This is why Westboro Baptist Church is a joke

[kandrathe]

Well the problem with the insurance situation in the Netherlands (and I guess it is the same as in the US) is that insurance companies work with certain hospitals that they choose because they do 'a good job' but most of all do it cheap....probably because they make big contracts, lowering the price.

We are still suffering from the government imposition of the HMO concept. A doctor who sets up a general practice is pretty much forced to associate with an HMO who route the patients (along with the government programs).

So the client cannot choose. Now it is true that this should not be an issue if you are sure you get good care, but once money starts deciding about your health things can become really scary.

It is scary. Money will make the decisions whether it is the individual, the insurance company, or the government. I prefer to give the decisions to the individual. I would prefer the government, or the insurance company to just set the price that they will cover on a procedure. It works that way for my dental work, and it works fairly well. I end up paying less for insurance, and less out of pocket and getting the level of care I expect.

The money needs to come from somewhere.....and because there is a whole new layer of managers added into the system (who get big pay checks) we are talking about even more money. What this basically means is lowers salaries and worse working conditions for medical staff. (and in NL the base salaries of doctors are not so high as in the US to begin with).

Exactly. Insurance, HMO's, administrative overhead, just drive up the costs, or drive down the salaries (if prices are fixed). We need individuals to have direct relationships with health care providers.

At least when the government runs an ineffective system (employing 10 nurses while you only need 5) the extra costs go to salaries of people that need a job anyway.

Thinking like a socialist. The way I see that inefficiency is that the costs for the patient are double (as someone will pay for it, either directly or as taxes).

If a private system has higher costs, the money goes to bonuses, and commercials.

I would advocate the ability to shop around and get the best deal you can. In a private system, inefficiency or excessive bonuses and salaries leads to bankruptcy when your customers move to the doctor that provides the same quality, and better service at a lower price. There is a role for government, and industry self oversight to ensure patient care is kept adequate.

Making health care cheap is going to be difficult when people are getting older and older. And there is a whole technical issue there (cheaper medicine, cheaper equipment etc.)

Yes, the demographics are against us. We needed to get more students into more doctor and nursing programs 10 years ago. The college where I work is looking to begin a medical and nursing school, however there is a huge shortage in Ph.d educators in the field as well. Demand is very high, and will be growing higher over the next 20 years.