Caveat: I understand arguments for/against on both sides, and I am not calling Obama's plan true universal healthcare.


I want to start this discussion on real AND philosophical terms.


Scenario:

Single-payer universal healthcare is instituted for all US citizens. I don't think whether A. medical centers are owned/run by the gov and B. anyone else here can get all the healthcare they want matter in terms of my particular problem, but if you disagree, explain.


Background:

I am pretty libertarian when it comes to personal freedom issues, save abortion. IMO, most laws or ideas of laws banning adult, consensual sexual activity, banning USE of illegal drugs (in an of itself, not what someone might do while on them), smoking, eating whatever, etc are against natural law. On abortion, I do NOT support the federal government making it illegal, but do support states being allowed to put in reasonable regulation on it, and 99.9% of the time I believe choosing abortion is not the most moral or an equally-moral option.


Problem:

Since single-payer has been instituted, health insurance is provided by and administrated by the gov. You can buy excess insurance on the private market, but that's it. As a US citizen, I want to and am forced to pay taxes, some of which will go toward healthcare.

Since, short of moving to another country I am FORCED to pay for other's healthcare expenses, should I reconsider my positions on smoking, drugs, alcohol, and eating crap food?

Hey, I don't smoke, but I enjoy some brew, wine, liquor, and a greasy burger at times just like most people. But, I have no control over what others do. Since I have to pay for it, should I now support 1. regulated consumption habits (food/drink/smoke) and 2. mandated physical activity?

Put another way, since I have to pay for your healthcare and you mine, should we still maintain the right to basically do whatever we want to our bodies? Does the government then have a reasonable claim to be responsible for our personal eating and physical activity habits?


Discuss.

The issue you bring up is exactly why slippery slope arguments matter -- people are unruly and expensive and difficult to control. It's just human nature. We are not sheep, we are not machines to be programmed. So the people who say "we'll just run this little itty bitty tiny bit of your life, you won't even notice", are just being naive. Because in order to control that little itty bitty tiny corner of everyone's life, they have to control the thing adjacent to it, otherwise people just shift their behavior to the adjacent, slightly more expensive thing. And from there, it's all downhill.

This isn't a problem just with health care, it's a problem in all areas of life.

But with the threat of socialized medicine looming over us now, we need to take a long hard look at the points you made, because countries that already have socialized medicine are sliding quickly down that slippery slope, such as fat police in Japan, where, if you are over a certain weight, you have to be tested regularly and cooperate with govt run programs to shape you into their image.

As if the economic destruction of socialized medicine isn't enough, the personal loss of freedom is a deal breaker all on its own.

omg fat police

It's job creation at it's finest.

I used to think it was wrong that my government taxes cigarettes and alcohol so heavily, but then i realised that we also have to pay for the health costs caused by people smoking.

Personally, I think out system needs to strongly consider less subsidizing for health costs for certain conditions such as lung cancer (caused by smoking) and non-hereditary obesity.

Do they tax fast food at a higher rate, etc?

Ok I take back everything i've said against universal heath care, i'm all for it.

I'll go get 5,000 signatures a day for universal healthcare, you just make sure that the fat police are ready when we get this thing passed

fat police....lol, best. idea. ever.

Japan brings in compulsory fat checks for over-40s

By David McNeill in Tokyo

Once the butt of jokes, the sight of men sucking in their bellies to hide expanding waistlines just got a lot more serious in Japan, where the government has introduced mandatory "fat checks" for the over-40s.


Aimed at trimming bulging annual health costs of more than $3bn (£1.5bn), the Health Ministry says from next month 56 million people must start keeping waistlines tucked in or be asked to change diet, see a doctor and possibly pay higher insurance costs.

But critics say the plan for the potbelly police, which sets a waist limit of 85cm (34in) for men and 90cm for women, will do more harm than good. "It's a comedy," Professor Yoichi Ogushi told The Japan Times. "If you follow the government's logic, you can do whatever you want as long as you have a slim waist."

