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Thread: Hospital Publishes Rates; Capitalism Ensues

  1. #61
    Quote Originally Posted by Veldan Rath View Post
    Also wrt back surgeries, in my small experience, surgery was the last resort unless it was painfully obvious that it was the only way to correct, just because of those issues you mentioned earlier. So, I'll take the USA Today with some salt.
    You disagree with a report that says surgeons weren't performing surgery as a last resort because you know that surgery is suppose to be performed as a last resort? That makes no sense whatsoever. But maybe I read your post wrong.

    GGT is simply concerned (from my perspective) that if surgical centers are diagnosing and performing surgeries, which is their sole source of revenue, that they will be tempted to perform unnecessary surgeries (under the guise of elective surgery). I think this sort of behavior currently happens in other elective surgery practices such as plastic surgery and there should be concern of it happening in other surgical centers performing other types of surgery (wow that sentence is a mess). The concern is that their business is in cutting you open not in making you healthy. I think GGT is more concerned that the diagnosis (need to perform surgery) is coming from the same place that makes money from the surgery, rather than with the center actually performing the surgery itself. [If I'm wrong, sorry to put words in your mouth GGT]

    Personally I think it's possible. The Plastic Surgery industry is across the spectrum with necessary and unnecessary surgery, without any 3rd party diagnosis.
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  2. #62
    dentistry is a notorious example of how much bullshit they will try to sell to or perform on uneducated people when you put everything under one person/roof.
    "In a field where an overlooked bug could cost millions, you want people who will speak their minds, even if they’re sometimes obnoxious about it."

  3. #63
    Stingy DM Veldan Rath's Avatar
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    Quote Originally Posted by sheadunne View Post
    You disagree with a report that says surgeons weren't performing surgery as a last resort because you know that surgery is suppose to be performed as a last resort? That makes no sense whatsoever. But maybe I read your post wrong.

    GGT is simply concerned (from my perspective) that if surgical centers are diagnosing and performing surgeries, which is their sole source of revenue, that they will be tempted to perform unnecessary surgeries (under the guise of elective surgery). I think this sort of behavior currently happens in other elective surgery practices such as plastic surgery and there should be concern of it happening in other surgical centers performing other types of surgery (wow that sentence is a mess). The concern is that their business is in cutting you open not in making you healthy. I think GGT is more concerned that the diagnosis (need to perform surgery) is coming from the same place that makes money from the surgery, rather than with the center actually performing the surgery itself. [If I'm wrong, sorry to put words in your mouth GGT]

    Personally I think it's possible. The Plastic Surgery industry is across the spectrum with necessary and unnecessary surgery, without any 3rd party diagnosis.
    No, I just said I take it with a grain of salt, due to my work in claims, that most of the time other methods are tried first. Are there some? Yes, I'm sure just like there are some asshat cops and incompetent teachers.

    I guess I just can't see this as an issue. I just don't walk into a heart surgeon's office and say cut me, I've had to jump through some hoops (other Docs) to get there.

    I don't really give a fig about plastic surgery...by definition it's elective if cosmetic and not reconstructive.
    Brevior saltare cum deformibus viris est vita

  4. #64
    Stingy DM Veldan Rath's Avatar
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    I guess my real suprise here is: Are people really objecting to Sugical Centers (or any other medical site) posting its prices?
    Brevior saltare cum deformibus viris est vita

  5. #65
    Quote Originally Posted by Veldan Rath View Post
    I guess my real suprise here is: Are people really objecting to Sugical Centers (or any other medical site) posting its prices?
    I don't think anyone is objecting to that. I think the objection is asking how do you make Capitalism work for the people, where clearly in certain situations it will not on it's own. The problem lies partly in education of the public, but also there are problems of moral hazard that we have to address. I think the way to address them is to create a pressure for honesty and transparency. Create a website called RateMyDoctor, much like RateMyTeacher, where people post their personal experience with a given doctor. No doctor will be perfect, one bad review, or a misdiagnosis doesn't mean they are evil, corrupt, or incompetent, but it can be a way for people to find local doctors that are highly rated. If I was a good doctor, or just if I was a doctor in the business of helping people, I'd welcome such scrutiny. Pay doctors by % of successful treatment and happy patient reports (or have that be a factor in their pay). I think many of these idea will happen on their own over time, and creating competition is a good thing, it will make hospitals strive to be the best.

