Government run Healthcare genius.

I am not at all surprised to find that the people that so love and want government controlled healthcare – because of those evil profit making insurance companies and their callous ways – would think this refusal to be genius and just:

A man from Nyköping in eastern Sweden has been denied a power wheelchair despite having had both of his legs amputated as the local health authority remained “uncertain if the impairment was permanent”. The man had his legs amputated after a long struggle with diabetes, but despite being unable get about, his application for a power wheelchair has been denied. “I was bitterly disappointed in the local authorities. I don’t feel I got the support I deserve,” Evert Stefansson told The Local. Evert Stefansson had struggled with his health for a long time. As a long-suffering diabetic his kidneys have taken a beating, as has his eyesight.

I would also not be surprised to find out that they refused him because they think he isn’t doing a good job dealing with his diabetic condition. It’s just as likely to be that as it is them callously calculating that he isn’t long for this world and a set of wheels would be wasted on him. Of course, it could also be that they think this guy has lizard DNA and will regrow his appendages or that he is slated to get bionic legs and thus not need them sweet wheels. Any way you cut it, it isn’t what they tell us it is going to be when the “right” people are in charge of this stuff.

Comments are closed.

  1. CM

    “But I had my suspicions right from the start that it wouldn’t be easy, when the woman from the county visited. She sort of hinted that he could have an ordinary electric wheelchair,” Siv Stefansson said.

    The electric wheelchair was less desirable as it would still need a carer operating it, and would therefore not allow Stefansson to get about by himself, without the constant help of his wife.

    I wonder what the actual differences are between a ‘power wheelchair’ and an ‘ordinary electric wheelchair’? I mean, what exactly is the electric part, if it still requires someone to assist?

    Alex, are you suggesting that decisions such as this are not made in private healthcare? Do people just get whatever they like? I would assume that the insurance companies also make these sorts of decisions based on assessments. Do they not?

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  2. CzarChasm

    I think it’s fair to assume that any right-leaning (or right-thinking for that matter) person would prefer that a privately-trained and employed healthcare professional be the person (or people) involved in those assessments over being bound by the decisions of a government-trained and employed bureaucrat. Is that really hard to understand?

    CC

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  3. Mississippi Yankee

    Do people just get whatever they like? I would assume that the insurance companies also make these sorts of decisions based on assessments. Do they not?

    CM, in this country, on broadcast and regular cable TV, there are numerous commercials for several electric motion devices. The Scooter Chair and the Hover-round come immediately to mind.

    These companies advertise they will file all necessary paperwork for you too. So the simple answer is by and large people do get whatever they want.

    Do I suspect a kickback scheme here and there… perhaps. But I’ve never had disillusion of a Utopian world either.
    BTW-that’s not an accusation.

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  4. CM

    Nice aggressive end to your post there Czar….LOL

    I guess my questions would be….

    Why would professionals in a government system necessarily be government trained?

    And at the end of the day, whether it’s private or government, surely the decision is still going to come down to allocating resources (i.e. money). The decision is always going to involve medical AND a financial assessment. At least in the government version there can be systems of public accountability (and appeals to independent arbitars etc). Where do you go in a private company? Do you petition the shareholders?

    What are the benefits of the assessor being bound by the constraints of a private company (where perhaps criteria isn’t disclosed)? It’s not as though the private assessor has no constraints. And if they are run for profit, surely the patient is less likely to get the expensive option (the ‘power wheelchair’)? I’ve never known an insurance company in NZ to pay out more than it needs to. Usually they try and get away with paying out as little as possible, because they are a business and they have shareholders who don’t expect their dividends to be handed out as wheelchair upgrades just because someone asked. In which case why would government constraints in healthcare be inherently worse?

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  5. Miguelito

    I wonder what the actual differences are between a ‘power wheelchair’ and an ‘ordinary electric wheelchair’? I mean, what exactly is the electric part, if it still requires someone to assist?

    I was wondering about that myself.

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  6. Tripper

    It does seem like most of them are focused on medicare ‘customers’ though.
    They usually have some line in the add along the lines: “If we approve you for a power chair and medicare denies your claim, we’ll give you your chair free” or something like that.
    So at the end of the day they seem to still be appealing to a government healthcare decision maker to approve the chair, though in this case the application probably never gets denied by the government as the private chair company is probably never going to send them something they’ll deny or the chair company will be out of pocket (if they stand behind their words). I suppose that means the private chair company likely makes some denials before Medicare ever sees those applications.