Although mostly spared the obesity epidemic that plagues many Western nations, Japan is struggling with a recent rise in lifestyle illnesses, especially among the middle-aged.

This is being linked to a widespread shift from the traditional Japanese diet – based around fish, rice and vegetables, and including little red meat, dairy and processed foods – towards a more "modern", Western diet. Japanese men are faring worse than women: government statistics show that men are now 10 per cent heavier than they were 10 years ago, and the average woman's weight has increased by 6.4 per cent.

The Health Ministry says 27 million people now either suffer from, or are at risk of, high blood pressure, blood sugars and cholesterol, collectively known as metabolic syndrome, or "metabo" in the popular media.

Fear of the condition, and its associated diseases of strokes, heart attacks and diabetes, is behind a wave of new health fads and crash diets. With half of all men aged 40 to 74 sufferers, one estimate is that the market for "anti-metabo" services such as private health guidance and fat farms could soon reach 100 billion yen.

It seems appropriate that the country known for its love of cutting-edge technology should be seeking equally innovative,and expensive, ways to lose weight. Popular new fitness crazes include the Joba, a bucking-bronco style exercise machine that promises to lighten dieter's wallets by £700 a time, and the £20,000 Metabology Diet System, a space-age machine that subjects users to electric currents and steam.

The fight-the-flab campaign has already claimed at least one victim. Last year, a 74-year-old local government official in rural Mie Prefecture collapsed while jogging in an effort to cut his 100cm waist. He was in the government's weight-loss programme.

"We have to bring medical costs down," said Toshi-yuki Sato, a spokesman for the Ministry of Health, Labour and Welfare, who denied the plan would encourage crash-dieting and pill-popping. "Dieting badly will eventually cause medical costs to rise even more, so we hope the metabolic tests will be properly supervised."

Plans for a 25 per cent cut in metabo ranks by 2011 bothers some. "Fat people will be criticised by skinny people, old people by the young and companies will refuse to hire overweight people," said Katsura Sigiura, 37, a Tokyo construction engineer who says he is "borderline" tubby. "It makes me angry that the government has started this without consulting us."

I know this isn't quite what this topic was originally about, but here's a good article on one reason why healthcare is so expensive.

from healthbeatblog.org
The Disease: The Exorbitant Cost of U.S. Healthcare; The Symptom: The Uninsured and Underinsured



Over at Healthhcare Policy and Market Place Review, Bob Laszewski suggests that the elephant in the center of the room is the cost of health care—and I would add, healthcare inflation. The nation’s healthcare bill is rising 6 percent to 7 percent a year—far faster than either GDP or wages. This means that in roughly ten years, your health care bill will double. Even if you have insurance now, do you believe your salary will double over the next ten years? Do you think your employer will be able or willing to pay twice as much for your premiums?

As I have written in the past, U.S. healthcare is so impossibly expensive because we pay more for virtually everything—drugs, devices, hospitals, physicians’ services. Physicians complain that their incomes are not rising as quickly as their costs—and it is very true that the doctors at the low end of the income scale (the family docs, pediatricians, internists, general surgeons, primary care physicians, geriatricians and palliative care specialists) need to earn more.

Yet overall, better-paid physicians continue to command higher incomes each year. Even though fees for many of their services remain flat, they have more than made up for the difference “on volume”—i.e. by “doing more”—more tests, more treatments. Medicare bills confirm that they are taking in more each year.

The bottom line is that many specialists now take home four to six times as much as primary care physicians who typically earn $125,000 to $160,000 a year —yet it is difficult to argue that the services these specialists provide are four to six times more valuable. Meantime, hospitals pay for much of a specialists’ overhead—the operating room, the nurses, the receptionists, the testing equipment—while a primary care provider must cover most of his own overhead.

Granted, specialists who perform the most aggressive and expensive procedures usually spend more years in training. But does it make sense to pay them four to six times more, every year, for thirty or thirty-five years? It would make much more sense to subsidize medical education in specialties where we need more doctors .