  6. #66
    Quote Originally Posted by Veldan Rath View Post
    I guess my real suprise here is: Are people really objecting to Sugical Centers (or any other medical site) posting its prices?
    You are surprised by this? Why do you think liberals would support any of this when their belief is that medical procedures should be free to the public.

  7. #67
    Quote Originally Posted by Lewkowski View Post
    You are surprised by this? Why do you think liberals would support any of this when their belief is that medical procedures should be free to the public.
    Everyone pays taxes, nothing is free.
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  8. #68
    Quote Originally Posted by Ominous Gamer View Post
    dentistry is a notorious example of how much bullshit they will try to sell to or perform on uneducated people when you put everything under one person/roof.
    Good analogy. And yes, Sheadunne you got my meaning right.

    Veldan, we're not talking about open heart surgery ...but outpatient surgical clinics (like the one in the OP) owned by the surgeons, and the possibility of conflict-of-interest. Your work in claims doesn't really apply, since we're also talking about bypassing insurance and their review process.

    Those asshat cops and incompetent teachers aren't putting folks under anesthesia and cutting them open, but they do have Internal Affairs and outside forces evaluating their work ethics. I don't think it's so unusual to expect something similar for outpatient surgical sites un-affiliated with a larger network (of third party physicians, surgeons, hospitals, insurers).....for patient protections. Why do you?

    It's understandable that providers and patients got fed-up with medical insurance as the middle-man. Doctors saw insurance review and cost-containment measures as 'intrusions' and 'telling them how to practice medicine', but they weren't doing anything to reduce costs themselves. Patients saw insurance as a necessary evil (otherwise care is unaffordable and even bankrupting) but didn't like being told the surgery their doctor recommended was 'not medically necessary'.

    Like it or not, those third party payers often protected patients from unnecessary elective surgeries, and unanticipated OOP payments. I have no objection to the open pricing in the OP...but it's still fee-for-service medical care, just without the patient advocate or intermediary. And I think there ought to be one. Why don't you?

  9. #69
    Quote Originally Posted by Veldan Rath View Post
    No, I just said I take it with a grain of salt, due to my work in claims, that most of the time other methods are tried first. Are there some? Yes, I'm sure just like there are some asshat cops and incompetent teachers.

    I guess I just can't see this as an issue. I just don't walk into a heart surgeon's office and say cut me, I've had to jump through some hoops (other Docs) to get there.

    I don't really give a fig about plastic surgery...by definition it's elective if cosmetic and not reconstructive.
    There was an interesting study that showed that when medical centers partner with a hospital (and get a portion of the profits), the amount of free beds in that hospital drastically decreases. Medicine is a very ambiguous science, and there are many marginal cases that could be referred for specialist treatment who probably (but not definitely) don't need it.
    Hope is the denial of reality

  10. #70
    Did you mean to say "open" beds instead of "free"?

  11. #71
    Quote Originally Posted by Being View Post
    Everyone pays taxes, nothing is free.
    Cool so if someone doesn't pay federal income tax (or whatever bucket you gather the money from) its OK for them to be denied medical care?

  12. #72
    Quote Originally Posted by GGT View Post

    Like it or not, those third party payers often protected patients from unnecessary elective surgeries, and unanticipated OOP payments. I have no objection to the open pricing in the OP...but it's still fee-for-service medical care, just without the patient advocate or intermediary. And I think there ought to be one. Why don't you?
    Not if the government is running it.

