HDTenEightyP/NetNews huggingface dataset:
From: nanook@eskimo.com (Robert Dinse)
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Summary: Health Care Costs
Date: 24 Jan 93 07:42:07 GMT
Article-I.D.: eskimo.1993Jan24.074207.14191
Organization: -> ESKIMO NORTH (206) For-Ever <-

In article <1586@nazgul.UUCP>, bright@nazgul.UUCP (Walter Bright) writes:
> You'll need to look elsewhere for why health care is expensive here.

     I've got a suggestion with regards to where to look.  This is the way I
see the problem:

     Major cost of health providers overhead is malpractice insurance.

     What is the (theoretical) purpose of the court system in a civil
situation?  Provides a means for a wrongly injured party to seek compensation
from the party inflicting the injury.

     What is the purpose of insurance?  To spread the costs associated with
a risk over a group at risk.

     So where does malpractice insurance fit in?  Does it make sense to allow
a Doctor who screwed up and harmed a patient to spread the cost of compensating
the victim over the entire medical community, and then have that cost turned
around and passed back on to the patient?

     Well, if the court system was fair, if frivilous law suits weren't
common place, if verdicts were based on factual evidence rather than emotional
considerations, then perhaps legitimate practitioners wouldn't need malpractice
insurance, but right now that isn't the case.

     To make things worse there is a positive feedback loop here.  Doctors,
being pinched on one end by high malpractice insurance cost, and on the other
by managed health care organizations are left with one option to increase
their margin, see more patients.  This means spending less time with each
patient, increasing the liklihood of mis-diagnoses and resulting malpractice
suits.  Further, to protect themselves, they are forced to do more diagnostic
tests, not so much because they are unsure of their diagnosis, but because
they might be forced to prove, in court, that their diagnosis was reasonable.
This further drives up the cost of providing health care.

     There needs to be reform in the court system.  There needs to be real
substantial penalties associated with frivilous law suits, or those that are
designed to transfer wealth as opposed to seeking compensation for damages.
There needs to be larger penalties for scam artists faking injuries in an
attempt to collect damages and there needs to be stiff penalties for any
lawyer or anyone else who cooperates in such scams.

     Until this happens, no amount of trying to redistribute the costs of
providing health care are going to provide relief to spiraling health care
costs and inaccessability for many people who can't afford needed health
care.
Newsgroups: pnw.general
From: ausmusmr@tc.fluke.COM (Mark Ausmus)
Subject: Woodinville 3BD rambler For Rent
Followup-To: poster
Organization: John Fluke Mfg. Co., Inc., Everett, WA
Distribution: pnw
Date: Thu, 21 Jan 1993 16:16:37 GMT

Three bedroom, one bath Woodinville rambler for rent.

New carpet, new washer/dryer.  Den, large fenced backyard,

on quiet cul-de-sac.

One year lease.

$900/month, $500 damage, first and last.

Home: 668-7857

Work: 865-2215 ask for Eric
      450-0995 ask for Laurie
From: dreitman@oregon.uoregon.edu (Daniel R. Reitman, Attorney to Be)
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: 24 Jan 93 20:11:00 GMT
Article-I.D.: oregon.24JAN199312113287
Distribution: world
Organization: University of Oregon
NNTP-Posting-Host: oregon.uoregon.edu
News-Software: VAX/VMS VNEWS 1.41

In article <MS-C.727818320.377401575.mrc@Ikkoku-Kan.Panda.COM>,
 Mark Crispin <mrc@Ikkoku-Kan.Panda.COM> writes...
>Phil Hughes writes:
>> in Canada (unlike HMOs here) you have a choice of what doctor you go to.
> 
>HUH???  I've always had a choice of what doctor I go to, and I've used HMO's
>for years.  If I didn't like my HMO, I could fire it and pick another.
> 
>With the Socialistic health care system advocated by Hughes et al, I won't
>have that choice.  I'll be stuck with the Official US Government Approved
>insurance system and if I don't like it my only choice will be to move to
>another country.
> 
>What it really is is that Hughes et al are distressed by the fact that people
>who are working productively for a living aren't being forced to pay for
>health care for homeless drug addicts with AIDS.  Socialism has no hope in
>catching on until the people who do the real work in the country are dragged
>out of the comfortable middle class and are made to feel utterly wretched and
>miserable.

Please stop ranting and remove the name-calling from your post.

Then please try again.  You haven't added to the debate.  Also, you've missed
two points:

1.	Since most proposed single-insurer programs are based on the Canadian
model (which every Canadian I've heard from loves), the freedom to choose your
own physician would probably be written into the legislation.

