Something that I've talked about for years is the possibility of having 
health cooperatives as a means of getting insurance.  Because they are 
non-profit and member-owned, YOU (collectively) would decide what (and who?) 
the insurance should cover.  Yes, these are getting a little bit of 
attention lately.

But.  I'm not sure this really solves the problem.  Why are healthcare costs 
rising?  Insurance.  Maybe lawyers factor into this to some extent, but the 
real reason is that we HAVE insurance.  When you take your car in to get new 
brakes (assuming you don't do it yourself), they tell you "Oh, you need new 
rotors, yada yada.  $350."  At that point, I say, "I've got a buddy that 
will simply change my pads and it'll cost me $40 plus a 6-pack of beer." 
Ok, you don't want that buddy doing your heart transplant, but the idea is 
the same.  If my auto-insurance covered the $350, would I care?  Heck no! 
Change all 4 rotors, and charge me $700.  Why should I care?

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Jeremy "UncleHoot" Praay wrote:
> Why are healthcare costs rising?  Insurance.  

I've come to the conclusion that everything sucks when the people getting 
the benefit aren't the people paying the money out. See, for example, most 
forms of interrupt-advertising (as in, advertising you didn't ask for, vs 
ordering a catalog from the manufacturer, say).

Why don't we have these similar problems with auto insurance? Well, we do, 
but to a much smaller extent. (Ever need to get a window replaced on your 
car? There's a fixed minimum fee that's about 5x what a competent person 
would need to charge to do the job, published by the auto manufacturer.) 
However, the other half is that you don't need any particular license to 
work on your own car.

-- 
   Darren New, San Diego CA, USA (PST)
   Understanding the structure of the universe
    via religion is like understanding the
     structure of computers via Tron.

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Jeremy "UncleHoot" Praay wrote:
> Something that I've talked about for years is the possibility of having 
> health cooperatives as a means of getting insurance.  Because they are 
> non-profit and member-owned, YOU (collectively) would decide what (and who?) 
> the insurance should cover.  Yes, these are getting a little bit of 
> attention lately.
> 
A coop would have a similar function to a union. I am in Arizona. We are 
8 months *behind* negotiating for a new contract, we may be getting 
close to having to strike, the company tried to gut "everything" 
including health coverage and benefits, and, at least one person stated, 
"I have been working here 15 years, and every year I lose something on 
the new contract."

No, coops will *not* work, without someone telling the state what they 
can and can't do to screw with those coops. You can't compete 
effectively against someone else, if the deck is stacked against you the 
whole time. Sure, *eventually* you might win, but we are up against 
companies that actually, often, *own* the agencies responsible for 
setting the prices, based on the real cost of procedures, in the first 
place, and anything that isn't national, can't kick them in the nuts 
when they get uppity.

-- 
void main () {

     if version = "Vista" {
       call slow_by_half();
       call DRM_everything();
     }
     call functional_code();
   }
   else
     call crash_windows();
}

<A HREF='http://www.daz3d.com/index.php?refid=16130551'>Get 3D Models, 
3D Content, and 3D Software at DAZ3D!</A>

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On 31-8-2009 18:10, Jeremy "UncleHoot" Praay wrote:
> Something that I've talked about for years is the possibility of having 
> health cooperatives as a means of getting insurance.  Because they are 
> non-profit and member-owned, YOU (collectively) would decide what (and who?) 
> the insurance should cover.  Yes, these are getting a little bit of 
> attention lately.
> 
> But.  I'm not sure this really solves the problem.  Why are healthcare costs 
> rising?  Insurance.  Maybe lawyers factor into this to some extent, but the 
> real reason is that we HAVE insurance.  When you take your car in to get new 
> brakes (assuming you don't do it yourself), they tell you "Oh, you need new 
> rotors, yada yada.  $350."  At that point, I say, "I've got a buddy that 
> will simply change my pads and it'll cost me $40 plus a 6-pack of beer." 
> Ok, you don't want that buddy doing your heart transplant, but the idea is 
> the same.  If my auto-insurance covered the $350, would I care?  Heck no! 
> Change all 4 rotors, and charge me $700.  Why should I care? 

