This is going to be a fairly long post about what I believe is the solution to health care in America. I’m going to touch on the scientific reasons, the economic reasons, and also discuss the emotion impact. I’m going to try and give goals for each of my positions, as well as explanations on how this position is going to achieve that goal. As a for the record thing I’m not getting anyone to review this before posting it so it likely will have spelling and grammar errors, and may not be as organized as it should be, and while you are welcome to criticize those parts my hope is that you will look past them and discuss the various points and how valid you feel like they are.
The problem
Our current system is too costly because of regulations which prevent small at home type hospitals from operating, as well as the lawsuits against medical personal. These regulations also prevent new drugs from being brought into market, and increase the time and costs involved to bring the drug to market. On the flip side the patents or copy rights to drugs keep drug prices very high in this country because once a drug is created only that company can legally produce it for many many years. This is all designed through corruption of our state and federal government to benefit the few at the cost of the many.
Universal healthcare cuts back much of company’s corruption, lowers medical and drug costs. It is not without its problems though as it removes much of the incentive to become a doctor, which leads to less doctors, longer wait times, or patients not qualifying for needed treatments. This again remove options of the poor to get healthcare.
The goal
To create a system where everyone can get healthcare, provide an incentive for people to become medical professionals, and lower healthcare costs.
The solution
1) Deregulate medical buildings
2) Lower patent and copy right terms
3) Making being a medical personal easier
4) Regulate the amounts of lawsuits
5) Bringing it all together
1) Deregulate medical buildings
Did you know that in an abortion clinic it’s required to have hallways big enough to fit two gurneys side by side? Did you also know that they don’t use gurneys in an abortion clinic? The point being there are many laws in place that regulate what a medical building must have, and these laws double if not triple the cost require to build these facilities. By removing these regulations, we could have doctors who saw patients out of their homes completely removing the overhead costs of having a hospital at all. Obviously, this opens concerns about infection and hygiene but if we want to lower costs and allow more people to make money in the medical profession we need to be able to treat it like any other profession. If you want to pay the extra money for a nice that is always an option, but for the poor this gives them other options to get the treatment they need. And as with everything else, as the demand in the hospitals drops, the cost of going to the nicer facilities will drop as well. This is what capitalism excels at. Once we’ve done that we can setup classification of facilities by standards.
2) Lower patent and copy right terms
Many drugs are patented and copy righted for life, and they have a monopoly on the market so they can charge through the roof. Other companies have to wait years before they are able to make generic versions of the drugs. Companies spend a LOT more on marketing than they do on research. The government is doing most of the research. “75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding†source: http://www.latimes.com/opinion/op-ed/la-oe-1027-mazzucato-big-pharma-prices-20151027-story.html
Government pay for the research (as with the case of the epi-pen) and then private company buy the patient, regulated all the schools to use it, and then increased the price by 5000%. We need to break the patent/copy right monopoly sooner, and force drug companies to invest into research rather than milking what’s already been created.
3) Making being a medical personal easier
One of the best ways to lower the cost of something is to have a better supply. Currently to be a doctor you need over a decade of school, from which you will exit with a mountain of debt, and there are no half measures here. The closest being a nurse practitioner who is still over a decade in the making. Also let’s be clear, medical malpractice is the 3rd cause of death in this country (at over 200 thousand a year) so it’s not like the people who go through all those classes are providing. So, let’s make it easier to break into the medical profession. Let create tiers like what we do with emergency personal. EMT is the first, paramedic is the second, ER nurse is the third, doctor is the fourth. My suggestion is to have 5 tiers for both general and surgery. The higher the tier the more schooling that’s required, and obviously testing and certification for each of level. I purpose to do the tiers in two year increments so Tier 1 = two-year degree, Tier 2 = four-year degree, Tier 3 = six-year degree, Tier 4 = eight-year degree, and Tier 5 is what we have today. Now this could mean 75% in class and 25% on the job, or whatever the industry feels is best, but the amount of time it takes to get to the point where you can see someone needs to be shortened. Also, the ability to prescribe drugs would be attached to the various levels as well.
4) Regulate the amounts of lawsuits
If we put tiers in place then there needs to be an understanding that the less you spend on a doctor the less you can sue them. This could be regulated based on the tier of the individual who saw you or the amount of money you spent to receive care. For instance, if you saw a tier 1 then you couldn’t sue him for more than 10k, tier 2 30k, tier 3 100k, tier 4 200k, and tier 5 unlimited, or it could be something like 100 times what you spent so that if you had a $20 doctor visit then the most you could sue that doctor for would be $2,000, but if you spent $300 then you could sue for 30k. Accidents are going to happen, and if you want to take a higher risk to save money then the person trying to provide you care needs to have the incentive that one mistake isn’t going to bankrupt him.
