Monday, August 01, 2011

Safeway to Open 100 Retail Clinics in California


"Although there is no official announcement yet, Mer­chant Medicine has learned that Safeway is building retail clinics in its stores in California, from the Bay Area to south of Los Ange­les. We have learned from our sources that the company could have plans for 100 or more clin­ics. Some are nearly completed, and furniture has been ordered. Based on one of the building per­mits we reviewed online, which listed the clinic at 399 square feet, we anticipate that retail clinics will open inside Safeway stores this fall. A spokesperson for Safe­way was not immediately avail­able for comment.

We were unable to confirm who will operate the clinics. Given California’s tough corpo­rate practice of medicine laws, it is unlikely Safeway will operate the clinics themselves through a wholly owned sub­sidiary, as is done by Target, CVS, Walgreens and Kroger. Among the options would be local area phy­sicians, regional multispecialty groups, or national or regional health systems."

42 Comments:

At 8/01/2011 8:39 PM, Blogger Larry G said...

the thing that would supercharge this kind of medical service would be the implementation/use of a common electronic medical record so that no matter where you went, they'd have immediate access to your complete medical history which would aid them in diagnosis and treatment and help reduce errors/duplication of prescriptions and allergies.

I think the private sector is capable of doing this.. after all.. we do have an electronic banking system/ATMs, cell phone networks, etc..... but for some reason, we still don't have a universal (optional, voluntary) medical record that belongs to us and we determine who can access it and for what purpose.

It would be especially helpful if you end in a an ER far from home, unconscious and time short for diagnosis and treatement.

 
At 8/01/2011 10:11 PM, Blogger Benjamin said...

I agree with Larry G. We have to re-think health care. Seems to me many diagnoses could be made by standardized tests, by a nurse-type professional. Also, we need euthanasia for many elderly.

On the other hand, OECD nations spend half what we do on health care and have greater life expectancy. Japan spends one-quarter and has greater life expectancy than OECD nations.

The less spent on health care the better.

 
At 8/01/2011 10:13 PM, Blogger Larry G said...

" The less spent on health care the better. "

If we presume that the countries that spend the least on health care are the best - could we name the TOP 5 with the LEAST expenditures for health care?

:-)

 
At 8/02/2011 2:55 AM, Blogger Ron H. said...

"I think the private sector is capable of doing this.. after all.. we do have an electronic banking system/ATMs, cell phone networks, etc..... but for some reason, we still don't have a universal (optional, voluntary) medical record that belongs to us and we determine who can access it and for what purpose."

But we don't have universal banking records, or universal cell phone records, and there's no reason to have them.

The reason there aren't universal medical records, isn't a technical problem, but a question of need. If there was demand - except from you - for a universal, voluntary, free market medical records system, it would already exist.

Your belief that great benefits would result from such a system, apparently isn't a view shared by very many people.

 
At 8/02/2011 9:11 AM, Blogger Larry G said...

We DO have what amounts to a universal banking system DUDE when ANY MERCHANT can consult a universal database to check your credit. We DO HAVE essentially a UNIVERSAL phone system where you can call anyone regardless of which system they are on with a land-line or cell.

We DO have MANY systems that operated off of shared universal databases precisely BECAUSE there is a NEED.

and your lame idiocy towards the concept in general is a FAIL everytime.

People NEED universal medical records so THEY have the FREEDOM to pick any provider whether it be Safeway or a new Primary Care -which would be simple with a universal medical record.

when you are passed out in an ER -a universal medical records is a NEED.

When you go to a new physician who wants to prescribe you a drug - he/she NEEDS to see what drugs you currently are taking and in what doses and whether any where discontinued because they did not work or you could not tolerate.

You are so a fool on these things... it's pitiful.

Universal Medical Records would empower a more free, more competitive market.

 
At 8/02/2011 9:22 AM, Blogger morganovich said...

"If there was demand - except from you - for a universal, voluntary, free market medical records system, it would already exist."

ron-

actually, i think it's a bit more complex than that. HIPPA rules etc make it damn near impossible for such a system to emerge. the rules are so complex and contradictory and requirements so absurd, that no private system can evolve, especially as these rules change all the time.

larry-

you do realize that you can already have that if you just keep your own records, yes?

this is how people keep records for cars, homes, and taxes.

just make sure you ask for copies of all your records.

the market for auto repair is plenty competitive with people keeping their own records.