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  7. CM

    The electric-powered wheelchair was invented by George Klein who worked for the National Research Council of Canada, to assist injured veterans during World War II.

    http://en.wikipedia.org/wiki/Motorized_wheelchair

    Sheesh, it’s another government invention….

    This is interesting. Seems the prescribing of powerchairs is a known issue.

    Powerchairs are generally prescribed for use by users who are unable to use a manual wheelchair. However in both the US (Medicare and some private insurers) and the UK (National Health Service) powerchairs are generally not prescribed to users who have any ability to walk within the home, even if that ability is so functionally constrained as to be practically useless and where the user is unable to use a manual wheelchair independently. Disability rights activists are campaigning for prescription procedures to focus on an individual needs based assessment rather than on inflexible application of prescription rules. The restricted prescribing leads to many users being forced to procure a solution privately, in some cases settling for a powerchair or a mobility scooter that is less than ideal to their needs but which falls within their budget.

    The use of powerchairs is not restricted solely to users unable to use manual chairs. Any disabled person with a mobility, fatigue or pain-based impairment or cardio-vascular issues may find a powerchair advantageous in some circumstances, however existing prescription practises generally means that powerchairs for such use must be privately procured or hired for the occasion.

    So it seems some private insurers don’t prescribe them (aside from Medicare). No source provided for that though, so of limited value. But this specific Swedish example doesn’t appear to be anything strange.

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  8. CM

    Government Just Now Realizes It Is Wasting Millions On Motorized Scooters

    Records from the Centers for Medicare and Medicaid Services show the cost of motorized wheelchairs to the government health service for senior citizens has risen from $259 million to $723 million, or 179%, from 1999 to 2009, the last year for which full records are available.

    Advertisements for the wheelchairs, also called scooters, have exploded nationwide in recent years, as companies tout the improved mobility they provide and how Medicare, not the patients, will pay for the chairs.

    A report released last week by Medicare’s inspector general also showed that 61% of the motorized wheelchairs provided to Medicare recipients in the first half of 2007 went to people who didn’t qualify for them. The inspector general found that Medicare is billed an average of $4,018 for a motorized wheelchair that normally sells for $1,048.

    http://wonkette.com/450599/government-just-now-realizes-it-is-wasting-millions-on-motorized-scooters

    So in the US the exact opposite of what Alex is saying is occuring. TOO MANY people are getting them from THE GOVERNMENT.

    Add yet another one to the list…

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  9. Mississippi Yankee

    But this specific Swedish example doesn’t appear to be anything strange.

    The examples mentioned described
    Any disabled person with a mobility, fatigue or pain-based impairment or cardio-vascular issues…

    The Swede had no legs. In some circles the Swedish governments decision might be construed as a “pre- death panel decision”.

    /slight sarc tag/

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  10. Mississippi Yankee

    CM, I don’t doubt there is a fair amount of chicanery in the motorized scooter business but your source is quite suspect.

    Wonkette was started and owned by the once beautiful (and redheaded) and brilliant Anna Marie Cox in the pre Bush daze. See was somewhat left of center but certainly willing and able to skew both sides of the isle. Both funny and witty too.

    She ended up over at TIME and sold Wonkette to GAWKERS. That canker blossom entity and now Wonkette has become lefty site on par with DU and Daily Kos.

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  11. CM

    I see that I quoted inaccurately. The part I quoted is actually from the source of the Wonkette piece, being USA Today. Here is that original piece:
    http://www.usatoday.com/money/industries/health/2011-07-12-wheelchair-medicare-fraud_n.htm?csp=hf

    Interesting about Wonkette though, I didn’t know that (although I’m not familiar with the site, I just stumbled across the piece via Google. I thought it was hilarious given Alex’s opening.

    The patient will often receive a wheelchair, but not a motorized wheelchair worth about $3,600 for which Medicare will be billed, Schoen said.

    Death-panels!! ObamaHitler!!

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  12. CM

    People in those circles don’t wait for the details. They scream ‘death-panels’ at the moon long after everyone else is tucked up. After all, it’s on all the blogs you know, and the LSM isn’t reported it, so it fulfills all conditions to be true.

    However, the motivation for the county council’s decision was allegedly that it was “uncertain if the impairment was permanent”, reported local media.

    Shit, yeah, case closed then. Lock the door and turn out the lights. Clearly we need no further information.