2.	Considering how many people in the United States have inadequate, or
even no, health insurance, the "homeless drug addicts with AIDS" accusation is
a complete misstatement of the facts.

							Dan, ad nauseum
From: bright@nazgul.UUCP (Walter Bright)
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: 24 Jan 93 17:23:39 GMT
Reply-To: bright@nazgul.UUCP (Walter Bright)
Organization: Zortech, Seattle

In article <1993Jan22.204239.14099@ssc.com> fyl@ssc.com (Phil Hughes) writes:
/And in Canada (unlike HMOs here) you have a choice of what doctor you go
/to.  Why do people continue to attempt to equate one insurance provider
/with on choice in health care?

Because I would go to jail if I didn't sign up and *pay* that one provider.
Just like Social Security here. Don't sound like choice to me.
Newsgroups: pnw.general
From: zeke@fasttech.com (Bohdan Tashchuk)
Subject: Re: Trust Me - I'm from the Government to help you
Organization: Fast Technology   Beaverton, OR
Date: Mon, 25 Jan 1993 00:11:34 GMT

In <1993Jan24.074207.14191@eskimo.com> nanook@eskimo.com (Robert Dinse) writes:
>     There needs to be reform in the court system.  There needs to be real
>substantial penalties associated with frivilous law suits, or those that are
>designed to transfer wealth as opposed to seeking compensation for damages.
>There needs to be larger penalties for scam artists faking injuries in an
>attempt to collect damages and there needs to be stiff penalties for any
>lawyer or anyone else who cooperates in such scams.

This is 100% true, and is one of two main factors driving up health costs.
The other is the AMA union. It has done an outstanding job limiting the
number of new physicians.

Unfortunately I haven't got a clue of how to change either of these.

One of Quayle's goals was court reform. Did he accomplish ANYTHING in this
area? The vast majority of our scummy politicians are lawyers, so I don't
see how anything can change. Perhaps the easiest solution would be what
Shakespeare suggested.

There is some slight hope in fighting the AMA. Occasionally lawyers and
doctors square off against each other.

It's easy to talk about government reforms of various sorts. But, step by
step, how do you make meaningful changes? How can you even begin to?
-- 
Bohdan            The Clinton Administration -- America Held Hostage -- Day 5
From: Mark Crispin <mrc@Ikkoku-Kan.Panda.COM>
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: Sat, 23 Jan 1993 11:45:20 -0800 (PST)
Organization: University of Washington
NNTP-Posting-Host: ikkoku-kan.panda.com
MIME-Version: 1.0
Content-Type: TEXT/PLAIN; charset=US-ASCII

Phil Hughes writes:
> in Canada (unlike HMOs here) you have a choice of what doctor you go to.

HUH???  I've always had a choice of what doctor I go to, and I've used HMO's
for years.  If I didn't like my HMO, I could fire it and pick another.

With the Socialistic health care system advocated by Hughes et al, I won't
have that choice.  I'll be stuck with the Official US Government Approved
insurance system and if I don't like it my only choice will be to move to
another country.

What it really is is that Hughes et al are distressed by the fact that people
who are working productively for a living aren't being forced to pay for
health care for homeless drug addicts with AIDS.  Socialism has no hope in
catching on until the people who do the real work in the country are dragged
out of the comfortable middle class and are made to feel utterly wretched and
miserable.

Newsgroups: pnw.general
From: fyl@fylz.wa.com (Phil Hughes)
Subject: Re: Trust Me - I'm from the Government to help you
Organization: FYL
Date: Thu, 28 Jan 1993 06:55:35 GMT
X-Newsreader: TIN [version 1.1 PL6]

Walter Bright (bright@nazgul.UUCP) wrote:
: In article <1993Jan21.054210.14736@fylz.wa.com> fyl@fylz.wa.com (Phil Hughes) writes:
: /This example has nothing to do with what we are talking about.  We are
: /not talking about government provided health care (doctors working for
: /the government, hospitals owned by the government, etc) we are talking
: /about having one insurance provider (logically the state or federal
: /government) paying the bills.  Quite different from how the VA works.
: 
: We already got a single insurer for retirement benefits. It's called
: Social Security. I've never heard anyone argue that SS saves money over
: private retirement insurance plans.

Nope.  We have a single *provider* of retirement benefits.  If we
distributed retirement benefits in the form of food and retired people
could only get if from government stores, that would be the same.

