Noam Chomsky On Health Care

[jjrglobal]

Do you agree that there should be different classes of hospitals just as there are motels? With the regulations the gov has to open a hospital, they all must be the Ritz Carlton, but everyone cant afford to stay at the Ritz and the government wont allow anything less. The free market would allow for a wide range of hospitals from luxurious to dumps, but if people were responsible for the costs they could choose which place they wanted to stay. The dr's would be the same from hospital to hospital

[rickbar123]

@jjrglobal I like what we have now. Smaller community hospitals with large centers for research and training. I must tell you- I am a hard core socialist. I would like to see America adopt German style social democratic government (it's really our system, our Generals put it in place post WW2). I would never trust the free market and the CEOs. I rather see lots of regulations with strong inforcement , standard across all hospitals than less regs.

[rickbar123]

@jjrglobal Sorry, I want a single payer system.

[jjrglobal]

@rickbar123

But do you really understand the system well enough to make that claim? The answer is health savings accounts that you control. Buy a catastrophic policy with a $10000 deductible and put 10k into a savings account with the savings from not buying health ins. Pay as you go for small stuff, regular dr's visits etc out of the health savings account. Paying cash to dr's will allow competition between them and prices will plummet. As it is now, the worst Dr gets paid as much as the best

[rickbar123]

@jjrglobal I do not see prices droping. Dental care is a good example. In Phila, Pa. we now have cash dental offices in every mall. Walk in and pay cash for care. It's strange how everybody has the same prices. Docs are not stupid, prices will be set and no doc will undercut another doc. Prices only plummet when the providers are stupid. They are not stupid.

[jjrglobal]

@rickbar123

Where I live we are starting to see clinics that are cash only, no insurance, and it costs $25 per office visit. Sound like prices are falling to you now? Prices fall when there is competition

[jjrglobal]

This really illustrates how little Chomsky actually knows about health care and the problems that exist in the US. Its no coincidence that lasik and cosmetic surgery have seen falling costs and rising quality, its called the free market.

[rickbar123]

@jjrglobal Bullshit. Those are 'joke surgerys'. Large amounts of the population wanting a fast and minor surgical procedure that has few if any post op problems. Lets see you work out a trip bypass with a 2-3 wk ICU stay, then on to a 1 wk stay on a med surg floor, then back to the ICU for a wk when the patients BP drops, then back to med surg for 1 wk. Lets not forget the 3 wks in rehab with a trip back to med surg for a fever of unknown origin for a 1 wk. Toss in 3 months of home care.

[rickbar123]

@jjrglobal The free market falls apart when it comes to a REAL surgery. Rand Paul talks alot of bullshit. Lasik and alot of cosmetic surgery are not what I would call a real surgery. RN x15 years.

[jjrglobal]

@rickbar123

How would you know if the free market falls apart when it comes to real surgery? We haven't had a free market in health care since the gov got involved in the 30's.

So as an RN did you do any billing? Do you even know how the insurance industry works and who sets the guidelines for CPT coding? Married to an MD and former CFO and still Board Member of Texas Childrens Clinic x10 years

[rickbar123]

@jjrglobal Yea so, ask what a hospital stay of that nature would cost ?? In the end, we would have people losing their homes to pay for it (something you free market types could care less about). Remember, the cost of the surgery is nothing next to the wks that can be spent after the surgery.

[jjrglobal]

@rickbar123

Heres where I think you have my opinion wrong, Im not for what we have now either. I want for gov to get out of the health care business altogether, starting with employer tax incentives. Employers shouldnt be involved in health care, they dont buy my home owners or car ins. I also want the regulations for hospitals to be done away with. Imagine if the hotel industry had regs like hospitals, people would be forced to sleep on the streets because there could be no Motel 6.

[rickbar123]

@jjrglobal If you get rid of hospital regs, the next day all the nurses would be gone and the aids would be in charge of your care. I agree, employer provided HC needs to go.

[jjrglobal]

@rickbar123

No they wouldn't, the doctors wouldn't allow it. Although perhaps some of the cheaper hospitals may have aids instead of nurses. They would be your motel 6 hospitals.

?

I went into the hospital a few yrs back and was in for 5 days, my hospital bill was $7700 My dr bill was only $750. My ins paid $7700 to the hospital, yet only paid my Dr. $450 which was the contracted amount. Why are ins co's paying the billed amount to the hospitals, but have a contract allowed amount for docs?

[jjrglobal]

It seems as though the hospitals are NOT taking any reductions on what they are billing and I have verified this through several EOB 's with several different hospitals and ins co's. When a dr files a claim the actual amount billed is inconsequential, the ins cos have a contract with the dr that is predetermined what each cpt code pays its called the allowed amount. This is not negotiated, its dictated by the ins co. Why not hospital charges Why does a crappy hotel room cost $1500 a night

[rickbar123]

@jjrglobal I hear ya, its nuts.

[jjrglobal]

@rickbar123

Where you aware of the hospitals getting reimbursed whatever they charge and the doctors getting reimbursed whatever the ins co's decide the cpt code is worth? Dr 's cant bill the patients the difference either. People say, well you dont have to sign the contract with the ins co's, but if you dont you lose your patient base. BCBS drops their reimbursement every year, but they ins 40% of the people in our state, who can afford to lose 40% of their patient base?

[rickbar123]

@jjrglobal I hear the docs bitch all of the time. I once walked into a OR during a surgery while a doc was going off on the payment problems he was having with a new COO. He tossed a large hemostat at the door while I was walking in.

[Revolucionario02]

eres grande Chomsky!!

[bebop54]

great upload ..

thanks man !