eliminate insurance. Pay as you go like a car repair shop. Make people more responsible for their own care. Stop being crash test dummies.
I was in the Queens ER once and there was a woman there because she didn't take her meds for her condition and her diet was horrible. She was rather large. She demanded a lot from the nurses and staff. Wipe toilet seat several times before she sat on it etc. and she bragged to her family how she demanded things from the ER staff.
Insurance is FUBAR because govt touched it. Govt aren't healthcare SMEs. They aren't trasnportation SMEs either (i.e. our stupid rail)

You think this congress critter is getting the same level of care as the rest of us?
https://www.foxnews.com/politics/nancy-pelosi-announces-major-surgery-after-fall-germany

What would happen if you fell overseas and required med care?

A good doctor should make around the same amount as a good plumber.

pelosi is getting health care at our tax dollar expense.

Which means a suite, Wynn quality bed and sheets, private chef, and a side table with her favorite spirits, hors d ovaries, and crack.  Hunter will drop by to provide the latter.

What would happen if you fell overseas and required med care?

Probably get dumped in an alley somewhere when nobody's looking.......

Oh wait.  I heard in some places in the US we do the exact same thing if you have no insurance....(or not enough)

What would happen if you fell overseas and required med care?

Not as simple as one might assume.

If you're a US citizen on government business in a country with US military facilities like a base with a hospital, you have the option to get treatment there. 

If you're a tourist and have no US Diplomatic or other government position, you can contact the consulate/embassy if there is one and possibly be allowed to use local US medical facilities.

if none of that applies, then you use the local medical services, pay out of pocket (usually needed up-front), and file a claim with your insurer.

i've seen stories of US tourists in Mexico waiting in an ER until a friend or family member wires the funds to the hospital before they were treated. 

The level of care provided will normally be the minimal needed to safely travel back home where your regular healthcare services will follow up.

On one of my trips to Japan as a civilian contractor, I was on military orders and staying in a government-reimbursed hotel.  I went to the Yokosuka Naval Base hospital one night to get checked out.  I gave them my insurance info with Kaiser HMO, but i never heard anything from Kaiser nor the Navy seeking any money.  i assumed Kaiser covered it as an out of network ER visit.  It's possible the Navy covered it since I was on government orders.

Most countries in which the US has a permanent presence have a SOFA -- Status of Forces Agreement.  It outlines the services and courtesies the two countries can expect the other side to provide to each other's citizens associated with their official duties.  That includes law enforcement, legal and medical situations.

There are no permanent US facilities in Luxembourg other than an embassy.

Depending on what country you can pay out of pocket for elective surgeries, get a luxurious vacation, and still pay only a fraction of what you would in the US.

just a coincidence?


https://youtu.be/UqnNrRBefhY?t=450

Taiwan Healthcare example: Don't read too much into this as this is based on XP and asking questions. I haven't read the "law".

My grandmother in law had to get her annual. It's like the DMV. You show up and wait in line. If you're not seen by X time, you need to come back tomorrow. So she was at the hospital from 4am or so waiting. She was seen at 2pm.  She also had a small paper bag of RX's. Everything was free.

A youtuber we watch was in Taiwan with her parents. Her father is a foot doctor in the US. He had a shoulder problem for years. He went to their hospital and saw a doc, then immediately went upstairs to do an xray. THen back down and the doc told him what's up.  Cost was about $80 total or so for Xray and doc visit.  As a foreigner, he had to pay out of pocket.  He said that the cost in the US would have easily been $800 and a longer wait for someone with no insurance. He was amazed at the speed and quality and cost of care.  The YTer's are husband and wife and are haloe and both speak mandarin. Hailey Jane is her channel. She has a Taiwan focus channel.  SHe and her husband live in the US but love Taiwan.  Even her brother and sister have taken Mandarin and they're in middle to high school.

Being CAPT Obvious, I've long detested the "healthcare industry", which only serves to make the execs in that industry rich.  Not the doctors and the patients suffer.  I mean I get protocols to ensure money is being spent wisely, but removing discretion from doctors because of protocol or policies is stupid.  I have damaged nerves in my back because I had to wait a few days to even see a specialist, then more days for MRI to be cleared, then weeks for PT, then more weeks for surgery to get cleared. 

I have close friends that used to be part of that industry, including HMSA and other national level companies of whatever they call them.  93/7. . . such a crock

And no, I have no ill will for the HMSA CEO. . .

This is the question, how do we have better health insurance and prices without having the long waits that "free healthcare" countries have.

Then another thing we need to do is keep our people healthy. We have the most gyms and options, yet the USA is the fattest. This should be a separate thread, but I just wanted people to think about this.