5) Bringing it all together
Once we have a system in place where medical care is much cheaper and more available we can cheaply subsidize it. For instance, it wouldn’t be expensive to cover 100% the cost for tier 1 medical professions in a tier 1 building, 80% for 2/2, 60% for 3/3, 40% for 4/4, and nothing for 5/5. Insurance companies could easily adapt to this system, and allow for MUCH more flexibility in healthcare plans that cover the difference, and work on top. Making it affordable to even see tier 3 medical professionals. Doctors have the freedom to build their own practices without having to worry about the regulations of the facilities, and our society would likely even have doctor house calls again. If we can stop trying to remove risk, and stop trying to force people to work for less I think we can easily provide healthcare for everyone.
So ... free market witch-doctoring?
Medical care is expensive, because ... we do a lot more of it now than when Doc carried a black bag on house-calls in Gunsmoke. Also people live longer so our terminal stage expenses are going thru the roof ... and people are hypochondriacs who self medicate badly. There is no free lunch, and no escape from death. Don't expect me to pay for your problems, and get real about human life. Nah ... too simple, doesn't involve economics and politics.
I admire your intent, but with 20 years experience in medical admin, and recent experience with a very elderly mother ... the best thing is to die young doing something you like. Cuts out the insurance guy, the government, the medical pharma complex.
Quote from: Baruch on October 06, 2017, 07:52:55 PM
So ... free market witch-doctoring?
Medical care is expensive, because ... we do a lot more of it now than when Doc carried a black bag on house-calls in Gunsmoke. Also people live longer so our terminal stage expenses are going thru the roof ... and people are hypochondriacs who self medicate badly. There is no free lunch, and no escape from death. Don't expect me to pay for your problems, and get real about human life. Nah ... too simple, doesn't involve economics and politics.
I admire your intent, but with 20 years experience in medical admin, and recent experience with a very elderly mother ... the best thing is to die young doing something you like. Cuts out the insurance guy, the government, the medical pharma complex.
Other countries do a better job of medical care than we do. We could just copy the ideas.
Other countries systems also have problems. I think my system is better.
Quote from: Cavebear on October 08, 2017, 03:51:30 AM
Other countries do a better job of medical care than we do. We could just copy the ideas.
We need to rejoin the British Empire? Definitely. No more colonial shit lords.
Quote4) Regulate the amounts of lawsuits
Arbitrary limits on awards on lawsuits are a terrible idea. There are legitimate reasons people get awarded millions or even tens of millions of dollars as a result of medical malpractice. A person that loses their ability to earn a living, spends the rest of their life in pain and has to have millions of dollars in additional medical procedures as a result of the gross negligence of medical practitioners ought to be compensated justly.
Quote from: PopeyesPappy on October 08, 2017, 08:15:35 PM
Arbitrary limits on awards on lawsuits are a terrible idea. There are legitimate reasons people get awarded millions or even tens of millions of dollars as a result of medical malpractice. A person that loses their ability to earn a living, spends the rest of their life in pain and has to have millions of dollars in additional medical procedures as a result of the gross negligence of medical practitioners ought to be compensated justly.
Some people don't like the notion of consequences. The AMA isn't policed sufficiently as it is. The real question is, should we use tort law to create consequences?
Quote from: PopeyesPappy on October 08, 2017, 08:15:35 PM
Arbitrary limits on awards on lawsuits are a terrible idea. There are legitimate reasons people get awarded millions or even tens of millions of dollars as a result of medical malpractice. A person that loses their ability to earn a living, spends the rest of their life in pain and has to have millions of dollars in additional medical procedures as a result of the gross negligence of medical practitioners ought to be compensated justly.
Class action suits by commercial lawyers are a scam. They get most of the settlements.
Quote from: Cavebear on October 08, 2017, 10:22:53 PM
Class action suits by commercial lawyers are a scam. They get most of the settlements.
True ... that is why we should have a Colosseum and throw the accused to the lions. Unless you think the lions might get an upset stomach?
Yes, as a civilization (more than the US) we need a really deep think about law, courts, lawsuits ... but probably we can't make that happen ;-(
Quote from: Baruch on October 08, 2017, 10:25:07 PM
True ... that is why we should have a Colosseum and throw the accused to the lions. Unless you think the lions might get an upset stomach?
Yes, as a civilization (more than the US) we need a really deep think about law, courts, lawsuits ... but probably we can't make that happen ;-(
Civilization is more than just the US and I have never denied that.
Quote from: Cavebear on October 08, 2017, 10:28:16 PM
Civilization is more than just the US and I have never denied that.
Good. I don't think you are nuts. Not that is much of a claim. I consider poetical irrationality to be a higher rationality, but you are free to disagree, literally. Homer (Simpson) trumps Play-do.
Quote from: Baruch on October 08, 2017, 10:42:41 PM
Good. I don't think you are nuts. Not that is much of a claim. I consider poetical irrationality to be a higher rationality, but you are free to disagree, literally. Homer (Simpson) trumps Play-do.
Ah, we start to see what you are up to. Attacking rational thought in the guise of bad jokes and non-sequiturs. I keep asking why you do that and you never answer.
