US companies are evading taxes by opening/operating an office in Ireland. But US citizen must pay income tax to US Gov if he is working in Ireland. Insider trading is legal to US Congress members. And insider trading is illegal to US Citizens. How long this hypocrisy will continue?
I didn't say SS, I said medicare and medicaid, and no those have not run real cash surpluses over the last 30 years. Proponents use the phony trust fund accounting and ignore part B. Using real cash in and out the surpluses stopped sometime around 2000. It doesn't really matter though, where are we at now and looking down the road.? People knew in the 80's that medicare and medicaid were destined to destroy us financially due to demographics and rising costs. So here we are at the edge, sooner than we thought due to other factors, but we are at the edge we knew would happen. We knew that entitlements as they are now are unustainable. The unfunded mandate is something on the order of $60T now. Reich and his clan of losers keep shifting the argument to emotional appeals and sleights of hand like the one I brought up in the open. If you want to condemn gov't finances in general, I chose the largest probelm at the moment- entitlements.
Yes, thank you. If gov't would butt out and liberals not insist that all the tit suckers get the latest and greatest, medical care would be much more affordable for all. Government policy produced by heart tugging anecdotes to eliminate all heart tugging anecdotes will only produce a far far greater number of problems for people down the road. The selfishness and immorality of it all is staggering, but hey as long liberals feel good that's all that matters. Bill Gates is trying to cure Africa, guess what that's going to produce? Check out population projections and ask yourself will there more or less human suffering there in 50 years.
Mav, you'll be cheered to learn that I too favor a competitive free market in the medical care business, with minimal government interference other than to play the role of referee and assure a competitive market place. Unfortunately if government "butts out" as you put it, we are not left with a competitive situation but a cartel. It seems that never quite sunk in with you. (A truly competitive market in health care would be extremely difficult to achieve without unacceptable risk because of the nature of the beast. That's undoubtedly why so many nations have nationalized, highly regulated health care.) Also, interjecting political ideology into this issue is not really accomplishing much as far as addressing the problems with health care in the United States which are serious and troubling. Costs and access in the U.S. remain completely out of line with the cost and access that citizens of other countries experience with better outcomes. Of course, if you are relatively young, you may not of had much experience with U.S. health care, so a little naivete on your part can be excused. Have a great day.
I guess I agree more with his blathering and "lack of substance" than his opponents blathering and lack of substance.
IMO, this sums up the problem. The medical industry has gone crazy. The prices charged have NO reflection on any type of market. I was prescribed a pill to take, indefinitely, so I started to take it about 1 year ago. It is some non systemic antibiotic; that might help a problem I have. I, nor the doctor, am sure it helping me, but he tells me to keep taking it. I pay $35 per month to take this pill (twice a day). A few months ago I decided to 'look' at what the real charge was: almost $1500 a month! No way in hell would I be popping this pill that may or may not be helpful if the 'charge' was straight out of my pocket; we are not even sure it can help! $18,000 a year... Don't even get me started on my wife's ER visit 5 months ago... And we wonder why a family insurance plan is now 15,000+ a year.* *http://www.healthcarefinancenews.co...ily-health-insurance-cost-now-over-15000-year Quote: *Since 2001, family premiums have increased from an average of $7,061 to $15,073 last year â a 113 percent total premium increase over that period.* We need to wake up. The whole medical field is raping us blind. So we have Doctors who want costs to go up, we have Hospitals who want costs to go up, we have Therapists who want costs to go up, we have Drug Companies who want costs to go up, we have Medical Device Companies who want costs to go up, we have Insurance Providers who don't mind if costs to go up (as long as they can market the higher premiums, they will end up with more profits too)... The only people that would want costs to be stable/real are the everyday Joe, and he doesn't even know what is being paid. >>'thank you sir, that will be your $15 co-pay... Just don't look at any of the real costs, don't bother cost comparing, and please pay that ever increasing premium.' BTW, it was a Saturday and the wife had a small issue. Her doctor told her to go to the ER to get it 'checked-out'. No problem, our $100 co-pay netted about $5,000 is "services" (shitty service too). I literally had to stop them from doing stuff.