How do we justify asking taxpayers to pay some doctors $500,000 or $600,000 or $800,000 a year (and taxpayers now pick up slightly more than half of the nation’s healthcare bill) when we cannot afford to provide basic healthcare for all of our citizens? People who cannot afford health care insurance for their own families are subsidizing those $500,000 incomes.

Other nations put patients first, and outcomes are better, even though specialists in other developed countries earn roughly 40 percent less, as a share of per capita GDP.

I’m not arguing for slashing specialists salaries, but clearly, health care dollars need to be redistributed, up and down the physician income ladder. We need to adjust fees, with an eye to the benefit to the patient.

Finally, research shows that when a service becomes particularly lucrative, volume increases: over-payment drives over-treatment.

I’m focusing on payment to physicians here only because I have talked so often in other posts about how health care dollars are squandered on over-priced, often unproven, drugs and devices—not to mention seven-figure salaries for hospital CEOs who don’t seem to understand the difference between a hospital and a hotel. Too often, they would rather invest in the hotel-like amenities that will bring in “the customers” than the systems that would make patients safer.

Why focus on the cost of care rather than keeping our eyes fixed on the need for care? Because, as Bob Laszewski argues below, if we don’t face up to costs, we won’t be able to fill the need.

Finally, yes, I know how much we have spent bailing out Wall Street banks. And, in my view, the money was not spent wisely. (I’ve said most of what I have to say about Wall Street in my first book, Bull! A History of the Boom and Bust, 1982-2003. )

But the difference between the bail-out and healthcare legislation is this: when we promise universal coverage we are not talking about a one-time expenditure, this year or next. We are talking about a recurring contribution to a industry riddled with corruption and conflicts of interest where costs are climbing by 6 percent to 7 percent a year.

Anyone who thinks that making that industry larger will somehow make it easier to make the tough decisions about where to cut costs hasn’t been paying attention to how American capitalism works.

When an industry grows, it power increases; its lobbyist are better –funded; and the chances of persuading it to settle for a smaller piece of the pie diminishes. (See: the oil industry; the investment banking industry . . . )

----------------------

To Break the Bank or Not to Break the Bank With Health Care Reform?--The Wrong Question

By Bob Laszewski, Healthcare Policy and Marketplace Review, January 30, 2009


The new debate in Washington these days seems to be over whether we can or cannot afford to do health care reform given the financial crisis and the huge budget deficits.

Some argue that with the rising unemployment rate, certain increases in the number of those uninsured to follow, and the need to inject money into the system, this is the right time.

Others say that in the face of daunting national debt it is not the time to dramatically increase our entitlement obligations even further.

In my mind this is a false debate.

Both sides seem to presume that solving the access problem, and not the cost of care in America, is the real problem.

I come from the perspective that the onerous cost of health care in America is the problem that needs to be solved. Solving it is exactly the right thing to do in the face of an already dramatic increase in the national debt.

The number of those uninsured--or on the edge of becoming uninsured--is a symptom just as the looming insolvency of Medicare is a symptom of the health care cost problem.

If you want to really reform America's health care system and pay for more people to be a part of it you have to solve its long-term cost problems.

What better time to do that then when we are faced with enormous budget deficits that, even before the financial meltdown, were always being driven to a great extent by health care costs?

But here's the rub. Dealing with costs is the problematic part of health care reform. In a way, agreeing that we should pay to cover everyone is the easy part. Kind of like buying that new Porsche is the easy part--who wouldn't want one? The hard part is paying for it.

The CBO's December report on the cost of health care broken down by 115 options tells the story of real health care reform. *MM-- I have written about the CBO report here

The discussion on whether specialists are paid too much is a bit silly; as far as I know, anyone can apply to medical school, and once accepted, can specialize in whatever they want. Presumably, there is a reason that doctors are choosing to be general care/family doctors instead of brain surgeons. I don't know what it is, but is very likely that some of it is not financial. Maybe by the 8th year they are burned out on school and the lure of an extra $100K/year isn't that exciting; maybe it's got to do with following what they love; or maybe it's just plain the difficulty of the various areas.

