Comments | tongodeon: Health Care Compatibility and the Free Market Model

tongodeon

Health Care Compatibility and the Free Market Model

Mar 23, 2010 16:05

I didn't get a chance to complete this post before HR 3590 was signed by the President today. Some of what I say here is no longer true as a result of the bill (and some of it still is), but I thought I should post this anyway to show where we came from.

If someone buys a car or house they can't afford you can reposess that car or house. Not so ( Read more... )

health care, economics

Comments 10

Switzerland gauntleteer March 24 2010, 02:49:54 UTC

A colleague of mine from Switzerland who is working full time here and going for his green card (basically, does not plan to leave the USA) has told me about the trouble he's gone to in order to STOP paying for his Swiss healthcare. Apparently the system over there is compulsory in the extreme... you cannot stop paying for it without an act of god. The management at Roche on the Swiss side had to jump through tremendous hoops to convince them he's out of the country, not coming back, and isn't going to pay in anymore. Roche is also incredibly powerful: you can walk into a restaurant and just leave your Roche business card as promise of payment (this is what I'm told) and they will gladly keep the tab. Damn honest people, I have observed.

If you can handle their rigidity, the Swiss aren't bad to work for. I love their country. I love their machine guns. I might emigrate someday :)

Re: Switzerland tongodeon March 24 2010, 06:00:13 UTC

Can you find out how much the minimum compulsory insurance costs?

Re: Switzerland gauntleteer March 24 2010, 06:26:44 UTC

I will ask. His wife is/was an actual physician in Switzerland, she's practicing in the USA now. If he doesn't know then I bet she will.

Re: Switzerland loic March 29 2010, 15:47:15 UTC

I think it's a lot. Not quite what US health insurance costs but I think for my cousin's family (2 adults + 3 kids) she pays somewhere between US $500 - US $1000 per month. She grew up in France and is grumpy at having to pay so much for healthcare. Of course we Swiss love doing things our own stupid way.

Thread 5

drjohn March 24 2010, 03:39:50 UTC

As a data point, our group gets paid for around 31-32% of the studies we perform. I was surprised to find out it was that low. I am very much looking forward to HCR causing an increase in that percentage, even if we get reimbursed at current Medicare rates or lower.

tongodeon March 24 2010, 06:01:55 UTC

I hear that doctors in foreign countries get paid less than they do in the USA. I rarely hear the disclaimer "when they actually get paid". I also don't hear how much lower the overhead is, since in some systems the billing would seem to be a lot more straightforward.

ikkyu2 March 25 2010, 14:44:51 UTC

Most of the newly insured will be on Medicaid, I think.

I get paid for about 70% of the E+M I do, and I ostensibly only see patients whose insurances I'm contracted with. Sounds fishy, doesn't it?

scrambledeggs March 24 2010, 04:22:15 UTC

Ha! I've been thinking for a while about posting almost exactly the same thoughts (albeit much less eloquently and well-informed).

One thing I want to amplify from your above points: not only does an unconscious or disoriented person lack the ability to accept medical care, they also lack the ability to *reject* care that they are unable to pay for. If you don't have (non-liability) auto insurance and you get into an accident, the worst case is that you get stuck with no car. Because of the obligation to treat, if you don't have health insurance, you may end up stuck with debt that you could've rejected had you been able to respond rationally.

tensegritydan March 24 2010, 23:43:28 UTC

Thank you for yet another of your clear, rational explanations.

On Monday, I heard the president of the AMA address an audience of health care researchers about health care reform and then the director of the AHRQ talk about current and future health care research priorities. It was so refreshing to be in a crowd of people for whom everything you've written is so familiar as to be nearly axiomatic. And when you discuss health care reform with people who are actually engaged in the delivery of health care and its improvement (I do not count medical insurance companies or their shareholders in that group), the obvious wisdom and practical necessity of these reforms is a foregone conclusion.

Will post more on this observations later, but just wanted to chime in for now.