12 minutes ago, Tramp Graphics said:

I disagree. Too many unnecessary tests also eats into a doctor's or hospital's profits as well since a good chunk of that money is required to pay for the overhead costs those tests entail. Also, what you're talking about is going from enlightened self-interest to pure greed .

Doesn't matter where it's coming from, it's what happens when you have fee-for-service healthcare. Remember, for me this is not a theory or what "should be" but rather what I've seen firsthand.

Also, the overhead costs you describe are more than covered by what they charge for each (unbundled) service. They profit on every one, so they just keep ordering more. This is usually done with repeat daily labs and x-rays as they can use the same rationale over and over again. However, there are also nursing activities that amount to little more than busywork that can be demanded (like Q2H neuro checks on a patient with abdominal pain) just to up the acuity and allow for higher billing. Newer plans fight this but have problems of their own.

9 minutes ago, HappyDaze said:

Doesn't matter where it's coming from, it's what happens when you have fee-for-service healthcare. Remember, for me this is not a theory or what "should be" but rather what I've seen firsthand.

Also, the overhead costs you describe are more than covered by what they charge for each (unbundled) service. They profit on every one, so they just keep ordering more. This is usually done with repeat daily labs and x-rays as they can use the same rationale over and over again. However, there are also nursing activities that amount to little more than busywork that can be demanded (like Q2H neuro checks on a patient with abdominal pain) just to up the acuity and allow for higher billing. Newer plans fight this but have problems of their own.

Yes, and as such, you get much better quality care. Socialized medical care tends to be very poor quality. I'd rather have good quality commercial care than poor quality socialized care.

16 minutes ago, Tramp Graphics said:

Yes, and as such, you get much better quality care. Socialized medical care tends to be very poor quality. I'd rather have good quality commercial care than poor quality socialized care.

All those extra tests and treatments are not linked to superior outcomes. Again, I've done the research and lived it.

6 minutes ago, HappyDaze said:

All those extra tests and treatments are not linked to superior outcomes. Again, I've done the research and lived it.

Maybe, but if healthcare is rationed, then people who need medical care in order to live could be denied by the government because of lack of funding. Rationing is never the right option.

For me the comparison is %coverage, outcomes and %GDP spent on health.

So comparing US and UK, US has smaller coverage, similar outcomes and higher %GDP spent on health.

12 minutes ago, Darzil said:

For me the comparison is %coverage, outcomes and %GDP spent on health.

So comparing US and UK, US has smaller coverage, similar outcomes and higher %GDP spent on health.

For me the faces and stories of those I treat are far more meaningful than the cold numbers (not that I don't work with the data too). Healthcare is more than $.

2 hours ago, Tramp Graphics said:

Maybe, but if healthcare is rationed, then people who need medical care in order to live could be denied by the government because of lack of funding. Rationing is never the right option.

There are many right options, but each can also be the wrong option depending on one's point of view. IMO, the best option provides universal coverage up to a set limit--and yes, it does ration that care because there will never be enough for everyone to have everything--but beyond that allows individuals to pay premiums to buy services above the level of universal coverage. The downside to this is that those premiums would be considerably higher than what most people imagine because the young and healthy will not be forced to pay into supporting it.

4 minutes ago, HappyDaze said:

There are many right options, but each can also be the wrong option depending on one's point of view. IMO, the best option provides universal coverage up to a set limit--and yes, it does ration that care because there will never be enough for everyone to have everything--but beyond that allows individuals to pay premiums to buy services above the level of universal coverage. The downside to this is that those premiums would be considerably higher than what most people imagine because the young and healthy will not be forced to pay into supporting it.

And that's the problem with so-called "universal" healthcare. The real solution is simply to lower the cost. And that's done through competition. Because, ultimately, it's not the hospitals nor doctors who ae driving up the costs. It's the HMOs

8 minutes ago, Tramp Graphics said:

And that's the problem with so-called "universal" healthcare. The real solution is simply to lower the cost. And that's done through competition. Because, ultimately, it's not the hospitals nor doctors who ae driving up the costs. It's the HMOs

You're partially correct, but providers and sites have a strong influence on the rising costs too. However, the biggest problem is CMS because whatever they decide on the paying of Medicare and Medicaid very quickly gets echoed by every other payer. When this hits the providers and sites, they have no choice other than to overbill with the knowledge that, while their returns will still be reduced, they do ok by starting high.