    So really, why should we pay too much attention to those circles? They inevitably just go around and around anyway with their own facts and reality.

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  13. CM

    chicanery in the motorized scooter business

    I forgot to mention how much I loved the wording of that. I think it’s perhaps the on-its-face absurdity of that being a dodgy business juxtaposed with the absurdity of a motorised scooter handling a series of chicanes. Anyway, I like.

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  14. CzarChasm

    Nice aggressive end to your post there Czar….LOL

    THAT was aggressive? Jeesh, your skin is thinner than ever.

    Why would professionals in a government system necessarily be government trained?

    On the healthcare side, I guess they wouldn’t necessarily be government-trained, but on the deciding-who-gets-the-money-and-what-factors-go-into-that-decision side of the equation, they most certainly would be government-trained. The second they accept a job with the government, they go from a professional administrator/manager of healthcare-specific industries to a government bean-counter. As mundane, and perhaps cynical, as the description may be, one doesn’t learn government bean-counting in college, they learn it from working for the government. That’s why former healthcare professionals necessarily have to be government-trained to be “successful” bureaucrats.

    And at the end of the day, whether it’s private or government, surely the decision is still going to come down to allocating resources (i.e. money). The decision is always going to involve medical AND a financial assessment. At least in the government version there can be systems of public accountability (and appeals to independent arbitars etc).

    Accountability of the kind that Eric Holder is being held to for Operation Gun Runner perhaps? The kind of “public accountability” that William G. McMahon, William D. Newell, and David J. Voth, all key supervisors of Fast and Furious who got promoted for their roles in the traitorous program, rather than held accountable, is that the mythical “public accountability” of which you speak? Maybe there’s such a thing as public accountability where you live, where the government is answerable to about as many people as one of our small to medium sized states, but it’s a total myth here CM.

    Where do you go in a private company? Do you petition the shareholders?

    No, you and/or your spouse finds a job with adequate health insurance, and you accept the responsibility of supplementing it if the coverage offered isn’t adequate for your needs. Policies are fairly well spelled out for those who take the time to read them and have anything that they don’t understand clarified before they sign on the dotted line. That’s not to say that no arbitration would ever be necessary even if a family does go over the policy with a fine-toothed comb, but the process is well-defined and well-established, and works fine for the overwhelming majority of people. As you know, I’ve had to use an awful lot of insurance over the last 10 years or so, surgeries, chemo therapy in the $2000 a month range for 48 weeks, broken bones yada yada yada, so it’s not like I’m just taking some right-wing source’s word for it when I say it works well. In fact, the only thing I can think of that would make it work better is if government was less involved, but whatever, it’s not, as you imply, like there’s no one to turn to and get good results in the current system. Quite to the contrary, government being more deeply involved will surely cause reduced numbers of good results for the patient in arbitrated disputes. It’s not like the arbitrator is likely to be of the patient’s choosing, and if the government is paying their bills, well, do the math, the government will win more often.

    Private insurers will certainly try to cut costs, but the dispute between them and a patient basically falls under contract law. The insurers and insureds make an agreement and disputes are settled like any other contract dispute is settled; in court, or in some cases, an arbitrator’s office. But at least in a court setting between two private entities, the judge refereeing the dispute isn’t an employee of the side trying to cut the corners.

    Gotta git. But really, nothing I’ve said should be hard to understand, nor should it be challenged like it’s wrong or something. My opinion is that government is a detriment to efficiency and good healthcare for the reasons articulated. That’s before ever getting anywhere near death panels or the hit to freedom and liberty and self-reliance and self-responsibility. You don’t really think you’re going to change my mind with examples of a country such as yours with less than 5 million people who may well be perfectly satisfied with your system, do you? It’s like comparing apples and rocks.

    CC

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  15. sahrab

    You are correct, your source (wonkette/usa today) does refute Alex’s contention. You have to wonder about Alex’s purpose for bringing it up as the add’s for these (scooters) and many of the other medical doo-dads. It is very obvious the intention of the advertisment is to inform those on Medicaid/Medicare that they (company advertising) will go out of their way to “Assist” those with Medicaid/Medicare to “Freely” acquire whatever it is they are advertising for (Diabetes monitors are another one).

    But your source, and Alex’s mistaken assertition, do expose the very innefficiencies and corruption that exists and is symptomatic of any type of Government Run Program. Thanks for making our point again.