Quote from: PopeyesPappy on October 08, 2017, 08:15:35 PM
Arbitrary limits on awards on lawsuits are a terrible idea. There are legitimate reasons people get awarded millions or even tens of millions of dollars as a result of medical malpractice. A person that loses their ability to earn a living, spends the rest of their life in pain and has to have millions of dollars in additional medical procedures as a result of the gross negligence of medical practitioners ought to be compensated justly.
And not limiting lawsuits makes it so that people who don't have the financial power to defend them can't be in the medical profession, as well as making it so that anyone trying to help others can't for fear of getting suited. So instead of getting "subpar" medical help... they get no medical help at all and die.
Quote from: Coveny on October 08, 2017, 11:23:23 PM
And not limiting lawsuits makes it so that people who don't have the financial power to defend them can't be in the medical profession, as well as making it so that anyone trying to help others can't for fear of getting suited. So instead of getting "subpar" medical help... they get no medical help at all and die.
Class action suits do offer collective response. The only problem is that the lawyers get to much of the settlement.
Quote from: Cavebear on October 08, 2017, 11:40:55 PM
Class action suits do offer collective response.
Which is why we need them. As individuals, it is difficult to take on a giant corporation or in cases of price fixing an entire industry.
QuoteThe only problem is that the lawyers get too much of the settlement.
Which is why regulations to fix class action lawsuits should focus on how the lawyers are compensated not on how much the victims get.
Quote from: Coveny on October 08, 2017, 11:23:23 PM
And not limiting lawsuits makes it so that people who don't have the financial power to defend them can't be in the medical profession, as well as making it so that anyone trying to help others can't for fear of getting suited. So instead of getting "subpar" medical help... they get no medical help at all and die.
I'm curious what your experience with the costs of malpractice are. It is my understanding that actual malpractice insurance premiums for a nurse in most states are less than what I pay for a similarly sized umbrella liability policy. Somewhere in the neighborhood of a $100 a year for a $6,000,000 policy.
Other's pay more. A GYN can pay $30,000 a year for a malpractice policy. Which is still in the scheme of things only a drop in the bucket of healthcare costs.
Quote from: PopeyesPappy on October 09, 2017, 07:45:57 AM
Which is why we need them. As individuals, it is difficult to take on a giant corporation or in cases of price fixing an entire industry.
Which is why regulations to fix class action lawsuits should focus on how the lawyers are compensated not on how much the victims get.
I also think lawyers get to much money, but I don't advocate fixing their pay in any way as that doesn't seem to work from my economic research. However, I think if you made the laws simpler the need for lawyers would disappear. Given that lawyers create laws that would be as radical change as the healthcare change I'm purposing to make it happen, and just as I don't see anyone adopting my medical system, I don't see anything about law reform passing either.
Quote from: Coveny on October 09, 2017, 08:21:13 AM
I also think lawyers get to much money, but I don't advocate fixing their pay in any way as that doesn't seem to work from my economic research. However, I think if you made the laws simpler the need for lawyers would disappear. Given that lawyers create laws that would be as radical change as the healthcare change I'm purposing to make it happen, and just as I don't see anyone adopting my medical system, I don't see anything about law reform passing either.
That is the point, with a big plate of spaghetti ... you don't know where the end of the pasta is, to start rolling it. Yes, we can't have medical care reform, unless we have legal reform. But it gets worse, we can't have legal reform, unless we abolish the US as an independent country, but resume being a crown colony of Her Majesty.
Quote from: Cavebear on October 08, 2017, 11:03:20 PM
Ah, we start to see what you are up to. Attacking rational thought in the guise of bad jokes and non-sequiturs. I keep asking why you do that and you never answer.
Rational? People aren't from Vulcan.
All Greeks are assholes
Socrates is a Greek
Therefore Socrates is an asshole
That was perfectly rational ... disagree? Rationality just keeps you from spilling logic all over your shirt when you gorge on argument. It has nothing to do with Truth. Truth/Falsehood was mis-defined deliberately by the logicians, to get them more jobs.
Quote from: PopeyesPappy on October 09, 2017, 07:45:57 AM
Which is why we need them. As individuals, it is difficult to take on a giant corporation or in cases of price fixing an entire industry.
Which is why regulations to fix class action lawsuits should focus on how the lawyers are compensated not on how much the victims get.
That isn't the point. Most doctors are in medicine to make big bucks, not to help common people. They are part of the Elite. So of course they resent anything that costs them money, like lawsuits, and malpractice insurance. I would do the same if I were a doctor. Where I work, in the military, we don't have to have malpractice insurance, because you would have to sue the government, not the individual ... and look how far that gets you. We have perfect socialized medicine, such as it is quality wise, in the military ... legal consequences are taken care of thru the JAG, not tort law. The answer is total war, full mobilization of the entire population for a cage match to see which small population survives. In that case, you will all have full medical care as part of your draft notice.
