Video: What free-market medicine looks like

posted at 1:51 pm on November 15, 2012 by Ed Morrissey

This helpful reminder of the value of price signals comes to us from Reason Magazine and Reason TV, which underscores why ObamaCare won’t actually do anything to lower medical costs.  Two surgeons in Oklahoma City got tired of working within the third-party-payer construct and started posting cash-up-front retail costs for surgeries on their website.  The result?  Patients responded to the honest approach, and surgeries took place at a significantly lower cost than within the traditional insurance/Medicare model.  Why?  Because these patients didn’t have to subsidize surgeries for other people — or pay for expensive administrators to deal with the issues arising from the third-party-payer model:

The Surgery Center demonstrates that it’s possible to offer high quality care at low prices. “It’s always been interesting to me,” says Dr. Jason Sigmon, “that in any other industry, tons of attention is devoted to making systems more efficient, but in health care that’s just completely lost.” Sigmon, an ear, nose, and throat surgeon, regularly performs procedures at both the Surgery Center and at Oklahoma City’s Integris Baptist Medical Center, which is the epitome of a traditional hospital. It’s run by a not-for-profit called Integris Health, which is the largest health care provider in Oklahoma serving over 700,000 patients a year.

Sigmon says he can perform twice as many surgeries in a single day at the Surgery Center than at Integris. At the latter institution, he spends half his time waiting around while the staff struggles with the basic logistics of moving patients from preoperative care into the operating room. When the patient arrives, Sigmon will sometimes wait even longer for the equipment he needs.

Except for the clerical staff, every employee at the Surgery Center is directly involved in patient care. For example, both human resources and building maintenance are the responsibility of the head nurse. “One reason our prices are so low,” says Smith, “is that we don’t have administrators running around in their four or five thousand dollar suits.”

In 2010, the top 18 administrative employees at Integris Health received an average of $413,000 in compensation, according to the not-for-profits’ 990 tax form. There are no administrative employees at the Surgery Center.

This model has already been in place for decades in the health care market, but doesn’t get much attention in reform discussions.  This is the same economic model used in Lasik and cosmetic surgery markets, services which insurance companies typically won’t cover.  Instead, these providers have to market themselves directly to consumers, which means they compete on price and services — making their operations more efficient (less overhead, as with the Surgery Center) and more responsive.  Providers don’t have to deal with bureaucracies in the private (insurers) or public (government) sector to get paid, which generates enough interest that there is no lack of providers at all to meet the demand.

How about in the third-party-payer world?  Not so much:

The United States will require at least 52,000 more family doctors in the year 2025 to keep up with the growing and increasingly older U.S. population, a new study found. …

The problem does not appear to be one of too few doctors in general; in fact, in 2011 a total of 17,364 new doctors emerged from the country’s medical schools, according to the Association of American Medical Colleges (AAMC). Too few of these doctors, however, choose primary care as a career — an issue that may be worsening.

In a 2008 census by the AAMC and the American Medical Association, researchers found that the number of medical graduates choosing a career in family medicine dropped from 5,746 in 2002 to 4,210 in 2007 — a drop of nearly 27 percent.

“It’s pretty tough to convince medical students to go into primary care,” said Dr. Lee Green, chair of Family Medicine at the University of Alberta, who was not involved with the study.

Green added that he believes this is because currently primary care specialties are not well paid, well treated or respected as compared to subspecialists.

“They have to think about their debt,” he said. “There are also issues of how physicians are respected and how we portray primary care to medical students.”

The policy recommendations to solve this include providing “bonuses” to physicians who take Medicaid cases.  However, if we pushed a retail model in family practice (which has been burgeoning in the US), we could lower costs, provide better access, and have an economic model that would encourage family practice provider to emerge, especially since the costs are lower to get certified in that kind of medicine rather than surgery or other specialties.

What happens to the poor in this case?  Medicaid or something similar would have to exist, but in an environment where most people handled routine medical care directly with their physicians, the small percentage that would have to rely on third-party-payer assistance would present much less of a distortion to the market, and make it much easier to deal with the consequences.

Update: Here’s the inevitable endgame of the enforced third-party-payer system, this time in Quebec:

Surgery wait times for deadly ovarian, cervical and breast cancers in Quebec are three times longer than government benchmarks, leading some desperate patients to shop around for an operating room.

But that’s a waste of time, doctors say, since the problem is spread across Quebec hospitals. And doctors are refusing to accept new patients quickly because they can’t treat them, health advocates say.

A leading Montreal gynecologist said that these days, she cannot look her patients in the eye because the wait times are so shocking. Lack of resources, including nursing staff and budget compressions, are driving a backlog of surgeries while operating rooms stand empty. The latest figures from the provincial government show that over a span of nearly 11 months, 7,780 patients in the Montreal area waited six months or longer for day surgeries, while another 2,957 waited for six months or longer for operations that required hospitalization.

The worst cases are gynecological cancers, experts say, because usually such a cancer has already spread by the time it is detected. Instead of four weeks from diagnosis to surgery, patients are waiting as long as three months to have cancerous growths removed.

But at least it’s fair.

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Comment pages: 1 2

That’s why a hospital aspirin costs $2. You’re not just paying for your aspirin but for all the uninsured moochers who need aspirin, too.

CrustyB on November 15, 2012 at 1:56 PM

Well bho/team can’t have this now can they? Gotta find some way to put a stop to this STAT! NO one should make money if big bro doesn’t approve?
L

letget on November 15, 2012 at 1:56 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Welcome to the new world order where Cash is King.

JPeterman on November 15, 2012 at 1:57 PM

The free market will return because the Democrat’s need to feed. With the spurring of free markets there is no growth, without growth there is no new employment, without new employment their is no narrowing of the deficit, and without a narrowing of the deficit our system will fail.

And then the Democrats will not feed.

itsspideyman on November 15, 2012 at 1:58 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Thank you for the unhelpful non sequitur.

22044 on November 15, 2012 at 1:59 PM

It’s a scam! A bait and switch to get you on their operating table so they can chop off your feet and harvest your organs

Ditkaca on November 15, 2012 at 2:00 PM

What happens to the poor in this case? Medicaid or something similar would have to exist, but in an environment where most people handled routine medical care directly with their physicians, the small percentage that would have to rely on third-party-payer assistance would present much less of a distortion to the market, and make it much easier to deal with the consequences.