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  16. balthazar

    So basically you are saying that government run healthcare doesnt give the services to the people that need it, and wastes money on people bilking the system that dont need those services. Please explain why you are for GRHC again? Are you that self deluding?

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  17. Xetrov

    From CM’s wiki quote above –

    However in both the US (Medicare and some private insurers) and the UK (National Health Service) powerchairs are generally not prescribed to users who have any ability to walk within the home

    I’m curious as to what ability a legless person has to walk within the home that the request might be denied for.

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  18. Kimpost

    This made major news in Sweden. He had both his legs amputated. Yet his application was denied because “they weren’t sure whether his condition was permanent or not”. :)

    It basically was a human error. An idiot (or several of them) said no. The official word now is that they’ll look at the application again, which is new-speak for “we’re sorry we screwed up”.

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  19. balthazar

    I’m curious as to what ability a legless person has to walk within the home that the request might be denied for.

    Maybe he lives in a very large swimming pool. I hear his name Bob.

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  20. AlexInCT *

    Alex, are you suggesting that decisions such as this are not made in private healthcare? Do people just get whatever they like? I would assume that the insurance companies also make these sorts of decisions based on assessments. Do they not?

    Actually CM, my point was precisely that the people that absolutely hate private healthcare cite cases like this, where private companies make these decisions they find so wrong because they are based on profit making, as the primary and defining reason why they want government to run it all, while pretending government won’t need to or do more of the same.

    In fact, removing the profit motive from the equation to me removes any and all incentive to have a system that has any real mechanism to enforce good behavior or change when things are off. A private company that pisses off too many of their costumers would go belly up fast. That is, unless of course the very people in government that fight the hardest for government to take over the healthcare sector money and decision making process, are bought by the private companies to pass laws they know will keep the company alive but also anger more consumers into join the ranks of those demand government take it all over, like we too often see. If we could mitigate the protection that big government regulation way too often provides scoundrels, the system would be self correcting.

    Big government on the other hand, especially one with the power of life & death decisions for all individuals, has no incentive to do anything right. Only idiots think government employees are somehow saintly beings working to do good. My experience has left me convinced that government workers suffer far more from biases and vindictive character flaws than most people, and protected by the monopolistic big government act out on them frequently and in tyrannical ways. Spend a day at the DMV and dare complain and watch how well that works out. Expand that into something as critical as healthcare when government has removed the private option from all but the real well to do, and it will be far worse.

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  21. AlexInCT *

    It basically was a human error.

    Funny how when it happens with those privately insured it is blamed on “greed/stupdity”, but when government does it it is “human error”… BTW, that was also my point.

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  22. Tripper

    So basically you are saying that government run healthcare doesnt give the services to the people that need it, and wastes money on people bilking the system that dont need those services. Please explain why you are for GRHC again? Are you that self deluding?

    Or, the argument could be that in a system like the UK’s NHS where there is no direct connection between the for profit company making the electric wheelchair and the recipient, there would be a lot less over prescribing(?) of these for people who don’t need it.

    It’s always going to boil down to this though:
    Where the government is the provider of the chair the accusation will be that the government is trying to save $s by not providing them when they are needed.
    Where a private company is the provider of the chair they are going to try and maximize profits by selling them to as many people as possible.
    Where a private company is the provider, and a government is paying for it, common sense suggests there’s even more likelihood of the afor mentioned chicanery

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  23. CM

    On the healthcare side, I guess they wouldn’t necessarily be government-trained, but on the deciding-who-gets-the-money-and-what-factors-go-into-that-decision side of the equation, they most certainly would be government-trained. The second they accept a job with the government, they go from a professional administrator/manager of healthcare-specific industries to a government bean-counter. As mundane, and perhaps cynical, as the description may be, one doesn’t learn government bean-counting in college, they learn it from working for the government. That’s why former healthcare professionals necessarily have to be government-trained to be “successful” bureaucrats.

    I guess I don’t understand why they must necessarily turn into a “bean-counter” just because govt is involved. Ultimately the same decisions need to be made, no matter what the system. And the two main drivers are going to be need versus cost. Medical opinion about need should be pretty similar no matter the system, so the main difference is going to come down to cost. Resources are finite under any system, so the difference then comes down to policy (quotas, thresholds, how specific budgets are allocated, etc etc etc).

    Accountability of the kind that Eric Holder is being held to for Operation Gun Runner perhaps? The kind of “public accountability” that William G. McMahon, William D. Newell, and David J. Voth, all key supervisors of Fast and Furious who got promoted for their roles in the traitorous program, rather than held accountable, is that the mythical “public accountability” of which you speak?