I am certainly not impressed with the was SSA runs but we (the voters)
have allowed it to run that way.  The problem isn't inefficiency, it
is the fact that money is paid out of income rather than investing
income.  I see two reasons why this will be a non-problem with
government health insurance:
   1. there is nothing to invest -- it is just a matter of collecting
      and distributing
   2. we get to specify what we want
-- 
Phil Hughes - FYL - 8315 Lk City Wy NE - Suite 207 - Seattle, WA 98115 
Phone: 206-526-2919 x74      Fax: 526-0803
E-mail: fyl@fylz.com or nwnexus!fylz!fyl
From: bright@nazgul.UUCP (Walter Bright)
Newsgroups: pnw.general
Subject: Re: Health Care Insurance Reform
Date: 27 Jan 93 17:36:01 GMT
Reply-To: bright@nazgul.UUCP (Walter Bright)
Distribution: pnw
Organization: Zortech, Seattle

In article <1993Jan26.170516.3949@fylz.wa.com> fyl@fylz.wa.com (Phil Hughes) writes:
/The Problem

I'll add one major contributor to costs: the FDA, whose sole purpose is to
impede medical progress.
From: bright@nazgul.UUCP (Walter Bright)
Newsgroups: pnw.general
Subject: Standard of Living
Date: 26 Jan 93 18:52:16 GMT
Distribution: pnw
Organization: Zortech, Seattle

A previous poster stated that the UN decided that Canada had the highest
standard of living.

I have done a little digging, and came up with a report from the Organisation
for Economic Co-operation and Development (OECD). It is a group headquartered
in Paris that studies industrialized countries, and is noted for objectivity
in its reports.

They studied standard of living based on Purchasing Power Parity (PPP), an
approach that adjusts for things like relative price differences and the
volatility of foreign exchange rates.

Anyhow, they rank the US significantly higher than anyone else, in fact, about
20% higher than the nearest competitor (Canada). The other rankings were:
Switzerland, Luxembourg, Iceland, UK, Japan, France, Italy and Belgium in
that order.

Interestingly, Germany wasn't in the top 10, this maybe due to the deleterious
effect of trying to absorb the ex-socialist DDR.
Newsgroups: pnw.general
From: fyl@ssc.com (Phil Hughes)
Subject: Re: Trust Me - I'm from the Government to help you
Organization: SSC, Inc.,  Seattle, WA
Date: Fri, 22 Jan 1993 20:42:39 GMT
X-Newsreader: TIN [version 1.1 PL6]

slh@gibdo.engr.washington.edu wrote:
: In article <1993Jan20.071414.4698@fylz.wa.com> fyl@fylz.wa.com (Phil Hughes) writes:

: |I don't understand why this is such a problem for Americans.
: |Americans are willing to shop at Pace and other large-scale retailers
: |that eliminate the middleman.  The Canadian health care system is
: |exactly the same -- eliminate unnecessary middlemen and the cost goes
: |down.
: 
: 	because we have a choice of whether or not we go to costco.
: 	should we have one phone carrier, one postal service,
: 	one grocery store, one...?
: 	the same could be said of all of them.

And in Canada (unlike HMOs here) you have a choice of what doctor you go
to.  Why do people continue to attempt to equate one insurance provider
with on choice in health care?
-- 
Phil Hughes, SSC, Inc. P.O. Box 55549, Seattle, WA 98155  (206)FOR-UNIX
>>> Publishers of pocket references for UNIX, C, VI, Emacs, Ksh, MS-DOS, ... <<<
     ...!ssc!fyl or fyl@ssc.com            (206)527-3385
From: del@fnx.uucp (Dag Erik Lindberg)
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: 27 Jan 93 01:22:45 GMT
Article-I.D.: fnx.1993Jan27.012245.11637
Organization: I/Ovations

In <1993Jan22.204239.14099@ssc.com> fyl@ssc.com (Phil Hughes) writes:

>And in Canada (unlike HMOs here) you have a choice of what doctor you go
>to.  Why do people continue to attempt to equate one insurance provider
>with on choice in health care?

This is the wrong analogy.  Choosing which doctor to go to like choosing
which checkout clerk to go to in the state run store.

If there is only one 'insurance' provider, and no means of choosing my
own health care, then I am left with the wares at the 'company store'.
If the 'insurance' provider says maximum 5 day hospital stay for
procedure X, and I don't feel up to leaving at the end of 5 days, what
do they do?  Throw me out on the street?  Suppose I want elective
surgery not covered by 'the plan'?  Do I need to go to Mexico?  Suppose
there is a year waiting list because there is no longer any major
incentive for new doctors to go into the field that I need for my
treatment?  Where do I go to pay extra for 'expedited' service?

I have heard stories of how great the plan is in Canada.  Probably from
people who have very 'normal' health care requirements.  Because I
also hear horror stories from people who's needs are a little out of
the ordinary and were unable to get service in their own country.