It simply won’t work if Medicaid exists. Then everyone would be one it so they wouldn’t have to pay. Our country can no longer afford to be subsidizing all this.

If government just got out of the way and let the free market operate, everyone would be better off.

nazo311 on November 15, 2012 at 2:02 PM

That’s why a hospital aspirin costs $2. You’re not just paying for your aspirin but for all the uninsured moochers who need aspirin, too.

CrustyB on November 15, 2012 at 1:56 PM

$2 is a deal, I was charged $10 for a box of Kleenex.

nazo311 on November 15, 2012 at 2:03 PM

from ObamaCare headlines thread:

At my dentist’s yesterday, a well-established, thriving, family practice with 4 dentists, there was a buzz. There’d been a meeting that morning on employee’s health insurance. Because of ObamaCare, an average extra $100 would be taken out the employee’s paychecks — dental assistants, hygienists, managers, front desk workers.

Paul-Cincy on November 15, 2012 at 12:45 PM

Paul-Cincy on November 15, 2012 at 2:05 PM

Will they accept ammunition as pay for surgical services? Reloads, I mean.

a capella on November 15, 2012 at 2:06 PM

If government just got out of the way and let the free market operate, everyone would be better off.

except people who need surgeries but, for whatever reason can’t afford them. Oh, that’s right. Moochers. Let ‘em die, I guess. Hooray for the market.

lostmotherland on November 15, 2012 at 2:07 PM

A leading Montreal gynecologist said that these days, she cannot look her patients in the eye because the wait times are so shocking. Lack of resources, including nursing staff and budget compressions, are driving a backlog of surgeries while operating rooms stand empty. The latest figures from the provincial government show that over a span of nearly 11 months, 7,780 patients in the Montreal area waited six months or longer for day surgeries, while another 2,957 waited for six months or longer for operations that required hospitalization.

Where is Drywall? Come out, come out wherever you are Davey!!!!

Defend this I dare you!

D-fusit on November 15, 2012 at 2:08 PM

Just great! ØbamaCare will force all these people to exit the system in favor of this type of care, costs will come down naturally due to competition, and the libs will all scream “See! We told you we would bring down the cost of care.”

Odysseus on November 15, 2012 at 2:08 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

You need to go back and check that again. The study that showed most bankruptcies being caused by medical costs was done by that famous Indian, Fauxcohontas. It was used as the basis of the Obama care plan, but guess what? That study was debunked and ridiculed by her peers. It is called, sloppy, badly researched and useless. Try again.

Night Owl on November 15, 2012 at 2:08 PM

Trust me; the Obamacare juggernaut will make such common-sense businesses illegal.

The next step is a medical ship that sails out to international waters to do something radical; practice medicine absent massive bureaucracy.

michaelo on November 15, 2012 at 2:09 PM

Instead of four weeks from diagnosis to surgery, patients are waiting as long as three months to have cancerous growths removed.

Meh. Give ‘em the pain pills and call it good. /

iurockhead on November 15, 2012 at 2:09 PM

Finally someone is listening to my free-market healthcare approach!

Why the hell don’t doctor’s offices have a price board like a Jiffy lube does when you walk in the door!?!??!

I say this as a professional in the drug research field, and a spouse who is a physician.

My wife is seriously considering opening a cash-only primary care practice in the near future, and I think that this video does a good job of illustrating why.

Defenestratus on November 15, 2012 at 2:10 PM

This sounds like it would work perfectly with this idea:

http://www.youtube.com/watch?feature=player_embedded&v=s02SypCcYIc

Parallel economy!

Night Owl on November 15, 2012 at 2:12 PM

And so all the good doctors will end up taking cash (thus absolving themselves from EMTALA burden) whereas all the bad doctors will fully latch onto Medicaid/Medicare nipple. Then the government, desperate to provide best service to the “underprivileged”, will introduce federal licensing. Blue states will jump onto it like a sailor on a cheap rum bottle, and red states will… You get the idea. Note to self: buy a rifle, find an outdoor range, practice, practice, practice.

Archivarix on November 15, 2012 at 2:12 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Better bankrupt than dead.

Gelsomina on November 15, 2012 at 2:12 PM

I’ve actually had surgery at the Surgery Center of Oklahoma in the Reason video. It was a sinus surgery. I think I paid ~$700 out of pocket. What amazed me was the surgeon gave me one of the surgery tools in a sealed bag afterward. He explained to me that it was a very expensive piece of equipment that could only be used on me and that I should keep it in case a similiar procedure needed to be done in the future. What shocked me was he also told me that in a traditional hospital, they would have just thrown it away and sold me a new one if I needed the procedure again. Wow.

They’re doing some great things at that place.

Meric1837 on November 15, 2012 at 2:13 PM

It’s a scam! A bait and switch to get you on their operating table so they can chop off your feet and harvest your organs

Ditkaca on November 15, 2012 at 2:00 PM

Tonsil rustlers!!!

String ‘em up!

iurockhead on November 15, 2012 at 2:14 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

I thought this one was examined a week or so ago.
Remember seeing a stat that showed average medical debt in bankruptcies was about $1,000 or so.
That does not trigger a filing by itself.

Also, what does your comment have to do with the information here. Point is that there ARE ways to keep costs down.

Jabberwock on November 15, 2012 at 2:15 PM

I watched a real estate show on hgtv where a woman in Vancouver was saying she wants a new house but in the same neighborhood because she had waited for 3 years for a primary physician and didn’t want to go back on the waiting list in a new place. Soon to be the new normal in the US.

BTW I worked for a bankruptcy lawyer and, yes, people always include medical debt in their filing but in only one case in 4 years was medical debt the cause. It’s usually credit cards and a house they couldn’t afford.

PattyJ on November 15, 2012 at 2:15 PM

Everything is worth what the buyer is willing to pay for it.

