From: Bill Graham on

"Peter" <peternew(a)nospamoptonline.net> wrote in message
news:4bd83654$0$27723$8f2e0ebb(a)news.shared-secrets.com...
> "David J. Littleboy" <davidjl(a)gol.com> wrote in message
> news:headnfGgW-s2h0XWnZ2dnVY3goSdnZ2d(a)giganews.com...
>>
>
>> If the choice is a bureaucrat or an insurance company making health care
>> decisions, you want the bureaucrat. When push comes to shove, the
>> bureaucrat may be trying to save money, but s/he is also committed to
>> getting good results from the system (and the decisions on what to cover
>> are a priori and public). Insurance companies only care about the bottom
>> line and thus impose silly "rules".
>
> I was referring to insurance companies whose payment policies would be
> strictly regulated. Including, but not limited to{
> Not allowing the carrier to refuse based upon a preexisting condition;
> Mandating that everyone have coverage;
> Making the carriers legally responsible for bad failure to pay decisions;
> Giving realistic and prompt right of review of denial of coverage;
>
>
>>
>> Not only are the overall results of health care in Japan substantially
>> better than in the US, there is none of the amazing garbage that the
>> insurance companies inflict on people in the US. Everyone is covered.
>> Period. No one is refused care. Ever. Essentially no one goes bankrupt
>> from medical costs. If you get to an available doctor, you are treated.
>> There was a case here of a foreign woman who had been living here years
>> without paying her premiums. When she needed emergency surgery, she got
>> it. The charge? She had to pay her unpaid premiums (which came to a lot
>> less than the cost of the surgery). (Then the idiot foreigner activists
>> went ballistic claiming that that was unfair. ROFL. But I digress.)
>
> I agree that our current system sucks. We do not agree on how to fix it.
>
>>
>>> Most people here will also disagree. Third party pay should be
>>> truly competitive.
>>
>> But it can't be competitive. When you need care, you can't change
>> insurers; it's too late.
>>
>
> Policies need to be written in plain language. Rates can be easily
> compared.
> What protection do you have against unecessary claims by healthy people.
> (hyopcondriacs.)
> For Example: Here certain tests are limited as to the number of times it
> is permitted.
> Under Medicare, physical therapy is limited to about $1,750 per year,
> unless given in a hospital. Why! Too many people were going to physical
> therapists, instead of a gym. The result, people who really need extensive
> therapy cannot get it free. A lot of expense is incurred when people
> become hypocondriacs. (this is especially common with people older than
> 50. A lot of people use the hospital ER when they should be going to a
> primary care physician. This problem can be alleviated by ambulatory care
> centers.
>
>
>
>> Since single-payer just works, there's no need for letting the capitalist
>> pigs get their grubby paws on your life.
>>
>
> All capitalists are not pigs. Many are small business people who started
> their own business. BTW, ever look at who controls business in Japan?
> unless you are Japanese and a descendant of the Sumari, you could not
> start your own business.
>
>>> With a single payer, my life is in the hands of some bureaucrat. I will
>>> not accept that.
>>
>> You should not only acept it, but jump at it. That bureaucrat's main job
>> description is to make sure that you get the best care science can prove
>> works. As soon as there's an insurance company, the company's bottom line
>> becomes an issue. There really isn't time for that sort of BS when one is
>> sick.
>>
>
> See above. Also, think incompetent bureaucrat. I certainly do not intend
> to put down government workers, I agree that most are sincere and
> dedicated. But think "good job Brownie."
>
>>> Yes, that type of system works very well
>>> in Japan. I'm sure you understand that, in many respects, Japanese
>>> people
>>> have different cultural characteristics than Americans.
>>
>> Actually, I don't. At least in the sense that I've never seen an argument
>> based on "different cultural characteristics" that was anything other
>> than somewhere in the clear wrong to very silly to downright racist range
>> of things.
>
> Stating that there are cultural differences in the context of this
> discussion is definitely not racist.
>
> BTW Ever hear the word "ginja?"
>
>>
>> And cultural characteristcs hardly apply to the delivery of medical
>> servuces. There are things, like the lower level of obesity, that make it
>> easier to achieve better results. But
>>
>
> We disagree.
>
>>> e.g. How often have you heard of an American being decapitated by a
>>> train
>>> because he was bowing when getting off his cell phone. Another perhaps
>>> more
>>> relevant example: how many lawyers per capita are in Japan.
>>
