[paraclete]

Honestly, you need to calm down. There are no nitwits on this board, but there is one person who just cannot maintain a civil attitude.

Your statement was that insurance could not pay for a GP visit, so it would seem the individual would pay for it. Now you add some information that, it would seem, the government pays for 80% of the service, which is about the same as an insurance company paying for it. That really changes things and makes it plain that the consumer does not pay for the service directly. They do, of course, pay for the service through taxes, which is to say they pay for it indirectly. So whether it is through a copay or through taxes, the consumer still pays. The primary difference is that in your system there are price controls on what a doctor or a drug company can charge for services or products.

Your mindset means you don't understand the English language, I didn't say the government pays 80% of the fee, The government pays for 80% of all services through a "single payer" bulk billing system. The patient does not part with cash. The average person is not insured. What the patient pays, if they are a taxpayer, is a levy on their income so you could say the visit is prepaid. They can even avoid the levy by having private insurance but the poorer people live from week to week and cannot afford it

Government debt in Australia is well over 800 billion and climbing steadily, so you are borrowing money to pay for your med care. I would be much more impressed if you were actually paying your bills. And yes, in the U.S. we are in much worse shape, which makes it all the more amazing that people are actually proposing increased government spending for health care.

Government debt here doesn't represent the percentage of GDP that it does there and the budget will return to surplus next year so long as the wind doesn't blow to the left so we are not borrowing money to pay for health care. We have the GFC and stupid leftist thinking, to thank for the debt, not health care costs. I understand why your debt is an impediment to changing the way you do things but studies have shown the costs on the public purse would be less if you got rid of the expensive middle man

[talaniman]

Just curious Clete, but who gets the bill for that leftover 20%?

[jlisenbe]

I didn't say the government pays 80% of the fee, The government pays for 80% of all services through a "single payer" bulk billing system.

The government doesn't pay, but then the government pays. Oh. That makes sense now. Thanks for the clarification.

You have been borrowing money, and some of that went to health care. It's simple math.

Only one person ever pays, and that's the consumer. It's because only the consumers have money. Governments have no money. So the bill gets paid either in taxes (your case) or insurance (our case). There is no such thing as doing away with the middle man so long as the consumer does not pay the bills directly.

[paraclete]

Just curious Clete, but who gets the bill for that leftover 20%?

Those who have the money and don't use the system will pay fees, be entitled to rebates and use their insurance to offset major costs. You don't need to use the health care insurers unless you want private rooms and quicker service for elective surgery. The way it works is private hospitals are not covered by the government system and many specialists like to use them because they can charge more, the patient must pay for the gap. If you are admitted to hospital through ER the government picks up the bill and they will deal with whatever they find that is life threatening.

Example;, my son-in-law was admitted because of an industrial accident, they couldn't stabilise his blood pressure and found a rare cancer, this was removed at a major city hospital, all free

Example; I consulted a specialist and eventually had a hip replacement using my health insurance to reduce waiting time. I made a gap payment to the surgeon but my hospital costs were completely covered

[jlisenbe]

Well, I have no idea how the 20% gets paid, but I know who pays the 80%, and that would be the taxpayer, who of course pays for the whole thing regardless. We are going to pay the bills for this. It can be through insurance or taxes to the feds, but WE are going to pay for it. The big question is how to control prices. I do know that a person can buy prescription drugs much cheaper through foreign outlets than he/she can here, and that same person can get medical treatments much cheaper in other countries than here. Maybe we should find out why that is.

A high deductible would solve some problems. It would force us to pay attention to prices instead of just ignoring them like the great majority of people do now.

[talaniman]

Everything seems to be cheaper in other countries, and it's no wonder Big Biz makes stuff overseas because of cheap labor. You actually think the Mo'Money crowd will take a cut in pay because their prices are to high? Ever wonder if the sweat shop worker that make Nike's can afford to buy what they make?

If you ever wonder why prices are so high, and rising, ask the guy who sets the prices.

https://www.verywellhealth.com/healt...crease-2615099

[jlisenbe]

Health insurance premiums go up because medical costs increase. Doctors need to be paid more, drugs are more expensive, testing technology gets more sophisticated and expensive, and so forth.

That doesn't even come close to explaining going from 27 bil to over 3 tril in only fifty years.

Greatest incentive to control costs is competition. There is but very little competition in health care costs.

[talaniman]

The bigger insurance companies have a distinct advantage in all the markets which they have effectively carved up and dominated.

[jlisenbe]

The bigger insurance companies have a distinct advantage in all the markets which they have effectively carved up and dominated.

I think you have a good point there. The solution would be to allow people some means of purchasing policies across state lines.

[talaniman]

That would be up to the states themselves, since they have that individual power through the state insurance regulators.

https://www.quora.com/Why-cant-Ameri...-today-if-true

https://thehill.com/blogs/congress-b...ss-state-lines

The main difference between auto insurance and health insurance is that individuals own auto insurance, but employers own health insurance. Obviously, states would not attract residents if they impeded a national market for auto insurance. Similarly, if we owned our own health insurance, states would quickly harmonize their laws to facilitate a national market.Which brings us to a legitimate recommendation for Congress: Stop the tax code’s discrimination against individually owned health insurance.