 
At 8/02/2011 9:32 AM, Blogger morganovich said...

"The less spent on health care the better."

that's an absurd statement.

rich people can spend more on health. that's a good thing.

the problem is that our insurance structure encourages us to massively overconsume because it's essentially a buffet. pay to get in, and pig out.

the real answer is to move the whole system to cash pay and let people make their own choices.

insurance should cover major emergencies, not basic care. car insurance doesn't cover getting your car washed or oil or belts changed or replacing the transmission you stripped.

homeowners insurance doesn't cover replacing your dishwasher because yuo want a new one.

the problem is that our "health insurance" is not "insurance" at all.

life expectancy is not comparable across the OECD. it is not calculated the same way. the US counts preemie deaths, no one else does. americans drive more, and so die more.

it's a poor gauge of the effectiveness of a health system.

premature infant survival is MUCH higher in the us. so is cancer survival.

we just need cash pay to bring costs down. you can get a $1000 MRI instead of a $4000 one, but no one bothers to shop around because they hit their $500 deductible either way and don't care.

the european models are mostly going bankrupt.

the model most worthy of emulation is singapore.

the whole system is cash pay with HSA's. you make your own choices. there is true "insurance" in case you get hit by a car or whatever, but mostly it's just a free market.

medicine is predominantly a technology business. it's costs should be dropping, not going up at multiples of inflation.

only introducing the price signal so that users pay can make that happen.

 
At 8/02/2011 9:58 AM, Blogger Larry G said...

". HIPPA rules etc make it damn near impossible for such a system to emerge. the rules are so complex and contradictory and requirements so absurd, that no private system can evolve, especially as these rules change all the time."

BS Morg.

They are used by the VA and they are going to be mandatory in Medicare shortly.

besides.. that's not the argument dejure being given..anyhow. If that was the problem then the industry would say so like they have with other things like cell phone frequencies and other regs.

Having your "own" records is your "own" format and content is not a solution.

It would be like you showing up at WalMart bringing your own "records" for them to look at and then write the prescription.

If you've noticed, WalMart has their own system for recording prescriptions INCLUDING being able to share the info with other pharmacies including transferring them so there already ARE some electronic sharing of info at the drug store level and I don't see HIPPA stopping that.

HIPPA is not the problem...more likely the excuse.

 
At 8/02/2011 10:11 AM, Blogger Larry G said...

" the problem is that our insurance structure encourages us to massively overconsume because it's essentially a buffet. pay to get in, and pig out."

I actually agree with much that you say...except for this for sure:

"the model most worthy of emulation is singapore.

the whole system is cash pay with HSA's. you make your own choices. there is true "insurance" in case you get hit by a car or whatever, but mostly it's just a free market."

to say this is ludicrous when the govt MANDATES a 33% paytoll tax which is WHERE people get their money for HC and without that individual "mandate" many would not save and then become wards of the state.

It's the individual mandate to SAVE that makes that system work.

The govt ALSO .. SUBSIDIZES catastrophic insurance so that no one goes broke if they get a really expensive illness...the govt pays for it.

Finally, the Govt HEAVILY REGULATES the price and availability of care.

I actually LIKE the Singapore system but you can't take the parts of it you like and get rid of the parts you don't and still call it the Singapore system implemented US-style.

It's the 33% individual mandate, subsidized catastrophic and price regulation that makes that system work as well as it does - making it one of the least expensive and most effective in the world.

but taking the parts you like and saying it's modeled Singapore when you take away the major provisions...

well.., that's just funny..

 
At 8/02/2011 10:15 AM, Blogger Larry G said...

the fundamental question that we dance around here is whether or not govt should be involved AT ALL, in ANY WAY with health care.

I personally think it must be but the devil is in the details.

The only way govt could stay completely out of health care is if they REPEAL EMTALA and the law of the land says that if you or your kid or your parents get sick and did not save enough for their health care needs - that the govt will not pay and if they can't pay then they get no care.

This is what happens in the majority of non-industrialized countries in the world.

That's how health care is delivered.

Is that what folks here really mean when they say that govt should not be involved in HC or are there "caveats"?

 
At 8/02/2011 10:34 AM, Blogger Larry G said...

The really funny thing about Obamacare is that it tries (arguably) to do some of the things that Singapore does.