-- 
del AKA Erik Lindberg                             uunet!pilchuck!fnx!del
                          Who is John Galt?
From: del@fnx.uucp (Dag Erik Lindberg)
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: 23 Jan 93 21:18:15 GMT
Organization: I/Ovations

In <1993Jan20.071414.4698@fylz.wa.com> fyl@fylz.wa.com (Phil Hughes) writes:

>Walter Bright (bright@nazgul.UUCP) wrote:
>: In article <1993Jan18.194858.21798@ssc.com> fyl@ssc.com (Phil Hughes) writes:


>We don't care about profits in this case.  We are talking about
>eliminiation of an industry that doesn't need to exist -- or at least
>not in its present form.  The costs (the 25% overhead) exists because
>there are multiple insurance companies that the health care providers
>must deal with.  If this unnecessary intermediary is eliminated (by
>having one non-profit insurance plan) the overhead goes away.  It's
>that simple.

Assuming that a national health care program would reduce health care cost
by 20% (and I'm not at all convinced it would), how does this address
the problem?  The problem is that health care costs are "SPIRALING".  A
20% reprieve will be eaten up in a matter of months.

>I don't understand why this is such a problem for Americans.

I have a problem with it because you have eliminated FREEDOM OF CHOICE
for me, for a supposed benefit I am not convinced will materialize.

>Americans are willing to shop at Pace and other large-scale retailers
>that eliminate the middleman.  The Canadian health care system is
>exactly the same -- eliminate unnecessary middlemen and the cost goes
>down.

There is one major difference between large-scale retailers and a
national health care system: FREEDOM OF CHOICE.  I can choose to go
to any retailer I wish.  With national health care I am forced to
go with a government "merchant".

-- 
del AKA Erik Lindberg                             uunet!pilchuck!fnx!del
                          Who is John Galt?
From: bobk@gibdo.engr.washington.edu (Bob)
Newsgroups: pnw.general
Subject: Re: Standard of Living
Date: 28 Jan 1993 11:31:16 GMT
Organization: University of Washington
NNTP-Posting-Host: gibdo.engr.washington.edu

bright@nazgul.UUCP (Walter Bright) writes:
| Anyhow, they rank the US significantly higher than anyone else, in fact,
| about 20% higher than the nearest competitor (Canada). 

  That probably only takes material goods into account.  If you take 
  stuff like quality of life, health, crime, pollution, population
  density, traffic, etc. into account, I can see where someone can
  try to make a case for Canada having a higher standard of living and
  still keep a straight face.

  Of course, you'd never be able to prove him wrong, because there is no
  way of accurately measuring that stuff.  Or you could do something lame
  like pointing at the net migration statistics and asking why so many
  Canadians are moving here (or vice-versa?) if the standard of living is
  higher there.
  ==

  Bob                                         Seattle, Washington

Newsgroups: pnw.general
From: bill@Celestial.COM (Bill Campbell)
Subject: Re: Trust Me - I'm from the Government to help you
Organization: Celestial Software, Mercer Island, WA
Date: Mon, 25 Jan 1993 05:34:05 GMT

In <1586@nazgul.UUCP> bright@nazgul.UUCP (Walter Bright) writes:

:In article <1993Jan18.194858.21798@ssc.com> fyl@ssc.com (Phil Hughes) writes:
:/Walter Bright (bright@nazgul.UUCP) wrote:
:/: You cannot have the socialist policies *and* have prosperity.
:/: It would be wonderful if you could have both, but TANSTAAFL.
:/Once again this doesn't address reality.  Unless we are willing to treat
:/health care as a luxury, whether taxes, employers or individuals pay for
:/health care, the costs are still there.  And, in the US, about 25% of the
:/cost is in unnecessary overhead.  In Canada the overhead is around 5%.

:You speak as if you believe that health care costs an irreducible value.
:In a free market system, costs are steadilly driven down. Note that the
:American health care system is *not* much of a free market system, for
:many reasons which I outlined in a previous post. (And one of those suggestions
:was how to make insurance companies more responsive to their customers.)

Unfortunately the free market doesn't really apply to health care
in the U.S. where ``health insurance'' is really a bill paying
function where we pay the insurance companies instead of paying
for routine health car ourselves.  The insurance companies don't
have any incentive to reduce health care costs since they make a
percentage on all the dollars that pass through their hands.

:Free market systems are full of examples of incredibly creative ways that
:people have cut costs (which has resulted in the high standard of living
:we enjoy today versus pre-industrial revolution America). Government systems
:are full of examples of incredible cost overruns and lots of whining about
:spiralling costs.

