U.S. Healthcare

Re: U.S. Healthcare

PostBy: Dallas On: Sat Mar 01, 2008 2:19 pm

In my opinion, there's a whole lot more to the problem than "health insurance". As a matter of fact, "health insurance" may be part of the problem, as it's like "welfare" to the doctors. If you have insurance and the doctor can get you into the office, "they've made the system work for them".

GP doctors don't do too much any more, except analyze your blood test results and route you off to a specialist, although they do get paid handsomely for doing so. Very seldom will a GP try to get to the bottom of the problem, many times "they have never seen anything like, what you have", so they give you a prescription, if the particular specialist, to be sent to, isn't evident. Many times the prescription side effects are much worse than the ailment and many times, IMHO, has nothing to do with the ailments cure. I'd also guess, many doctors continue aggressive treatment on terminal patients, long after they have a good feel for the outcome (this may be a hard one to work around).
Dallas
 
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Re: U.S. Healthcare

PostBy: gaw On: Sat Mar 01, 2008 2:30 pm

stockingfull wrote:Excellent analytical points.

But what I've been getting at here is that, if there are well over 40 million people without health insurance in this country, we've got a problem that has to be dealt with. And, for that reason alone, we can't possibly have the "best healthcare in the world."

So we need to have a fullsome discussion of how to make it better. Unburdened by the flag-waving, walk-away lines that we've got the "best healthcare in the world," implying that what ain't broke don't need fixin'. It's definitely in need of fixin'.

Besides, don't people realize that, once we get healthcare separated from the workplace, employers won't have to be the bad guys who have to raise employee contributions and co-pays all the time and people won't have to stay in jobs they don't want just because they need the health insurance for their families? It's really a liberty issue.

We need new group health coverage -- and the "group" is the population of the United States of America. If we can shoot down satellites, we're smart enough to study the other programs that have been tried and devise one that works best for everybody.

Well it's hard to argue much with the above.

I am assuming you are a Barack supporter? Maybe not? So I read on his web page how he will "fix" health care and, correct me if I am wrong, it sounds strangely like what the Republicans were trying to sell back when Hilary was busy writing her own cure for the nations health care system. It actually does not sound all that bad. But the problem now is the Republicans will be the loyal opposition in an Obama run white house and then what?
The way I see it, the only thing worse than our broken health care system is having our politicians fix it for us. God bless them if they ever do it no matter which side of the isle, but debating it on a coal forum is one thing and having Washington do the right thing is another. :flush:
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Re: U.S. Healthcare

PostBy: pvolcko On: Sat Mar 01, 2008 3:37 pm

Damn it... this is why I've been involved with that politics discussion list for so long... I can't let a challenge pass. :roll:

stockingfull wrote:But what I've been getting at here is that, if there are well over 40 million people without health insurance in this country, we've got a problem that has to be dealt with. And, for that reason alone, we can't possibly have the "best healthcare in the world."


I do not agree. A large portion of those people have medicare/medicaid, free clinics, SCHIP, and many other state run programs available to them. Many of them are young persons who can afford health care but have made choices not to buy it. Single person policies can be had for $150-$300/mo, I know I've gotten quotes within the last few months. That is entirely affordable to all but the poorest, and like I said they have various programs available to them already. Some actually consciously choose to depend on the nearly guaranteed emergency room care safety net available to every person in this country, despite being able to afford insurance and out of pocket doctors visits. The number of people that truly can not afford it and do not have public funded or free services available to them are a small fraction of that 40 million figure that gets bandied about. I'm all for finding ways to either help them pay for insurance themselves or if necessary fund their necessary medical care. I'm also in favor of making existing insurance more affordable and increasing insurance availability and choice. But I reject the idea that we must adopt a sweeping, national universal health care system to achieve these ends, to address the problem of a relative few people.

Besides, don't people realize that, once we get healthcare separated from the workplace, employers won't have to be the bad guys who have to raise employee contributions and co-pays all the time and people won't have to stay in jobs they don't want just because they need the health insurance for their families? It's really a liberty issue.


You really lose me here. What makes you think it would be better to have the oversized, politically motivated, inefficient US federal government be the "one" people have to consider the bad guys when they inevitably have to increase co-pays and contributions and/or reduce coverage (or introduce fixed medical profession salaries, or reduce those salaries, or federalize hospitals, or any number of other common tropes of government run, universal health care systems)? Consider for the moment that one generally can not sue the federal government. Even if the legislature crafts a law/system allowing citizens to sue the government health care system on the basis of denied coverage or other such medical torts, they control how much can be awarded, what qualifies for suit, etc. They'd also have a great deal of control over hospitals and doctors/nurses in terms of salaries and payment, which directly affects their ability to afford malpractice insurance. Indeed, it is likely the government would be forced to get into the business of providing this insurance too. This can not be a good recipe for responsive and accountable health services. And the government is the ultimate "deep pocket". The ambulance chasers and malpractice suit lawyers will absolutely feast on what amounts to a government run, universal HMO if restrictions on qualified suits and damage amounts aren't put in place.