>> Americans can be pretty stupid, too. For example, this American almost
>> got decapitated by a Japanese train photographing it as it came into the
>> station. (Keeps this thread on-topic<g>.)
>
> No one group of people has a monopoly on stupidity. I almost tumbled down
> a slippery set of rocks photographing a lighthouse, because I wanted to
> get a lower angle.
>
>>
>> And while Japan has about 1/10 the number of lawyers they need, the US
>> has ten time what we need: we're both off by an order of magnitude. (I
>> think the US is erring on the right direction in this, though.)
>
> In Japan it is considered a shame to need a lawyer. Yet they rely heavily
> on accountants.
>
>>
>>>> The reason that there are so many malpractice cases is that there's so
>>>> much malpractice and so many patients are hurt:
>>>
>>> There is a vast difference between malpractice and honest error in
>>> judgment,
>>> or failure to perform some obscure test.
>>
>> I'm not sure what your point is. Every serious study over the last 40
>> years has concluded that malpractice is a major problem in the US (and
>> that frivolous cases are almost always rejected).
>>
> Just an example: malpractice premiums for an orthopedist run in excess of
> $150,000, per year. An internist will pay over $80,000. I am not familiar
> with the curent rates for other specialities.
>
>>> A screening panel should be
>>> established to distinguish between the two.
>>
>> Oops: You are advocating for more bureaucrats! (And you have a good
>> idea.)
>
> Maybe. I didn;t say it should be government run. I could be a private
> organization similar to hte American Arbitration Association, but with a
> different mission.
>
>>
>>> Sorry about your father. Since I really don't know the facts, I cannot
>>> comment. However, most likely you sincerely believe what you say. You
>>> should
>>> ask if that colors your judgment on how best to reform the system.
>>
>> It doesn't color my attitudes, at all (since father had Medicare, he had
>> single-payer). As you note below, it turns out that dealing with the
>> medical system requires that you or a relative or partner take charge,
>> figure out the problems involved, and make sure the doctors are doing
>> their job. This doesn't change with single-payer.
>
> Err! Medicare may be single payer, but Medicare supplemental coverage is
> not.
>
>>
>>> Also, people must be proactive in dealing
>>> with their health care professionals. About a year ago my wife had a
>>> stroke. I suspected a stroke but the local ER doctor said they could not
>>> do
>>> a scan until Monday morning. (This was a Saturday night.) I insisted in
>>> immediate transfer to a
>>> different facility and after a somewhat heated discussion in which I
>>> threatened to take her in my car, they finally agreed. At the new
>>> hospital she received a proper
>>> diagnosis and prompt treatment. She has fully recovered and except for a
>>> slight limp has no signs of her stroke. Had she not received prompt
>>> treatment, the result may very well have been different.
>>> Did I mention that the argument used by the first ER was that the
>>> insurance
>>> would not pay for two ER visits in the same evening? I said I didn't
>>> care
>>> and no @#$! insurance company was going to dictate a medical decision.
>>
>> Which, of course, proves my point. You really don't want commercial
>> interests involved in your medical care. Sure, the bureaucrat's job is to
>> keep costs down. But they do it a priori and transparently: what will be
>> covered is defined in advance (and is subject to public discussion), and
>> all you need is a doctor to sign off on it being necessary, which isn't a
>> problem since they get paid for running the procedure.
>>
>
>
> I have dealt with bureaucrats my entire professional career and differ.
> What you are saying is good in theory, but is not reality. We have a rule
> that a Medicare provider may not accept private payment and Medicare from
> the same patient. The rule is designed to protect the patient from
> gouging. Unintended side effect. I am unable to get a medically indicated
> treatment that is not sanctioned by Medicare, from my regular doctor.
> Another rule forces me to come back the following day for a procedure that
> is ancillary to the primary treatment, even though before Medicare I could
> go through both procedures the same day and doing so is considered better
> medical practice.
>
>
>
>
> --
> Peter
A bad rule. I had a very good dentist. When she couldn't accept the partial
payment my poor insurance provided, I had to drop her, even though I would
have been happy to make up the difference out of my own pocket....but the
state laws made that impossible....She was not allowed to bill me the
difference. So today, I have a different, (and not as good) dentist. As
usual, my government screws me. - So what else is new?

