I have a friend who worked in hospital billing when it changed to the insurance company system. She said she was instructed to triple the cost of every item. True story.

No doubt. In the '50s and '60s, when huge company-wide policies were first being written, the insurance companies were so flush with cash that they didn't care what things cost. A lot of inflation-expection was built into the system; doctors assumed that they would be seeing 25% per year increases indefinitely, while insurance companies assumed that they could cover the increases because the companies who were their customers were expanding and hiring a bunch of young, healthy employees. The insured personnel lost track of what things cost, so they didn't care. Government took advantage of the opportunity to jump in and regulate without anyone noticing.

Now we have an aging population and a shrinking economy, but the inflation-expectation is now structural and almost impossible to root out. The industry is structured for high costs, and the government has its fingers everywhere. Ham-fisted, one-size-fits-all solutions proposed by the insurers met strong resistance, and the government is using the crisis as an opportunity to expand its power. Everyone involved, including most of the insured, is demanding a solution that assumes a collective. Of course, that will not work any better than any other forced collectivization has ever worked.

What we're going to witness will be the medical equivalent of the Soviet starvation of Ukraine.

When you put large amounts of readily-available money into any exchange system, the prices in that system rise while the quality of output will be diminished - be it college tuition, medical care, housing loans, whatever.

Why does this continue to surprise people?

I say bullshit to the part about the lady dying of breast cancer waiting for a biopsy. I am canadian and this just doesn't happen. People get excellent care and it doesn't bankrupt us. Also, if she didn't have a biopsy, how did they know she had cancer?? There is more to that story.

Stormy;

I'm Canadian too and you're full of shit. If you've been to a doctor in the last twenty years, if you've been to the ER, if you've had a fucking pap smear you know that the quality of care has taken a nose dive while the costs and wait times have skyrocketed into the stratosphere. And I say this from within the system.

This isn't the fault of our healthcare system, mind you, or the insurance industry. The fault lies with the Ministry of Health, and cocksuckin shiteating sons of whores like Dalton McGuinty, who imposed the "Health Tax" in Ontario.

If the Health Ministry would kick Parliament in the ass and get the Dr.'s what they're worth, we'd be in waaaaaaay better shape. If you talk to most Dr's, they'd prefer billable hours instead of the retarded flat rate system they have in place now. Anything that brings them in more in line with the American system is preferable. Why should they stay and fight to pay overhead when they can head south and drive a Rolls?

And Montreal IS NOT Canada.

Them bastid's are a special little race unto themselves, according to them.

Please take them over.....

please?

Stormy,

If the care was so great, I wouldn't have patients from Canada. One patient who had a breast lump when she was told how long she would have to wait for a DIAGNOSTIC mammogram (not a routine screening one - she had a lump) decided to seek her care here, paying out of her own pocket. She came to the US because she could get diagnosed and if necessary treated much faster.

We gave her an appointment on the day that she called. She and her husband drove five hours to get here. We were able to get her a mammogram, get the radiologist to do a STAT read on it, get a follow up ultrasound of the lump, and send her home reassured that she didn't have cancer. Same day.

The cost was actually very reasonable as well, and she and her husband thought that knowing if this was cancer, and possibly starting treatment that much sooner, was well worth what it cost them.

Stormy: "I am canadian and this just doesn't happen."

I've worked in six different hospitals in the Pacific Northwest during the past 20 years. There were Canadian patients in every one of them every day. Many of them were there to have life saving treatments that they couldn't get, or couldn't get soon enough, in Canada. Most were there at their own expense; others got their care paid for by their Canadian healthcare system.

There are healthcare providers in the U.S. whose primary business is providing medical services for patients from Canada and the UK. And there are businessmen in Canada who serve as consultants and brokers for Canadians seeking healthcare services in the U.S.

I have a Canadian friend in his late 40's who suffered a serious work related back injury in Canada. He has had multiple surgeries, physical therapy and treatment for chronic pain, all in the U.S. It would all be free in Canada... if he could get it. It amuses me to hear him extolling the Canadian healthcare system that hasn't done a thing for him.

I have a question for the Canadians:

Why is the wait on CHC about 12-18 months than private pay being about 48 hours?

Health insurance is regulated, manipulated, and distorted in every state. Lobbyists at the state level arrange for their particular offerings to be covered by insurance, such as accupuncture, chiropracty, and health clubs.