It has individual mandates and mandatory penalties if you don't get insurance. It has subsidies for those who cannot afford insurance (the working poor) and it sets up insurance exchanges in an attempt at a more competitive market.

But what's REALLY funny about the opponents is that NOT A ONE of them say that ObamaCare tried to do some right things - a wrong way and that we should instead modify to be more like Singapore's highly touted system.

Nope.

We have NO PROPOSAL for ANY alternative system much less the Singapore system.

Just kill Obamacare and forget govt involvement in health care and "let" the free market do it.

ha ha ha...

140 countries in the world -let the "free market" do it but of all those countries -not one is cited as the one most like something we should pursue.

Nope.

Instead, we are told that the "best" is the heavily-govt-dominated Singapore system - that we'd have to "change"... like get rid of the 33% mandated tax...

 
At 8/02/2011 10:49 AM, Blogger morganovich said...

larry-

you are WAY off on your costs.

singapore mandates a 6-8% tax on income for HSA's. your 33% number is WAY off.

you are including the rest of their forced savings to cover pensions, mortgages, etc. they are also heavily capped (regressive). i see no reason to emulate the rest of that policy.

the 6-8% medisave forced savings is not terribly different from our FICA except that the system it supports in viable, unlike ours.

they spend about 3% of GDP on healthcare. that's about 1/6 of what we do.

i'm not saying it's a perfect system.

frankly, i'd prefer it to be voluntary as opposed to forced.

but us is an outstanding example of just how much introducing user pays free market pricing can reduce costs.

the rest of your argument seems like gibberish and straw men.

i already said that having high deductible catastrophe insurance makes sense.

it need not be publicly provided, but it ought to exist (and would if private companies were allowed to issue it)

regarding funding the poor, that's just block grants to HSA's. it's still cost controlled. you spend X. you know exactly what X is. it works like food stamps, not medicare.

i never said it was perfect or that we ought to swallow it wholesale, just that it was "most worth of emulation". could it be improved? of course. your notion that imitating such a system is all or nothing is absurd.

 
At 8/02/2011 10:52 AM, Blogger morganovich said...

larry-

having the government get out of the health care market does not mean they cannot help the needy.

the government does not open grocery stores, they give out food stamps.

that does not distort the grocery market, it merely participates in it.

it also has predictable costs that can be easily controlled. you get $x a month, and that's it.

medicare is such a disaster because it cannot control costs. you can go to the doc as much as you like.

the food stamps equivalent would be giving the poor amex black cards to use at any supermarket they like. imagine how much more (and better) they would eat and what it would cost.

 
At 8/02/2011 10:55 AM, Blogger Benjamin said...

"the problem is that our insurance structure encourages us to massively overconsume because it's essentially a buffet. pay to get in, and pig out."

Why Morgan Frank, you actually got off of your flying saucer long enough to grasp one of the tenets of the situation.

Now, if you will just own up to the need for euthanasia for patients both elderly and terminally ill...

 
At 8/02/2011 10:57 AM, Blogger morganovich said...

that should read "it" not "us". typo.

 
At 8/02/2011 11:03 AM, Blogger morganovich said...

"Now, if you will just own up to the need for euthanasia for patients both elderly and terminally ill.."

bunny-

would you be on the list?

"need"? if by that you mean it ought to be legal and the old and ill should be free to choose it, i agree with that.

if by this you mean denial of care and putting the elderly out on ice flows or assassinating them, i think that's absurd.

the beauty of a user pays system is we all make our own choices about what's worth it.

$500k of chemo to live an extra month would appeal to few people under such a system. but to deny them the possibility outright is monstrous and runs counter to individual freedom.

you would not need "death panels" etc. people would make the choices that worked for them and pay for it.

 
At 8/02/2011 11:28 AM, Blogger Larry G said...

@morg

"Medisave is a subset of the mandatory Government pension scheme (the Central Provident Fund or CPF) to which a total of 33 per cent of wages is contributed (comprising 13 per cent employer contributions and 20 per cent employee contributions) to individual accounts to fund retirement and health related expenditure. Of the 33 per cent contribution, around 6 per cent to 8 per cent (depending on age) is credited to the employee’s Medisave account. In practice, Medisave covers approximately 85 per cent of Singapore’s population."

http://www.liberatehealthcare.com/foreign/Singapore.htm

 
At 8/02/2011 12:24 PM, Blogger Benjamin said...

