably the most exploitive industry in America. At this point in time, without insurance or a trust fund, healthcare for a major issue (or even relatively mild issues) is not affordable for anyone.

SolRo
My extended stay and multiple surgeries after my motorcycle crash some 12 years ago cost around 350,000. Today that same treatment would likely cost more than one million dollars.

Do any of you have a million dollars saved up? or even a million dollars in assets if you sold literally everything?

Bort
"Do doctors' salaries really drive up healthcare costs substantially? I always assumed it was the insurance/pharma industries. I haven't watched the clip though."

First learn, THEN form opinions.

The main thing that the ACA accomplished was reining in the insurance companies. Insurance companies are now obligated to spend 80%-85% of all premium dollars collected on paying medical claims; all costs of doing business, including profits, have to come out of that 15%-20%. Single payer could do better, maybe 95% efficiency, but the savings would be marginal: if you're paying a $400 premium under private insurance, single payer could knock the price down to maybe $340 for comparable coverage.

Medical COSTS, on the other hand, are sky-high in this country, including doctors, pharmaceutical companies, hospitals, and equipment manufacturers. We pay 50% more than Canada and 100% more than most of the Western world:

https://www.vox.com/2014/12/22/7427117/single-payer-vermont-sh umlin

15th
I didn't present an opinion.


Thanks for the info tho.

Chocolate Jesus
someone should slash your face for that comment bort

John Holmes Motherfucker
No one has mentioned that kidneys are covered separately‚Äč by Nixoncare. It's in the.video. I usually don't watch the videos, so I shouldn't criticize,
but it's obvious that NO ONE has watched the video., Which is a.shame,. because‚Äč a lot of the comments seem well informed, just not about the topic of the video.
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