Obamacare: Businesses get extension, individuals don't

The nice thing about living elsewhere: you can compare and contrast.
Belgium has one of the best, and cheapest, education systems in the world ("cheap" of course being "mostly paid for by the government"). A year's studying at our best university costs about €600 (say $800 or so). Some post-university degrees are more expensive, but anyway - getting a Masters will cost you about €3000 over 5 years. And even so, for those who have trouble paying, there's scholarships all over the place and tax returns and whatever. Basically, anyone who can and wants to can get at least a Bachelor's, probably a Masters. It's one of our country's most socialist endeavors and one of our greatest accomplishments, really.
The downside, however, is that pretty much everyone wants to get a degree. And of course, most people don't actually have something specific they want to do. Sure, interested in animals, become a vet. Interested in French? Become a Romanist and teach. Turns out, most people who can't quite decide go do something like communication sciences, or psychology, or educational sciences, or cultural management. We're swamped in humane sciences degrees, and we have a continuous lack of, say, nurses, car mechanics, welders, carpenters, good hard-working laborers, etc.

In fact, nurses in some hospitals and retirement homes are getting cars in their benefits package, and a higher pay than the doctors working in the same institutions, simply because we can't find any. We have too many unemployed high degree people who "don't want to work below their level" (aka "get their hands dirty"), along with the opposite, the ones who dropped out and never got anything, and far too little technically savvy people and people who are willing to work. There's a lot of complaints about immigration, but the fact of the matter is - they're doing jobs our local youth doesn't want to do anymore.

Anyway, I'm a fan of the Belgian system, it's certainly better than a system designed to indebt all bright young minds while closing off college/university for anyone who can't afford it - but some sort of regulations/checks are somewhat in order. It's far too easy to stay a student and live off of society for far too long (a friend of mine just graduated in film studies at 32. Yeah, that's going to be a useful and contributing member of society!)
 
Fear not. It is presently popping.
The banks went crazy there for a while, trying to find ways they could lend money to people. After the mortgage situation blew up, they promoted education loans. The schools thought people were taking out loans because education was so important, so they raised prices to meet the perceived "demand." I can't wait until textbook prices, tuition, and all that finally return to some sort of normalcy.

--Patrick
 
Man needs hernia surgery, schedules it and tries to use his medical insurance. Hospital wants $20,000 up front for his portion of the cost.

Man cancels surgery, goes to different hospital, claims "self paying/no insurance," Hospital charges him $3000.

Methinks I see a glimmer of a solution.
Yeah, this kind of bullshit is coming more and more to light. NPR has really been hammering this kind of stuff home in the last few months and it's HORRIFYING the kind of stuff Hospitals/Health Care Systems are doing regarding costs. The question is, will anyone do anything about it and CAN anyone really do anything about it?
 

GasBandit

Staff member
Yeah, this kind of bullshit is coming more and more to light. NPR has really been hammering this kind of stuff home in the last few months and it's HORRIFYING the kind of stuff Hospitals/Health Care Systems are doing regarding costs. The question is, will anyone do anything about it and CAN anyone really do anything about it?
Make health insurance health INSURANCE again, instead of pre-paid health plans. As in, only for major things, like cancer and horrific car wrecks. Pay day-to-day or less serious medical expenses out of pocket. Reintroduce market forces. Guarantee you there will be websites popping up like the cheap ticket/hotel websites that comparison shop/find deals at doctors and hospitals for you PDQ.

As the article mentions, the areas of medical expenditure where costs stay low and progress is made are the ones not covered by anybody's insurance. $2000 lasik vs $25,000 hernia outpatient surgery (that doesn't involve lasers or cutting open eyeballs).
 
As I read it, the problem isn't health insurance or even health insurance companies, it's hospitals inflating their prices to ridiculous amounts because of insurance. It's the hospitals jerking these people around and asking ludicrous fees, not the insurance companies.

That said, providing the same service for 7x the price because of non-essential differences like that would be illegal in Belgium - it's extortion.
 
As I read it, the problem isn't health insurance or even health insurance companies, it's hospitals inflating their prices to ridiculous amounts because of insurance. It's the hospitals jerking these people around and asking ludicrous fees, not the insurance companies.

That said, providing the same service for 7x the price because of non-essential differences like that would be illegal in Belgium - it's extortion.
The hospitals inflate the prices because they are required to treat everyone for emergency care, so they take huge losses when uninsured people rack up big bills and can't pay. Which means insurance gets more expensive, so less people can afford it. Which mean more people come in uninsured and the hospitals take more losses, so the prices go up again, etc.

It's a fucked up system, and no one really wants to fix it. Mainly because the people in charge of fixing it don't have to worry about not being able to afford insurance and can get the best care available.
 
It's largely a shell game. The hospital knows that each year the insurance company is going to try to negotiate a deeper discount, so they raise their prices slightly more than the actual increase in expenses so the insurance companies think they're getting a better discount. Meanwhile the insurance companies know this, and push for deeper discounts.

In both cases they have to not only make a profit, but also both have to cover expenses that are somewhat variable. Insurance companies have to pay out to patients with horribly expensive diseases, and hospitals have to cover patients that require immediate life saving treatment but can't pay for it.

However hospitals have to give everyone the same price structure to avoid lawsuits about giving preference to one customer over another in pricing. So they have to give out these hugely inflated prices to people who ask for them. About the only place where they can cut the actual charge down outside of insurance is at the time of billing. If a family explains hardship, and attempts to make some payments, they can often ask that the bill be reduced, and the hospital will do so if it means that the family will pay for the lower cost, but probably won't pay much if they have that high cost hanging over them.

A quick way to fix this system is to force insurance companies to stop paying hospitals directly. Standardize medical invoicing, bill the patients directly, have the patients agree to and pay the cost, and then get reimbursed from the insurance company. Give everyone the power to shop around, and eliminate the huge insurance billing department each hospital has to have simply to deal with 40 providers with 800 different fee schedules. I have two hospitals close enough for emergency treatment, and several more close enough for non emergency care. If I could call them and compare prices, I would.

Insurance companies can then provide standard payment amounts for services, hospitals could charge and compete on price to the consumer, and the consumer can keep the difference if they get a better deal and are satisfied with the service. Alternately they can pay more out of pocket if they want to choose a different provider.

Put consumers back in the loop, and let them be the drivers for lower cost.

This would also have the effect of treating insurance as insurance, rather than health care. Yes, you can buy into the play that includes birth control, it's just going to cost you more per month since it's a fixed cost. Or you can shop around and pay it directly to the provider, rather than asking for reimbursement periodically.

But that's never going to happen.
 
It's a fucked up system, and no one really wants to fix it. Mainly because the people in charge of fixing it don't have to worry about not being able to afford insurance and can get the best care available.
Yes. A co-worker of mine has a wife who works for a local hospital group. He gets a bigger paycheck because he does not subscribe to any of the health insurance plans at our job. Why? Because the health plan provided by his wife's employer is this: "You are covered 100%. For anything we (or anyone in our hospital group) can do. So is your family. Done." It makes me sooooo jealous.

--Patrick
 
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I'm pretty sure that headline would hold true of the dumbasses in Washington who voted on it.
True, though something tells me you could "insert legislation name here" for that headline, and it would still be just as true. In any country.
 
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