    No, I’m not saying that because it’s government it’s therefore always going to be 100% transparent and accountable. No system is perfect. But at least with government there can (and always should) be a system of public transparency and accountability. In the private world it can all be as secret as they like. I mean, they do obviously need to at least have the appearance of those things in order to attract people, but when things go pear-shaped, are you not ultimately at their whim?

    Maybe there’s such a thing as public accountability where you live, where the government is answerable to about as many people as one of our small to medium sized states, but it’s a total myth here CM.

    I’m not sure that size is the key determinant here. Dunno. I’ll have to consider that further.

    No, you and/or your spouse finds a job with adequate health insurance, and you accept the responsibility of supplementing it if the coverage offered isn’t adequate for your needs.

    I still stuggle to wrap my head around a system which links healthcare directly to employment. Seems odd.

    Policies are fairly well spelled out for those who take the time to read them and have anything that they don’t understand clarified before they sign on the dotted line. That’s not to say that no arbitration would ever be necessary even if a family does go over the policy with a fine-toothed comb, but the process is well-defined and well-established, and works fine for the overwhelming majority of people.

    And in the public system there are clear guidelines and policies, which are determined at an elected level (local health boards). Taking into account budgets of course. Specific medical assessments and then decisions can be made by following those guidelines and policies, but ultimately each assessment decision is specific and the practitioner uses discretion.

    As you know, I’ve had to use an awful lot of insurance over the last 10 years or so, surgeries, chemo therapy in the $2000 a month range for 48 weeks, broken bones yada yada yada, so it’s not like I’m just taking some right-wing source’s word for it when I say it works well.

    Ok well I’m glad to hear that (honestly I am, I certainly wish no bad healthcare outcomes on anyone, regardless of what system they operate under or prefer). But, if I can ask, what would have happened had you (or your wife) not had that job that provided you with that healthcare plan? If you and your wife had split, what would have happened?

    In fact, the only thing I can think of that would make it work better is if government was less involved, but whatever, it’s not, as you imply, like there’s no one to turn to and get good results in the current system.

    If you disagreed with how the insurance company dealt with a claim, who would you complain to? What specific government involvement in your situation would you have been better without?

    Quite to the contrary, government being more deeply involved will surely cause reduced numbers of good results for the patient in arbitrated disputes. It’s not like the arbitrator is likely to be of the patient’s choosing, and if the government is paying their bills, well, do the math, the government will win more often.

    I don’t think that has to be the case. If they are made independent (in the same way as the judiciary), then they can make a reasoned decision based on medical need versus established policy. I assume in the private health-care world a person would need to sue their private provider for such an independent reasoned assessment? How much does that cost?

    Private insurers will certainly try to cut costs, but the dispute between them and a patient basically falls under contract law. The insurers and insureds make an agreement and disputes are settled like any other contract dispute is settled; in court, or in some cases, an arbitrator’s office. But at least in a court setting between two private entities, the judge refereeing the dispute isn’t an employee of the side trying to cut the corners.

    How many patients who are unhappy with how the insurance company have treated the claim can afford to go to court? Surely not a whole hell of a lot. Would you be able to spend thousands (tens of thousands?) going to court if you had to? Whereas in the public system an less-costly arbiter can sit independently. In much the same way as a judge sitting on a criminal case doesn’t favour the prosecution simply because they are govt employees.

    Gotta git. But really, nothing I’ve said should be hard to understand, nor should it be challenged like it’s wrong or something.

    I’m more interesting in following the logic (starting with Alex’s opening post) than challenging something as wrong. I’m interested in the best possible argument as to why individual private outcomes are going better than public ones. To this point all I’m hearing are vague ideological arguments rather than specifics.

    My opinion is that government is a detriment to efficiency and good healthcare for the reasons articulated. That’s before ever getting anywhere near death panels or the hit to freedom and liberty and self-reliance and self-responsibility. You don’t really think you’re going to change my mind with examples of a country such as yours with less than 5 million people who may well be perfectly satisfied with your system, do you? It’s like comparing apples and rocks.

    Changing minds (other than by accident) isn’t part of the equation at all. I’m interesting in the detailed logical arguments which support beliefs. I have no doubt that there are sound logical arguments supporting beliefs that I don’t hold. I’d like to know what they are (on this issue and others). If an opposing argument to my own actually makes more sense, I’m happy to alter my opinion on the matter. I’ve done that with gun control.

