New York has a Lotto. http://nylottery.ny.gov/wps/portal/Home/Lottery/Home/Jackpot+Games/LOTTO
Instead of just posting skepticism, you could do a quick google search. The source of the BoingBoing posting is Newsweek, not some random internet fake news rumor.
these, and other exciting kinds of victim blaming, can be yours for the low price of this one shit sandwich.
No thank you, new community member.
the reasonable standard being… non-profitable
Competition for what? I can “set up my shingle” as a doctor anywhere I like, doing whatever l like. All l need is an MD and depending on the state regulations, anywhere from 1 to three years of post graduate training-- this is based on the requirements of the state medical board, a PRIVATE ENTITY; the only government interference is to require a license from them to practice. And when I say anything l like, it is literally anything from psychiatry to obstetrics, regardless of my area of post-graduate training. I can hire anyone I like and pay them anything I like based on the hiring standards of my state.
I am free to apply to be reimbursed by any insurance (or none) I like, just as any insurance agency is free to reimburse me (or not) as they like, based on rates and conditions that they negotiate with me. Of course, patients with insurance will prefer to use my services if their insurance reimburses me as they will not wish to pay out of pocket if they are already paying for insurance.
I can buy any drugs and or devices I can afford; I will need to apply for a DEA number for certain drugs (opioids etc). Drugs and devices will of course be priced based on my negotiation with the seller; my rates may not as be as favorable as a larger entity since my negotiation powers are limited.
Not really seeing any onerous regulations preventing “competition” here.
This is why you ALWAYS take the lump sum payout.
So what does prevent competition? Why don’t you set up a company to provide cheaper health care services? Clearly there is money to be made from that.
Because all of the other links in the industry’s chain, from insurance providers to medical device manufacturers, are dedicated to extracting their six pounds of flesh from everyone else. If you want to provide, say, low-cost dental care to people, but have to pay thousands and thousands of dollars for your equipment and supplies because that’s what the manufacturer charges, you’re going to be limited in how far you can afford to lower your prices. Plus the additional cost of paying back your medical degree in the US (versus getting it essentially debt-free in every other developed nation on the planet that understands the value of an educated populace) means that you can’t set your prices too low or you’ll never be able to make your loan payments. And then you have to hire someone (or several someones) to navigate the labyrinthine maze that is every private insurance company’s uniquely awful billing and claims department system, which is dedicated to never paying for anything it can get away with not paying for, because our extremely capitalist insurance system is a fucking rent-seeking disaster.
Medicine and health care are also not things that can reliably be “shopped” like buying a new couch. If you get hit by a car, you’re not going to be in a position to call around to find the cheapest ambulance service that will deliver you to the least-expensive hospital. You’re not going to be able to comparison-shop surgeons willing to stitch you back together for the lowest amount of money. Not to mention that even for less-critical things, who among us has the time or patience to do something like comparison-shop the various medical services labs in town (assuming they aren’t all owned by the same company) to find out who will charge you the least for a kidney function test or diabetes screening (assuming they’ll even tell you), then coordinate a referral through your doctor’s office because nobody in a specialized practice or service just accepts walk-ins off the street?
For-profit medical services are almost completely immune to economic pressures the way something like a sandwich shop is. While economic theories that rely on humans being rational actors are shaky even at the best of times, health care is so vital to our survival that there’s absolutely no way for a rational market to evolve naturally. If you need to get carted off to the hospital in an ambulance or you’ll die, then odds are good that you’ll pay whatever the ambulance company is charging. If you need kidney dialysis or you’ll die, you’ll pay whatever the dialysis provider is charging. Because these providers know that their services are essential, and people will pay them because they have to, there’s absolutely no incentive for them to charge anything less than that absolute maximum in every circumstance, and pocket every cent of profit for themselves. Whenever pharma companies defend obscene practices like charging $600 for an EpiPen, their justification is always that “people with insurance won’t see that price”. But people without insurance will, and insurance companies still have to pay that enormous price or spend possibly hundreds of man-hours negotiating a lower one for their customers, which still ultimately results in increased premiums for everyone.
The US is the only developed nation on Earth that has stuck to this stupid idea that a patchwork of private enterprises is better than a government-run health care system, because we have this ludicrous notion that people in government-run systems have shitty health care services. Yet we spend vastly more money and actually have worse health care outcomes than everyone else, in everything from cancer survival to maternal mortality. It’s almost like “more capitalism” isn’t the solution to the problem…
Well sort of. In Australia and a lot of other places the safety net is government run, so your immediate needs are taken care of regardless of what private services you use. This makes it easier for competition in the provision of premium services because it doesn’t suddenly become an issue when you get sick or have an accident.
My local doctor is still privately employed but part of his fee comes ultimately from my taxes. A patchwork of private enterprises is just a market place, and than should be efficient. But if you have large businesses which have fairly exclusive licenses to work in a particular field, then the licensing authority really should have some visibility over their books to ensure that the licenses are not being exploited.
My first thought was lucky for his family that he died so quickly so he didn’t have to spend the rest of his winnings on treatment. Second thought that maybe he did. Or did he die so quickly because he altruistically refused treatment? Anybody know which it was?
If that was a short story, it would be the sort of story that the word ‘mawkish’ was coined for. But, apparently, it’s real.
When you want to carefully choose between various options, weighing one benefit over another cost, taking your time to shop around… Capitalism is absolutely the best way to go… For buying a car or a house, sure, knock yourself out
The moment you are suddenly, violently ill with the clock ticking and wracked with pain… Capitalist market choices are absolutely the worst thing to subject the patient to.
There should be a law forcing shareholders to only have access to the kind of care their stock provides for.
Lesson is, never go to a doctor.
Life imitate arts. At least he didn’t have to setup a devastating drug production and distribution operation to leave his loved ones some money to support themselves.
never mind… however it can happen off-shore in other domains father away…
… Doctors visits are a better use of your money than buying enough $10 scratchers that you win a jackpot.
Oho, “let them eat cake”, is it? I hereby challenge you to do this, in the continental USA.
I will give you five hundred dollars cash money, and I will sing you a song composed by me lauding your wisdom and honesty, if you can legally do this without encountering onerous regulations requiring you to invest literally years of your time and large amounts of money to get various elite certifications only available through specific gatekeepers (such as medical schools with complex entrance requirements, and federal agencies that only respond to specific formal behaviours) that will allow you to purchase and prescribe drugs and practice medicine.
Or were you being ironic? Farmers can barely sell raw milk in the USA without government gunslingers showing up. Try calling yourself a doctor and prescribing drugs, and see what happens to you!
Your ideas intrigue me and I would like to subscribe to your newsletter.
This topic was automatically closed after 5 days. New replies are no longer allowed.