When individuals are the buyer…. prices come down and service gets better.

lm10001 on November 15, 2012 at 2:17 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

That’s exactly what health insurance was originally for. Not to distribute money to provider, but to compensate the insured in case of catastrophic medical event. That’s how all other insurances work. That’s how HSA plans were designed before OgabeCare had its wicked way with them.

Archivarix on November 15, 2012 at 2:18 PM

except people who need surgeries but, for whatever reason can’t afford them. Oh, that’s right. Moochers. Let ‘em die, I guess. Hooray for the market.

lostmotherland on November 15, 2012 at 2:07 PM

So I guess you do need us, huh? In the past, hospitals were able to help those people because they were often non-profits. People donated funds that allowed the hospital to treat people without the means to pay. Now people can’t afford to do things like that because of your socialist system of HMO’s, high taxes, and ungodly regulations. Producers will always find a way around your socialist programs, but the disgusting part is that you expect us to find those of you who wanted it a way around it to. Sucks to be you.

Night Owl on November 15, 2012 at 2:18 PM

Hey, where’s DRywall and his commentary on this topic?

ChicagoBlues on November 15, 2012 at 2:19 PM

except people who need surgeries but, for whatever reason can’t afford them. Oh, that’s right. Moochers. Let ‘em die, I guess. Hooray for the market.

lostmotherland on November 15, 2012 at 2:07 PM

Dumb, broke, & stupid is no way to go through life, son.

22044 on November 15, 2012 at 2:21 PM

Hey, where’s DRywall and his commentary on this topic?

ChicagoBlues on November 15, 2012 at 2:19 PM

Obamacare kicked in and the trolls aren’t allowed to spend as much hours trolling Hot Air as they used to.

22044 on November 15, 2012 at 2:22 PM

The worst cases are gynecological cancers, experts say, because usually such a cancer has already spread by the time it is detected.

Tell me again, which party was it that was launching a war on wymmynses?

UltimateBob on November 15, 2012 at 2:22 PM

except people who need surgeries but, for whatever reason can’t afford them. Oh, that’s right. Moochers. Let ‘em die, I guess. Hooray for the market.

lostmotherland on November 15, 2012 at 2:07 PM

It doesn’t matter if you can afford surgery or not, if you can’t get it.

That’s what you socialists don’t understand. In East Germany most people had the money for bread, but there was no bread.

In your world nobody has bread, that’s what you call “fair”. In my world I can buy to loafs of bread and give one to the poor.

Gelsomina on November 15, 2012 at 2:24 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Pay up, shut up, leave, or be a whiny little b!tch about the fact that the best healthcare system in the world isn’t cheap.

Those are your only options liberal trolltard. Of course you’ll always choose option #4.

MelonCollie on November 15, 2012 at 2:25 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

They go bankrupt because of the cost of healthcare. A HUGE part of healthcare costs nowadays is the huge burden of administrative costs and torts.

You can still have insurance, but have it be something the PATIENT has to file for. You go to the Dr. that fits you, both in bed side manner and cost. You get it cheaper because that doctor has stop having to deal with insurance. You take your receipt, go home, attach a claim coupon and wait for reimbursement.

In my case, I’d love to be putting $200 a month into an HSA instead of paying for health insurance (and I am, even if my employer is paying it because that’s money they could be paying to me). Then I could use that $2400 for Dr visits, catastrophic health insurance for a major event, and have it roll over and earn interest.

Should the government step in and keep people from going bankrupt because of every cause? If you lose your job and can’t get another I guess we should have a system where those still working pay off their debts, huh?

Also, you liberals love to make it sound like bankruptcy = death. Oh boo hoo, they have to rent instead of buy a house, it’s harder to buy a brand new car, their kids have to go to state colleges instead of private. Bankruptcies are not the end of the world. I know a couple that made over 100K a year but did so much overshopping they had back to back bankruptcies because shark lenders kept lending anyways. They drove $40,000 cars and lived in a great part of town, with beautiful furniture and didn’t lose any of that, they just had bankruptcy on their credit reports.

If somebody goes bankrupt because of a health issue, even if it was none of their own choices that caused it (very, very rare), they will be just fine. There’s plenty of societal support. Yeah, they won’t be able to buy a house and they might have to pay 20% on a car loan, but they won’t die. They’ll just have to struggle back to their feet.

But if they can get the $4,000 dollar surgery from one hospital, instead of the same surgery for $40,000 across town (as was the case for one surgery in Madison, WI) because the market puts patients in touch with the costs, then that climb out of debt won’t be quite as bad, now will it.

PastorJon on November 15, 2012 at 2:31 PM

You need to go back and check that again. The study that showed most bankruptcies being caused by medical costs was done by that famous Indian, Fauxcohontas. It was used as the basis of the Obamacare plan, but guess what? That study was debunked and ridiculed by her peers. It is called, sloppy, badly researched and useless. Try again.

Night Owl on November 15, 2012 at 2:08 PM

Yep. That’s the study where if you went into bankruptcy in any part due to your gambling debts, that was labeled a bankruptcy due to health problems. It was one of the most outrageous pieces of scientific misconduct that I’ve ever read.

Molester and squid and some of the other trolls like to dredge that study up from time to time.

slickwillie2001 on November 15, 2012 at 2:31 PM

Pay up, shut up, leave, or be a whiny little b!tch about the fact that the best healthcare system in the world isn’t cheap.

The best healthcare sysrtem in the world – unless you consider stuff like outcomes, infant mortality and longevity. You know, medical stuff.

plewis on November 15, 2012 at 2:33 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Hahaha. You aren’t “surprising” anybody, lester. Most everyone here is well aware of those phony studies. Don’t trust any “scholarship” that involved Lizzie Warren. She’s a con and a fraud, in addition to being a faux Aff*rmative Act*on Indian.

Her bankruptcy studies have been debunked numerous times, but for those still unfamiliar with what the great “consumer advocate” and new Massachusetts Senator did, she attributed any bankruptcy that had any unpaid medical bills (no matter the size) to the medical bills, regardless of the amount of other unpaid debt. So if a person declaring bankruptcy had half a million dollars’ worth of outstanding debt from their shopping addiction on their 27%-interest credit cards, and a $3 million dollar mortgage they couldn’t pay, and a half-million dollars in gambling debts, if they had any unpaid medical bills (even if just for a few dollars), Warren classified it as a “medical” bankruptcy.

