1. Post #81
    Gold Member
    Firgof Umbra's Avatar
    January 2005
    2,049 Posts
    ilikecorn posted:
    I mean it costs the hospital like 50$ for the 100$ bag, and they bill the insurance company for 100$, and the insurance company pays 51$, and all for a bag that costs no more than 2$ to make.
    Probably more along these lines:
    Bag-cost to manufacture: $1/unit
    Bag-shipping-cost: $1/unit

    Hospital bag buying price: $10/unit
    Hospital bag selling price: $100/unit

    Insurance company's starting bid: $5/unit
    Hospital's counter-offer: $30/unit
    Final offer: $20/unit

    Profit for hospital: $10/unit. (50%)
    Amount shaved off from sticker price: $80 (80%)

    The big problem here comes from neither the supplier or the hospital (directly): it comes from a hostile insurance company who begins negotiations on any line-item by saying "We'll pay 5% of whatever you wrote down". Naturally, the hospital will adjust itself accordingly and raise prices knowing that no matter what they do the insurance company in question will request such a ridiculous drop in price.

    Those really impacted in this case are those who aren't fighting with the insurance companies. Mr. Joe doesn't have insurance; he doesn't know that his $4000/night hospital stay in reality costs something like $200. All he'll see is a $12,000 hospital bill and have a near-heart-attack. The hospital will then offer to reduce his payments to something like $2,000 because they can't lower them much further while still justifying the sticker price to insurance companies - knowing he only really cost them something like $600 in full costs for a bag of saline and occupying a bed and a few minutes of a few doctors' time.

    So the ones who really lose out here are the uninsured.
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  2. Post #82
    I'M A SHAAARK!
    Lambeth's Avatar
    October 2009
    16,523 Posts
    I'm sure you could help mitigate the doctor shortage issue if you incentivized immigration for foreign doctors but hahaha that will never happen with this current government.

  3. Post #83
    Gold Member
    thelurker1234's Avatar
    June 2011
    10,336 Posts
    I'm sure you could help mitigate the doctor shortage issue if you incentivized immigration for foreign doctors but hahaha that will never happen with this current government.
    Don't they?

    Though I dunno maybe the h-1b program needs improving.

    Well, is the tax in the US higher than in Canada (including the Bernie Tax™)? If not, what spurs a Canadian student to become a doctor?

    I know for a fact that taxes are higher here in Denmark (that's putting it mildly), and the pay is lower, so it seems that the supply side (students) should be large enough in the US to saturate the pipeline even at a significantly lower pay.
    Canada is experiencing a doctor shortage right now. And denmark lightly does as well.

    Anyways, that's not how it works. Individuals have their own motivations and limits, and even if being a doctor paid 40k a year, there would still be some incredible people willing to do it, but it would be lower than at 50k, 60k, and so-on.

    I'm not going to say that a country with low pay for doctors will have no doctors. Just that it reduces the supply, whether a pay cut causes a large problem depends on where the equilibrium is and other factors such as general interest in the field.

  4. Post #84
    Gold Member
    GoDong-DK's Avatar
    November 2009
    17,781 Posts
    Canada is experiencing a doctor shortage right now. And denmark lightly does as well.

    Anyways, that's not how it works. Individuals have their own motivations and limits, and even if being a doctor paid 40k a year, there would still be some incredible people willing to do it, but it would be lower than at 50k, 60k, and so-on.

    I'm not going to say that a country with low pay for doctors will have no doctors. Just that it reduces the supply, whether a pay cut causes a large problem depends on where the equilibrium is and other factors such as general interest in the field.
    Actually the latest (as far as I'm aware) prognosis is currently that we won't be lacking doctors: http://nyheder.tv2.dk/samfund/2016-0...de-laegemangel
    But what is a doctor shortage anyway? When patients no longer need to wait at all? When less threatening diseases see reasonable waiting times? When morbidity rises a little bit?