Quote from: PopeyesPappy on October 09, 2017, 07:45:57 AM
Which is why we need them. As individuals, it is difficult to take on a giant corporation or in cases of price fixing an entire industry.
Which is why regulations to fix class action lawsuits should focus on how the lawyers are compensated not on how much the victims get.
Total agreement there...
Quote from: Coveny on October 09, 2017, 08:21:13 AM
I also think lawyers get to much money, but I don't advocate fixing their pay in any way as that doesn't seem to work from my economic research. However, I think if you made the laws simpler the need for lawyers would disappear. Given that lawyers create laws that would be as radical change as the healthcare change I'm purposing to make it happen, and just as I don't see anyone adopting my medical system, I don't see anything about law reform passing either.
So you agree that the lawyers are the problem, but don't want to fix that. You'd rather focus on fucking the victims.
Fuck...
Quote from: PopeyesPappy on October 12, 2017, 10:17:21 PM
So you agree that the lawyers are the problem, but don't want to fix that. You'd rather focus on fucking the victims.
Fuck...
Well that escalated quickly. Hmm
Yes I agree they are the problem. Yes I do want to fix that, but it's not this topic. I'm trying to help the victims but you seem to be missing that part.
Quote from: Coveny on October 12, 2017, 10:52:36 PM
Well that escalated quickly. Hmm
Yes I agree they are the problem. Yes I do want to fix that, but it's not this topic. I'm trying to help the victims but you seem to be missing that part.
But ... but ... it is a plate of spaghetti. Doing one thing over here, while doing nothing over there ... typical short sighted government program. Just make it a law that the doctors can't be sued. See ... dictatorship solves so many problems ... if you are the dictator.
Quote from: Coveny on October 12, 2017, 10:52:36 PM
Well that escalated quickly. Hmm
Yes I agree they are the problem. Yes I do want to fix that, but it's not this topic. I'm trying to help the victims but you seem to be missing that part.
I'm not missing the part where you want to lower the cost of medical care. I just don't see where you have put much thought into your plan. It sounds more to me like you've been listening to Trumplethinskin's talking points. Putting arbitrary caps on malpractice awards is screwing victims of malpractice, and would not result in particularly big savings.
The actual costs of malpractice settlements are less than 0.5% of our medical costs. A bigger problem is defensive medical practices. Even then the cost of malpractice insurance, suits, and defensive medical practices combined account for less than 3% of our medical costs. In 2016 a 3% savings would have brought our per capita cast down from $10,345 to $10,034.65. That a whopping per person savings of $310.45. It's a start, but hardly saving our healthcare system.
Quote from: PopeyesPappy on October 13, 2017, 08:58:57 AM
I'm not missing the part where you want to lower the cost of medical care. I just don't see where you have put much thought into your plan. It sounds more to me like you've been listening to Trumplethinskin's talking points. Putting arbitrary caps on malpractice awards is screwing victims of malpractice, and would not result in particularly big savings.
The actual costs of malpractice settlements are less than 0.5% of our medical costs. A bigger problem is defensive medical practices. Even then the cost of malpractice insurance, suits, and defensive medical practices combined account for less than 3% of our medical costs. In 2016 a 3% savings would have brought our per capita cast down from $10,345 to $10,034.65. That a whopping per person savings of $310.45. It's a start, but hardly saving our healthcare system.
You are focusing on big hospital and the most expensive care that can be provided. I'm not looking to cap those lawsuits in the least. I'm looking to cap lawsuits to maw and paw medical professions who don't have the financial might that those huge companies have. I'm trying to break up the monopoly that the big healthcare providers have. Capping the lawsuits allows for more competition which in turn lowers the costs. The effect is one step removed from the cause in this case. I want to make it so that someone can get a two year degree and see patients out of his home as a small business if he wants. Something that is impossible today for several factors, one of those factors is lawsuits. If you make it so that entry level personnel are subject to million dollar lawsuits then the ONLY way they can function is to purchase insurance, and the overhead of insuring a minimally trained health care professional from multi-million dollar lawsuits defeats the purpose of a healthcare small business as it won't lower costs significantly.
I get the desire to have only the very best healthcare professionals, and I get that you want everyone seen by only the best. But this is a democracy and you can't force the top 10% of the population into indentured servitude. So you will have to deal with a range of quality of care in the healthcare system until we can mass produce robots that can preform as healthcare professionals. This is the reality of the situation.
What I hear you saying is you want to legalize the sale of snake oil and protect the snake oil salesman from full liability from any damages that might result.
Tell me something. What kind of home health care that can't legally be provided today do you propose these associate degree holding health care providers should be allowed to practice? Perscribe antibiotics? Neurosurgery? Where do you draw the line? Is there one?
Quote from: PopeyesPappy on October 13, 2017, 10:40:31 AM
What I hear you saying is you want to legalize the sale of snake oil and protect the snake oil salesman from full liability from any damages that might result.