85% of Americans get health insurance through an employer.

[paraclete]

The big question is how to control prices. I do know that a person can buy prescription drugs much cheaper through foreign outlets than he/she can here, and that same person can get medical treatments much cheaper in other countries than here. Maybe we should find out why that is.

.

Well I have been trying to tell you but you don't like the answer. The problem is your screwed up political system which allows too many middle men to stick their snout in the trough. Countries that have single payer government run systems have lower costs. Are there inefficiencies, of course there are, are there doctors who gouge the system, of course there are, but the focus isn't on how much the patient/taxpayer pays the insurance companies. Think of our scheme as a ponzi scheme, not a taxpayer funded scheme, the population keeps growing so there are more contributors and costs are controlled so the impact on the public purse is limited but public health is more important than creating a political nightmare

[tomder55]

The bigger insurance companies have a distinct advantage in all the markets which they have effectively carved up and dominated.

It goes back to the rent seeking that comes with over regulation. Of course the major insurers love the fact that They can make arrangements with states ,through their laws ,to reduce competition. Any reform of the existing system must remove these monopolies and allow purchases across state lines . But there is one thing ….Obamacare made many of the mandates federal mandates . So yeah states are complicit in the unholy alliance. But so is the feds .

[talaniman]

but public health is more important than creating a political nightmare

It's certainly a higher priority than say aircraft carriers.

It goes back to the rent seeking that comes with over regulation. Of course the major insurers love the fact that They can make arrangements with states ,through their laws ,to reduce competition. Any reform of the existing system must remove these monopolies and allow purchases across state lines . But there is one thing ….Obamacare made many of the mandates federal mandates . So yeah states are complicit in the unholy alliance. But so is the feds .

I tried to make the point to JL that nearly everyone has insurance through the job, so guess who has the leverage for price control?

[jlisenbe]

I tried to make the point to JL that nearly everyone has insurance through the job, so guess who has the leverage for price control?

The figure is actually a little over 70%, so it's hardly "nearly everyone", but you do have a valid point. I can tell you that Blue Cross does exercise price controls as does, of course, Medicare and no doubt most other insurance companies. But there is still but very little incentive for the average person to look at what they are being charged. A high deductible would eliminate that problem.

[talaniman]

How/ Please elaborate.

[jlisenbe]

When was the last time you asked a doctor how much a procedure was going to cost? Most people don't really care since they are not going to pay for it, all of which allows cost to become a very minor consideration. Now if you had to pay for it, then you would care a great deal.

Just ask yourself this question. When was the last time you walked into a doctor's office and saw prices posted?

[talaniman]

You get a pain in your gut that has lasted for a day or two you go to a doctor for relief not discounts, after the pepto doesn't work. Good luck telling a GP what tests he will order, from your complaints. Now you can get those prices before hand in a walk in clinic (In Texas anyway), but emergency rooms triage everybody by need and intake information. The wait time for non insured, non emergency cases could be hours.

Go ahead shop around for the best deals by doctors and let me know how that works out, or how much you suffered through. You need a price setting structure in place for sure and who sets the price is the crucial point and right now the health care industry sets prices and states regulate the rules. Therein lies the whole problem in making things affordable.

Poor people had no options before Obama Care, and now that they have it, I doubt we go back to insurance companies running the whole show, or repubs repealing a darn thing. They have been successful in raising costs by eliminating the mandate, and bring back junk insurance you don't find out is useless until you try to use it.

If a person could pay for his own health care we wouldn't NEED insurance but even the rich guys have high costs for doctor care, but don't have to choose between seeing a doctor, and paying rent or groceries. Healthy people betting they will never be sick or injured is not a good bet, and a crap shoot.

[jlisenbe]

Go ahead shop around for the best deals by doctors and let me know how that works out, or how much you suffered through. You need a price setting structure in place for sure and who sets the price is the crucial point and right now the health care industry sets prices and states regulate the rules. Therein lies the whole problem in making things affordable.

Well, it works for everything else. I purchase prescription drugs at the cheapest place I can find. I shop for the best deal on cars, but the problem is you cannot shop for the best prices on health care because no one advertises prices. Why? Because we basically don't care. We think that it doesn't matter since someone else (we think) will pay for anyway. I went to see a doc yesterday because he had scheduled a follow up visit. It was a complete waste of time and money, but it wasn't MY money, so I was not so concerned. Now if the expense had fallen on ME, I would not have gone.

If I had some sort of insurance that would buy a new car for me every five years, I would buy a LOT more care than I typically do, and I would not really care about the cost of the car. When someone else is perceived as paying for it, we don't care about cost. When we have to pay for it, we care a great deal.

[talaniman]

You can shop for health insurance and get all the price quotes you want to get the cheapest price.

[jlisenbe]

You can shop for health insurance and get all the price quotes you want to get the cheapest price.

That's kind of my point.