AZCoyote on November 15, 2012 at 2:33 PM

Hey, where’s DRywall and his commentary on this topic?

ChicagoBlues on November 15, 2012 at 2:19 PM

He’s Canadian, remember. Probably doesn’t have internet in the waiting bedroom, where you sleep and eat for a few days waiting for a doctor to see you.

PastorJon on November 15, 2012 at 2:33 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Good heavens if an Obama voting retard was able to convey just what the typical medical debt was, in those bankruptcies.

Must suck to have won, and yet still feel the need to cower from your beliefs.

MNHawk on November 15, 2012 at 2:36 PM

The best healthcare sysrtem in the world – unless you consider stuff like outcomes, infant mortality and longevity. You know, medical stuff.

plewis on November 15, 2012 at 2:33 PM

None of which you have any authority on, phew-is.

MelonCollie on November 15, 2012 at 2:36 PM

One commonly cited comparison, the 2000 World Health Organization’s ratings of “overall health service performance”, which used a “composite measure of achievement in the level of health, the distribution of health, the level of responsiveness and fairness of financial contribution”, ranked Canada 30th and the US 37th among 191 member nations.

He’s Canadian, remember. Probably doesn’t have internet in the waiting bedroom, where you sleep and eat for a few days waiting for a doctor to see you

plewis on November 15, 2012 at 2:36 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is.

lester on November 15, 2012 at 1:56 PM

I think the point that medicine wouldn’t be this expensive if not for Medicare/Medicaid/forcing the whole market into an ill-fitting insurance format has been made.

Here’s part 2: What the heck is wrong with going bankrupt? That’s exactly what you’re supposed to do when you hit insurmountable financial difficulties. You don’t have to go to prison, you get to keep your house and a car, you have crappy credit for seven years but that’s a pretty minor price to pay.

alwaysfiredup on November 15, 2012 at 2:38 PM

I am sort of surprised that wingnuts don’t grasp that the idea behind Obamacare is to destroy, not to correct, private systems, with the result that single payer shows up as a knight in white armor. I kinda worry about the wingnuts sometimes. They are too literal.

kunegetikos on November 15, 2012 at 2:38 PM

which used a “composite measure of achievement in the level of health, the distribution of health, the level of responsiveness and fairness of financial contribution

plewis on November 15, 2012 at 2:36 PM

And I’m sure they told you how they calculated distribution, responsiveness and fairness and how each factor is weighted?

That measure is meaningless and devised by people who like single-payer systems.

alwaysfiredup on November 15, 2012 at 2:39 PM

The AMA supported Obamacare: NEVER forget that. Physicians in France make about 55k and report being very happy.

kunegetikos on November 15, 2012 at 2:40 PM

1.^ a b c Szick S, Angus DE, Nichol G, Harrison MB, Page J, Moher D. “Health Care Delivery in Canada and the United States: Are There Relevant Differences in Health Care Outcomes?” Toronto: Institute for Clinical Evaluative Sciences, June 1999. (Publication no. 99-04-TR.)
2.^ Esmail N, Walker M. “How good is Canadian Healthcare?: 2005 Report.” Fraser Institute July 2005, Vancouver BC.
3.^ Nair C, Karim R, Nyers C (1992). “Health care and health status. A Canada—United States statistical comparison”. Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d’information sur la santé 4 (2): 175–83. PMID 1421020.

Read these or have someone read them to you.

plewis on November 15, 2012 at 2:40 PM

well i’m sure lester is right..most people would rather be dead than bankrupt….well, or at least, most leftists would rather have other people die rather than go bankrupt.

r keller on November 15, 2012 at 2:40 PM

slickwillie2001 on November 15, 2012 at 2:31 PM

I’m starting to think they think we’re stupid. /sarc

Night Owl on November 15, 2012 at 2:41 PM

That measure is meaningless and devised by people who like single-payer systems.

alwaysfiredup on November 15, 2012 at 2:39 PM

Science bad. Web site gooood.

plewis on November 15, 2012 at 2:41 PM

It’s like the deficit: the GOP plays on people’s fears to keep high-end profits in tact. The market answer, obviously, is to double the number of medical schools.

kunegetikos on November 15, 2012 at 2:42 PM

infant mortality

plewis on November 15, 2012 at 2:33 PM

Interestingly enough, the reason our stats aren’t as good on infant mortality is that we count every single birth where the child is breathing a “live birth”, even if the child dies shortly thereafter. Other countries do not. Reduce the denominator and you reduce the number.

alwaysfiredup on November 15, 2012 at 2:42 PM

The worst cases are gynecological cancers, experts say, because usually such a cancer has already spread by the time it is detected.

and Romney keeps his war on women going in Canada too….the h8r
/dancing vayjayjays

burrata on November 15, 2012 at 2:43 PM

Science bad. Web site gooood.

plewis on November 15, 2012 at 2:41 PM

Troll who doesn’t know a thing about science still stupid.

MelonCollie on November 15, 2012 at 2:44 PM

plewis on November 15, 2012 at 2:41 PM

How exactly does science measure fairness?

alwaysfiredup on November 15, 2012 at 2:44 PM

plewis on November 15, 2012 at 2:36 PM

Perhaps you aren’t aware that different countries count things differently. I can’t remember the whole thing, but some countries don’t count still births as a death in their statistics. You can’t compare apples and oranges to come up with the results you want.

Night Owl on November 15, 2012 at 2:45 PM

Double the number of medical schools.

kunegetikos on November 15, 2012 at 2:47 PM

plewis on November 15, 2012 at 2:40 PM

I bet you didn’t even read the story linked above. Here read this or as you said “have someone read them to you.”
.
‘It’s a crisis for Quebec women’

D-fusit on November 15, 2012 at 2:49 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Do you know what the NUMBER ONE cause of poverty in America is?

Divorce.

Suddenly single mom, piddly child support and alimony, having to find her own place, etc.

So would you advocate we ban divorce? Have the taxpayers pony up more money?