The result is the same: if you increase pay, you get more doctors there. If you decrease pay, you get a shortage of doctors. There is no such thing as a "correct" number of doctors or a "correct" salary; the best we can do is give people a choice of what they want to do and get the obstacles out of the way.

There are tons of regulatory obstacles, from the AMA monopoly, to state insurance laws, to the federal govt's distortion of pricing, to FDA interference in patient-doctor decisions. All of these thing cause incorrect pricing, and are a large part of why competition cannot drive prices down. I'm all in favor of that, but anyone who says things like "specialists make too much" just really doesn't understand the problem.

im not as educated on this suject as i should be because i have heath care now through work. I dont know if universal heath care is the answer, i just think health insurance company should be more regulated. It should be more affordable for those people with lower incomes. Im for everyody having health coverage just not free.

<insert snarky comment here>

One of the major cost factors now is the over-regulation of insurance companies. There is no reason that insurance contracts need any additional regulation over any other contract, such as your contract with your plumber or your exterminator. You need a contract, you need enforcement, you need dispute resolution. What regulations would you want besides that?

Like i said uneducated. But with a plumer or an exterminator there going be negotiations it doesnt seem that way with insurance companies. I work for a home builder and now that times or tough these trades or asked to lower prices but insurance companies prices keep going up. Another thing i dont understand is why if i go into a doctor visit i pay full price say 3$300 but if i got insurance i might only personally pay $30 but then the insurance doesnt pay the other 260 they only end up paying half of that. Why someone who doesnt have insurance have to pay more in the end? The other that gets me is pre-existing conditions should people that need health coverage be able to get it?

This is because there is no free market for insurance, so there is nothing to negotiate. Insurance companies are strictly regulated in what types of policies they may offer. The other reason is because most insurance is through group employers plans. This is because of the stupid tax laws that make it cheaper to get non-portable insurance through an employer instead of portable insurance on your own. Eliminating these two obstacle would go a long way toward creating real competition.



Again, markets are distorted by our lack of choice. If we had the choice to not insure certain procedures, price pressure on the providers would force them to negotiate and close the gap between what groups can get and what private individuals can get. Doctors would be forced to rationally price each procedure, instead of shifting costs around to people who don't have the ability to choose cheaper options.

And these to things are unale to be regulated?

Cash patients can almost always get a discount. Just ask.

Dizzlerock,

If you don't have insurance, you can think of yourself paying retail prices for your healthcare ($300). If you have insurance, you'd be paying wholesale, maybe $200.

Some insurance plans have copays for office visits, prescriptions, ERs, etc., and that's why those costs are less.

Like Henry said, if you go to the doctor and have the $300 to pay but don't have insurance, the doctor's office will likely take a substantial discount so they can get paid immediately.

The reason insurance pays less than that $300 in your example is because insurance companies have contracted rates with doctors and other providers. The provider signs a contract agreeing to charge a certain amount for people who have that insurance. The doctor can charge people without insurance whatever they want, usually much more than the contracted rate.

Regarding pre-existing conditions, you need to realize that when you get insurance, the insurance company is agreeing to take you on as a risk. If you have pre-existing conditions and the carrier thinks your medical costs will be more than the premiums you pay, they'd be losing money by offering you a policy.

Insurance is regulated by each individual state so the rules where you are might be different than the ones where I'm at, and the rules for pre-ex conditions are different for group coverage through employers, as opposed to private individual insurance you'd get on your own.

Pre-existing conditions are covered on group plans but not individual ones, and there are limitations on coverage with group plans if you've had a lapse in coverage of more than 63 days.

Does that answer your questions? I'd be happy to get into this more, but it can get pretty confusing pretty quickly.