Living in a country where more is covered by insurance then in the US, I 
can tell you this is not how it works. I must admit at first glance it 
sounds plausible, like most conspiracy theories.
Yet I simply don't want the dentist to pull my teeth if not absolutely 
necessary. Moreover preventive medicine is also insured. In fact you can 
pretty much get away with not insuring for extensive dental work because 
a checkup every 6 months or so will prevent that from happening in most 
cases.
Another factor that you did not include is the professional standard of 
doctors. In general they won't do unnecessary procedures. Those few that 
do and are found out are kicked out of the profession. Not because of 
the fraud, though that is a factor, but for unprofessional conduct.

The trick of insurance is to punish those who let unnecessary procedures 
happen. If your car insurance pays such bogus repairs as in your 
example, it has to raise the amount people have to pay for the 
insurance. That will result in people going to other companies and there 
fore a loss of money. Another thing is that regularly someone brings a 
car with the same problem to different garages and publishes what they 
charge. Most firms don't like it when they appear in a paper showing 
that they charge 10 times a much than a competitor.

If you talk about wasting money in hospitals, they should get financial 
incentives (from the government) if they reduce the number of stays in 
the hospital and if they reduce the amount of MRIs etc. etc.
In general our media are focussed on finding out if and why our health 
system fails and then the government often tries to patch that. For any 
particular problem that may take some years but people know that they 
are watched and often repair things before we even need a new law.

Unfortunately for you, such a system requires journalists and a 
government that is not influenced too much by the current players with 
money. So it is extremely difficult to change your health system if you 
do not at the same time reduce the influence of big companies on your 
broadcasting companies and your politicians. (I originally wanted to 
write "if you don't stop selling your political offices to the highest 
bidder", but you might be offended if I put it that way).

(Ok, I know it is not as ideal as I tried to sketch above, but still our 
health care system works better and is cheaper than that in the US. I.e. 
for the general people like me, not for the very rich of course)

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"andrel" <a_l### [at] hotmailcom> wrote in message 
news:4A9### [at] hotmailcom...
>
> Another factor that you did not include is the professional standard of 
> doctors. In general they won't do unnecessary procedures. Those few that 
> do and are found out are kicked out of the profession. Not because of the 
> fraud, though that is a factor, but for unprofessional conduct.
>
> The trick of insurance is to punish those who let unnecessary procedures 
> happen. If your car insurance pays such bogus repairs as in your example, 
> it has to raise the amount people have to pay for the insurance. That will 
> result in people going to other companies and there fore a loss of money. 
> Another thing is that regularly someone brings a car with the same problem 
> to different garages and publishes what they charge. Most firms don't like 
> it when they appear in a paper showing that they charge 10 times a much 
> than a competitor.
>

Actually, there were no "bogus" repairs in my example.  The "spec" 
(specification) for rotors pretty much requires that you get your rotors 
replaced, perhaps every 5 years or so.  Realistically, they can last much 
longer, but the lawyers get involved and due to some lawsuit have made the 
spec state that the rotors must have less than X millimeters or wear.  I'd 
love to have the ability to say, "Thanks, but I'll take my chances," but 
it's not an option.  They cannot do a brake job without swapping out the 
rotors too, but they can send me on my merry way without replacing my 
brakes.  Doing so would open them up to a lawsuit (at a minimum) and 
possibly criminal negligence, if I somehow died as a result.

It's similar in hospital situations.  The doctor can be 99% certain that you 
don't have cancer (which is good enough for me), but because of that 1% 
uncertainty, he has send you to have test after test, just to make sure that 
he doesn't get sued by you for missing some step along the way.

Obviously that's where the lawyers come in, that I initially referred to. 
But my original point is that we'd still be up in arms, if our insurance 
wasn't paying for it.  Whether it's a private insurance company, or 
government footing the bill, we could care less.  Give me every test out 
there, because I want to be absolutely certain that I don't have cancer.  In 
fact, test me every year.  I don't care because I'm not paying for it (so we 
say).