    And yeah, sure, there's a limit to how much you can reduce the wage, but I'm not suggesting anything outlandish - I'm suggesting that the wages in the US could be put in-line with other countries' without it really affecting how many qualified doctors the US could output a year.

  5. Post #85
    Gold Member
    thelurker1234's Avatar
    June 2011
    10,336 Posts
    Actually the latest (as far as I'm aware) prognosis is currently that we won't be lacking doctors: http://nyheder.tv2.dk/samfund/2016-0...de-laegemangel
    But what is a doctor shortage anyway? When patients no longer need to wait at all? When less threatening diseases see reasonable waiting times? When morbidity rises a little bit?

    And yeah, sure, there's a limit to how much you can reduce the wage, but I'm not suggesting anything outlandish - I'm suggesting that the wages in the US could be put in-line with other countries' without it really affecting how many qualified doctors the US could output a year.
    That's good, the stuff I heard about that shortage was a couple years old.

    I mean, technically when patients no longer need to wait is ideal. But that's an ideal. It's in comparisons to other countries (physicians per 1000,) and the opinion of consumers.

    And yeah. You're right. But I would want to focus on other things first than direct salary cuts. Such as the other bottlenecks in the education pipeline, which in itself will cut salaries. The overuse of specialists, which too will reduce salaries, and so-on.

  6. Post #86
    Gold Member
    GoDong-DK's Avatar
    November 2009
    17,781 Posts
    That's good, the stuff I heard about that shortage was a couple years old.

    I mean, technically when patients no longer need to wait is ideal. But that's an ideal. It's in comparisons to other countries (physicians per 1000,) and the opinion of consumers.

    And yeah. You're right. But I would want to focus on other things than direct salary cuts. Such as the other bottlenecks in the education pipeline, which in itself will cut salaries. The overuse of specialists, which too will reduce salaries, and so-on.
    Yeah, making it easier to study medicine (and study in general) in the US sounds like a good idea - from what I've heard, it's a pain in the neck. Here in Denmark you basically just finish high school and apply with your grades. If you can't hit the average to get in, you can apply through quota 2, which basically means a written application where you qualify yourself in that way instead.

    It's not a perfect system by any means, but it definitely leads to less "faffing around" putting stuff on your CV.

  7. Post #87
    Gold Member
    thelurker1234's Avatar
    June 2011
    10,336 Posts
    Yeah, making it easier to study medicine (and study in general) in the US sounds like a good idea - from what I've heard, it's a pain in the neck. Here in Denmark you basically just finish high school and apply with your grades. If you can't hit the average to get in, you can apply through quota 2, which basically means a written application where you qualify yourself in that way instead.

    It's not a perfect system by any means, but it definitely leads to less "faffing around" putting stuff on your CV.
    That's interesting. Apparently it takes 6 years there too?

    Here's quite a pain in the ass, where you have to finish a 4 year uni degree before even thinking about applying to do 7 more years of education.

  8. Post #88
    Gold Member
    ilikecorn's Avatar
    January 2006
    5,486 Posts
    That's interesting. Apparently it takes 6 years there too?

    Here's quite a pain in the ass, where you have to finish a 4 year uni degree before even thinking about applying to do 7 more years of education.
    Bear in mind its a 4 year degree in something that might be fairly useless (like general chemistry), just so you can get into the 7 year schooling.
    Bear in mind that those 7 years of schooling cost like 100k$, also those 7 years are just for general practice, you wanna specialize, then enjoy another 5-10-15 years of school.

  9. Post #89
    Gold Member
    GoDong-DK's Avatar
    November 2009
    17,781 Posts
    That's interesting. Apparently it takes 6 years there too?

    Here's quite a pain in the ass, where you have to finish a 4 year uni degree before even thinking about applying to do 7 more years of education.
    Well, it's a three year bachelor's, a three years master's and then one year of interning. Then you spend maybe a couple to a maximum of six years before you start your specialization.

