Healthcare Content (Protest Instructions) >>>>>

[aphineday]

The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.

[DoW]

The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.

please define your logic.
if a hospital lost money every year, how could it stay open?  employees want their paychecks.  vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too.  they can't buy supplies and pay employees and have nothing leftover for themselves.

the profits are meant to be reinvested in new technology and benefit the community. 
there is a growing trend for hospitals to be for profit entities.  I have an opinion on that which I won't share at this time.

[Hicks]

http://www.huffingtonpost.com/bill-maher/new-rule-not-everything-i_b_244050.html

[DoW]

here I go again 
you can argue what an acceptable profit margin is but how can a hospital lose money and stay open?
I'm just talking accounting 101.  forget policy.
if my expenses for the month are $100,000, how can I make $90,000 in revenue and pay those expenses.  are the drug companies going to forgive the extra $10,000 and say the hospital doesn't owe it.
forget these articles that make no sense.  let's just discuss simple accounting.

you can definitely argue that a hospital doesn't need to make a 15% contribution margin.  but you can't lose money every year.  it is fiscally impossible.

[Hicks]

Probably in the same way that governments continue to function with deficits.

Which is why the single payer system with a taxpayer funded healthcare system is the only way out of this mess.

[DoW]

sorry, but a hospital can't be run like a government running at a deficit.
we have bank accounts.  when philips delivers an MRI machine, we need to pay them for it or they come take it back.  nurses will not come to work if they don't get paid the previous week.  drug companies won't deliver drugs.  american red cross won't deliver blood.
I hate to be mean about it but you can't run a hospital at a deficit.  the bills are paid out of a bank account.  if there is no money, the bills aren't paid.

[runawayjimbo]

The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.

please define your logic.
if a hospital lost money every year, how could it stay open?  employees want their paychecks.  vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too.  they can't buy supplies and pay employees and have nothing leftover for themselves.

the profits are meant to be reinvested in new technology and benefit the community. 
there is a growing trend for hospitals to be for profit entities.  I have an opinion on that which I won't share at this time.

C'mon, bvaz, get in the game!

I wouldn't even say "meant to be reinvested". Clearly the profit motive provides the incentive to create new drugs and machines that ultimately lead to greater health outcomes.

Conversely, under a single payer system, the gov't will need to make difficult decisions about how to spend their limited healthcare dollars. Do you (aphineday) have a lot of faith in the gov't making a politically difficult decision or do you think it's more likely they'd continue to blow smoke up our ass and keep promising the moon even though we're broke as shit?

[DoW]

The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.

please define your logic.
if a hospital lost money every year, how could it stay open?  employees want their paychecks.  vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too.  they can't buy supplies and pay employees and have nothing leftover for themselves.

the profits are meant to be reinvested in new technology and benefit the community. 
there is a growing trend for hospitals to be for profit entities.  I have an opinion on that which I won't share at this time.

C'mon, bvaz, get in the game!

I wouldn't even say "meant to be reinvested". Clearly the profit motive provides the incentive to create new drugs and machines that ultimately lead to greater health outcomes.

Conversely, under a single payer system, the gov't will need to make difficult decisions about how to spend their limited healthcare dollars. Do you (aphineday) have a lot of faith in the gov't making a politically difficult decision or do you think it's more likely they'd continue to blow smoke up our ass and keep promising the moon even though we're broke as shit?

I don't even bother discussing a single payer system.  it will never happen.  trust me on that.  I know enough about the industry to know it could never work here and will not work.  it will not ever get to the point that it will happen.
the only thing I will argue on your point is new drugs are developed by drug companies and machines by manufacturers.  they are of course regulated, but their prices are not based on reimbursement for services.  I guess they are indirectly but it is indirect.
a hospital needs to make enough money to buy a new piece of equipment from a manufacturer or new drugs.  it completely expands the whole discussion to a very wide discussion when adding drug companies and device manufacturers.

[Hicks]

The government needs to stop spending all its money on guns and start spending it on medical technology.

See I just solved all our problems.   :wink:

[aphineday]

The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.

please define your logic.
if a hospital lost money every year, how could it stay open?  employees want their paychecks.  vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too.  they can't buy supplies and pay employees and have nothing leftover for themselves.

the profits are meant to be reinvested in new technology and benefit the community. 
there is a growing trend for hospitals to be for profit entities.  I have an opinion on that which I won't share at this time.

Right, sorry. What I meant was the "for profit" trend to which you're referring. I understand that hospitals need to turn a profit for sure. I just hate the fattening of wallets based on healthcare.