  13. #73
    Quote Originally Posted by Lewkowski View Post
    Cool so if someone doesn't pay federal income tax (or whatever bucket you gather the money from) its OK for them to be denied medical care?
    You could have just said you don't understand and moved on. But no, you have to show that you have no clue as to the existence of taxes outside of federal control. And that last part about denied medical care? I'm pretty sure we were talking about how the medical care is paid for since it cannot be denied. Everyone pays taxes. Nothing is free.
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  14. #74
    Stingy DM Veldan Rath's Avatar
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    My claims experience is disability not health, so yes it does apply, and of course you run with the heart surgery like it was the only possibility.
    Brevior saltare cum deformibus viris est vita

  15. #75
    Quote Originally Posted by Being View Post
    You could have just said you don't understand and moved on. But no, you have to show that you have no clue as to the existence of taxes outside of federal control. And that last part about denied medical care? I'm pretty sure we were talking about how the medical care is paid for since it cannot be denied. Everyone pays taxes. Nothing is free.
    Again your being stupid. The argument that "everyone pays taxes so anything the government hands out isn't free" is deliberately misleading. If you get more goods and services beyond what you put in you are absolutely getting something for free.

    Also not everyone pays taxes.

  16. #76
    Quote Originally Posted by Lewkowski View Post
    Again your being stupid.
    pot - kettle, yada yada

    The argument that "everyone pays taxes so anything the government hands out isn't free" is deliberately misleading. If you get more goods and services beyond what you put in you are absolutely getting something for free.
    no it means you're getting it at a lower rate. Someone buying an item on sale doesn't mean they got the item for free because someone else paid more.
    "In a field where an overlooked bug could cost millions, you want people who will speak their minds, even if they’re sometimes obnoxious about it."

  17. #77
    Quote Originally Posted by Ominous Gamer View Post
    pot - kettle, yada yada



    no it means you're getting it at a lower rate. Someone buying an item on sale doesn't mean they got the item for free because someone else paid more.
    Its deliberate use of cheap rhetoric to imply that government handouts aren't government handouts.

  18. #78
    You are surprised by this? Why do you think liberals would support any of this when their belief is that medical procedures should be free to the public.
    I am a Liberal, I support displaying prices, and letting the free market lower them. What you're saying is a non-sequitur. It doesn't follow that if I want something freely accessible to US citizens that I don't want the price of the item expressed. In fact, I'd want a system that rewards people for finding the best deal, so even if we're insuring everyone in the country they are still encouraged to find the best deals. Maybe it could affect how much they get back from Social Security, or there could be an annual allotment per person that rolls over if you have saved money for that year. So if when you're 50 you need a heart transplant you can get one. Hopefully those will be less expensive as we perfect growing organs.

  19. #79
    Quote Originally Posted by Lewkowski View Post
    ...Also not everyone pays taxes.
    Everyone pays taxes.

    edit: deleted the word idiot.
    Last edited by Being; 08-11-2013 at 03:22 AM.
    Faith is Hope (see Loki's sig for details)
    If hindsight is 20-20, why is it so often ignored?

  20. #80
    Quote Originally Posted by Being View Post
    Everyone pays taxes.

    edit: deleted the word idiot.
    Not everyone pays federal income tax where the money liberals what to use come from. Don't really care if someone pays sales tax on a stick of gum that still doesn't make the government handout anything other than free.

  21. #81
    It's obviously true that some people get more out of the system than they put in directly, some people are getting hand-outs. We wish to minimize this, have them work to put back into the system, overall we just have to figure out if it's worth it. A healthy population to me is well worth it, healthy people are useful to society, healthy people bring happiness to their friends, and families unhealthy people do so less.

  22. #82
    Quote Originally Posted by Lewkowski View Post
    Not everyone pays federal income tax where the money liberals what to use come from. Don't really care if someone pays sales tax on a stick of gum that still doesn't make the government handout anything other than free.
    Everyone pays taxes. I don't know how I can make it more clear than that.
    Faith is Hope (see Loki's sig for details)
    If hindsight is 20-20, why is it so often ignored?