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  24. CM

    But your source, and Alex’s mistaken assertition, do expose the very innefficiencies and corruption that exists and is symptomatic of any type of Government Run Program. Thanks for making our point again.

    Seems to me that those who oppose government involvement in healthcare have two contradictory arguments that are brought out when the circumstance suit:

    1. Government denies people to save money – death panels death panels!!
    2. Government wastes money giving people healthcare they don’t need!

    If they argue 1 and information is provided to demonstrate why that might not be true in the specific area cited, they immediately reverse their argument and use 2.

    And vice versa. I’ve seen discussions where conservatives post about the government wasting money in the healthcare system, but when examples are given of stict policies around certain areas, the response immediate switches to DEATH PANELS DEATH PANELS!

    Ultimately both private and public systems are going to involve a degree of inefficiency and difficult calls. For exactly the same reasons. And examples of human error or fraud are going to be found in either.

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  25. CM

    I’m curious as to what ability a legless person has to walk within the home that the request might be denied for.

    Obviously that quote is from a general wikipedia entry trying to give an overview, not the specific policies/guidelines this particular County Council was following (or not following). We’d have to know the difference between the chair the guy was prescribed and the one he was wanting. I.e. we need more information. We’d have to know what the criteria was. Which is one of my main points. But ideology doesn’t wait for relevant and necessary information . Which is why Alex thinks that anyone who favours govt involvement in the health system must necessarily therefore believe that inflicting suffering on any person is not only ‘just’ but in fact ‘genius’.

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  26. AlexInCT *

    Seems to me that those who oppose government involvement in healthcare have two contradictory arguments that are brought out when the circumstance suit:

    1. Government denies people to save money – death panels death panels!!

    Well, why is it called evil profiteering and waiting for people to die when private companies do it, but not the same when government people do it? Again, remember that a for profit company has to keep customer satisfaction high enough to stay in business, so too many denials to save money will kill them. Government, once it controls healthcare, has no such restriction. If the private insurance company stiffs me, I can turn to the courts. If government stiffs me, I have no recourse. In fact, government has made it a point to protect istelf from the lawsuits a private entity would face when they screw up.

    2. Government wastes money giving people healthcare they don’t need!

    If that were the case CM, you would have a point. However, I content your second point is not just incorrect but misleading, on purpose, so you could make the case that the problem is with those of us that feel government will be a worse provider than the worst private company can be. Government doesn’t waste money giving people care they don’t need: they waste money in the massive bureaucracy and the corrupt system they breed in whatever they touch, and they will be doing the same with healthcare where they will now control trillions more and have the power of life & death decisions, WHILE delivering shitty healthcare. The point is that we will have BOTH waste and bad healthcare.

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  27. Tripper

    Again, remember that a for profit company has to keep customer satisfaction high enough to stay in business, so too many denials to save money will kill them.

    This is true in a proper free market, but it’s not as simple as that with health insurance in the US, which while being private and non government controlled (at least my healthcare and the stuff I’m talking about) is anything but a free market.

    Most people are limited to the companies they can buy insurance from because of the regulations each state puts on companies selling insurance within those states. Of course the companies that are allowed to sell insurance in that state spend plenty of time and money making sure the barriers to entry are high to any would be competitors.
    I often hear calls to make it possible to purchase insurance across state lines usually as opposition / alternative to the affordable care act but I’ve yet to see anything showing how the federal government prevents this currently. It’s my understanding that it is the States who set the rules on which companies can sell insurance within that state, and as such, Washington would have to remove those powers from the states in order to facilitate people truly being able to purchase insurance from companies located in any state.

    Additionally, state licensing boards and rules will determine who can provide treatment also, and the same applies, where those who currently are providing the treatment will work hard to make sure others can not get into that business. Just google stories of hospitals opposing ‘birthing centers’ for a good example.

    Neither of these points is an argument for or against government or private healthcare, just an illustration of how healthcare is hardly a typical free market where providers live / die based on their customer satisfaction ratings.

    I can add to the above examples however, a story of a friend in the UK who recently had the runs for a couple of weeks before deciding to consult his NHS doctor. The doctor solicited from him a stool sample which was sent to the NHS lab for analysis. He never did get the results back because somebody at the doctors office had made a simple mistake of only adding two pieces of identifying information on the sample packaging rather than the required three so the lab tossed it and never even told the doctors surgery that this had happened or why until my friend pushed the doc to find out why his results had not come back.
    I’d expect with 2 pieces of identifying info it would have been possible with a tiny bit of effort for somebody at the lab to find the 3rd or at least get the results back to the right doctor who could work it out from there, but I think the argument that there was no real incentive for anybody to do this in this case is what caused it not to be done.