Morgan Frank:

A small mind like yours is easily certain about many things.

And what if a man, 45 years old, decides he wants to live but has not enough money for the health care that will fix him?

 
At 8/02/2011 12:59 PM, Blogger morganovich said...

larry-

yes 6-8%. the rest is for unrelated matters like pensions and mortgages.

you have just made my point for me.

i'm not suggesting we emulate the rest of singapores system, just pointing out that we can cut costs dramatically and control the size of federal programs better by moving to an all HSA system.

 
At 8/02/2011 1:02 PM, Blogger morganovich said...

bunny-

what if you decide you want a ferrari but don't have enough money to buy one?

what does your point have to do with euthanasia?

it's not euthanasia to not get care any more than it is a ferrari deprivation for a dealer not to give you one just because you want it.

your logic, as ever, is utterly lacking here.

seriously, can you think at all?

 
At 8/02/2011 3:10 PM, Blogger Benjamin said...

"it's not euthanasia to not get care any more than it is a ferrari deprivation for a dealer not to give you one just because you want it." --Morgan Frank, comparing a broke man deprived of health care and who subsequently dies to one who cannot afford a Ferrari.

Morgan, really that is nice. Some guys can't buy Ferraris, and others die from lack of medical care. Tra-la, tra-la.

Every once in a while I am reminded that the GOP is a vile confederacy of strumpets, grifters and poltroons. I just had one of those moments.



BTW, Morgan, can you use caps ever? Your command of English is that of a backwoods maroon in Guyana.

 
At 8/02/2011 3:35 PM, Blogger morganovich said...

bunny-

coming from a near illiterate, your comments really lack any sort of sting.

and again, you utterly dodge the issue and try to hide behind taunts.

you really ought to just admit you have nothing to add nor any ability to think logically and call it quits.

what is it you are proposing to do with this 45 year old? euthanize him? tax others to pay for him no matter what it costs? let a death panel decide?

those who choose to live in an uninsured house face the costs if it burns down. that's called prudence and personal responsibility. you should check these ideas out. i suspect it would be enlightening for you.

you call yourself a free marketer, but propose socialism, fascism, and government intervention at every turn. when someone actually proposes a straightforward idea like "user pays" you find it objectionable.

you may be the most self deluded person i have ever met.

and what does any of this have to do with the GOP? i am not a republican, a fact i've made clear to you before.

your inability to remember simple facts from day to day may go a long way toward explaining why you never seem to understand anything.

 
At 8/02/2011 3:40 PM, Blogger morganovich said...

"BTW, Morgan, can you use caps ever"

SURE. I JUST DON'T LIKE TO.

i prefer to write like e.e. cummings.

can you ever address an actual argument or demonstrate even a rudimentary command of the facts?

now there's a more interesting question.

 
At 8/02/2011 6:56 PM, Blogger Larry G said...

@Morg - the total bite is 33% and you are correct - 6-8% is for Medisave but there are other mandatory requirements also. you have to buy compulsory catastrophic insurance.

It is NOT a voluntary system. It IS a govt-controlled compulsory system (this is one way to keep the costs down by having everyone pay into from the beginning so they have set aside money which our system did not require until ObamaCare which is TBD.

I don't think you can have it both ways by citing Singapore as an example of a "free market" system.. the best example in the world (?) and then turn around and say it's not for us and what you advocate for us - does not exist in the world except in 3rd world countries.

The problem here is that you don't like our system and you don't like any of the other industrialized countries systems and the one you say you do like - you would not agree to implement it.

That's not really dealing with the issue.

It's being opposed to any existing systems and not specifying one that is remotely similar to any of them.

This is why I asked earlier if fundamentally you (and others) are fundamentally opposed to the govt being involved in health care at all.

I think it's a valid question that deserves an honest answer.

 
At 8/03/2011 2:06 AM, Blogger Ron H. said...

"We DO have what amounts to a universal banking system DUDE when ANY MERCHANT can consult a universal database to check your credit. We DO HAVE essentially a UNIVERSAL phone system where you can call anyone regardless of which system they are on with a land-line or cell."

Wow, Lame Larry, you've just found two more subjects you can demonstrate your peculiar lack of knowledge about.