Insurance plans differ in total financial coverage, but don't offer ways for the consumer to benefit from choosing older, cheaper drugs. So, everyone has the incentive to choose newer, more expensive drugs, and the state-standardized insurance plans evolve to universally cover those and to cost more. Or, everyone is restricted to the older, cheaper drug to save money, and you find yourself uninsured for the newer drugs which you would have preferred.

There is no incentive for the patient to use the judgement of the doctor rather than pay another $600 for an MRI "just to be sure". Of course, the cost of insurance is higher in anticipation of this choice.

That may seem as if I am arguing both sides at the same time. The point is, the individual has lost the ability to choose the detail of what his insurance will or will not cover, because it is a product sold mostly to companies and is standardized by the state.

A woman might prefer more mammography rather than a discounted health club membership. She does not get to choose. She gets what lobbyists and health bureaucrats have chosen for her.

The government has broken the free market in health care. Our policy makers have already designed a system of price controls that doesn't work. Their solution is to cover up this failure by blaming "the market". The "market" is short for the freedom of people to produce and cooperate among themselves, always delivering value and achieving efficiencies that government cannot match.

That freedom is what the government has taken and is taking away, in favor of higher hidden taxes and rationing. Our leaders have been buying votes with lavish promises of what the government will deliver. Their plan is to put us all in one boat, then make us pay for their promises to prevent the boat from sinking.

Obamacare Bails Out Medicare.

Together, We All Pay More For Healthcare

The socialist idea of "community" distorts the costs of healthcare and insurance. Socialists want to push everyone into the same plan, so that people with lower health risk (the young) will pay for people with greater risk (the old). Socialists expect that people will not see this as a tax because it appears as a higher price paid to insurance companies rather than as a direct tax bill.

Even better, the cost of health insurance comes out of the employee's possible salary (less is offered) rather than as a full deduction from his stated salary.

Consider this situation. Fred tries a new restaurant. The waiter seats him at a group table for 10. This is an adventure. He isn't very hungry; a ceaser salad for $5 will do. The waiter asks "Will that really be all, Sir?" "Yes, just the salad."

The other nine people at the table all order lobster for $25! The person next to him explains that this is a Lunch Club which encourages community and good feeling. The costs for everyone are added together, and the bill is divided equally among the people at the table.

Fred quickly calls back the waiter and orders lobster.

Shared payment is the problem. Fred faces an average cost he can't control. Say he can get a salad for $5 or a lobster for $25. The change in his personal cost is just $2 [ ($25-$5)/10 ]. He would rather have the lobster for $2 more. This does not depend on the restaurant charging "fee for service" or any lack of choice by the customers.

If he can, he will avoid the restaurant unless he loves lobster. He pays just $2 more for the lobster, but of course pays $25 overall.

Everything would work well if each customer is billed separately. But, our health care reformers insist that we all pay the average costs together. They want to force us into lunch clubs just like that one, and have already gone far in doing this.

"I have a question for the Canadians"

See my original comment above Jim. The wait times in Canada are in part due to the fact the Health Ministry, in it's infinite wisdom, has seen fit to pay doctors on a per exam basis.

This would be fine, except the "payments" are a joke in the first place, considering student loans, start-up and equipment costs, overhead.When you're getting paid $450 for a two hour exam, something is seriously wrong. Supplies for a Dr's office aren't cheap, and you can't pick them up at Staples.

Factor in how much our American counterparts are making, and you have some pretty pissed off professionals. Most of the healthcare professionals I've spoken to would like our system to be based on billable hours paid by Provincial budgets.

"BUT WE'RE BROKE!" cries the Ministry. Well. If they would stop spending millions of dollars on stupid initiatives like "E-health" and "Ambulance Orange", and other idiocy like sending ambulances 45km out of their territory due to "jurisdiction issues", they'd have a helluva lot more money. Neither of those initiatives were effective, drained millions from the public coffers, and were cancelled in the end anyway. Add in the drastic cuts made in the last twenty years, and plain ol' corruption, it's a nasty mix.

Twenty bucks says good ol' McGuinty and his chums will be up on charges in the next two years.

Interesting article by a cardiologist and a Republican on single payer plans, Medicare and Medicaid versus Insurance companies:

http://blog.cardiosource.org/post/I-Am-A-Republicane280a6-Can-We-Talk-About-A-Single-Payer-System.aspx

"I am a Republican. For those who know me that is not a surprise. I live in a red state. I have never voted for a Democratic presidential candidate. I can field strip, clean and reassemble a Remington 12-gauge pump blindfolded. And on top of it, I think we should talk about having a single payer national health care plan. The reason is quite simple. In my view, we already have one; we just don’t take advantage of it. "