  10. Post #90
    Gold Member
    thelurker1234's Avatar
    June 2011
    10,336 Posts
    Bear in mind its a 4 year degree in something that might be fairly useless (like general chemistry), just so you can get into the 7 year schooling.
    Bear in mind that those 7 years of schooling cost like 100k$, also those 7 years are just for general practice, you wanna specialize, then enjoy another 5-10-15 years of school.
    Although to be fair, in the latter 3 of those 7 you're working residency for what appears to pay an average of about 50k a year.

  11. Post #91
    Dennab
    March 2017
    505 Posts
    How would this even be paid for?

    Here in Aus we have a separate tax dedicated for our Medicare system, which is a percent of income and is pretty hefty.

    I don't see Americans warming to the idea of a huge Medicare tax on everyone.

  12. Post #92
    Gold Member
    ilikecorn's Avatar
    January 2006
    5,486 Posts
    Although to be fair, in the latter 3 of those 7 you're working residency for what appears to pay an average of about 50k a year.
    Yea, but you're also being treated like hammered dog shit for the first 1.5 of those 3 years, with the other 1.5 being pretty OK. Also keep in mind this is just to become a GP, not for any form of specialization at all.

  13. Post #93
    Gold Member
    thelurker1234's Avatar
    June 2011
    10,336 Posts
    How would this even be paid for?

    Here in Aus we have a separate tax dedicated for our Medicare system, which is a percent of income and is pretty hefty.

    I don't see Americans warming to the idea of a huge Medicare tax on everyone.
    The bill has some vague mentions (some of it horrifying) of how.

    We'll probably get more details about what this thing entails exactly when the CBO has gotten their hands on it.

    Yea, but you're also being treated like hammered dog shit for the first 1.5 of those 3 years, with the other 1.5 being pretty OK. Also keep in mind this is just to become a GP, not for any form of specialization at all.
    Hmm. I guess that's why when I asked one of my family members about how residency was I got a big "ehhhhhhhhhh" as a response. (The japanese would probably say that these people should work less hours)

    Where did you get the 5-10-15 extra years figure for specialization btw? Cursive search on google indicate that it's typically just a couple years extra. Usually 3, of not strictly schooling.

  14. Post #94
    Gold Member
    Goberfish's Avatar
    February 2007
    661 Posts
    How would this even be paid for?

    Here in Aus we have a separate tax dedicated for our Medicare system, which is a percent of income and is pretty hefty.

    I don't see Americans warming to the idea of a huge Medicare tax on everyone.
    Considering that introducing a universal healthcare system would probably reduce economic activity, a tax is probably the last thing they should tack alongside it

  15. Post #95
    screamin 4 da gold
    RenegadeCop's Avatar
    January 2010
    12,772 Posts
    How would this even be paid for?

    Here in Aus we have a separate tax dedicated for our Medicare system, which is a percent of income and is pretty hefty.

    I don't see Americans warming to the idea of a huge Medicare tax on everyone.
    I already pay ridiculous amounts for shit coverage. I don't mind replacing my insurance payments with taxes.
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  16. Post #96
    I'M A SHAAARK!
    Lambeth's Avatar
    October 2009
    16,523 Posts
    Considering that introducing a universal healthcare system would probably reduce economic activity, a tax is probably the last thing they should tack alongside it
    From older people leaving the workforce right? There might be a dip in unemployment if Universal Healthcare was enacted and there was a sudden demand to fill jobs that had previously been full.