May government cost overruns are on CPFF (Cost Plus Fixed Fee)
contracts.  The contractors don't have any incentive to reduce
costs since they make a percentage on all costs incurred.  I was
a data processing managaer for 12 years for a ``Beltway Bandit''
outside of Washington, D.C. and always tried to operate my
department as efficiently as possible -- not realizing that this
wasn't really what the company wanted.  I would have been more
successful to build an empire of systems programmers and staff
instead of supporting the entire company with two computer
professionals (we ran Burroughs mainframes, not IBM).

Bill
-- 
INTERNET:  bill@Celestial.COM   Bill Campbell; Celestial Software
UUCP:   ...!thebes!camco!bill   6641 East Mercer Way
             uunet!camco!bill   Mercer Island, WA 98040; (206) 947-5591
SPEED COSTS MONEY -- HOW FAST DO YOU WANT TO GO?
From: bright@nazgul.UUCP (Walter Bright)
Newsgroups: pnw.general
Subject: Re: Seattle City Light vs. Puget Power
Date: 24 Jan 93 17:15:34 GMT
Reply-To: bright@nazgul.UUCP (Walter Bright)
Organization: Zortech, Seattle

In article <1993Jan21.053516.14470@fylz.wa.com> fyl@fylz.wa.com (Phil Hughes) writes:
/Personally I would
/rather subsidize the cost of health care than the cost of putting
/pepsi in aluminum cans.  Isn't it more in the American spirit to be
/able to say "everyone has access to health care in our country" than
/"everyone saves $.05 on a can of pepsi"?

Neither should be subsidized. Subsidizing causes distortions and uneconomic
choices in an economy. The American spirit, in my opinion, is individual
freedom and individual responsibility. It isn't "subsidize my company"
or "give me free health care".
From: bright@nazgul.UUCP (Walter Bright)
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: 27 Jan 93 06:09:51 GMT
Reply-To: bright@nazgul.UUCP (Walter Bright)
Organization: Zortech, Seattle

In article <1993Jan25.184423.1113@ssc.com> markz@ssc.com (Mark Zenier) writes:
/Bill Campbell (bill@Celestial.COM) wrote:
/: Unfortunately the free market doesn't really apply to health care
/: in the U.S. where ``health insurance'' is really a bill paying
/: function where we pay the insurance companies instead of paying
/: for routine health car ourselves.  
/In addition, health care is considered a fringe benefit of employment.  

This is an artifact of health insurance being tax-deductible if paid for
as part of your salary, and non-deductible if paid for separately. Since
marginal tax rates are at 31%, this creates a powerful incentive to go along
with your employer's scheme, and never mind the fact that if you opt out
of your employer's coverage, you don't get the money anyway.

To address the problem, health insurance should be tax-deductible regardless.
Then, shopping for health insurance would be comparable to shopping for
home insurance, and would be independent from shopping for a job.

The tax status of health insurance is just another example of well-intentioned
government policies instead producing serious economic inefficiencies.
From: slh@gibdo.engr.washington.edu ()
Newsgroups: pnw.general
Subject: Re: Trust Me - I'm from the Government to help you
Date: 25 Jan 1993 03:41:17 GMT
Organization: N.O.N.E.
NNTP-Posting-Host: gibdo.engr.washington.edu

In article <1993Jan22.204239.14099@ssc.com> fyl@ssc.com (Phil Hughes) writes:
|slh@gibdo.engr.washington.edu wrote:
|: In article <1993Jan20.071414.4698@fylz.wa.com> fyl@fylz.wa.com (Phil Hughes) writes:
|
|: |I don't understand why this is such a problem for Americans.
|: |Americans are willing to shop at Pace and other large-scale retailers
|: |that eliminate the middleman.  The Canadian health care system is
|: |exactly the same -- eliminate unnecessary middlemen and the cost goes
|: |down.
|: 
|: 	because we have a choice of whether or not we go to costco.
|: 	should we have one phone carrier, one postal service,
|: 	one grocery store, one...?
|: 	the same could be said of all of them.
|
|And in Canada (unlike HMOs here) you have a choice of what doctor you go
|to.  Why do people continue to attempt to equate one insurance provider
|with on choice in health care?

	first I don't know if that is true of all hmos here.
	second it's still giving you no choice in insurance providers.
	for you, this would be like being forced to go to costco,
	but still given a (limited) choice of brands.

	insurance costs too much,
	but I don't buy that most people can't afford it.
	I think a lot of people choose to spend their money otherwise and
	then whine when they need insurance they didn't bother to get early
	because there wasn't an immediate need.
	how many people have cable for instance?
	we know that's overpriced and plenty of people get that,
	probably including a lot people who claim they can't afford insurance.