The point is, things happen to people, things they have to deal with. The safety net is there, but we can’t be nannies. Grown ups have to deal with the decisions grown ups make, and the things that happen to them.

PastorJon on November 15, 2012 at 2:49 PM

It’s like the deficit: the GOP plays on people’s fears to keep high-end profits in tact. The market answer, obviously, is to double the number of medical schools.

kunegetikos on November 15, 2012 at 2:42 PM

Why read up on the topic when you can just go by whatever the media tells you about the wonders of ObamaCare? The problem isn’t the number of medical students, the problem is they aren’t going into general practice, they are going into specialties. The communist answer, obviously, is to have the government assign you your job. Takes all that agonizing over what you want to be when you grow up away. You just wait till you get the letter from the government telling you what part of utopia you will be assigned to.

Night Owl on November 15, 2012 at 2:50 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Do you have any links for that assertion?

I ask because I read that your assertion is a myth. Someone reputable looked into some bogus study that came to your conclusion, and it turned out that clowns who got in over their heads with consumer credit and mortgage indebtedness problems when they also had a reasonable monthly health-insurance premium were included as those who filed for bankruptcy because of medical expenses.

In short, the study didn’t pass the laugh test.

I’m sure that a very small number have a very big problem. But we didn’t need a 2,700-page monstrosity to address it. Yet too many Dems shed too many tears over a problem that’s not that widespread.

BuckeyeSam on November 15, 2012 at 2:51 PM

the problem is they aren’t going into general practice, they are going into specialties. The communist answer, obviously, is to have the government assign you your job. ….

Night Owl on November 15, 2012 at 2:50 PM

Doubling the number of medical schools solves this. Double the number of medical schools.

kunegetikos on November 15, 2012 at 2:55 PM

Since now we will be following the British system here,
here is our future :
http://www.youtube.com/watch?v=Eyf97LAjjcY

burrata on November 15, 2012 at 2:57 PM

Double the number of medical schools.

kunegetikos on November 15, 2012 at 2:55 PM

Let it be like Kennedy’s moon talk, or Reagan’s star wars talk, if it helps the folks to get behind it.

kunegetikos on November 15, 2012 at 2:57 PM

This is an example of a plank the GOP could win on, in align with common sense, and also not untrue.

kunegetikos on November 15, 2012 at 2:58 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

Do you know what the NUMBER ONE cause of poverty in America is?

Divorce.

Suddenly single mom, piddly child support and alimony, having to find her own place, etc.

So would you advocate we ban divorce? Have the taxpayers pony up more money?

The point is, things happen to people, things they have to deal with. The safety net is there, but we can’t be nannies. Grown ups have to deal with the decisions grown ups make, and the things that happen to them.

PastorJon on November 15, 2012 at 2:49 PM

Bankruptcy is there for people to be able to get on with their lives after an major change in life circumstances, typically the type you cannot easily plan for. So it works as intended. Medical bills in and of themselves are usually not the cause of a bankruptcy, the loss of health and the resultant reduction in productivity and wealth creation make it impossible to pay your normal bills, let alone the hospital bills. So, making people get health insurance will not significantly reduce bankruptcies anyways, as the underlying cause of the bankruptcies is loss of income to pay normal debts, and the few that make it to the point of having to do so simply for medical bills are rare.

astonerii on November 15, 2012 at 2:59 PM

You’re still operating on the false premise that the Left want to control costs, they don’t. They want to control us and they can’t control us in a free market.

Charlemagne on November 15, 2012 at 3:00 PM

Yet too many Dems shed too many tears over a problem that’s not that widespread.

BuckeyeSam on November 15, 2012 at 2:51 PM

And we all know that going bankrupt is the most horrible . . Oh, wait, it just impacts your credit . . .

Just remember though, libs live in Anecdote World. I’m sure they’ll come back with one case out of over 300 Million Americans that proves bankruptcy kills because somebody got depressed over theirs . . .

PastorJon on November 15, 2012 at 3:03 PM

Doubling the number of medical schools solves this. Double the number of medical schools.

kunegetikos on November 15, 2012 at 2:55 PM

Sorry, this will not solve the problem, at all.
What we need are more minority doctors, specially laaaateeeeno and LGBTQRSTLMNOP doctors , and atleast 50% of them should be illegals too.

burrata on November 15, 2012 at 3:04 PM

Outcomes? Ask Liam Neeson. Canadian hospitals lack the necessary diagnostic equipment because of rationing. So his wife, Natasha, died:

Since you libs love anectodal evidence so much

Her body had to come to the US so they could figure out what happened to her.

PastorJon on November 15, 2012 at 3:10 PM

The cash method is one way to get back more to treating health insurance as insurance not wealth transfer mechanism. It would be the most reasonable way to take care of routine type medical care for most people which would leave the more costly treatments to be handled via, perhaps, bad news insurance which because it only covers for the most part the financially destructive illnesses.

Catastrophic insurance, because those kinds of illnesses happen to only a fraction of a given population, tends to be much cheaper because the insurance does not cover routine this or routine that with all the attendant need to monitor and control (for the bottom line if nothing else).

If there were a situation where someone was literally uninsurable for a major illness for whatever reason, they would form a very small part of the population and that would likely be manageable via some government program of some kind.

No system of health care or insurance (private or government) is going to be perfect and if the demand is that the system must be perfect (or as close as possible) then other alternative that may do a good enough job will get rejected.

Russ808 on November 15, 2012 at 3:10 PM

What we need are more minority doctors, specially laaaateeeeno and LGBTQRSTLMNOP doctors , and atleast 50% of them should be illegals too.

burrata on November 15, 2012 at 3:04 PM

lmfao.

I apologize for presupposing that all doctors are equal. You nailed me, as to one of my premises.

kunegetikos on November 15, 2012 at 3:14 PM

Here is something that will come down the pike that will help do away with the insurance racket.

Decent Health care without the insurance.