The best thing we can do right now since the health care industry is so full of shiite is to try to be as healthy as we can be.

I mean it sucks if you already have crossed that threshold of chronic illness and disease, but if you're not there yet it's best to take measures so you don't get there.

And even if you have crossed that threshold, you still can improve your health by making smart choices.

The best thing we can do right now since the health care industry is so full of shiite is to try to be as healthy as we can be.

I mean it sucks if you already have crossed that threshold of chronic illness and disease, but if you're not there yet it's best to take measures so you don't get there.

And even if you have crossed that threshold, you still can improve your health by making smart choices.

The US has largely become a nation of "well intentioned" people, with little follow through, or lower percentage of people who follow through.

Case in point one of my best friend's mom is obese.  She talks all the time about getting more exercise, how she needs help getting started or with opportunities, etc.  During COVID, I bought a few home exercise machines (bike, row, etc).  She asked me to order a similar bike for her via Amazon.  Done, shipped to house. Son assembled and is now used to hang laundry.  My BJJ academy was regularly putting on self defense classes for women.  I bought tickets for one of those events and offered to friends.  My friend's mom said she was in, so I gave her a ticket.  She would tell us "what? I'm tough you know".  A couple of days before the event, I get a text from her other son (also a close friend) that she's out.  No explanation, nothing.  She wants to be healthier, but does nothing to start.  It sounds nice to have those intentions I guess. . .

Being CAPT Obvious, I've long detested the "healthcare industry", which only serves to make the execs in that industry rich.  Not the doctors and the patients suffer.  I mean I get protocols to ensure money is being spent wisely, but removing discretion from doctors because of protocol or policies is stupid.  I have damaged nerves in my back because I had to wait a few days to even see a specialist, then more days for MRI to be cleared, then weeks for PT, then more weeks for surgery to get cleared. 

I have close friends that used to be part of that industry, including HMSA and other national level companies of whatever they call them.  93/7. . . such a crock

And no, I have no ill will for the HMSA CEO. . .

That's not completely true.  All of these big healthcare companies have their ownership traded on the open market.  When a company is prosperous, the shareholders also make money.

The fact that CEOs make millions is no different than when a film company hires a big name movie star.  The money atracts the talent.  if Kaiser can't or won't pay top dollar for the person who knows how to run a profitable business, HMSA or Sentara will.  An experienced  CEO is not going to come cheap, and it's normally seen as an investment in the organization.  Top executives also get paid pretty nice salaries.  But the bottom line is the bottom line. 

Individuals, mutual funds and corporate retirement funds make money from these types of investments, building wealth for workers to retire, buy a home, send kids to school or just weather hard times.  We no longer live in an economy where only the wealthy play the stock market.  And the companies who sell stock understand they have a responsibility to the shareholders to earn a profit.  They also understand the mass of people they employee would like to continue being employed.

Thinking of a healthcare CEO like he's the only person making bank from keeping prices and claims within affordable ranges is a narrow view of how and why these companies operate like they do.

In my graduate class on Managerial Accounting, we studied an article written about hospital allocation of costs called "The 10 dollar aspirin."  It was a method many hospitals used to assign cost to everything they provided to patients.  The cost of utilities, disposable water cups, plastic water cups, the pharmacist dispensing the aspirin, the doctor prescribing the drug, the warehouse worker who handled the cases of aspirin, the administrator who ordered the aspirin, the accountant who added the aspirin to your bill, the nurse who brought you the aspirin and even the janitor who had to take your disposable water cup or packaging the aspirin came in to the dumpster all had to be allocated to your account somehow.  Those things don't happen for free, and there's no "miscellaneous" or "overhead" category the insurance will cover.  So that aspirin you took gets a small portion of all the costs associated with it tacked onto your bill as part of that medication's net cost.

If they didn't operate like this, they'd be losing money. as they would be unable to bill for more than actual cost of supplies and services.  When you take a car to a repair shop, they itemize the parts and service as well as add fees for shop towels, hazardous waste disposal, and other services that are necessary but not specific to the work performed.  Hospitals aren't allowed to do that as one patient might cost much more in certain "side services" versus other patients.  And since patients don't all use the same insurance company or use public assistance (Medicaid, Medicare), the costs would not be born fairly between payers.

Anyway, that's a "tip of the iceberg" view as to why profits are necessary for these companies.  That doesn't even touch on services like helicopter ambulances, top-rated  surgeons, or preventative care for patients that represent an on-going expense.  Without a great CEO at the helm, nobody would be happy with their healthcare costs or outcomes.

