me: >> 1) hospitals are going to pay for the uncollectable patient debts, so >> they're going to deny treatment more (or raise the price, whatever's >> easier) -- at a time when more and more patient debts are uncollectable due >> to persistently high unemployment, low consumer asset prices (401k, housing, >> etc.), and tighter consumer credit;<<
raghu: > This is a neoclassical argument: So? As they say, "sticks and stones can break my bones, but words will never hurt me." NC economics isn't totally wrong. It's good at stuff like supply and demand, budget constraints, etc. Not that NC economics adds anything significant to pre-NC understandings of these topics. Mostly, it's a matter of formalizing them. > "businesses will just pass on the > costs to consumers or simply close the shop" if you raise their cost > of doing business. Not necessarily. That depends on their profit > margins among other things. For e.g., do you know how much of this > uncollectable debt is incurred by hospitals just gaming the system > because they know they will get it from the government?... Since you asked the question, and I'm very busy, I'll let you find the data. I bet you'll find that the lion's share of the debt was incurred because of rising medical costs (the dysfunctional US medical-care system) and most people's stagnant incomes and net worth (the neoliberal policy revolution, the end of the housing bubble), combined with unavoidable medical problems. In any event, medical institutions' profit margins are squeezed in a lot of ways (Medicare rules, etc.) These companies are not going to cut their executives' salaries to cover these costs. After all, if they're not paid the megabucks they feel they deserve, they'll move into other sectors. They are also unlikely to cut medically-unnecessary overhead (fear of lawsuits, competition with other medical centers, etc.) They have more bargaining power than the patients, so they're going to make us pay for any cuts if they can. me: >> 2) getting rid of "overpayments" is great in a perfect world (assuming >> that they really are overpayments), but in the kind of situation that >> we now face, this means that nursing homes will cut admissions (or >> raise the price, whatever's easier) -- or possibly shut down;(Note >> that the savings of the retired on not in very good shape these days.) > Once again without details, how can you tell one way or another if the > overpayments are real or not? In a period where the entire medical-care system is under stress, that question is a bit academic. I'll leave it for someone who is an expert in medical economics. In any event, I was responding to a comment that was made using _even fewer_ details than I provided. If you're going to present abstraction arguments, raghu, you can't slam others for being similarly abstract. My point was only that it seemed to me that your abstractions were ignoring some major dimensions of the real world. >> 3) in a period when state governments' finances are almost all >> severely in deficit, cutting the federal share puts more weight on >> them, so they'll cut services, raise fees, or even go into bankruptcy; > I'll grant you this one. thank you. It's nice to have a break from the bitter tone of your missive. >> 4) last and most obviously, cutting spending on "the training of >> doctors" is cutting exactly the kind of "investment spending" that >> Obama used to be in favor of. > Why? Last I heard doctors are doing just fine. They can well afford to > pay for their own training. They're doing fine compared to most people, but in the trend the medical professionals are becoming more and more proletarianized (i.e., less independent of insurance companies, HMOs, etc.) In any event, the ones who benefit from US government training programs have to spend time is areas that usually get limited health care services > Now think about all the 'cuts' that progressives should really be > fearing that are *not* in this plan. Increasing Medicare eligibility > ages. Means-testing. Medicaid block-grants. Etc. any cuts of the sort listed in the NYT story are more on the level of the camel getting its nose under the tent instead of having the tent knocked down by the camel. To mix metaphors, it's opening the door to block grants, means-testing, etc.) I prefer my metaphors shaken, not stirred. -- Jim Devine / "Segui il tuo corso, e lascia dir le genti." (Go your own way and let people talk.) -- Karl, paraphrasing Dante. _______________________________________________ pen-l mailing list [email protected] https://lists.csuchico.edu/mailman/listinfo/pen-l
