On healthcare costs

Just listened recently to yet another news story about soaring health care costs and the sub-optimal care Americans get despite the cost. I still fail to see why fee-for-service is such a bad idea. Back before the days of HMOs and health insurance, people would pay the doctor for a visit - simple as that. But what about hospital stays? Who paid then? The individuals? Hospitals, probably even back then, were probably very expensive. Never mind all the new technologies and tests we have now that make health care so much more expensive - how did people pay for the basic nursing services of a hospital admission? Now I'm curious to find out...

Ok, just finished reading a long and interesting article on health care costs and insurance. The issue is really much more complex than I had originally thought, but my basic premise I believe remains the same. You cannot simply give people a product or service and request that they pay for it later (a la model of NPR). Most people are, by human nature, opportunistic. If you give them something and then request a "donation" later (similar to shareware model, etc.), few if any people would ever pay back no matter how wonderful a product/service you may have provided. You can extend this idea to health care as well but in reverse (this is true for most insurance models). We all pay a premium to the insurance company for a promise of future services. It's clear, however, that their goal is to retain as much of that money as possible and provide as few services as possible. Human nature. I believe the only way that insurance schemes can work is in a non-profit setting where you reduce as much as possible the motivation to hoard.

Arrgh - too complicated for my tiny brain. Let's all just hope we won't be needing those insurance services in the near future.

Need to think before I open my mouth

We had just finished transporting an elderly couple to the hospital after his wife took a small spill (apparently, a common occurrence). The husband was very nice and grateful, and I started feeling a bit uncomfortable with all his thanks. So, I stupidly replied, "It's all fun and games to us!". He took it well, saying he knew that, but wanted us to know how much he appreciated our service.
In thinking back, thank god that was not a more critical situation. I didn't realize that I just made light of a potentially serious situation. Next time, I'll just say we enjoy doing this...