Ronaldusmax on November 15, 2012 at 3:29 PM

1.^ a b c Szick S, Angus DE, Nichol G, Harrison MB, Page J, Moher D. “Health Care Delivery in Canada and the United States: Are There Relevant Differences in Health Care Outcomes?” Toronto: Institute for Clinical Evaluative Sciences, June 1999. (Publication no. 99-04-TR.)
2.^ Esmail N, Walker M. “How good is Canadian Healthcare?: 2005 Report.” Fraser Institute July 2005, Vancouver BC.
3.^ Nair C, Karim R, Nyers C (1992). “Health care and health status. A Canada—United States statistical comparison”. Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d’information sur la santé 4 (2): 175–83. PMID 1421020.

Read these or have someone read them to you.

plewis on November 15, 2012 at 2:40 PM

Dude, that is hilarious! You just cut and pasted the first three references from the Wikipedia page on “Comparison of the health care systems in Canada and the United States.” Seriously, does that make you feel smart or something, like you actually read the reports. The funny thing is too, the reports are used as a citation within the Wikipedia article to claim “Comparison of the health care systems in Canada and the United States are often made by government, public health and public policy analysts.” What a turd!

Here’s something you might find interesting plewis, the most recent report cited among the three is from the Fraser Institute, a Canadian libertarian think tank. Among other things, Fraser turns our an annual report entitled “Waiting Your Turn: Wait Times for Health Care in Canada” The report documents how wait times have exploded in Canada’s medical paradise. The most recent report had the average wait time at 19 weeks! That is a 104-percent increase from 1993, according to the report.

Now of course you, being sciency and all, I’m sure already knew all this, that’s why you came here and so deftly used your superior knowledge. It’s not like your some knuckle dragger who takes specious arguments at face value before putting them through the intellectual grist mill, right?

I’ll say it again, what a turd!

RMOccidental on November 15, 2012 at 3:39 PM

Ambulatory surgical centers

This model has already been in place for decades in the health care market, but doesn’t get much attention in reform discussions.

A little known aspect to the passage of ObamaCare was the fact that in order to get the AHA on board as supporting it, they had to limit the startup of new ambulatory surgical centers because hospitals were losing too much money to the competition. New centers cannot be built unless they completely forgo federal money like Medicare/Medicaid. Can you spell crony capitalism? I knew you could.

txmomof6 on November 15, 2012 at 3:40 PM

This is pretty much what the health care system looked like before Medicare. Insurance was used only for the most expensive cases, and was called “major medical,” A routine physical cost $10 and a night in the hospital was about $25.

My father was an anesthesiologist from 1945-1985, so he spent half of his career in a mostly direct-payment system and half in the third-party-payer world. By the time he retired in 1985, his charges were 5 times what they had been in 1965. I can only imagine what anesthesia charges are now. Most of it happened after 1974, when his malpractice insurance quadrupled, and the IRS made him hire a collector to collect overdue bills and denied most of his writeoffs of bills for poor patients.

Almost no insurance policies cover orthodontia, yet there are orthodonists in almost every town in America and people find a way to afford it when they or their kids need braces. I paid for my daughter’s complicated and lengthy orthodontia over 5 years, but I managed it.

It’s ridiculous to think that Americans could not shop around for health care or that there is nothing wrong with our current system except that too many people don’t have insurance.

rockmom on November 15, 2012 at 3:41 PM

The cash method is one way to get back more to treating health insurance as insurance not wealth transfer mechanism. It would be the most reasonable way to take care of routine type medical care for most people which would leave the more costly treatments to be handled via, perhaps, bad news insurance which because it only covers for the most part the financially destructive illnesses.

Catastrophic insurance, because those kinds of illnesses happen to only a fraction of a given population, tends to be much cheaper because the insurance does not cover routine this or routine that with all the attendant need to monitor and control (for the bottom line if nothing else).

If there were a situation where someone was literally uninsurable for a major illness for whatever reason, they would form a very small part of the population and that would likely be manageable via some government program of some kind.

No system of health care or insurance (private or government) is going to be perfect and if the demand is that the system must be perfect (or as close as possible) then other alternative that may do a good enough job will get rejected.

Russ808 on November 15, 2012 at 3:10 PM

This works in theory, but in real life, not so much. Concierge medicine might work for routine doctor visits. For surgery or trauma or oncology treatments, not so much.

txmomof6 on November 15, 2012 at 3:43 PM

I’m sure that a very small number have a very big problem. But we didn’t need a 2,700-page monstrosity to address it. Yet too many Dems shed too many tears over a problem that’s not that widespread.

BuckeyeSam on November 15, 2012 at 2:51 PM

Remember when lefties told us we had a “moral imperative” to pass Obamacare, because tens of millions of Americans didn’t have health insurance?

Well the CBO now says that even after Obamacare is fully implemented, there will still be over 30 million Americans who are uninsured. Meanwhile, everybody else’s health care and health insurance costs will be going through the roof — because of Obamacare.

Heckuva job, Barry!

AZCoyote on November 15, 2012 at 3:45 PM

Double the number of medical schools.

kunegetikos on November 15, 2012 at 2:55 PM

Let it be like Kennedy’s moon talk, or Reagan’s star wars talk, if it helps the folks to get behind it.

kunegetikos on November 15, 2012 at 2:57 PM

Good luck with that. Where will you find the doctors to teach at the medical schools or to staff the residency programs? Where will you get the patient load to justify the number of cases that are required to train a doctor adequately? And even if you could wave a magic wand and double the slots, it still takes a minimum of 8 years to get someone from graduation from college to practicing medicine in a general field of medicine so what do you do in the meantime?

txmomof6 on November 15, 2012 at 3:47 PM

Sorry that should have been 7 years not 8 (4 medical school, 3 year residency).

txmomof6 on November 15, 2012 at 3:48 PM

Interesting… I wonder how it works when there is a surgery-related complication (which do happen) – specifically the doctor-patient relationship – when $ is on the line?

Here in MN, there are ER physicians starting a primary urgent care model called the Urgency Room which I assume is based upon a similar model.

It’s only a matter of time when inclined internal medicine physicians and sub-specialists start to manage patients like this for medically related conditions. Hospitalists are currently driving more efficient in hospital management of medical problems currently… When they can cut out the administrative and union costs??? Who knows – the sky’s the limit.