1 minute ago, HappyDaze said:

You're partially correct, but providers and sites have a strong influence on the rising costs too. However, the biggest problem is CMS because whatever they decide on the paying of Medicare and Medicaid very quickly gets echoed by every other payer. When this hits the providers and sites, they have no choice other than to overbill with the knowledge that, while their returns will still be reduced, they do ok by starting high.

Yep. More government interference. Socialized medical care won't fix that problem. It'll just make it worse, resulting in the rationing I mentioned earlier.

1 minute ago, Tramp Graphics said:

Yep. More government interference. Socialized medical care won't fix that problem. It'll just make it worse, resulting in the rationing I mentioned earlier.

Rationing will always exist when demand outstrips supply. If you have three kids to feed but only two hotdogs, you're not going to give both hotdogs to one kid while you and the other two kids go totally without, right?

1 minute ago, HappyDaze said:

Rationing will always exist when demand outstrips supply. If you have three kids to feed but only two hotdogs, you're not going to give both hotdogs to one kid while you and the other two kids go totally without, right?

Very true, but the "supply" of healthcare isn't the problem. The problem is government . There are plenty of doctors, plenty of nurses, plenty of hospitals. But if government takes control of the system, they can artificially ration healthcare so that only those whom they deem "worthy" get it. It gives the government more control over us, and gives them the power to determine who lives and who dies. It gives them the power to say that one disease is "worth" curing, and another isn't. it gives them the power to say, one person has the right to be treated, but another person doesn't. It's Big Brother . That's Bad; very, very bad.

There is only one group of people who deserve free, unrationed healthcare. And that is military veterans . These people put their lives on the line in defense of our country. They've earned that benefit, and even then, not all Veterans get healthcare for free.

11 minutes ago, Tramp Graphics said:

There are plenty of doctors, plenty of nurses, plenty of hospitals.

There are neither plenty of doctors nor plenty of nurses. Significant shortages of both are widespread, particularly in rural areas. As for hospitals, there might be plenty in the big cities, but many are obsolete and can't afford to modernize because of the payment games they're forced to play. And, again, there are many parts of the USA without a local hospital, or where the local hospital isn't much more than a place to be admitted for observation and transfer after an emergency room visit.

13 minutes ago, HappyDaze said:

There are neither plenty of doctors nor plenty of nurses. Significant shortages of both are widespread, particularly in rural areas. As for hospitals, there might be plenty in the big cities, but many are obsolete and can't afford to modernize because of the payment games they're forced to play. And, again, there are many parts of the USA without a local hospital, or where the local hospital isn't much more than a place to be admitted for observation and transfer after an emergency room visit.

And it's the government that is making them play those games.

16 minutes ago, Tramp Graphics said:

And it's the government that is making them play those games.

You're taking a very limited view of a very complex issue. Pointing to the government and laying all of the failures on it fails to acknowledge the greed and irresponsibilites of many private parties (including some patients). If the government simply stepped out, the system would likely collapse rather than get better.

10 minutes ago, HappyDaze said:

You're taking a very limited view of a very complex issue. Pointing to the government and laying all of the failures on it fails to acknowledge the greed and irresponsibilites of many private parties (including some patients). If the government simply stepped out, the system would likely collapse rather than get better.

The government is what caused the problem in the first place. It was the institutions created by the government, such as the CMS, which first put us into this mess. Before that, healthcare was much more affordable, and easier to attain, by everyone. So yes, I do blame the government for this entire mess. Get the government out of it, and, after some trials and tribulations, eventually the problems will get fixed.

Much as I am loathe to enter into a real world political debate somehow intruding in my Science Fantasy RPG forum, I just want to clarify:

1 hour ago, HappyDaze said:

You're taking a very limited view of a very complex issue. Pointing to the government and laying all of the failures on it fails to acknowledge the greed and irresponsibilites of many private parties (including some patients). If the government simply stepped out, the system would likely collapse rather than get better.

1 hour ago, Tramp Graphics said:

The government is what caused the problem in the first place. It was the institutions created by the government, such as the CMS, which first put us into this mess. Before that, healthcare was much more affordable, and easier to attain, by everyone. So yes, I do blame the government for this entire mess. Get the government out of it, and, after some trials and tribulations, eventually the problems will get fixed.