You obviously don't understand the banking system, and you really shouldn't presume to discuss the subject with people who do.

Your ignorance here, as on so many issues is appalling.

One time I will offer you a short explanation:

If you are interested in consumer credit reporting, you should be aware that there are 3 major private agencies each of which maintains credit information reported by their subscribers. Each of the 3 has it's own methods and formats, and different information may be available from each. It's nowhere near the kind of universal system you would prefer.

If you are concerned with credit authorization at the check out counter, you need to know that each bank has only its own records, and there is nothing universal about it. Only your own bank has your records.

Get a clue, Larry, this information is easy to find if you bother to look for it.

I don't understand why you insist on commenting without knowing what you're talking about, when it's so easy to find information these days.

 
At 8/03/2011 2:13 AM, Blogger Ron H. said...

Bunny: "I agree with Larry G."

This kind of careless confession doesn't help improve your image or give you credibility.

 
At 8/03/2011 9:09 AM, Blogger Larry G said...

"If you are interested in consumer credit reporting,"

what an ignorant DOLT you ARE.

ALL 3 are UNIVERSAL - available to ALL merchants to check on YOUR finances.

they illustrate 3 separate examples of a master database that is used by virtually every business in the entire country.

If a business in Oregon wants to know about your finances in Virginia, they consult one or all 3 of those databases which are...

UNIVERSAL ELECTRONIC RECORDS

dumbass

 
At 8/03/2011 9:11 AM, Blogger Larry G said...

" I don't understand why you insist on commenting without knowing what you're talking about, when it's so easy to find information these days."

when it comes to ignorance - you and Van set the standard...

what fools you both are...

arrogant idiots... who don't really understand but use insults and condescension to cover their tracks.

 
At 8/03/2011 11:51 AM, Blogger Ron H. said...

"ALL 3 are UNIVERSAL - available to ALL merchants to check on YOUR finances.

they illustrate 3 separate examples of a master database that is used by virtually every business in the entire country.
"

Thanks, Larry, you made my point for me.

 
At 8/03/2011 6:16 PM, Blogger Larry G said...

the business in Portland can check the financial health of a customer in Va... another business in Phoenix can ALSO check the SAME electronic record to determine the financial health of the guy in Va.

but no Doctor in Portland or Phoenix can do the same to find out the medical history of an unconscious Virginia in his ER.

that's the difference - and that's why we need the EQUIVALENT CAPABILITY if that guy in Va wanted to stop by a Safeway clinic in Portland/Phoenix to get a prescription for the pills he left but can't remember the name/dosage.

 
At 8/03/2011 7:01 PM, Blogger Ron H. said...

"that's the difference - and that's why we need the EQUIVALENT CAPABILITY if that guy in Va wanted to stop by a Safeway clinic in Portland/Phoenix to get a prescription for the pills he left but can't remember the name/dosage."

That wouldn't help. You're forgetting that he wouldn't get a refill without his doctor's approval, so a call to his doctor would be required, and his doctor's records would include the prescription information.

When's the last time you were able to walk into a strange clinic and get a prescription drug without a doctor's order.

To get a prescription at an unfamiliar clinic would require an exam and testing that convinced a doctor he needed such a prescription, and it might not be the same drug prescribed by his regular doctor.

 
At 8/04/2011 2:32 PM, Blogger morganovich said...

larry-

"I don't think you can have it both ways by citing Singapore as an example of a "free market" system.. the best example in the world (?)"

you have totally missed my point here and are fighting with strawmen.

i never said i wanted compulsory savings. in fact, i said the opposite.

my point is that if users face the costs of medical procedures themselves instead of using a buffet model, healthcare wind up costing MUCH less, and the reults you get are good.

singapore does well spending 3% of GDP on health.

the reason is that the free market sets prices.

compulsorty savings is not free market.

but taking your own money out to buy healthcare and shopping by price is.

that is what i have been encouraging the emulation of.

 
At 8/04/2011 2:37 PM, Blogger morganovich said...

""We DO have what amounts to a universal banking system DUDE when ANY MERCHANT can consult a universal database to check your credit"

these are not the same things at all.

the credit databases are fun 9for profit) by groups to whom people report defaults.

they have no idea what most of your data is.

they don't know your bank balances (or even if and where you have accounts), what you spent on your credit card last month, what sort of investments you hold, or 95% of every other financial fact about you.

all they know is why you have defaulted on.

i think you are dramatically overestimating what this system is.

it was also created on a completely voluntary basis, so where is the argument for compelling medical providers?