It does get confusing fast. The whole point with pre-existing conditions is the person with the condition is going to be seen by a doctor anyway so now that person will aquire a massive medical bill which will probably make this person go broke and then be put on medcaid which we pay for as a whole anyway. So i think its crappy that insurance companies have the right to turn you down because you are a risk of -ev if you will. most people dont chose to get sick. The whole thing is just frustrating. And with the doctors signing rates with insurance companys and then charging an average joe whatever is price gauging and wrong it should be the same cost for any procedure no matter whos paying. I understand people go in busisness to make money, but there no way to live life with out some kind of insurance, auto insurance you have to have if you want to drive but if you cant drive its harder to find a job, Health insurancre is a must if you plan on having a family but not all jobs offer it and its almost impossible to pay for without company help, and if you want to own a house must have homeoners isurance. and all these companys make huge amounts of money because most of the time you really dont need it.

It's important to realize that people do not have a right to healthcare. It sounds harsh, but healthcare is a service like any other industry. Someone has to incur an expense while providing it, and they need to be compensated in order to continue.
In the case of someone with a pre-existing condition, it's not right to force the expense of the care on another party, whether that be a doctor, insurance company, or taxpayer in the case of nationalized medicine. It should also be noted that if a doctor or other party chooses to volunteer their service or resources to help the individual, that's great, but it shouldn't be forced on anyone else.

In a normal situation, it's up to the provider and the receiver to work out a fair payment for services rendered. Competition arises when you have multiple providers vying for the business of a customer (recipients of service are still customers, regardless of industry). Competition produces a better quality of service while lowering cost.

The problem with today's healthcare industry is reliance on insurance for everyday service, rather than catastrophe. Insurance picks up the majority of the tab, and so people are not concerned with the actual cost of their service. This eliminates competition that normally drives improvement. There are people that are realizing this and doing something about. There are good doctors who are now running practices without having involving insurance companies involved. By cutting out the overhead associated with insurance, they can keep their costs down. Since the patients are responsible for the cost of their care, they are concerned about value, which encourages competition. People who are underinsured, or simply uninsured, can receive quality healthcare at a reasonable price.

A combination of HSA plans and catastrophic insurance would also help. I kinda lost track of my post so I won't go any deeper there.

for the tl;dr crowd,
get insurance out of the way. make people responsible for their own well-being.

well i do understand that health care is a right but i as a tax payer regardless if my company provides health insurance am paying for medicaid and medicare which is free health care to people who are either less fortunate or lazy. so it seems to me the only people not getting covered are middle class people who make just enough to not get coverage which is a joke. I dont know howto fixthe problem but none the less theres a problem. i agree with people over use health insurance going tothe doctor for ant little thing which is also worng. What i dont understand people with serious problems are the ones that should have health coverage weather its pre existing or not. Cause its not like these people wont get seen they still are in the hospital or the doctors office so who ends paying for that. taxpayers. so if we already paying for others who can't afford why not everybody have it. this probably sounds stupid and socialistic but insurance companys shouls be non-profit. i dont even now if i trurly agree with that last statment. I know its free enterprise but i jsut feel like there are a lot of big corparations that are just greedy which in the end will only destroy this country.

Are you yanking my chain? If so, you're doing a good job of it.

They are already OVER-regulated. We don't need more regulation, we need less, so that competition can drive prices down.

This is such an important point I wanted to highlight it again. If we could do one fix to the system in the US, it should be to reverse the tax consequences of buying healthcare, so that it is taxable for employers, non-taxable for individuals. Within 5 years, medical costs would actually drop -- not just reduce the rate of growth, but drop.

Within 5 years, no doctor would accept medicare/medicaid payments, and that system would have to be restructured to the new economic reality, and that would send a second wave of innovation and cost cutting through the industry.

Simple fix, and zero percent chance congress would ever do it, because they'd lose millions in campaign funds.

The "pre-existing condition" problem is the toughest question of all. Think about it in terms of car insurance, and it helps focus on the correct issues.

While it's not strictly free market, I would not have a problem with a law that says that once an insurance company takes on a client, they cannot drop them as long as the person wants to renew. What this does is encourage people to get insurance when they are young and healthy, and then keep it. If you wait to get insurance until after you are sick, too bad. Time to rely on the kindness of your fellow citizens (and it's there; I know from personal experience) and some state and local support programs.