Only caveat it that sometimes patient medical problems are tenuous such that even if they are managed appropriately, that their hospital stay will be prolonged and more costly – those people, typically elderly, will not have the financial resources to pay for a 10 day hospitalization – e.g. a 65yo man with a very bad heart attack who lands in the intensive care unit requiring extensive support. This type of problem would need consideration – but then again, perhaps not.

People who become critically ill select themselves from the market because they often do not pick & choose where they would like to go online – from an ambulance – if they’re unconscious. Usually you would need outpatient physicians working with this type of system directly counseling patients & seeing patients more frequently to triage the problematic ones before they can get critically ill.

A benefit, you wouldn’t see any union employees working within this model. Good. Screw unions. (Seriously.)

Regardless of the problems for general medicine, if people know that they can select for more efficient care out of pocket, perhaps they can anticipate for this with health savings accounts that would be tax-free for them.

To all of my liberal clinical colleagues who say, “I don’t mind paying more taxes, so long as others pay more as well…” there are those of us who will be soon saying, “Screw you…” plus either “I’m retiring.” or “You can work for free then seeing all of these new patients because I won’t. There is a more efficient way to practice medicine….” the latter response, being one of those physicians $~$200,000 in student loans, I wouldn’t mind saying in order to pay them back more quickly in order to be able to securely provide a future for my children AND retire comfortably.

Danny on November 15, 2012 at 3:50 PM

Put this in the wrong thread.

Outcomes? Ask Liam Neeson. Canadian hospitals lack the necessary diagnostic equipment because of rationing. So his wife, Natasha, died:

Since you libs love anectodal evidence so much

Her body had to come to the US so they could figure out what happened to her.

PastorJon on November 15, 2012 at 3:10 PM

Sorry to say – this story is not a valid indictment of Canadian medicine (there are plenty of others though). In this case, she refused medical help for several hours because she felt fine. When the bad headache started, she finally went to see a doctor but by then it was too late. So this was just not a case of poor Canadian medicine.

BTW – Here in the US (Maine) my Dad had a stroke about 6 years ago – instant throbbing headache and loss of vision in both eyes. My Mom got him to the ER fast, and after awhile they gave him tylenol for his headache and told him to go see an opthamologist about his sudden loss of vision – and sent him home. The opthamologist diagnosed the stroke and sent him back to the ER. He survived the stroke with no major paralysis, but it was too late to save his eyesight.

I had the same concern for my son a year ago. He was attacked on the street in a college town 2 hours away from us – hit in the back of the head with a bicycle U-lock – but he didn’t tell us until the next morning when he still had concussion symptoms. I told him to go to the ER immediately, where he got a CT scan that luckily indicated no real damage (like Natasha had). BTW – the ER visit and CT scan cost over $2000 – glad we had decent medical insurance.

dentarthurdent on November 15, 2012 at 3:49 PM

dentarthurdent on November 15, 2012 at 3:58 PM

Obama will squash this quicker than Petreaus testifying. How and why?

2 tier medicine is not in the plan. ALL DOCTORS will participate in Obamacare. Good luck to those that have just opened their own surgical centers. Hope you got your tax write off because THAT is going away too.

It comes down to the same thing that got Obamacare as the law of the land: Commerce clause. The regulation of doctors will occur because one doctor who is in private practice in TX will have an impact on the doctors in a government program in NY.

Its true that the states are the ones that give the doctors their license to practice but Obamacare will make it a federal license that is needed, citing commerce clause – that the drugs used are cross border, the 10 panel judgment of life/death is the end result and all must bow down to that, so its not a state issue anymore.

To be a doctor? You’ll have to be have a federal license.
Or you won’t be able to practice.

athenadelphi on November 15, 2012 at 4:03 PM

it still takes a minimum of 8 years to get someone from graduation from college to practicing medicine in a general field of medicine so what do you do in the meantime?

txmomof6 on November 15, 2012 at 3:47 PM

I understand you. But isn’t this like the moonbat argument against energy? If we would just do it, in 8 years it would be DONE.

kunegetikos on November 15, 2012 at 4:03 PM

Quick Question I posed in another thread. . . if Obamacare is a tax, then shouldn’t we keep track of how much we are charged for our insurance and how much money we actually spend in a year for medical care, and if we are paying more than we are utilizing shouldn’t we file for a refund via the IRS?

cmsciulli on November 15, 2012 at 4:03 PM

kunegetikos on November 15, 2012 at 2:57 PM

Good luck with that. Where will you find the doctors to teach at the medical schools or to staff the residency programs? Where will you get the patient load to justify the number of cases that are required to train a doctor adequately? And even if you could wave a magic wand and double the slots, it still takes a minimum of 8 years to get someone from graduation from college to practicing medicine in a general field of medicine so what do you do in the meantime?

txmomof6 on November 15, 2012 at 3:47 PM

Also, where will you get the med students qualified to fill those expanded med school slots?
Look at the stats on how many students graduate from college in what kind of majors. As a percentage of all college grads, biological sciences and chemistry (necessary for med school) are a small percentage. We have the same problem with engineering and other hard sciences – too many kids are going for the easy fuzzy studies degrees and not willing to work hard enough for the hard sciences – which means you won’t find enough qualified students to fill all those new med schools.

dentarthurdent on November 15, 2012 at 4:07 PM

I understand you. But isn’t this like the moonbat argument against energy? If we would just do it, in 8 years it would be DONE.

kunegetikos on November 15, 2012 at 4:03 PM

It doesn’t matter how many slots there are if all of the students aim to go into a specialty because they get paid more. Who do you force to go into general medicine? The ones who are too stupid to cut it on the specialty track? That’s who I want as my primary care doctor!

Night Owl on November 15, 2012 at 4:12 PM

To be a doctor? You’ll have to be have a federal license.
Or you won’t be able to practice.

athenadelphi on November 15, 2012 at 4:03 PM

And you’ll be forced to accept whatever maximum wage the gubmint declares you are allowed to get.

So to bring this back around to this suggestion:

Double the number of medical schools.

kunegetikos on November 15, 2012 at 2:55 PM

How many people do you think will want to go into a field that requires many years of school, very hard coursework, huge expense, and killer residency hours – only to be told your lieftime earnings will be capped and controlled by the federal government?

dentarthurdent on November 15, 2012 at 4:13 PM

It doesn’t matter how many slots there are if all of the students aim to go into a specialty because they get paid more. Who do you force to go into general medicine? The ones who are too stupid to cut it on the specialty track? That’s who I want as my primary care doctor!