Would a co-op help in this example?  It could help to some extent, but I 
really don't think it would have a huge impact.  Whether we pay out of our 
pockets (directly), or pay an insurance company (indirectly), or a co-op, I 
think we're still stuck in this same mentality.  Add to that the malpractice 
issues, and it's greatly compounded.  I really don't know how we could get 
out of this short of some legislation that people would consider "insane". 
If some new machine that costs 50 million dollars will save 10 lives per 
year, then we have to have it, and we demand that our insurance pay for it.

Post a reply to this message

Jeremy "UncleHoot" Praay wrote:
> It's similar in hospital situations.  The doctor can be 99% certain that
> you don't have cancer (which is good enough for me), but because of that
> 1% uncertainty, he has send you to have test after test, just to make sure
> that he doesn't get sued by you for missing some step along the way. 

On malpractice:

http://photos-a.ak.fbcdn.net/hphotos-ak-snc1/hs134.snc1/5729_136982164496_20950654496_2232000_7359633_n.jpg

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On 31-8-2009 22:21, Jeremy "UncleHoot" Praay wrote:
> "andrel" <a_l### [at] hotmailcom> wrote in message 
> news:4A9### [at] hotmailcom...
>> Another factor that you did not include is the professional standard of 
>> doctors. In general they won't do unnecessary procedures. Those few that 
>> do and are found out are kicked out of the profession. Not because of the 
>> fraud, though that is a factor, but for unprofessional conduct.
>>
>> The trick of insurance is to punish those who let unnecessary procedures 
>> happen. If your car insurance pays such bogus repairs as in your example, 
>> it has to raise the amount people have to pay for the insurance. That will 
>> result in people going to other companies and there fore a loss of money. 
>> Another thing is that regularly someone brings a car with the same problem 
>> to different garages and publishes what they charge. Most firms don't like 
>> it when they appear in a paper showing that they charge 10 times a much 
>> than a competitor.
>>
> 
> Actually, there were no "bogus" repairs in my example.  The "spec" 
> (specification) for rotors pretty much requires that you get your rotors 
> replaced, perhaps every 5 years or so.  Realistically, they can last much 
> longer, but the lawyers get involved and due to some lawsuit have made the 
> spec state that the rotors must have less than X millimeters or wear.  I'd 
> love to have the ability to say, "Thanks, but I'll take my chances," but 
> it's not an option.  They cannot do a brake job without swapping out the 
> rotors too, but they can send me on my merry way without replacing my 
> brakes.  Doing so would open them up to a lawsuit (at a minimum) and 
> possibly criminal negligence, if I somehow died as a result.
> 
> It's similar in hospital situations.  The doctor can be 99% certain that you 
> don't have cancer (which is good enough for me), but because of that 1% 
> uncertainty, he has send you to have test after test, just to make sure that 
> he doesn't get sued by you for missing some step along the way.
> 
> Obviously that's where the lawyers come in, that I initially referred to. 
> But my original point is that we'd still be up in arms, if our insurance 
> wasn't paying for it.  Whether it's a private insurance company, or 
> government footing the bill, we could care less.  Give me every test out 
> there, because I want to be absolutely certain that I don't have cancer.  In 
> fact, test me every year.  I don't care because I'm not paying for it (so we 
> say).
> 
> Would a co-op help in this example?  It could help to some extent, but I 
> really don't think it would have a huge impact.  Whether we pay out of our 
> pockets (directly), or pay an insurance company (indirectly), or a co-op, I 
> think we're still stuck in this same mentality.  Add to that the malpractice 
> issues, and it's greatly compounded.  I really don't know how we could get 
> out of this short of some legislation that people would consider "insane". 
> If some new machine that costs 50 million dollars will save 10 lives per 
> year, then we have to have it, and we demand that our insurance pay for it. 