 
At 8/04/2011 7:03 PM, Blogger Larry G said...

re: "compulsory savings" HSAs

that's the FUNDAMENTAL BASIS that their system works.

It creates a very large pool of people paying into a fund that is then spent on those that need it.

Without that individual mandate - the system fails,.

None of you have yet to name a SINGLE SYSTEM where compulsory savings is not required but they have a system comparable to the countries that have compulsory saving.

Ya'll are promoting a myth that does not exist and claiming you can create one... and there is not a single real example.

 
At 8/04/2011 7:08 PM, Blogger Larry G said...

" the credit databases are fun 9for profit) by groups to whom people report defaults."

the databases are used by every kind of merchant imaginable including doctors and employers ...

but you miss the point entirely

they are universal nationwide databases where anyone in the country can consult an electronic record about you and your finances.

It's an exceptionally valuable capability that would be JUST as valuable if not more so if ANY health provider (with your permission) could consult your medical record - anywhere in the country....

A universal electronic medical record would ENABLE ,..MORE free-market competition because you would own your record and you could decide when/where to make it available instead of having to make "arrangements" with your current providers.

These electronic records are used by the VA and the armed services and many industrialized countries to allow any doctor who is treating you - no matter where - to look at your medical history.

It's common sense.

Why you folks argue against it is beyond me. It's idiotic.

 
At 8/04/2011 7:09 PM, Blogger Larry G said...

" all they know is why you have defaulted on."

Morg - have you actually LOOKED at your Credit Report?

I have and I can tell you that far more information than "default" is on it.

 
At 8/05/2011 11:15 AM, Blogger morganovich said...

larry:

"that's the FUNDAMENTAL BASIS that their system works."

no, it's not.

i keep trying to explain this to you and you keep not seeming to get it.

government compulsion is NOT what makes their system work. it does not allocate resources nor set pricing.

that is done by a market.

what makes their system work is USER PAYS.

just like our grocery system works to provide all manner of products at all manner of price points and quality levels, so too can healthcare work.

costs would drop like a stone.

the reason healthcare is so expensive is twofold:

1. no one ever asks what a covered procedure costs or shops around.

2. people overconsume because once you hit a deductible, marginal costs are near zero.

cash pay medical in the US drops in price every year, like most technology products.

you do not need government compulsion to make the system work, just a market pricing mechanism.

 
At 8/05/2011 11:18 AM, Blogger morganovich said...

larry-

"
Morg - have you actually LOOKED at your Credit Report?

I have and I can tell you that far more information than "default" is on it."

yes, i have.

they get reports from anyone who gives you credit.

defaults and loan extensions.

that's it.

they don't see your bank, brokerage, or other accounts.

it's a very limited system.

it was also created by the industry.

you still have no answer on why compulsion is needed/fair/reasonable.

what you are really saying is "i'd like the benefit of something so i'm going to make the government require you to give it to me (and pay for it) even though you don;t want to".

 
At 8/05/2011 11:23 AM, Blogger morganovich said...

larry-

no one is arguing that national databases are not possible.

i'm arguing that your coercive instincts are fascist.

i'm further arguing that if you want electronic health records, you have have them now. it's not difficult to put them together. i have every medical record in my life accessible on a server. it took an afternoon to do.

what you are really saying is that you value such a record at less than its cost, but want it anyway so you'd want to make someone else pay.

if you really want to get standardized medical records, you need to get rid of HIPPA and let the market do it.

you are looking to use government coercion of private parties to solve a problem created by government coercion of private parties.

that's no kind of solution.

 
At 8/05/2011 11:35 AM, Blogger Larry G said...

"that's the FUNDAMENTAL BASIS that their system works."

no, it's not.

i keep trying to explain this to you and you keep not seeming to get it.

government compulsion is NOT what makes their system work. it does not allocate resources nor set pricing.

that is done by a market.

what makes their system work is USER PAYS.

are you talking about HSAs are no HSAs and pure buy health care when you need it?