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  28. CM

    Well, why is it called evil profiteering and waiting for people to die when private companies do it, but not the same when government people do it?

    You’d need to ask the people making that claim. Ask them why they’re unable to see the same basic similarities under public and private systems. The same decisions being made, the same basic friction between need and cost.

    Again, remember that a for profit company has to keep customer satisfaction high enough to stay in business, so too many denials to save money will kill them.

    Not necessarily, they can all be about as bad as each other. If the bottom line is the priority (and it is, because they are first and foremost businesses looking to make as much profit as possible) then it’s effectively a race to the bottom. Offer as little as you can get away with for the most amount of money that people will be prepared to pay. And your customer service only has to reach the same level as anyone else, not exceed it. I experienced this (involving literally weeks of frustration) first hand in London with phone and power companies. The same thing happens here with power companies. A company can lose 1000 customers a week but so long as they are gaining 1000 a week through people coming from other companies (for much the same reasons), they’re not going to care. They have 100,000 other customers anyway, so it’s negligible And once you’ve switched once or twice and worked out they are all the same, the hassle of swapping again just isn’t worth it. So in a lot of these fields ‘competition’ only works to a certain degree.

    Government, once it controls healthcare, has no such restriction.

    I’m certainly not on favour of a poor Government system. Yes, of course the Government should face restrictions in terms of denying care – the people involved need to be making intelligent informed discretionary calls within the framework of policies and guidelines.

    If the private insurance company stiffs me, I can turn to the courts.

    How much does it cost to turn to the courts to dispute an insurance company decision? For a start you’re not going to be doing that without a lawyer. So that’s no doubt tens of thousands. How many people can afford to do that?

    If government stiffs me, I have no recourse. In fact, government has made it a point to protect istelf from the lawsuits a private entity would face when they screw up

    Favouring a system where govt is involved doesn’t necessarily equate to favouring a poor system. As I mentioned, in a government system you can have an independent arbiter/ombudsman. The system is able to be accountable and transparent to a far greater degree, and at less cost to the customer/patient.

    If that were the case CM, you would have a point.

    It IS the case that people claim this. Sahrab does it above.

    Government doesn’t waste money giving people care they don’t need: they waste money in the massive bureaucracy and the corrupt system they breed in whatever they touch, and they will be doing the same with healthcare where they will now control trillions more and have the power of life & death decisions, WHILE delivering shitty healthcare. The point is that we will have BOTH waste and bad healthcare.

    Well many people have first-hand experience of both of things occuring in private healthcare. Too expensive and poor outcomes. AND no recourse (unless they’ve got a spare chunk of cash to take it to court). And you give the game away again with your “in whatever they touch”. It says that the details aren’t particularly relevant to you, it’s the ideology that trumps all else.

    There IS a bureaucracy that accompanies govt involvement in healthcare. Obviously. But overall how much is spent on the same bureacracy in the private sector? Surely the inefficiencies are endless, as resources are duplicated over and over again for each provider. Because that bureaucracy is internal to each private company, you just don’t count it. The same tasks have to be undertaken but because it’s private sector, it doesn’t get considered in the same way as hoary old ‘goddamn gummit bureucracy’. But it’s the same thing, and if you’re going to make an honest comparison, you need to look at them cumulatively. And determine how much that duplication adds to private healthcare costs.
    There are also the extensive cumulative advertising/marketing budgets – who ultimately pays for all that? Where is the equivalent cost in the public sector?

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  29. HARLEY

    If you are relying on the government for your health care, then most quite certainly on a whim or a policy decision they can take it all away too. Now something to think about?

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  30. CM

    Yes I think that is a very valid point Harley. However there is some degree of wiggle room in private contracts too – I often get letters from various companies explaining what they are altering in the agreement and putting in a legal reference to say that they do not believe the ‘contract’ has to be re-visited. Usually the initial contract actually allows them to make various ‘adjustments’ without voiding it. They’re bloody clever like that.

    But a govt making a policy change of any consequence will know they stand to reap a whirlwind of protest. It’s not as though would be able to do behind closed doors (again, I’m talking about a decent public system, not a bad one).