My point was that if you organize it in such a way that people don't 
feel the pain you have implemented it wrong.
Your other point is IMHO simply that you have let things go out of hand 
and now the lawyers are dictating what happens in hospitals and not the 
doctors (who have taken an oath and have professional standards) nor the 
patient (who has the most to gain or loose). So don't blame the doctors 
or the people that try to reform health care and start solving the real 
problem.
Suggestion: here it is in most cases illegal for a lawyer to do a case 
on a 'no cure no pay' base. Try that for starters. I am pretty you won't 
be able to pass a law like that because some of those who did such cases 
have enough money to influence a couple of re-elections. Therefore I 
suggested that you may have to start with freeing your political system 
from 'gifts' by companies and wealthy people.

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On 08/31/09 14:43, andrel wrote:
> Yet I simply don't want the dentist to pull my teeth if not absolutely
> necessary. Moreover preventive medicine is also insured. In fact you can
> pretty much get away with not insuring for extensive dental work because
> a checkup every 6 months or so will prevent that from happening in most
> cases.
> Another factor that you did not include is the professional standard of
> doctors. In general they won't do unnecessary procedures. Those few that
> do and are found out are kicked out of the profession. Not because of
> the fraud, though that is a factor, but for unprofessional conduct.

	Over here, it's not rare for dentists to do unnecessary procedures. I 
hadn't gone to a dentist in about a decade, so I thought my teeth may be 
in bad shape (no symptoms, though). The first dentist I went to said I 
needed 10 cavities filled. I did 2. Then I went to another dentist. He 
looked at the X-Ray and said I didn't need any more.

	Mine is not the only story when it comes to dentists. That I was 
covered by insurance may well have been a factor...

	And I do know of doctors doing lots and lots of "unnecessary" tests. 
The thing is, they're not really unnecessary in that the patient has 
symptoms, and it may be a certain condition (albeit an unlikely one), 
and they decide to do a test to rule it out. I hear this happens more 
with Medicare (government paid) patients than with private insurance 
patients. The insurance companies have some muscle and can simply say 
"No" to excessive testing. My guess is that the oversight for Medicare 
is not as good (I wouldn't know, though).

	Dentists are probably more famous for this. I don't know the prevalence 
for (other) doctors.


-- 
DOS means never having to live hand-to-mouse

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Neeum Zawan wrote:
> My guess is that the oversight for Medicare 
> is not as good (I wouldn't know, though).

Or maybe that medicare tends to cover the people old enough to have lots of 
things that might be causing their symptoms.

>     Dentists are probably more famous for this. I don't know the 
> prevalence for (other) doctors.

It's also a judgement call. I've had my dentist say "You have a small 
cavity. Let's wait to see if it is getting bigger before we fill it." Would 
filling the small cavity be "wrong"?

-- 
   Darren New, San Diego CA, USA (PST)
   Understanding the structure of the universe
    via religion is like understanding the
     structure of computers via Tron.

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On Mon, 31 Aug 2009 16:43:03 -0500, Neeum Zawan wrote:

> 	Over here, it's not rare for dentists to do unnecessary 
procedures. I
> hadn't gone to a dentist in about a decade, so I thought my teeth may be
> in bad shape (no symptoms, though). The first dentist I went to said I
> needed 10 cavities filled. I did 2. Then I went to another dentist. He
> looked at the X-Ray and said I didn't need any more.
> 
> 	Mine is not the only story when it comes to dentists. That I was
> covered by insurance may well have been a factor...

Similar case here, no cavities but about 10 years since my last visit 
when I started going again this year (and that was only because of 
headaches that seemed localized in my jaw - turns out they were tension 
headaches - something my dentist suggested I check into).

I really like my dentist, but he's tried several times to get me to agree 
to a gingevectomy and/or facings on my teeth.  Purely cosmetic stuff, 
which he agrees isn't absolutely necessary, but he keeps trying to 
"upsell" these to me, even though he wouldn't do the procedures.

I'm going to have to suggest that he stop the attempts to upsell stuff I 
don't want the next time I see him.

Jim

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