Tell me something. What kind of home health care that can't legally be provided today do you propose these associate degree holding health care providers should be allowed to practice? Perscribe antibiotics? Neurosurgery? Where do you draw the line? Is there one?
You hear that because you can't hear what I'm saying over your fears and fantasies.
I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do. That's a strawman fallacy.
Quote from: Coveny on October 06, 2017, 04:12:53 PM
2) Lower patent and copy right terms
Many drugs are patented and copy righted for life, and they have a monopoly on the market so they can charge through the roof. Other companies have to wait years before they are able to make generic versions of the drugs. Companies spend a LOT more on marketing than they do on research. The government is doing most of the research. “75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding†source: http://www.latimes.com/opinion/op-ed/la-oe-1027-mazzucato-big-pharma-prices-20151027-story.html
Government pay for the research (as with the case of the epi-pen) and then private company buy the patient, regulated all the schools to use it, and then increased the price by 5000%. We need to break the patent/copy right monopoly sooner, and force drug companies to invest into research rather than milking what’s already been created.
I want to discuss this area particularly.
The original intent of copyright and patent law was to provide a term where the creator could make a living off their own work without competition; however, in the interests of advancements that might be made based on them, the term was limited and eventually the work would be made public domain.
The fix in patent law is fairly simple -- end the commoditization of patents. Specifically, if a patent is granted for something that was created using government money in the R&D phase, it may not be retained by the original inventor or their organization, but if they relinquish their rights, it reverts immediately to the public domain. They may (and should) license the rights to use the patent if they are not in a position to produce and market it themselves, of course, but it may not be
sold to a third party that was uninvolved in the invention.
Copyright is a whole 'nother problem. Should I ever get published, and assuming I live an average lifespan for a member of my family, anything I write will not go into the public domain until 2130 or thereabouts.
Even I, as creator, think that's nonsense. I can see 'life of the creator +10' so that my estate may continue exclusive rights briefly, so as to provide for descendents and beneficiaries. Life+70, however, only benefits corporations. There's a reason the Sonny Bono Copyright Act was nicknamed the Mickey Mouse Protection Act -- it really was intended to find a way to extend corporate protections of properties, not the protections granted actual creators.
Had my great-grandmother been a published writer, anything of hers would be covered up to 2052 -- by which time all her children, and most of her grandchildren, and many of her great-grandchildren will be dead. I'm the oldest of the great-grands -- and I'll be 89 in 2052.
This is not how copyright was intended to work.
If I were to offer a fix, I'd say publication date+50 or life of creator+10, whichever comes later, no renewals.
One other point, specifically relevant to corporate marketing budgets:
ban advertising of prescription drugs. I am a brilliant man, but I know perfectly well that I am not competent to make my own pharmacological decisions. If I need a 'little purple pill', I expect my doctor and his staff will know that it's an appropriate treatment for me. I have no business going an asking about it. That's the whole point of having semi-annual checkups: so my doctor
knows if I have acid reflux or depression or erectile dysfunction. And that's why I have a doctor, to consult someone who knows this stuff since I don't.
Quote from: trdsf on October 13, 2017, 01:07:35 PM
I want to discuss this area particularly.
The original intent of copyright and patent law was to provide a term where the creator could make a living off their own work without competition; however, in the interests of advancements that might be made based on them, the term was limited and eventually the work would be made public domain.
The fix in patent law is fairly simple -- end the commoditization of patents. Specifically, if a patent is granted for something that was created using government money in the R&D phase, it may not be retained by the original inventor or their organization, but if they relinquish their rights, it reverts immediately to the public domain. They may (and should) license the rights to use the patent if they are not in a position to produce and market it themselves, of course, but it may not be sold to a third party that was uninvolved in the invention.
Copyright is a whole 'nother problem. Should I ever get published, and assuming I live an average lifespan for a member of my family, anything I write will not go into the public domain until 2130 or thereabouts.
Even I, as creator, think that's nonsense. I can see 'life of the creator +10' so that my estate may continue exclusive rights briefly, so as to provide for descendents and beneficiaries. Life+70, however, only benefits corporations. There's a reason the Sonny Bono Copyright Act was nicknamed the Mickey Mouse Protection Act -- it really was intended to find a way to extend corporate protections of properties, not the protections granted actual creators.
Had my great-grandmother been a published writer, anything of hers would be covered up to 2052 -- by which time all her children, and most of her grandchildren, and many of her great-grandchildren will be dead. I'm the oldest of the great-grands -- and I'll be 89 in 2052.
This is not how copyright was intended to work.
If I were to offer a fix, I'd say publication date+50 or life of creator+10, whichever comes later, no renewals.
One other point, specifically relevant to corporate marketing budgets: ban advertising of prescription drugs. I am a brilliant man, but I know perfectly well that I am not competent to make my own pharmacological decisions. If I need a 'little purple pill', I expect my doctor and his staff will know that it's an appropriate treatment for me. I have no business going an asking about it. That's the whole point of having semi-annual checkups: so my doctor knows if I have acid reflux or depression or erectile dysfunction. And that's why I have a doctor, to consult someone who knows this stuff since I don't.