    Personally, although it also has it flaws, I like the system we have here – there is both a public and a private system operating. If you don’t like the public, then you can opt to go private. Of course you don’t get refunded any tax dollars for it, but I don’t really have a problem for that. It’s an informed choice. I think it’s preferable to relying solely on the public system. About once every 2 years I look into private options and weigh up the costs and benefits of taking out private insurance. Especially now I have kids. However I’ve decided each time to stick with the public system. It’s still good enough to rely on. My wife went into hospital last year for 4 days in an emergency situation and required an MRI, and the whole experience couldn’t be faulted. I don’t see how doing it under private insurance would have made any meaningful difference. Perhaps the MRI might have been slightly quicker, I don’t know.

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  31. AlexInCT *

    You’d need to ask the people making that claim.

    So then what’s the argument for letting government do it? Surely it isn’t that government can do a better job of it all? And nobody in their right mind would claim government would allocate resources more efficiently or spend the money wiser, would they? That’s based on historical evidence of whatever government program you want to look at. For example, here in the US we have been fighting “The war on poverty” for some 5 decades now. We have more people the usual suspects claim are poor than ever, after, if you go by the low end numbers, spending upwards of $17 trillion dollars. Name a government program and I will show you massive inefficiency, waste, mismanagement, and how it is abused by someone or another.

    Ask them why they’re unable to see the same basic similarities under public and private systems. The same decisions being made, the same basic friction between need and cost.

    I don’t see these same similarities you mention, either. I see government as far more prone to waste, on a massive scale, mismanagement, be it on purpose or simply because they don’t care, poor decision making, because the know it alls are not smart enough to realize they don’t have a clue, and most importantly of all, I fear the fact that once government controls healthcare, I will have no recourse to redress all the problems government will cause. That’s because the number one job of these bureaucrats seems to be to protect their sorry asses while sucking the productive dry. Some people might be stupid enough to think government, which has supplanted religion in the mind of the collectivist, can do what they make fun of religious people for believing in. Government has taken over the role of an almighty, all knowing, benign entity, be it a godlike being or someone like King Salomon, that dispenses justice and fairness, when it is far more qualified and inclined to do so because in the end it is always flawed people, with their own agendas and biases, if you will allow another religious or fairy tale comparison, to fill the role of the bad guy.

    Note that I did not say that the private companies are without fault. I merely point out that it should be quite obvious government is far, far worse at this stuff.

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  32. CM

    I said “You’d need to ask the people making that claim” in response to your comment:

    Well, why is it called evil profiteering and waiting for people to die when private companies do it, but not the same when government people do it?

    Your response just above seems to bear no relationship to that.
    The argument for govt involvement in healthcare is that more people will have access to it, and that it doesn’t need to be linked to employment. There can be greater transparency and accountability.

    And nobody in their right mind would claim government would allocate resources more efficiently or spend the money wiser, would they?

    Can you demonstrate the public healthcare costs more than private?
    Managing a public system does require discipline, but there is no inherent reason that it can’t be run well.

    I see government as far more prone to waste, on a massive scale, mismanagement, be it on purpose or simply because they don’t care, poor decision making, because the know it alls are not smart enough to realize they don’t have a clue, and most importantly of all, I fear the fact that once government controls healthcare, I will have no recourse to redress all the problems government will cause.

    This can all happen, but it doesn’t have to. The system can be designed to avoid all that (well aside from your weird know-it-all anti-intellectual fetish).

    That’s because the number one job of these bureaucrats seems to be to protect their sorry asses while sucking the productive dry .

    Well that’s because you’re an ideologue. That’s no different to what you mock (evil profiteering, waiting for people to die). It’s astounding that within the same post you can mock people for holding an extreme view, but then sincerely put forward an equally one-side extreme view.

    Government has taken over the role of an almighty, all knowing, benign entity, be it a godlike being or someone like King Salomon, that dispenses justice and fairness, when it is far more qualified and inclined to do so because in the end it is always flawed people, with their own agendas and biases, if you will allow another religious or fairy tale comparison, to fill the role of the bad guy.

    Sheesh, yet another meme. How helpful.
    People are always flawed and systems are always flawed. No way around that.

    Note that I did not say that the private companies are without fault. I merely point out that it should be quite obvious government is far, far worse at this stuff.

    Well I disagree. But then I’m looking at outcomes as the priority, as opposed to ideology.

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