[DoW]

The government needs to stop spending all its money on guns and start spending it on medical technology.

See I just solved all our problems.   :wink:

joking aside, clearly you're right.
the one thing I will say is that medical coverage is one of the highest (if not the highest) percentage of the federal budget.
it's a huge problem with no easy answer.
the government is trying to create quality healthcare with concepts like value based purchasing, medical homes and accountable care organizations.
there is already a ton going on in healthcare before health care reform takes effect.  but there is no doubt healthcare is expensive and cutting costs within healthcare is necessary.  as much as I discuss it, the fewer answers I have.

[runawayjimbo]

The government needs to stop spending all its money on guns and start spending it on medical technology.

See I just solved all our problems.   :wink:

Nice! Now can you get me a lower rate on my mortgage?

The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.

please define your logic.
if a hospital lost money every year, how could it stay open?  employees want their paychecks.  vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too.  they can't buy supplies and pay employees and have nothing leftover for themselves.

the profits are meant to be reinvested in new technology and benefit the community. 
there is a growing trend for hospitals to be for profit entities.  I have an opinion on that which I won't share at this time.

Right, sorry. What I meant was the "for profit" trend to which you're referring. I understand that hospitals need to turn a profit for sure. I just hate the fattening of wallets based on healthcare.

What would be an acceptable level of profit for a hospital? How about an insurance company? Pharma? Having a group of people determining what is fair or reasonable (be it for a company, an industry, or personal income) generally leads to outcomes that are neither and nearly always come down on the backs of those with less rather than those with the most.

[sls.stormyrider]

yea, there are a boatload of tough principles here

-hospitals need to make $. Even "not for profits" have to have a + margin. They need to be able to invest, expand, and borrow money. In order to get a good bond rating they need to have a good balance sheet

-Pharma and industry need to make $ to keep innovating. We're seeing a tragic shortage of important generic drugs (chemo for kids, "code blue" drugs, vaccines for example) because the producers aren't making enough $

-Health care is labor intensive, with highly trained professionals. training is expensive in both time and money.

Single payer sounds good in theory, I just don't see it working in the US, politics aside. The VA system is a mess. Govt programs (state and fed) move slowly and are somewhat tied to politics. A couple of weeks ago the "doc fix" was in the news. It's a long story, but it's a mess that started in the late 90s and Congress chooses to kick the can rather than fix it once and for all.

where we can cut $ (easier said than done)
we are all responsible for overutilization.
patients expect everything, and expect it now.
doc try to deliver to keep people happy - it's easier to order an expensive test or drug than to explain that a pt doesn't need it (or used judgement)
docs don't want to make a mistake and have a pt get sick or die. an extra test might be worth it. sometimes it's hard
docs don't want to get sued. if you do something extra, well you tried. if you didn't, you blew it. this is especially visible in the ED, which even without defensive medicine is the most expensive place to get routine medical care (except the icu and OR)
there's too much damn shit to know to be on top of everything
new technology and new drugs are expensive; they're often available before we fully know how to use them - or not use them
then, there's the fee for service system, which unfortunately is subject to abuse.

[runawayjimbo]

Well said, sls. +k

It's a number of extremely complex and interconnected issues and there is clearly no easy answer. But at least we all (ETA: except the politicians, obviously) recognize the status quo sucks and a change is drastically needed.

Single payer sounds good in theory, I just don't see it working in the US, politics aside. The VA system is a mess. Govt programs (state and fed) move slowly and are somewhat tied to politics.

Obviously the "death panel" rhetoric was bogus, but I just can't trust the gov't (who politicize what toilet paper they should have on Capitol Hill) to make the best decisions for me and my family's health, especially with something as personal and unique as healthcare.

A couple of weeks ago the "doc fix" was in the news. It's a long story, but it's a mess that started in the late 90s and Congress chooses to kick the can rather than fix it once and for all.

I meant to ask you how you felt about that. What was that about? Something about paying for the payroll tax cut?

-Health care is labor intensive, with highly trained professionals. training is expensive in both time and money.

You went to medical school, I wonder, what's your feeling on making it easier for people to become doctors? The AAMC accepts what, 1 out of every 10 applicants, many of whom will not finish medical school? Shortages raise prices in every market, even healthcare.

docs don't want to get sued. if you do something extra, well you tried. if you didn't, you blew it. this is especially visible in the ED, which even without defensive medicine is the most expensive place to get routine medical care (except the icu and OR)

Up yours, bvaz

[mbw]

What would be an acceptable level of profit for .... an insurance company?

i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.