The best thing we can do right now since the health care industry is so full of shiite is to try to be as healthy as we can be.

I mean it sucks if you already have crossed that threshold of chronic illness and disease, but if you're not there yet it's best to take measures so you don't get there.

And even if you have crossed that threshold, you still can improve your health by making smart choices.

^^^This.  But some things don't help. WHich is why I'm excited if RFK is able to get rid of artificial coloring. Other countries ban them totally.
 
This is why I don't trust real doc comrade green. During covid, he never stressed losing weight.  I've talked to many RN's and even respitory nurses and most the young people in the hospital cause covid jacked them up were fat.  Instead, comrade stressed to get the vaxx.  Most of my under 40 friends who got covid and got jacked up by it,were all fat.

That's not completely true.  All of these big healthcare companies have their ownership traded on the open market.  When a company is prosperous, the shareholders also make money.

The fact that CEOs make millions is no different than when a film company hires a big name movie star.  The money atracts the talent.  if Kaiser can't or won't pay top dollar for the person who knows how to run a profitable business, HMSA or Sentara will.  An experienced  CEO is not going to come cheap, and it's normally seen as an investment in the organization.  Top executives also get paid pretty nice salaries.  But the bottom line is the bottom line. 

Individuals, mutual funds and corporate retirement funds make money from these types of investments, building wealth for workers to retire, buy a home, send kids to school or just weather hard times.  We no longer live in an economy where only the wealthy play the stock market.  And the companies who sell stock understand they have a responsibility to the shareholders to earn a profit.  They also understand the mass of people they employee would like to continue being employed.

Thinking of a healthcare CEO like he's the only person making bank from keeping prices and claims within affordable ranges is a narrow view of how and why these companies operate like they do.

In my graduate class on Managerial Accounting, we studied an article written about hospital allocation of costs called "The 10 dollar aspirin."  It was a method many hospitals used to assign cost to everything they provided to patients.  The cost of utilities, disposable water cups, plastic water cups, the pharmacist dispensing the aspirin, the doctor prescribing the drug, the warehouse worker who handled the cases of aspirin, the administrator who ordered the aspirin, the accountant who added the aspirin to your bill, the nurse who brought you the aspirin and even the janitor who had to take your disposable water cup or packaging the aspirin came in to the dumpster all had to be allocated to your account somehow.  Those things don't happen for free, and there's no "miscellaneous" or "overhead" category the insurance will cover.  So that aspirin you took gets a small portion of all the costs associated with it tacked onto your bill as part of that medication's net cost.

If they didn't operate like this, they'd be losing money. as they would be unable to bill for more than actual cost of supplies and services.  When you take a car to a repair shop, they itemize the parts and service as well as add fees for shop towels, hazardous waste disposal, and other services that are necessary but not specific to the work performed.  Hospitals aren't allowed to do that as one patient might cost much more in certain "side services" versus other patients.  And since patients don't all use the same insurance company or use public assistance (Medicaid, Medicare), the costs would not be born fairly between payers.

Anyway, that's a "tip of the iceberg" view as to why profits are necessary for these companies.  That doesn't even touch on services like helicopter ambulances, top-rated  surgeons, or preventative care for patients that represent an on-going expense.  Without a great CEO at the helm, nobody would be happy with their healthcare costs or outcomes.

Add in R&D cost for pharm companies. Which is part of the reason why 1 pill cost a lot.  How many other pills didn't make it to the market and how much did it cost them?  But in the end, both are making more than enough profit that if they really wanted to help more people, then they could. But now I'm sounding like a socialist. Which is why I asked how do we get the best of both worlds. 

Personal XP: I had a sharp pain in my throat and my PCP sent me to get an ultrasound. Guess what, my carrier denied it as it wasn't necessary.  I had to pay $700 out of pocket. Luckily, I could afford this. But I can imagine that there are others who live paycheck to paycheck.  The ultrasound came back negative as no mass was detected. So my PCP ruled out cancer or an ulcer type. Then she sent me to a throat specialist. By the time I got to him, which was about 3 weeks later, the pain was gone. He said it's from dehydration. Which makes sense because I explained that it happened once before and this was the 2nd time, which is why I went to a doctor. And each time was after coming back from Vegas when I don't drink my normal 1 gal of water due to not carrying a jug with me.  All trips since I've made it a point to order lots of bottle water when the waitress comes by and it hasn't returned.