  17. Post #97
    Gold Member
    Sableye's Avatar
    October 2009
    21,655 Posts
    Considering that introducing a universal healthcare system would probably reduce economic activity, a tax is probably the last thing they should tack alongside it
    While it would certainly shrink the health insurance industry, universal health insurance wouldn't keep people from working since you have to be working pretty good jobs to get healthcare benefits as it is, people aren't going to quit their minimum wage jobs because they don't have to work for healthcare anymore, they didn't have healthcare before they had that job, and they will have more disposable income without having to dish out for healthcare costs which are enormous in the US

  18. Post #98
    Gold Member
    Goberfish's Avatar
    February 2007
    661 Posts
    From older people leaving the workforce right? There might be a dip in unemployment if Universal Healthcare was enacted and there was a sudden demand to fill jobs that had previously been full.
    Possibly, but I was considering more the effects of shrinking the health insurance industry

    While it would certainly shrink the health insurance industry,
    Thanks

  19. Post #99
    srobins's Avatar
    December 2014
    4,709 Posts
    Dental is largely cosmetic though. If something requires oral surgery because it's a health issue, it will often fall under medical.
    Dental maintenance necessary to prevent serious health issues isn't covered though. If you only go in once you have a catastrophic issue, your teeth will already be really fucked.

  20. Post #100
    Dennab
    March 2017
    505 Posts
    I already pay ridiculous amounts for shit coverage. I don't mind replacing my insurance payments with taxes.
    Unfortunately a lot of people don't think about it like that and just see it as government double dipping

  21. Post #101
    screamin 4 da gold
    RenegadeCop's Avatar
    January 2010
    12,772 Posts
    Unfortunately a lot of people don't think about it like that and just see it as government double dipping
    Well a lot of people are dumbasses and don't understand the concept of taxes. That's nothing new.
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  22. Post #102
    Gold Member
    TestECull's Avatar
    July 2007
    9,624 Posts
    Dental maintenance necessary to prevent serious health issues isn't covered though. If you only go in once you have a catastrophic issue, your teeth will already be really fucked.
    Which they can't do if they can't afford it.


    Source: Myself. There's a good 10k worth of dental work earmarked for my pie hole, yet I can barely keep myself fed. So that dental work just has to wait. Its not a state I enjoy being in but that's the way things are and they're not gonna get better unless either I see myself doubling my income or dental work gets mandated coverage. There's no way I can pay OOP for $10,000+ of teeth work when I have to choose between grocery shopping and replacing two dry rotted tires w/ no tread and broken belts.


    I've been on the 'don't get hurt' health plan for so long I lost count of the years.

  23. Post #103
    Gold Member
    GoDong-DK's Avatar
    November 2009
    17,781 Posts
    Oral health is just as important as any other kind of health. There's really no good reason that it often isn't included in insurance (even here in Denmark when you're 18+). If I fall and break my legs I can go to the doctor and it's covered, but if I fall and fuck up my teeth it isn't? Like what the fuck.
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  24. Post #104
    screamin 4 da gold
    RenegadeCop's Avatar
    January 2010
    12,772 Posts
    Not to mention that dental issues can actually lead to heart problems, somehow.

  25. Post #105
    Moderator
    Sgt Doom's Avatar
    March 2005
    15,824 Posts
    Not to mention that dental issues can actually lead to heart problems, somehow.
    Some heart problems are caused by actual infection, and rotting teeth is as good an entry point as any for bacteria.

  26. Post #106
    Gold Member
    ilikecorn's Avatar
    January 2006
    5,486 Posts
    Not to mention that dental issues can actually lead to heart problems, somehow.
    Teeth are pretty well supplied in terms of vascularity, so they make ideal points of entry for bacteria and viruses.

    Edited:

    The bill has some vague mentions (some of it horrifying) of how.

    We'll probably get more details about what this thing entails exactly when the CBO has gotten their hands on it.


    Hmm. I guess that's why when I asked one of my family members about how residency was I got a big "ehhhhhhhhhh" as a response. (The japanese would probably say that these people should work less hours)

    Where did you get the 5-10-15 extra years figure for specialization btw? Cursive search on google indicate that it's typically just a couple years extra. Usually 3, of not strictly schooling.
    Depends on the specialty. For example: I actually want to study pediatric oncology, for that i'd have to add around 5 years on top of my med school. I know some cardiologists that have a crazy subspecialty that had to study for like 7 years before they were licensed.