From: Walter Banks on


Bill Graham wrote:

> A bad rule. I had a very good dentist. When she couldn't accept the partial
> payment my poor insurance provided, I had to drop her, even though I would
> have been happy to make up the difference out of my own pocket....but the
> state laws made that impossible....She was not allowed to bill me the
> difference. So today, I have a different, (and not as good) dentist. As
> usual, my government screws me. - So what else is new?

Use another approach. Use the American approach buy different
insurance that would pay for the coverage you desire or buy no
insurance and just pay for the dentist you would prefer.



--- news://freenews.netfront.net/ - complaints: news(a)netfront.net ---
From: David Ruether on

"Walter Banks" <walter(a)bytecraft.com> wrote in message news:4BDA5E18.E6114D2F(a)bytecraft.com...
> Bill Graham wrote:

>> A bad rule. I had a very good dentist. When she couldn't accept the partial
>> payment my poor insurance provided, I had to drop her, even though I would
>> have been happy to make up the difference out of my own pocket....but the
>> state laws made that impossible....She was not allowed to bill me the
>> difference. So today, I have a different, (and not as good) dentist. As
>> usual, my government screws me. - So what else is new?

> Use another approach. Use the American approach buy different
> insurance that would pay for the coverage you desire or buy no
> insurance and just pay for the dentist you would prefer.

I chose no insurance, since my (good) dentist does not accept
Medicare Advantage coverage, and my dentist bills amount to
about $220 per year for cleanings and check-ups, unless I need
the very occasional greater amount of work done. Same for my
eye doctor (but he averages about $60 per year...). As you point
out, the solution is not difficult to figure out - but some people
just like to complain 'bout "th' gov'mint"...;-)
--DR


From: Albert Ross on
On Wed, 28 Apr 2010 23:43:35 +0900, "David J. Littleboy"
<davidjl(a)gol.com> wrote:

>
>"Japanese and Germans, with a superior record of economic prosperity and
>family life, appoint engineers and designers to their company boards.
>Britain�s major companies appoint accountants who are pre-occupied with
>controlling and cutting costs rather than maximising investment, production
>and value added."

BTDT. Our accountants in the UK will spend pounds in order to save
pennies

We always have been and still are good at generating Good Ideas. but
most of what were once family firms when they reach a certain size
become Corporates and fall apart, whereas the German equivalents are
still owned by maybe the third or fourth generation of the same family
and remain successful
From: Peter on
"Walter Banks" <walter(a)bytecraft.com> wrote in message
news:4BDA5E18.E6114D2F(a)bytecraft.com...
>
>
> Bill Graham wrote:
>
>> A bad rule. I had a very good dentist. When she couldn't accept the
>> partial
>> payment my poor insurance provided, I had to drop her, even though I
>> would
>> have been happy to make up the difference out of my own pocket....but the
>> state laws made that impossible....She was not allowed to bill me the
>> difference. So today, I have a different, (and not as good) dentist. As
>> usual, my government screws me. - So what else is new?
>
> Use another approach. Use the American approach buy different
> insurance that would pay for the coverage you desire or buy no
> insurance and just pay for the dentist you would prefer.
>


For dental procedures that works fine. Most dentistry is not covered under
Medicare. What Bill doesn't mention is that he can use the same dentist
without resort to the policy and all will be well. Most dental insurance is
a crock, anyway.

--
Peter