Chambers wrote:
> Darren New wrote:
>> If it's a collision between cars, then somebody (or multiple 
>> somebodies) is at fault.
> 
> Note here that they're always called "collisions", and never "accidents" 
> anymore. 

Yah. The TV here calls them "crashes". :-)

-- 
   Darren New / San Diego, CA, USA (PST)
     "That's pretty. Where's that?"
          "It's the Age of Channelwood."
     "We should go there on vacation some time."

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Warp wrote:
> Darren New <dne### [at] sanrrcom> wrote:
>> So, yeah, somebody has to pay for it, so?  Life isn't "fair".  You catch 
>> a serious disease, you have to pay to get cured too.
> 
>   Not if you live in Canada, Cuba, Finland, or basically any western
> country which is not the US. ;)
> 

But at times your options are limited because you don't pay for it.

People come from Canada all of the time to get more options for treatment.

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Chambers wrote:
> Darren New wrote:
>> If it's a collision between cars, then somebody (or multiple 
>> somebodies) is at fault.
> 
> Note here that they're always called "collisions", and never "accidents" 
> anymore.  The underlying assumption is that there is *always* someone at 
> fault (even if the fault is only that they were stupid enough to be out 
> driving in such bad conditions).
> 

I think that a lot of them need to be called "stupidities".

:-(

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>>   Not if you live in Canada, Cuba, Finland, or basically any western
>> country which is not the US. ;)
>>
>
> But at times your options are limited because you don't pay for it.

You mean to say that you pay for your medical care directly?  If you needed 
some complicated heart operation and the cost was $200k, you'd have to pay 
that sum yourself?  Or do you mean you pay an insurance company?  If you pay 
insurance, then I can't believe that the insurance company will let you 
choose how to treat your illness, otherwise everyone would be getting the 
most expensive treatment possible for tiny things and your premiums would be 
huge.  Or maybe you can, and that is why the US health system works so badly 
;-)

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scott wrote:
>>>   Not if you live in Canada, Cuba, Finland, or basically any western
>>> country which is not the US. ;)
>>>
>>
>> But at times your options are limited because you don't pay for it.
> 
> You mean to say that you pay for your medical care directly?  If you 
> needed some complicated heart operation and the cost was $200k, you'd 
> have to pay that sum yourself?

Technically, you are responsible to pay for your own care.


   Or do you mean you pay an insurance
> company?

It depends on what kind of insurance you pay for.

Some insurance plans reimburse you directly (Traditional)
	I pay a $500 doctor bill myself.
	I submit the receipt to my insurance company.
	The insurance company comes up with a UCR of $300.
		UCR is Usual Customary Reasonable
		How they come up with this - who knows....
	The insurance covers only 80% of my bill.
	So I get sent a check for $240.
	I am out $260.
	The doctor gets $500

Some insurance plans contract directly with the doctor (PPO)
	I go see the doctor.
	The doctor submits the $500 bill directly to the insurance
	The insurance already negotiated with the doctor $300 UCR
	The insurance company tells the doctor that I have a $10 co-pay
		a portion I pay for each visit
	The insurance sends the doctor a check for $290.
	The doctor bills be for $10
	I pay the doctor $10
	Since the doctor has an agreement with the insurance company
		The doctor agrees to only accept the UCR
	I am out $10
	The doctor gets $300


If I have a PPO insurance plan like above, but see a doctor they do not 
contract with, it turns into something like the Traditional plan.  All 
based on the terms of the contract with the insurance company.

This very simplistic description of health insurance plans is from my 
own experience.


What's really sad is that doctors will inflate the initial charge (the 
$500) higher to be able to get a higher end payment from the insurance 
company.

   If you pay insurance, then I can't believe that the insurance
> company will let you choose how to treat your illness, otherwise 
> everyone would be getting the most expensive treatment possible for tiny 
> things and your premiums would be huge.

Insurance companies do have mechanisms that help keep costs under 
control.  They also raise rates based on usage as a whole.  In some 
places this is turning into a real crisis - I know where I work the 
premiums for insurance have gone up 30% in a single year.

Also, some places will not treat you unless you have a prescription from 
a doctor... ie, you might have a problem getting a baby ultrasound if a 
doctor does not call for it.  That's the choice for the place, and 
possibly a restriction for accepting insurance covered people.


   Or maybe you can, and that is
> why the US health system works so badly ;-)
> 

It has its problems, yes.  And some people leave the US to go to other 
countries to get different care.  Just as some people come to the US to 
get different care.


I know a specific example where a person with eye cancer came the the US 
to get treatment that would allow him to keep his eye.  His only option 
in Canada was to lose the eye.



The health system in the US is full of problems - insurance is just but 
one of them.

Other places have problems as well, they are just different.

;-)




Tom

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> Also, some places will not treat you unless you have a prescription from a 
> doctor... ie, you might have a problem getting a baby ultrasound if a 
> doctor does not call for it.  That's the choice for the place, and 
> possibly a restriction for accepting insurance covered people.

Yeh, if you are in the public system here in Germany (well in Bavaria at 
least), you need to get referred from your normal doctor before you go to 
see a specialist.  Or you can just pay 10 euro ;-)  It's the same in the UK 
I think, you can't just make an appointment with a specialist, your normal 
doctor must do it for you.

> It has its problems, yes.  And some people leave the US to go to other 
> countries to get different care.  Just as some people come to the US to 
> get different care.

I don't think it's the level of care that is the problem, just the cost of 
the system.