LOTS of countries have the second option - both 3rd world and even industrialized.

show me some countries that work the way you say it should that do NOT have compulsory saving.


just like our grocery system works to provide all manner of products at all manner of price points and quality levels, so too can healthcare work.

costs would drop like a stone.

show me some successful current examples which do not have compulsory saving....

compulsory saving - is what makes the Singapore system work because it creates an large enough insurance pool to sustain the spending.

if your theory actually worked, we'd not need auto insurance REQUIRED which is essentially compulsory saving...

the mortgage companies require compulsory saving when they require you to have homeowners insurance.... also

When it comes to saving ahead for days when you'll need a service that is much more expensive than your normal weekly income - enough people won't do it such that it makes insurance for those that do - much higher and much less affordable.

compulsory savings is essentially like required insurance....for cars, homes, and health care.

that's what FICA is...

that's what funds pensions and Medicare Part A.


the reason healthcare is so expensive is twofold:

1. no one ever asks what a covered procedure costs or shops around.

no one who is COVERED does that - I AGREE.

what about those who don't have it and then have an injury/illness that they cannot pay for?

that's the problem.

who pays for these folks?

you and I do - that's who.

Anyone who is opposed to our current health care system on principles should clearly see that EMTALA is the problem.

EMTALA basically says that if someone wants to not have insurance that you and I will pay for them anyhow.


2. people overconsume because once you hit a deductible, marginal costs are near zero.

and I agree with this and point out to you just how ridiculous it is for retired people who have significant assets, multiple cars and homes.. are sold health care insurance for $100 a month with the $300 additional required paid for by you and me via our taxes - this year to the tune of about 210 billion dollars.

Medicare Part A, on the other hand, funded by universal compulsory savings is but 20 billion in the hole.


cash pay medical in the US drops in price every year, like most technology products.

and universal electronic medical records would seriously supercharge this by allowing people to pick providers more easily and even bargain for price.

it would also allow people to be more job mobile by being able to take their full and complete medical history with them whenever and wherever they move.


you do not need government compulsion to make the system work, just a market pricing mechanism.

you do when people have known expensive conditions including age-related.

The HSAs in Singapore are coupled with subsidized catastrophic insurance available to EVERYONE for the SAME PRICE and on top of that - the prices Medical Providers can charge - is controlled.

You need to provide me with at least ONE example of a system that works the way you say it can and should and show me how that system is better than the ones that have govt-dictated compulsory savings on everyone.

I want to COMPLIMENT you for debating on the merits and keeping it insult-free.

thank you - and as long as you do.. I'll be more than willing to debate you tooth and nail - but sans insults.

 
At 8/05/2011 11:40 AM, Blogger Larry G said...

" you still have no answer on why compulsion is needed/fair/reasonable.

what you are really saying is "i'd like the benefit of something so i'm going to make the government require you to give it to me (and pay for it) even though you don;t want to". "

the reason why we have HIPPA ... why we have the govt decide which radio frequencies different companies use for different purposes, etc.

you have to have a national uniform system or the "innovators" will do what's in their own best interests even if it's not in the public's best interests.

does every uniform standard require the govt to dictate it?

no.

but often.. govt actually stays out of it.. unless or until there are problems.

check out the recent issue with FourSquare.. who have an excellent idea (in my view) but the concern is "bleed over" from cellular to GPS frequencies.

WHO DECIDES this?

FourSquuare?

the cellular industry?

the GPS industry?

this is an example where you must have a uniform universal national standard.... and if the industry/industries can't or won't do it.. then govt has to step in.

 
At 8/05/2011 11:45 AM, Blogger Larry G said...

i'm arguing that your coercive instincts are fascist.

ha ha ha

are you saying that the VA should have told each serviceman to keep their own records instead of designing and operating a single standard system?

that's foolish Morg...


i'm further arguing that if you want electronic health records, you have have them now. it's not difficult to put them together. i have every medical record in my life accessible on a server. it took an afternoon to do.

and it would be like saying every business would keep separate credit records on you in different formats... and that each business would have to contact every other business to see who had credit records on you.

that's a big problem - Morg.

you need a uniform national database for credit reporting..

the industry itself say that and did it....

then the govt got involved....

same deal with medical providers.

it SAVES money for patients to have uniform national electronic medical records...

it's true, it costs physicians money just like it costs tire companies to dispose of tires.

why not have a line-item electronic medical record FEE ...JUST like we have a universal access FEE on phones?

 

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