Isn't that one of the issues, that since your insurance or Medicare is going to pay, there is a strong incentive for health care providers to recommend unnecessary treatments and drugs?
Yes, and it goes beyond that. Whether or not something is necessary, and more importantly the costs that are 'charged'. The drug manufacture smartly calculated that in the current 'system' they can charge $18,000 for the pill, and get away with it. This pill does not save lives, they would not be getting $18,000 a year for it if the patients were forking $$ directly for it... My doctor is obviously OK with it, my insurance pays the $1500 a month without question, and heck it only 'costs' me $35 bucks a month right? (But I pay for my insurance, so I actually do care, but those that are 'covered' and don't 'see' the costs actually think it only costs them $35) Can't really blame the drug company. They are not in business to leave money on the table, but we can blame a system that is unintentionally set up to promote it. I don't claim to know the answer, but it really is all parties against the general user (us). At this point NO-ONE is on 'our' side, and we are the party that ends up paying, and we have the least control on what is happening. Maybe the answer is totally 'open' system where people pay completely out of pocket. That would be hell for about a decade; families with anyone getting really ill going completely under until things normalize? (Doctors, Hospitals, Nurses, Theropists, Administrators, Insurance executives, Politicians etc.. All would have to learn to live with a lot less of our $$$) Maybe some type of tiered system, out of pocket with catastrophic insurance. Or, maybe it is some form of a national system (which I myself have argued against for years; stifles innovation, bureaucracy, corruption etc.)? All I know is that the current game is rigged, and like any rigged system it will finally squeeze us dry. What the other players don't realize (the ones making the rules and money) is that at this rate it will collapse on itself, and everyone will go under.
Ray, I too have noticed what you have. I think full disclosure on actual amounts paid might be very helpful in understanding what is really going on. My strong suspicion is that the actual amounts paid by 3rd parties are very heavily discounted, but the discount is not being revealed to the patient, i.e., the insured. I do not know that that is fact, just my suspicion. It seems a game is being played. The game may go something like this. You get billed 4500 for a colonoscopy. Your insurer actually pays $2500, by prior arrangement with the provider, but leads you to believe they paid $4500. The AMA then testifies to Congress that physicians are being underpaid by 40%. etc. Ditto with drug costs. It seems the whole enterprise may be one giant scam. Most insurers don't explain bills very thoroughly, particularly the billing codes used. This makes it very difficult to have proper patient oversight of billing. Patients are being kept in the dark, so to speak. Is this intentional. I wonder? We need a brighter light shining on the entire medical industry. Something is clearly wrong. A young friend has been taking a particular medication since a child. Recently his pharmacist told him they no longer stock the generic because his out of pocket expense will be much lower if he gets the name brand. The exact opposite of how things are assumed to work. What's going on here. Recently there has been severe shortages of some drugs that have been on the market for years in generic form. Currently, they are practically unobtainable, but why? These are, in some cases, extremely simple, low cost drugs to manufacture. What on Earth is going on here? Some years back I had simple arthoscopy performed on one knee. The physician billed $3500. My insurer wrote to tell me that because my physician was in network they could not allow $3500 and that I did not have to pay the difference. (I don't recall what they said the charge should have been.) I got billed the difference by the M.D. I called his office to tell them that my insurer said I was not responsible for the difference. The person I talked to said not to be concerned and that they would handle everything. A few weeks later i got a new statement from my insurer indicating that they had paid the M.D. $3500. What's going on? I have always suspected that the M.D.'s office just recoded the procedure to something more complex and resubmitted the bill. Bottom line is that it actually was just a simply arthroscopy, and and nothing more complex. Was my physician's resubmitted bill fraudulently coded with another higher paying procedure? How would I ever know?
Would you be against the consumer having the choice to chose between a public option and private insurance or some combination of public/private choice? Are you for total regulation free health care too?