> I know a specific example where a person with eye cancer came the the US 
> to get treatment that would allow him to keep his eye.  His only option in 
> Canada was to lose the eye.

Yeh, well it's the same in the UK for the public system, they have a finite 
amount of money from taxes so they can't go around fixing everything the 
expensive way.  If they cured everyone with eye cancer rather than removing 
the eye, they probably wouldn't have enough money to save some other peoples 
lives.  But, you can always go to a private doctor yourself and pay for 
whatever treatment you want, isn't that possible in Canada?

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scott wrote:
> 
> Yeh, if you are in the public system here in Germany (well in Bavaria at 
> least), you need to get referred from your normal doctor before you go 
> to see a specialist.  Or you can just pay 10 euro ;-)  It's the same in 
> the UK I think, you can't just make an appointment with a specialist, 
> your normal doctor must do it for you.
> 

Another health insurance option in the US is HMO (Health Maintenance 
Organization) - which is similar to what you describe.
Typically you have a primary care physician that directs your care.  You 
have to get prior approval before you can go/do anything else.
HMO's here have a bad reputation because of some things that have gone 
on in the system.  Doctors are pressured and even rewarded for referring 
less patients to expensive specialists (hmmm... is that in the best 
interest of the patient.)  I've heard horror stories about care that is 
denied and denied and finally in the end when it is approved it is too late.

But the HMO scenario is different from what you described in that in the 
US it is all capitalistic driven - profit is put ahead of people's lives 
and wellness.


OTOH
The PPO and Traditional plans, you can make an appointment with a 
specialist on your own without a referral.  It's just certain procedures 
that require a prescription from a doctor - kinda like a prescription 
for narcotic medicine.




>> It has its problems, yes.  And some people leave the US to go to other 
>> countries to get different care.  Just as some people come to the US 
>> to get different care.
> 
> I don't think it's the level of care that is the problem, just the cost 
> of the system.
> 

I agree, the level of care isn't the problem.  I think it does vary from 
location to location (even in the same country), but it isn't the issue 
with this.

I think it is also the available of choices that drive people to 
different countries.  I know that people will go to Mexico from the US 
to get certain treatments that are either hard to get or illegal in the US.


> 
> Yeh, well it's the same in the UK for the public system, they have a 
> finite amount of money from taxes so they can't go around fixing 
> everything the expensive way.  If they cured everyone with eye cancer 
> rather than removing the eye, they probably wouldn't have enough money 
> to save some other peoples lives.  But, you can always go to a private 
> doctor yourself and pay for whatever treatment you want, isn't that 
> possible in Canada?
> 

My understanding is that while you can do it, it can take a long time 
and may be complex to do it.  hence go to a country where it is readily 
available and quicker.


To bring this back closer to topic....

 From an financial point of view, if I were in an accident, I would 
prefer to be in a different country than the US.  In the US I would have 
to deal with insurance companies for the property damage.  I would have 
to deal with insurance companies for the medial costs.  Sometimes there 
are hidden medical problems that surface years later that you now have 
to pay for because the insurance stuff is all done.

 From a very narrow point of view...
So, in the US system, it is better to ban studded tires and save the 
road.  The government saves the tax dime while the people pay the 
private medical care as a result of the accident.

In Finland, or many other countries where there is medicine paid by 
taxes, the government saves the tax dime by allowing studded tires 
because it saves on the medical expenses that is also covered by tax.

Anyhow.... enjoy whatever snow is left in the season.

Tom

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Tom Austin wrote:
> I think that a lot of them need to be called "stupidities".

Or "greedy selfishisms."

-- 
   Darren New / San Diego, CA, USA (PST)
     "That's pretty. Where's that?"
          "It's the Age of Channelwood."
     "We should go there on vacation some time."

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Chambers wrote:
> Tom Austin wrote:
>> Here is the US the cost for tax money is much lower because so many 
>> things are not government run - health care, rescue and ambulance, tow 
>> truck service, etc...
> 
> Tom, "the people" end up paying, whether its through taxes, or insurance 
> hikes, or higher healthcare rates...
> 
> No matter what happens, "someone" has to pay, and that "someone" is 
> usually you and I.
> 

Notice that I was specific to taxes - government taxes.

That does not mean that our total costs are lower.



Tom

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scott wrote:
>>> Would you choose that 60 million people
>>> were all delayed by an extra 30 minutes every day to save one single 
>>> life?
>>
>>  Yes?
> 
> Because you are looking at the problem selfishly and not the whole 
> system. Of course, if you said to an individual that if they were forced 
> to wait an extra 30 minutes every day to save a life, they might say 
> yes.  But goverments need to look at the whole system in order to make a 
> decision, try the following:
> 
> How much would someone have to pay you if it meant you lost 30 minutes 
> each day to being stuck in traffic?
> 
> Ask 60 million people that question and add up all their answers, what 
> do you think the total would be?  I'd guess around $10 per person on 
> average, so say $600 million.
> 
> A hospital near you wants to buy some new piece of equipment that will 
> save more lives than the old bit.  It's very expensive, let's say it 
> will save an extra 10 lives, and costs 10 million dollars.
> 
> So, what you are effectively saying is that you'd rather waste $600m of 
> peoples time, to avoid having to spend $1m to save a single life.  Good 
> job you aren't an economic adviser for your government ;-)
> 
> BTW you can substitute the hospital equipment for anything that puts a 
> value on human life.  Actually, whenever you buy or use anything that is 
> not 100% safe, you are putting a value on your life.
> 
> 


here is something related

http://www.cnn.com/2008/US/03/05/crashes.costs.ap/index.html

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