Night Owl on November 15, 2012 at 4:12 PM

Well – matching up your argument with the ones I’ve posted – the easy answer is obviously – affirmative action. Qualifications and actual intelligence and capabilities don’t matter – just minority status – and viola – lots of new federal government approved doctors.
I think I’ll pass on the major surgery….

dentarthurdent on November 15, 2012 at 4:17 PM

RMOccidental on November 15, 2012 at 3:39 PM

You sir – win the thread.

As for the doctor education argument… my wife is in the 3rd year of a 4 year residency for Family practice/Neuromuscular medicine. She’s planning on doing a sports medicine fellowship.

It will be 9 years since she started this process when she finally is able to start being compensated more than a barely-more-than-minimum-wage worker. Meanwhile we have been making payments on her medschool debt that, at the apex was nearly $300k.

I’d say if you want more doctors, make medical education cheaper. Loans aren’t the issue… its the fact that you’re basically living paycheck to paycheck for a decade of your life that turns a lot of people off of training to become a doctor.

Defenestratus on November 15, 2012 at 4:28 PM

We could cover every uninsured American for a lot less than the cost of Obamacare. In fact, I’d probably support a pool for people who can prove that they’re unable to afford care.

But it’s clear that Obamacare isn’t really about saving money. If it was, it wouldn’t include so many regulations, guidelines, oversight boards and reporting requirements. All of those things add to cost.

hawksruleva on November 15, 2012 at 4:38 PM

This free market approach complete with price board has been around. In Florida, now Governor Rick Scott, started a walk-in emergency clinic called Solantis. Rick’s parents owned a donut shop, so in that style, Solantis had a “menu board” of services along with their prices. Setting a broken bone, x-rays, flu shots, etc. Because they are fee-for-service, prices are usually lower than most people’s insurance deductibles. Win! AND it frees up emergency rooms for the really traumatic patients.

Unfortunately, word is that Rick Scott, Governor of Florida, is going wobbly about refusing to set up exchanges for ObamaCare. All you from Florida, please contact him and tell him to say NO!!!

http://www.flgov.com/contact-gov-scott/email-the-governor/

parteagirl on November 15, 2012 at 4:45 PM

Free market medicine? For a quick idea check what the largest cause of bankruptcy declarations in America is. I won’t spoil the surprise but it might have something to do with the “best healthcare system on the planet”.

lester on November 15, 2012 at 1:56 PM

As mentioned above, one reason for this is classification of any bankruptcy where there is a balance of medical costs of about $1000 or more as a healthcare related bankruptcy, even if there was $20K in credit card debt.

In addition, most persons who do experience true health related bankruptcies do so despite having insurance, because of the 20% copay, which doesn’t max out and is based on the listed price, not the heavily discounted total that is billed to the insurer.

Also, the prices on the bill are very inflated for multiple reasons. a $2 aspirin would be cheap. It takes a lot of skill to negotiate the prices downward, and some facilities won’t even give a cash discount for self pay patients which is really unfair considering the discounts insurers get.

In the US, hospitals have to pay for administrators plus there are huge costs associated with all of the regulations that the hospitals must follow. Some are important and necessary. Others not so much. There are huge labor costs involved in the paperwork. Electronic records do little to reduce this burden. Electronic records are also very expensive. It costs $10,000′s per provider per year to maintain an electronic health record.

For instance, a transfer of a patient from an acute care hospital to a rehab facility might involve a 20 page form that the nurse must fill out. Thus, nurses can take care of fewer patients because they have so much paperwork to do.

Now that everything is done on computer, people working in hospitals become superspecialized, perhaps able to do one thing-monitor stress tests or draw blood or start an IV or collect the contaminated sharps containers or check patients in to the pre procedure unit, because they have to know how to use a computer program for everything they do. (It took 4 of us 20 minutes one day to figure out how to enter the order: daily PT/INR. call for coumadin dose-in many ways, paper was easier)

When you can’t cross train, your labor costs go up.

talkingpoints on November 15, 2012 at 5:48 PM

Well, all this is great, but Boehner is going to surrender. He already said ObamaTaxCare, is the “Law of the Land”. More “Dog & Pony Show”, from the eSTABrepubs & they’ll sell out Americans, Like They did on Fast & Furious. Like McCain in 2008, with evidence of Voter Fraud, he allowed the Dems to Double Down & 2012 has more eye witness accounts of Voter Fraud, than any Moron can count… and what are the eSTABrepubs, doing on the matter?

http://www.paratisiusa.blogspot.com

God Bless America!

paratisi on November 15, 2012 at 5:50 PM

It simply won’t work if Medicaid exists. Then everyone would be one it so they wouldn’t have to pay.

Check out the Australian system which runs a parallel public/private system and uses tax incentives to encourage people who can afford private health insurance to purchase it, while supporting the poor with a public hospital system, ‘bulk billing’ by many GPs and Medicare. Heck, there’s even a ‘Medicare Private’. It works pretty well, even though our current socialist government would tinker with it.

The Thin Man Returns on November 15, 2012 at 6:30 PM

The best healthcare sysrtem in the world – unless you consider stuff like outcomes, infant mortality and longevity. You know, medical stuff.

plewis on November 15, 2012 at 2:33 PM

Perhaps, if you find health care in America so lacking, you should consider moving to a country with “wonderful” health care.

That “medical stuff” is not going to improve under obamacare. It will, in fact, get appreciably worse.

Why wait? Emigrate now and avoid the rush.

Solaratov on November 15, 2012 at 7:44 PM

Trust me; the Obamacare juggernaut will make such common-sense businesses illegal.

The next step is a medical ship that sails out to international waters to do something radical; practice medicine absent massive bureaucracy.

michaelo on November 15, 2012 at 2:09 PM

Nah, it will happen on Indian Reservations much like the casinos operate now.

Theophile on November 16, 2012 at 4:43 AM

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