This already applies in Colorado, but the carrier can increase their premiums once a month or as often as they like to a point where it becomes impossible to afford.

With employer help or not its still almost impossible to afford.

And that's what needs to be addressed. Cost.

this is like saying the thing that needs to be addressed about the Ebola virus is how it kills you so fast.

Funny.

I think people are mis-informed when they say they want socialized medicine, that it's the answer to all of our problems. That's not the answer, reducing costs is. Reducing malpractice liability, reducing hospital profits, reducing the 7-14% annual rise in health insurance premiums, reducing costs for new medicines and new technologies.

Just because you're slightly more aware of how things work doesn't mean everyone else is. Have anything to add, or are you just being insulting?

He's a dirty Jew Lawyer, don't listen to him.

"serious face": Reducing costs is the key but my point with my jopke was that reducing costs will require a complete overhaul of everything related to health care (which some people think socialized medicine will accomplish). Some doctors make way too much which leaves a lot of doctors making not enough to justify what they go through to become a doctor. Health care companies throw gobs of money at candidates so they can get preferential laws later. The fact that drugs cost so much more here than they do basically anywhere else in the world doesnt help. I mean look at all the things you say need to be changed (have their costs reduced). That is basically everything!

The current system is completely broken and that is why you see so many people championing socialized medicine. They think that everything needs to change. I dont think socialized medicine will make the problem better or worse. It would just be a different kind of suck.

I am a hygenic Jew who cannot find employment as a lawyer. You can still listen to me.

We need to seriously stop using the phrase "completely broken" unless you can think of another place in the world you would rather get into a car accident right now.

Nowhere? Really? Big surprise.

One day without a shower and a job and your out. OK?

London. It would be interesting to crash on the left side of the road.

And this argument is completely unpersuasive. If America gets a D- on the health care test and everyone else gets an F (not agreeing with these grades just a hypothetical), should I celebrate?

Not to mention every independent ranking of the health care systems of countries disagrees with you. They all just hate America though.

Definitely not Japan.

http://www.msnbc.msn.com/id/29013386/

Injured man dies after rejection by 14 hospitals

TOKYO - A 69-year-old Japanese man injured in a traffic accident died after paramedics spent more than an hour negotiating with 14 hospitals before one admitted him, a fire department official said Wednesday.

The man, whose bicycle collided with a motorcycle in the western city of Itami, waited at the scene in an ambulance because the hospitals said they could not accept him, citing a lack of specialists, equipment, beds and staff, according to Mitsuhisa Ikemoto. One of the 14 finally admitted the man when the paramedics called it for a second time.

fair is fair. This makes me feel better about some things we do in America, health care wise.

What a debacle. Remember when Japan was going to replace us as the next superpower?

That was always tongue in cheek. Their average height is only 5' 7", i mean, cmon, really, a bunch of 5' 7" guys running the world.


I DON'T THINK SO!

you might never see them coming!

I read somewhere once that the majority of Navy Seals are relatively short for a variety of reasons. Anyone know if that is true?

Japan is like our mirror. We are great at short term solutions and thinking about the here and now. Japan is great at thinking 50 years ahead but sometimes misses/ignores the problem right in front of them.

This was the second story lately of someone dying in Japan from things that are routinely treated here. I wonder what the death toll needs to reach before people realize central planning doesn't work?

Most military positions have a height and weight range. I think pilots can be a max 6'2" and that is rare.

Seals have to fit in tight spots, they don't want a 6'5" 225lb yoked guy as an assassin.

He would be carrying the SAW in the ARMY.

I think for all Western societies the coming years will be ones of rationing health care as no society is going to be able to pay for everything that everybody wants or in a lot of cases needs.

In places like Canada and Japan the rationing results in waiting times and in this case a lack of emergency service and is spread over the entire population and not decided totally by somebodies economic situation.

In the US the rationing takes the form of a large number of people having little of no health coverage while those who have the best coverage have the best care possible and for the most part the rationing is one of economics with those with the most money having the best care.