So now my liver and kidney ALT/AST levels are elevated after coming off a cold. My PCP said it's common, but wanted to do a ultrasound because I've had elevated AST/ALT levels in the past that were corrected with OTC liver support supplement. She wants to see if my liver is fatty. My piss is light yellow and not frothy. I have no lower back pain. I told her that I'm going to hold off until I get another symptom of a fatty liver like dark urine, frothy urine, lower back pain, yellowing of eyes and skin,  etc...because I don't want to pay another $700 out of pocket. I haven't had the time to call my medical carrier to see if this would be covered.

That's not completely true.  All of these big healthcare companies have their ownership traded on the open market.  When a company is prosperous, the shareholders also make money.

The fact that CEOs make millions is no different than when a film company hires a big name movie star.  The money atracts the talent.  if Kaiser can't or won't pay top dollar for the person who knows how to run a profitable business, HMSA or Sentara will.  An experienced  CEO is not going to come cheap, and it's normally seen as an investment in the organization.  Top executives also get paid pretty nice salaries.  But the bottom line is the bottom line. 

Individuals, mutual funds and corporate retirement funds make money from these types of investments, building wealth for workers to retire, buy a home, send kids to school or just weather hard times.  We no longer live in an economy where only the wealthy play the stock market.  And the companies who sell stock understand they have a responsibility to the shareholders to earn a profit.  They also understand the mass of people they employee would like to continue being employed.

Thinking of a healthcare CEO like he's the only person making bank from keeping prices and claims within affordable ranges is a narrow view of how and why these companies operate like they do.

In my graduate class on Managerial Accounting, we studied an article written about hospital allocation of costs called "The 10 dollar aspirin."  It was a method many hospitals used to assign cost to everything they provided to patients.  The cost of utilities, disposable water cups, plastic water cups, the pharmacist dispensing the aspirin, the doctor prescribing the drug, the warehouse worker who handled the cases of aspirin, the administrator who ordered the aspirin, the accountant who added the aspirin to your bill, the nurse who brought you the aspirin and even the janitor who had to take your disposable water cup or packaging the aspirin came in to the dumpster all had to be allocated to your account somehow.  Those things don't happen for free, and there's no "miscellaneous" or "overhead" category the insurance will cover.  So that aspirin you took gets a small portion of all the costs associated with it tacked onto your bill as part of that medication's net cost.

If they didn't operate like this, they'd be losing money. as they would be unable to bill for more than actual cost of supplies and services.  When you take a car to a repair shop, they itemize the parts and service as well as add fees for shop towels, hazardous waste disposal, and other services that are necessary but not specific to the work performed.  Hospitals aren't allowed to do that as one patient might cost much more in certain "side services" versus other patients.  And since patients don't all use the same insurance company or use public assistance (Medicaid, Medicare), the costs would not be born fairly between payers.

Anyway, that's a "tip of the iceberg" view as to why profits are necessary for these companies.  That doesn't even touch on services like helicopter ambulances, top-rated  surgeons, or preventative care for patients that represent an on-going expense.  Without a great CEO at the helm, nobody would be happy with their healthcare costs or outcomes.

I didn't say anything about just the CEO.  I get companies, individuals, etc are (or can be) driven by money.  Not saying that healthcare companies can't make money/profits.  However, when do things cross the line between primarily for improving healthcare for the patients (who pay the premiums), or even the doctors, vice primarily (not only, or maybe mostly) benefitting the execs?  I used to be very close to a group of doctors and they'd have very long conversations about this occurring.  Both locally and nationally, with many comparisons to healthcare service (not industry) in other countries.  Did I do my own independent research on Google? Not much. . .

I am

I didn't say anything about just the CEO.  I get companies, individuals, etc are (or can be) driven by money.  Not saying that healthcare companies can't make money/profits.  However, when do things cross the line between primarily for improving healthcare for the patients (who pay the premiums), or even the doctors, vice primarily (not only, or maybe mostly) benefitting the execs?  I used to be very close to a group of doctors and they'd have very long conversations about this occurring.  Both locally and nationally, with many comparisons to healthcare service (not industry) in other countries.  Did I do my own independent research on Google? Not much. . .

I am

Did I take your statement, "which only serves to make the execs in that industry rich," too literally?

It's not just money that drives people, but what money provides -- unless they are just misers.  Money provides a lifestyle, generational wealth, stability, security, opportunities and so on.  Money is a placeholder -- a way to assign value to labor, talent and output. 

I'm sure there needs to be a degree of philanthropy by wanting to heal and ease suffering, and lots of doctors donate time to clinics and projects without compensation.  But getting where they are required at least some sacrifice -- some more than others. 