Good points, and I'm not against those methods to lower patient and copyright laws. I would only add that as you mentioned with copyright laws they need to prevent patents from being extended.
I have some issues about making profits off government funded research as well, and think there should be clauses that require repayment of the research grants if the drug is marketed and sold, but I understand that would be daunting, so it needs to hook into some percentage of the sales of the drug goes toward paying the research grant back. I'm just not sure on how the details would be setup on something like that, or what the numbers should look like.
Quote from: Coveny on October 13, 2017, 12:14:24 PM
You hear that because you can't hear what I'm saying over your fears and fantasies.
I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do. That's a strawman fallacy.
You threw some ideas out there for making health care in the US more affordable. One of the ideas you presented was limit the awards on malpractice lawsuits to some multiple of the amount spent. I said I thought that was a terrible idea. I said the amount of a settlement in a lawsuit needs to tied to the damages done not amount spent. I also pointed out that the overall cost of malpractice accounts for less than 3% of overall healthcare costs here. You haven't said anything that convinces me you are right and I am wrong.
You also said you wanted to allow people with 2-year degrees to provide healthcare services out of their homes as a means of lowering health care costs by reducing education costs. I simply asked what kind of services these people would be allowed to provide. I didn't say they would be allowed to do things doctors can't do today. Where is the strawman there?
If you want to reduce healthcare costs by reducing the cost of the education for health care providers you do it by lowering the cost of education. Not by lowering the bar for the kind of education healthcare providers need.
Quote from: PopeyesPappy on October 13, 2017, 10:40:31 AM
What kind of home health care that can't legally be provided today do you propose these associate degree holding health care providers should be allowed to practice? Perscribe antibiotics? Neurosurgery? Where do you draw the line? Is there one?
It sure sounds like you are saying my position is that they will provide services not legally provided today. That is the strawman fallacy.
I'm asking what kind of services your home providers would be allowed to provide under your new rules that they aren't allowed by law to provide today.
Quote from: PopeyesPappy on October 13, 2017, 04:21:19 PM
I'm asking what kind of services your home providers would be allowed to provide under your new rules that they aren't allowed by law to provide today.
The answer is none, I'm not suggesting that they provide any services that aren't allowed by law today. Please stop with the strawman fallacies.
Quote from: Coveny on October 13, 2017, 04:43:48 PM
The answer is none, I'm not suggesting that they provide any services that aren't allowed by law today. Please stop with the strawman fallacies.
OK .. I am now a neurosurgeon. I know that ancient Peruvians practiced trepanning. I should be able to do just as much good, provided I can get my patient to chew some coca leaves ;-)
Quote from: PopeyesPappy on October 13, 2017, 10:40:31 AM
What I hear you saying is you want to legalize the sale of snake oil and protect the snake oil salesman from full liability from any damages that might result.
Tell me something. What kind of home health care that can't legally be provided today do you propose these associate degree holding health care providers should be allowed to practice? Perscribe antibiotics? Neurosurgery? Where do you draw the line? Is there one?
One hundred years ago, doctors weren't viewed by the public as they are today. They were quacks getting an MD from a diploma mill. And those were the good ones, not the patent medicine salesmen (drug pushers). Have things really changed? Since then, there was a massive effort to bring professionalism to the medical profession. It was achieved. But it isn't cost free. If you want free, you get what you pay for.
Quote from: Coveny on October 13, 2017, 12:14:24 PM
You hear that because you can't hear what I'm saying over your fears and fantasies.
I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do. That's a strawman fallacy.
Parsing a double negative sentence. Are you sure you didn't mean ...
"I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now [can] do."
That isn't saying much. Home health care providers are prohibited from doing lots of things that doctors are allowed to do. Like prescribing prescription drugs.
And I don't think you mean that ...
"I am proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do."
Which means they have means beyond what doctors have. A fantasy.
You seem to be saying ...
"I am proposing that associate degree holding health care providers be allowed to do anything that doctors now [can] do."
Which is basically calling them MDs.
PS - "until we can mass produce robots that can preform as healthcare professionals" ... fantasy. Robots assemble doors on cars in car factories. Patients in a clinic aren't cars being assembled. The analogy fails. AI is market fraud, just like "financial advisor". The doctors aren't as much a quack as they used to be, but there are a lot of people who are just as much quack as they were 100 years ago. Not every snake charmer got professionalized.
You want cheap medicine? Look up a YouTube and remove your own appendix. Conservatives are always coming up with scams that are made to look like cost savings, but are just a way of moving the crooked gravy train from one set of bastards to another set of bastards.
You said
Quote from: Coveny on October 13, 2017, 09:57:14 AM
I want to make it so that someone can get a two year degree and see patients out of his home as a small business if he wants.
