4 ms·

So, the solution to that in the US is for the patients to either die or go bankrupt rather than hospitals or insurers going into debt. Everything has a price,

So, the solution to that in the US is for the patients to either die or go bankrupt rather than hospitals or insurers going into debt. Everything has a price, but that seems a little lopsided.

SkyMarshal 16y ago
Well neither is sustainable, so neither is a solution. I generally trust a self-correcting free market over a government bureaucracy to solve such problems, but in this case it seems the fundamental problem is that there just isn't enough margin for for-profit insurance companies to prosper without turning the screws on either doctors & staff, patients, and/or taxpayers.
tptacek 16y ago
This is an utterly nonresponsive comment. If the economics of providing healthcare don't work out, they don't work out. It's not as if "go into debt" means "fat cats make less money". No, it means that the skilled labor and capital that drives the insolvent health care system will simply migrate somewhere they can deliver it profitably. Say goodbye to hospitals for rural and poor areas.
- muhfuhkuh 16y ago
  "Say goodbye to hospitals for rural and poor areas." That was happening anyway, if it weren't for Medicaid, that is. There was a definite brain drain of doctors (especially specialists) who choose to go to affluent suburbs and urban areas simply because they get more (and better quality, AKA rich) patients. You think if we _further_ privatized the market, those in rural areas would be _better_ served? Isn't that the opposite of what the free market would actually do? In fact, take a look at this study[1] about physicians in rural America. It's eye opening how they advocate federal and state intervention (read Medicaid and Medicare) as one of the solutions (along with opening training up to more potential candidates, which even I as a liberal elitist supports). [1]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/
  - rdouble 16y ago
    Few doctors want to live in a rural area for lifestyle reasons more than salary. A GP or surgeon can make more money in a rural area.
    - intended 16y ago
      How? Do they charge higher rates than elsewhere - effectively using supply and demand and saying: "You don't have anywhere else to go, so pay my rates."
      - rdouble 16y ago
        Most doctors these days are salaried employees at a large health care organization. They get higher salaries in the sticks because nobody wants to work there.
        intended 16y ago
        Ah. Thanks for that info.
        Gobiner 16y ago
        Source for this assertion? It seems more likely (to me) that they'd make less due to their smaller and less affluent clientele.

So, the solution to that in the US is for the patients to either die or go bankrupt rather than hospitals or insurers going into debt. Everything has a price, but that seems a little lopsided.

SkyMarshal 16y ago

Well neither is sustainable, so neither is a solution. I generally trust a self-correcting free market over a government bureaucracy to solve such problems, but in this case it seems the fundamental problem is that there just isn't enough margin for for-profit insurance companies to prosper without turning the screws on either doctors & staff, patients, and/or taxpayers.

tptacek 16y ago

This is an utterly nonresponsive comment. If the economics of providing healthcare don't work out, they don't work out. It's not as if "go into debt" means "fat cats make less money". No, it means that the skilled labor and capital that drives the insolvent health care system will simply migrate somewhere they can deliver it profitably. Say goodbye to hospitals for rural and poor areas.

muhfuhkuh 16y ago
"Say goodbye to hospitals for rural and poor areas." That was happening anyway, if it weren't for Medicaid, that is. There was a definite brain drain of doctors (especially specialists) who choose to go to affluent suburbs and urban areas simply because they get more (and better quality, AKA rich) patients. You think if we _further_ privatized the market, those in rural areas would be _better_ served? Isn't that the opposite of what the free market would actually do? In fact, take a look at this study[1] about physicians in rural America. It's eye opening how they advocate federal and state intervention (read Medicaid and Medicare) as one of the solutions (along with opening training up to more potential candidates, which even I as a liberal elitist supports). [1]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/
- rdouble 16y ago
  Few doctors want to live in a rural area for lifestyle reasons more than salary. A GP or surgeon can make more money in a rural area.
  - intended 16y ago
    How? Do they charge higher rates than elsewhere - effectively using supply and demand and saying: "You don't have anywhere else to go, so pay my rates."
    - rdouble 16y ago
      Most doctors these days are salaried employees at a large health care organization. They get higher salaries in the sticks because nobody wants to work there.
      - intended 16y ago
        Ah. Thanks for that info.
      - Gobiner 16y ago
        Source for this assertion? It seems more likely (to me) that they'd make less due to their smaller and less affluent clientele.