One of the scary parts of universal healthcare is there's no incentive for doctors to make those sacrifices. They are forced to treat patients at whatever rate the government decides.  That's moving into socialism, where the doctors are treated as public property forced to provide services to patients whether they want to or not.  The next logical problem will be solved by spending whatever money gov't saved on healthcare to lure people in to becoming doctors.

SNIP

1) I'm sure there needs to be a degree of philanthropy by wanting to heal and ease suffering, and lots of doctors donate time to clinics and projects without compensation.  But getting where they are required at least some sacrifice -- some more than others. 

2) One of the scary parts of universal healthcare is there's no incentive for doctors to make those sacrifices. They are forced to treat patients at whatever rate the government decides.  That's moving into socialism, where the doctors are treated as public property forced to provide services to patients whether they want to or not.  The next logical problem will be solved by spending whatever money gov't saved on healthcare to lure people in to becoming doctors.

1) I personally wouldn't expect philanthropy from anyone, but definitely would be helpful.  Same/similar for many professions where the purpose/intent is care, development, etc of others.  Like teachers.  My mom used to spend a bunch of own money for her classes.  Her personal values, which I know and hope more doctors do the same. 

2) And that's more to what I was getting at.  Where (IMO) the industry got twisted by people away from healthcare to wealth (generational, personal, etc), influence, power, whatever.  Where it's the patients, who need the care and in many cases already paid into the system for that care in the form of insurance.  And doctors who in many cases have to settle for what insurance companies dictate.  I don't know all the details about what goes in/out, but based on principle. Maybe I'm the naive one here, but just stinks when I've been personally affected.

For my back surgery, my spine dr flat out said prior to a recent change in coverage, rules, etc (maybe 6-12 months before seeing me), that he could have had me in surgery 1-2 days after the complete eval, which was within a week of injury.  Where time was/is key factor.  Then to find out that this is pretty common occurrence recently. 

Anyways, yeah, I'm salty at medical insurance industry. . . still wouldn't harm anyone.  Well, other than some "harsh language" over drinks with one close friend who is still in the industry. . . then come to find out many in the group had similar experiences or felt the same. . . . 

The US has largely become a nation of "well intentioned" people, with little follow through, or lower percentage of people who follow through.

Case in point one of my best friend's mom is obese.  She talks all the time about getting more exercise, how she needs help getting started or with opportunities, etc.  During COVID, I bought a few home exercise machines (bike, row, etc).  She asked me to order a similar bike for her via Amazon.  Done, shipped to house. Son assembled and is now used to hang laundry.  My BJJ academy was regularly putting on self defense classes for women.  I bought tickets for one of those events and offered to friends.  My friend's mom said she was in, so I gave her a ticket.  She would tell us "what? I'm tough you know".  A couple of days before the event, I get a text from her other son (also a close friend) that she's out.  No explanation, nothing.  She wants to be healthier, but does nothing to start.  It sounds nice to have those intentions I guess. . .

Yes, the committment to better health has to come from the individual.  I want my wife to be healthier and to outlive me.

Out of concern for her health I bought her an elliptical machine.

Guess who is using it now and guess who doesn't even give it a glance, LOL!!

Ever since I retired, I made the commitment to get healthier.  Since I have more time than money nowadays, I am pretty successful so far.

Now I just have to keep at it and gently coax my wife to join me so we both can live to 150 years old.

Yes, the committment to better health has to come from the individual.  I want my wife to be healthier and to outlive me.

Out of concern for her health I bought her an elliptical machine.

Guess who is using it now and guess who doesn't even give it a glance, LOL!!

Ever since I retired, I made the commitment to get healthier.  Since I have more time than money nowadays, I am pretty successful so far.

Now I just have to keep at it and gently coax my wife to join me so we both can live to 150 years old.

The best results I got so far were from cutting out seed oils.
BlackRock, State Street, and Vanguard own most of the healthcare industry AND food supply.
In other words they sell both the disease AND the cure.
Learn to read labels.

Yes, the committment to better health has to come from the individual.  I want my wife to be healthier and to outlive me.

Out of concern for her health I bought her an elliptical machine.

Guess who is using it now and guess who doesn't even give it a glance, LOL!!

Ever since I retired, I made the commitment to get healthier.  Since I have more time than money nowadays, I am pretty successful so far.

Now I just have to keep at it and gently coax my wife to join me so we both can live to 150 years old.

Yeah, I think consistency is key.  Can't force someone to be more active, they have to want it or something happens to force them.  My dad was largely 'stay at home and cruise' mode later in his life and that certainly had an impact on his physical health, and deterioration in the later years.  That said, I am positive he enjoy most of that time in his own way.  I am guessing retired life does have many advantages.