Insurance premiums aren't the barrier to this market you want them be. According to a 2010 survey of medical professionals the average annual liability insurance premium paid by general practitioners was less than $4000. A nurse can get liability insurance for a few hundred dollars a year. That's not a terrible liability insurance premium for any kind of small business. The medical people that pay large premiums are specialists.
The barrier to this market is people without medical degrees can't legally practice medicine. My question to you is and has been what kind of services do you expect your 2-year degree home healthcare providers to provide? The reason I want to know that is because if your 2-year degree holders aren't going to be able to do anything that they can't do today, then they aren't going to help make healthcare costs more affordable.
Quote from: Baruch on October 13, 2017, 06:47:18 PM
OK .. I am now a neurosurgeon. I know that ancient Peruvians practiced trepanning. I should be able to do just as much good, provided I can get my patient to chew some coca leaves ;-)
Exactly...
Quote from: PopeyesPappy on October 13, 2017, 07:11:29 PM
You said
Insurance premiums aren't the barrier to this market you want them be. According to a 2010 survey of medical professionals the average annual liability insurance premium paid by general practitioners was less than $4000. A nurse can get liability insurance for a few hundred dollars a year. That's not a terrible liability insurance premium for any kind of small business. The medical people that pay large premiums are specialists.
The barrier to this market is people without medical degrees can't legally practice medicine. My question to you is and has been what kind of services do you expect your 2-year degree home healthcare providers to provide? The reason I want to know that is because if your 2-year degree holders aren't going to be able to do anything that they can't do today, then they aren't going to help make healthcare costs more affordable.
Is Coveny = William Shakespeare? "First lets kill all the lawyers ..." Or maybe he is just the ultimate in consumer choice ... let the consumer choose how much medical care they get, and of what degree ... and Obama/Trump will pay for it all. Except as pointed out, as a consumer, most patients are hopeless. Of course, it is anti-libertarian, to prohibit non-architects to build buildings or non-engineers build bridges. To paraphrase the new Muslim mayor of London ... "this kind of thing is the new normal" (daily terrorism).
Quote from: PopeyesPappy on October 13, 2017, 07:12:05 PM
Exactly...
Don't worry, I will get a second opinion from an African witch doctor, before I open your skull ...
Quote from: PopeyesPappy on October 13, 2017, 07:11:29 PM
You said Insurance premiums aren't the barrier to this market you want them be. According to a 2010 survey of medical professionals the average annual liability insurance premium paid by general practitioners was less than $4000. A nurse can get liability insurance for a few hundred dollars a year. That's not a terrible liability insurance premium for any kind of small business. The medical people that pay large premiums are specialists.
The barrier to this market is people without medical degrees can't legally practice medicine. My question to you is and has been what kind of services do you expect your 2-year degree home healthcare providers to provide? The reason I want to know that is because if your 2-year degree holders aren't going to be able to do anything that they can't do today, then they aren't going to help make healthcare costs more affordable.
"For example, malpractice costs in Minnesota could cost anywhere from $4,000 to $17,000 per year, depending on your specialty. But in California, a surgeon can expect to pay anywhere from $22,000 to $34,000 per year."
http://truecostofhealthcare.org/malpractice/
Another interesting site. https://www.gallaghermalpractice.com/state-resources/florida-medical-malpractice-insurance/
Also there are two other factors.
1) How are is the cost going to change if the person insured less qualified but still opened up to the same level of malpractice suit? (understand the expectation is there will be more suits)
2) This is aimed at people who have less money. Even at the minimum of $4,000 a year that's pretty steep for the 75% people who live paycheck to paycheck. https://www.cnbc.com/2017/08/24/most-americans-live-paycheck-to-paycheck.html
As far as what they "can" do. I'm open to it. My assumption is that the tier 1s will focus on the most common minor illnesses. Sinus infections, common colds, flu, etc. The course will go over not only the symptoms but major gotchas to look out for. Also as part of the system there would be medical databases where the symptoms could be entered and possible illnesses listed. Obviously with guidelines on when the patient should be escalated and how far up the chain they should be escalated. Another thing I didn't mention was that there would be two sets of tiers the general practitioner and the surgeon. Tier 1 surgeons would have a tougher time of it and only be able to do minor things like take blood, stitches, etc. As the tiers went up more complex and dangerous surgeries could be preformed. Now I'm not hard and fast on exactly what each tier can do I was only an EMT and an army field medic so I don't have enough knowledge to set those up, but getting and regulating a review board for the process or some other way to setup a governing body to regulate the tiers wouldn't be hard to do.
Organization only occurs within ... organizations. National Heath Care by the Cadres of The Resistance? I am fine with that. I provide health care, but can't receive it, because I don't wear a uniform. Join the Armed Forces, get heath care etc. It also works to be a US Federal government worker. Anyone else, you are out of luck.