  23. #83
    Everyone pays taxes. I don't know how I can make it more clear than that.
    Just to give Lewk's point some legitimacy, which is to does have. If it cost the government more money than you personally have put into the government then you are profiting off the government, especially if they're giving you stuff you need. They're stopping you from taking a loan out or whatever, effectively they are giving you money. My point is that it can be worth it, because in the long-run I'd argue the government will make it the money back, but also our society will reap rewards via positive externalities.

  24. #84
    Quote Originally Posted by Lewkowski View Post
    Cool so if someone doesn't pay federal income tax (or whatever bucket you gather the money from) its OK for them to be denied medical care?
    Would you be okay with that? Medical care based on your tax returns?

    Quote Originally Posted by Lewkowski View Post
    The argument that "everyone pays taxes so anything the government hands out isn't free" is deliberately misleading. If you get more goods and services beyond what you put in you are absolutely getting something for free.
    Also not everyone pays taxes.
    Says the guy who works in insurance, where no one pays full price for medical care services by design. Aren't those tax credits and state/federal funds for hospitals (and medical school student loans) "government handouts", too?

    Quote Originally Posted by Lewkowski View Post
    Its deliberate use of cheap rhetoric to imply that government handouts aren't government handouts.
    The cheap rhetoric is your use of "free handouts" for individuals (but not corporations) while comparing healthcare subsidies to income taxes, or sales tax on gum. What are you smoking?

  25. #85
    Quote Originally Posted by Lebanese Dragon View Post
    Just to give Lewk's point some legitimacy, which is to does have. If it cost the government more money than you personally have put into the government then you are profiting off the government, especially if they're giving you stuff you need. They're stopping you from taking a loan out or whatever, effectively they are giving you money. My point is that it can be worth it, because in the long-run I'd argue the government will make it the money back, but also our society will reap rewards via positive externalities.
    You realize there are countries that pay a significant number of people to not seek employment, right? If you don't believe that, just pretend to and see how things look.
    Faith is Hope (see Loki's sig for details)
    If hindsight is 20-20, why is it so often ignored?

  26. #86
    Quote Originally Posted by Being View Post
    Everyone pays taxes. I don't know how I can make it more clear than that.
    The type and quantity matter. And depending on the type and quantity some people get free stuff from the government. I don't know how I can make it more clear than that.

  27. #87
    Quote Originally Posted by GGT View Post

    The cheap rhetoric is your use of "free handouts" for individuals (but not corporations) while comparing healthcare subsidies to income taxes, or sales tax on gum. What are you smoking?
    A tax break is not a handout. Corporations shouldn't be taxed on profits because its double taxation. "Corporate welfare" is a misnomer. Outside of idiotic green and agricultural subsidies corporations don't ever get handouts.

  28. #88
    Quote Originally Posted by Lewkowski View Post
    The type and quantity matter. And depending on the type and quantity some people get free stuff from the government. I don't know how I can make it more clear than that.
    Taxes are taxes. The more money people have to spend, the more taxes they pay. You think places like Detroit and Stockton are in bad shape now? Think what situation they would be in with even less local taxes coming in.

    Quote Originally Posted by Lewkowski View Post
    A tax break is not a handout. Corporations shouldn't be taxed on profits because its double taxation. "Corporate welfare" is a misnomer. Outside of idiotic green and agricultural subsidies corporations don't ever get handouts.
    I guess, technically, you can't call the billions of dollars Apple will make selling banned products in the USA corporate welfare.
    Faith is Hope (see Loki's sig for details)
    If hindsight is 20-20, why is it so often ignored?

  29. #89
    Wow. You mentioned Detroit. And you're a liberal. Ballsy.

  30. #90
    Quote Originally Posted by Lewkowski View Post
    Cool so if someone doesn't pay federal income tax (or whatever bucket you gather the money from) its OK for them to be denied medical care?
    You didn't answer the question: Would you be okay with that? Medical care based on your tax returns?

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