2 hours ago, Tramp Graphics said:

There is only one group of people who deserve free, unrationed healthcare. And that is military veterans . These people put their lives on the line in defense of our country. They've earned that benefit, and even then, not all Veterans get healthcare for free.

Sooooo you want the government to get out of the healthcare business entirely, potentially letting the system collapse (with the inevitable byproduct of having people die of preventable and treatable diseases), for the sake of lower healthcare prices... eventually (maybe?).

Meanwhile you are advocating FREE, UN-RATIONED healthcare to a demographic you happen to belong to?

HappyDaze nails it the quote above, and he's got experience in the field. Would it hurt to listen for once instead of trying to win the internet? In BOLD?

And in lieu of that, is it too much to ask that we get back to discussing FFG's SWRPG?

45 minutes ago, oneeyedmatt87 said:

And in lieu of that, is it too much to ask that we get back to discussing FFG's SWRPG?

Mea culpa.

So... Stimpacks?

This is an interesting question that I really needed to consider so the feedback was helpful.

In my case, I also made stimpaks less effective with each daily usage and they're addictive. So my PC's tend to avoid using them unless it's REALLY dire.

Ergo, Bacta tanks are far more efficient and useful In My Star Wars Universe (IMSWU). I'm thinking that $ 200 for a dunk in the tank might be a good retail cost IMSWU.

However, I do have the issue that my group are in an AoR campaign and they don't have to pay for most of their medical costs, once they get back to their base.

It's fascinating that americans seem to think that canada and western europe is some kind of medical wasteland, when it's actually compareable or better than the US for a fraction of the cost.

It's also funny (not in a ha-ha kind of way) that some people beleive that soldiers contribute more to and are owed more by society than nurses, teachers, firemen or even garbage collectors or the postman. If there's conscription it makes some kind of sense, but if you volunteer you should know what you're getting yourself into.

EDIT: Perhaps I should have let this side topic lie, but considering that I am at this very moment enjoying high quality, socialized medical care which could have fincially ruined me in more privatized system, I have a fairly strong opinions on the topic.

(Also, I'm coming off some really hardcore painkillers, so my judgement might be a little impaired.)

Dunno about the need to nerf Stimpaks. Crits, dump stat targeting, strain strain, skill barrier; there are many ways to hinder besides wounds=money. Seems unnecessary bookkeeping for little narrative gain.

You also are impacting Stim Talents, so some Specializations will feel hurt, while others won't care.

On 8/10/2018 at 11:54 AM, burninghoff said:

Dunno about the need to nerf Stimpaks . . .

You also are impacting Stim Talents, so some Specializations will feel hurt, while others won't care.

I DO from personal experience. In one of my first campaigns we'd buy Stimpacks by the gross and our combats turned into comical video game mechanics of having PC's stabbing themselves repeatedly with Stimpaks while firing recklessly at the enemy . . . while the enemy was doing the same . . . .

And the stimpak talents may arguably be more important, when employed, as the talents leverage healing more.

1 hour ago, Mark Caliber said:

I DO from personal experience. In one of my first campaigns we'd buy Stimpacks by the gross and our combats turned into comical video game mechanics of having PC's stabbing themselves repeatedly with Stimpaks while firing recklessly at the enemy . . . while the enemy was doing the same . . . .

And the stimpak talents may arguably be more important, when employed, as the talents leverage healing more.

Once again, however, Stimpacks grant diminishing returns for each use, so you can't go stabbing yourself, or each other, "Willy-Nilly" with them to get healed over and over. You're only allowed to use five stimpacks per 24 hour period, and each use is less effective than the one prior. Within very short order, they become completely ineffective .

15 minutes ago, Tramp Graphics said:

Once again, however, Stimpacks grant diminishing returns for each use, so you can't go stabbing yourself, or each other, "Willy-Nilly" with them to get healed over and over. You're only allowed to use five stimpacks per 24 hour period, and each use is less effective than the one prior. Within very short order, they become completely ineffective .

That's still a minimum of 15 Wounds healed per day. Consider that a guy with Soak 4 (Brawn 3 and heavy clothing) takes 3-5 Wounds per hit from a blaster pistol and that stimpacks allow the character to shrug off 3-5 such hits per day ! Such a character might even feel safe spending a weekend in Space Chicago!