This reminds me of the predictions of how efficient communism would be. It is much more efficient to make a million left shoes all the same size, and only later do a run of a million right shoes of the same size. If you can't wait for the other shoe to drop ;-) ... you are an enemy of the People. Fake efficiency experts like Frederick Taylor (inventor of factory fascism). This is where all you pay attention to is the quantity, not the quality. You want quality, you have to pay for it.
Quote from: Baruch on October 13, 2017, 08:25:53 PM
Organization only occurs within ... organizations. National Heath Care by the Cadres of The Resistance? I am fine with that. I provide health care, but can't receive it, because I don't wear a uniform. Join the Armed Forces, get heath care etc. It also works to be a US Federal government worker. Anyone else, you are out of luck.
This reminds me of the predictions of how efficient communism would be. It is much more efficient to make a million left shoes all the same size, and only later do a run of a million right shoes of the same size. If you can't wait for the other shoe to drop ;-) ... you are an enemy of the People. Fake efficiency experts like Frederick Taylor (inventor of factory fascism). This is where all you pay attention to is the quantity, not the quality. You want quality, you have to pay for it.
The sad thing is you aren't disagreeing with me, but you think you are. I'm trying to provide a mix so that there is both quantity and quality. Basically a socialist or near socialist floor that's available to everyone with a capitalist ceiling for good doctors who prove themselves and "deserve" better pay. This is the whole point of my purposed solution.
Quote from: Coveny on October 13, 2017, 08:40:23 PM
The sad thing is you aren't disagreeing with me, but you think you are. I'm trying to provide a mix so that there is both quantity and quality. Basically a socialist or near socialist floor that's available to everyone with a capitalist ceiling for good doctors who prove themselves and "deserve" better pay. This is the whole point of my purposed solution.
You nor I can do anything, except as the gruppenfuhrer of health in the American Reich. Otherwise ... everyone, including doctors and patients are going to do whatever damn random thing they end up doing. But I get you, you are an "idea" guy ...
You can argue all day long about legal reform that may or may not put more money in the hands of litigants instead of litigators, but the problem is that the people who write the laws are almost always lawyers and nobody writing laws is about to write laws that favor their opponents and put the lions share of the money in the hands of non-lawyers.
We keep having this conversation that makes it appear that the rich people will suddenly decide to not be rich instead of paying taxes, etc... It's never going to happen.
I'm side tracking, but the argument goes like this. If you tax the rich they'll all go out of business and fire everyone in lieu of paying taxes.
Just as soon as anyone can identify one single rich guy who decides to not be rich just because he has to pay taxes let us know..
Oh yeah, I'd rather live in poverty and squalor than have to pay a nickel in taxes said nobody ever and anyone who might suggest it would certainly be lying.
The wealthy folks have always used the switch and bait tactic and the public has always bought into it hook, line and sinker. It's not about to change just because it makes sense.
Quote from: AllPurposeAtheist on October 14, 2017, 12:31:58 PM
I'm side tracking, but the argument goes like this. If you tax the rich they'll all go out of business and fire everyone in lieu of paying taxes.
Just as soon as anyone can identify one single rich guy who decides to not be rich just because he has to pay taxes let us know..
Oh yeah, I'd rather live in poverty and squalor than have to pay a nickel in taxes said nobody ever and anyone who might suggest it would certainly be lying.
This.
Remember when Bill Clinton raised taxes modestly on the wealthy? All of a sudden, the economy took off. The wealthy had an incentive to do something with their money rather than sit on it and watch the pile grow bigger -- because an economy doesn't work when the money settles into huge, stagnant ponds. It works when money moves.
Also, I would gladly trade places with someone making a million a year and paying 40, 50 percent between fed, state and local taxes, as against the 15, 20% on my pittance. If someone thinks half a million dollars after taxes is an intolerably tight wallet, that's someone who has no business managing money since they obviously have no sense of proportion or priorities.
Quote from: AllPurposeAtheist on October 14, 2017, 12:31:58 PM
You can argue all day long about legal reform that may or may not put more money in the hands of litigants instead of litigators, but the problem is that the people who write the laws are almost always lawyers and nobody writing laws is about to write laws that favor their opponents and put the lions share of the money in the hands of non-lawyers.
We keep having this conversation that makes it appear that the rich people will suddenly decide to not be rich instead of paying taxes, etc... It's never going to happen.
I'm side tracking, but the argument goes like this. If you tax the rich they'll all go out of business and fire everyone in lieu of paying taxes.
Just as soon as anyone can identify one single rich guy who decides to not be rich just because he has to pay taxes let us know..
Oh yeah, I'd rather live in poverty and squalor than have to pay a nickel in taxes said nobody ever and anyone who might suggest it would certainly be lying.
The wealthy folks have always used the switch and bait tactic and the public has always bought into it hook, line and sinker. It's not about to change just because it makes sense.
The solution is to place limits on the percentages lawyers can earn in class action suits. You think they wouldn't work for 10% of $500 million as 50%? They would chase a $10 bill into a tornado!