No country is going to be able to keep spending more and more of it's GDP on healthcare forever and every country really needs to take it's ideological blinders off and come up with solutions that make sense for them. In Canada it would be impossible for our universal system to go back to a private insurance one and it's going to be very very hard for the US to move towards a Canadian or European system even if it is the best one which is another debate since the health care cultures are so different.

good timing for the purposes of this argument: http://news.yahoo.com/s/ap/20090204/ap_on_...ildren_s_health

basically, it sounds like everyone likes sCHIP but the GOP wants to restrict access to people who they believe CANT get private insurance under any circumstances. they estimate of the 4 million kids covered under this bill that 2.4 million of them could have gotten private insurance instead.

if I am following the argument right that means the GOP believes it is better to make the lower middle class pay for their own kids insurance in the private sector rather than making the taxpayers as a whole pay for 2.4 million kids to get free health insurance coverage through the government.

Discuss.

Huh? I have Kaiser for my Kids with all the bells and whistles. It is $100 a month for each individually, but as a family we have gotten it down to $460 a month for all four of us. I don't understand these statements. I could go get health insurance on my kids tomorrow for $60 a month or less. That is a cell phone bill.

It seems obvious beyond controversy that if someone CAN get private insurance they should, rather than pass the cost on to strangers. I'm not sure why this is even a question.

If you are wondering whether a tax on the poor (cigarette taxes) to pay for health care for upper-middle class kids is fair or moral, my vote would be no, it's not.

you don't care about your kids if you're not paying iphone rates.

I guess we're on the same page. Holy shit.

Also,


I just bought this tshirt

I find it funny that health care premiums continue to rise by 6-7% every year, but re-imbursement to us doc's continues to go down every year. Co-payments for patients are at an all time high as well. Many of my patients now have $30-40 co-pays. I see more and more patients every year to make the same or slightly less money every year. I am seriously considering leaving the healthcare field, and getting more rental properties.

Having the goverment run healthcare would be even worse. Medicare and medicaid are the worst when it comes to payment. All other health insurance companies base their prices off of what medicare will reimburse. In attempts to drive down costs, medicare cuts services that they will pay for, and in turn, other insurers are able to do the same. However, if the standard of care requires that the patient needs such treatment, you must provide it for the patient even though medicare will not reimbuse you for it. You are supposed to collect from the patient. Blood from a stone comes to mind. In other instance, they won't pay for certain tests, but if those tests aren't done, you can't get paid for the treatment. (example:Xrays-> treatment of back pain, medicare won't pay for the xrays, but you must provide proof that they were done to get paid for treating sciatica)

Our system is terrible now, but I feel it is better than socializing it. The costs would become astronomical. Many people avoid going to doctors because they don't have insurance, and can't afford it. Imagine if they suddenly had someone else paying the bill. They would be showing up at the office everytime they have a sniffle.

The future is murky at best, at least from my vantage point.

According to research published in Forum for Health Economics and Policy, community ratings regulations (which require insurers to offer the same rate to every individual, regarless of age, gender, or health status) raises premiums by 10 to 17 percent for individuals and 21 to 33 percent for families.

Guaranteed issue regulations, which require insures to offer coverage regardless of a group's or individuals health status are also expensive. For example, in New Jersey, premiums are twice as high as those charged for similar individual and family policies offered in Pennsylvania.

Regulations which prevent insurers from excluding specific doctors or hospitals from coverage also drive up costs.

A legislator here in Colorado has introduced a bill to stop medical insurance companies from rating females higher than males, saying it's discrimination. Of course it's a woman who introduced it.

What a dumbass. Women have much higher utilization, that's why their rates are more expensive. Just like males pay higher car insurance premiums because they have higher and more expensive claims.

She doesn't realize that she'll pay more for community rates. It's infuriating to see politicians attempt to take control of our insurance policies, especially when it's so obvious they're completely clueless.

You just have issues with women, we all know it. But, so do I, so preach on, brother.