And I will not be held emotional hostage by people who think that they are tied to their job due to the burden of having a family and needing insurance. They have a nation (a world even) of other employment and living options available to them. And even if they are tied down to a job they don't like, tough. Life is hard and it isn't the responsibility, moral or otherwise, for the people or the goverment to take on the responsibility for everyone's medical needs just to make such a person feel they have a more mobile employment situation or life situation. If this is a real problem and a real concern for the nation, then fashion a system based on existing private insurance that allows people to buy their own policy which can follow them from job to job, state to state. Want to decouple employer from insurance, the same kind of scheme addresses that.

Why is it good to keep medical services out of the hands of the government? Because it is better to have the government acting as an advocate for the people in regulating and setting a legal framework for insurance carriers and for the medial industry, natural and necessary tension of interests to keep service quality high and responsive and accountable. If they become both the law makers, the peoples' advocate, and the payor of services and even defacto employer of service providers... that is a recipe for disaster, how i that not obvious?

We need new group health coverage -- and the "group" is the population of the United States of America. If we can shoot down satellites, we're smart enough to study the other programs that have been tried and devise one that works best for everybody.


Unfortunately they are very different problems. Shooting down a satelite is a purely technical act, grounded in the laws of physics limited only by the state of science and technical knowledge and funding to achieve it. Providing "ideal" health care is a much much more nebulous problem to be solved for many reasons, not the least of which is that there are many notions of what "ideal" health care is or what the necessary responsibilies and constraints of any such system are.

I'm all for making the effort at bettering national health and national health care services, but I need a lot of convincing that national universal health care, paid for and administrated by the government and operating in a sea of law defined by that same government, is at all the way to go. So far it strikes me as nothing more than a deeply misguided attempt to put our health, indeed our very lives, in the hands of the federal government. That is antithetical to everything this nation has stood for and is against all good judgement and common sense in my opinion.
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Re: The Problem With Republicans

PostBy: ktm rider On: Sat Mar 01, 2008 3:45 pm

spc wrote:
stockingfull wrote:Nice try. OK, health care was the one I named.

I never said on this forum that the US has the best health care in the world, but I do think it. Big difference. If I or anyone in my family gets sick I am going to World Health Report's country #37 & I think you would too. ;) See, I don't know about other countries health care systems, don't need to, & I'm not going to depend on michael moore or the nyt to fill me in. If you would like clarification on any more of my positions I'll be glade help. :) Like I said your hatred is clouding your reasoning.


Lets say you need a brain tumor removed, Would you want to be seen by a brain surgeon in Botata Columbia.
OR.....
A brain surgeon at say, Johns Hopkins University Hospital in Baltimore Md.???

I don't know about you, but I have weighed the options carefully and I do believe I will " Take My Chances" at Johns Hopkins, even though the US is rated lower than Columbia in health care.
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Re: U.S. Healthcare

PostBy: spc On: Sat Mar 01, 2008 5:57 pm

Some of us are talking about 2 different things. There is the quality of medical services & the availability of services. IMO the quality of medical care in the US is second to none. Now we come to availability & I can see why people are gun shy about the Government getting more involved. It seems there is always a large amount abuse with these programs, as . The disabilities act passed in 1990 has become another form of welfare. People get a note from there doc & they are eligible. I know people on disability that are more than capable of working & I’ll bet my house that on the 1st Tuesday of Nov. 95% will flip that (D) lever. Now before you say Bush 41 signed that bill, just think of the political ammo he would have handed the dems. I’m all for helping the disabled but the abuses sicken me.
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Re: U.S. Healthcare

PostBy: stockingfull On: Sat Mar 01, 2008 6:10 pm

C'mon katoom, nobody said Colombia was better than Hopkins. What the WHO found is that, apparently, so few get Hopkins-quality care in our country that the level of care falls to where other countries are doing a better overall job.

And pvolcko, it's been held that you can't sue your HMO for medical malpractice when they say no to a procedure you can prove you need, either. So what's the diff? One of the stats above, IIRC, showed that we have a higher per capita cost for the level of healthcare we get than most other countries, so doesn't that tell you something? Since the HMO's took over the healthcare delivery system about 20 yrs ago, the hospitals and doctors have had their costs capped (and many have gone bankrupt) while the consumer has paid more and more in premiums, and higher and higher co-pays, for what has seemed to be a more limited scope of medical care. So where's that money been going? To HMO execs and stockholders? What's your belief?

Bottom line: sure, there are all kinds of problems with engineering a new solution. But I'm sure we can do better than what we have. We can hardly do worse.
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Re: U.S. Healthcare

PostBy: pvolcko On: Sat Mar 01, 2008 7:26 pm

stockingfull wrote:And pvolcko, it's been held that you can't sue your HMO for medical malpractice when they say no to a procedure you can prove you need, either. So what's the diff? One of the stats above, IIRC, showed that we have a higher per capita cost for the level of healthcare we get than most other countries, so doesn't that tell you something? Since the HMO's took over the healthcare delivery system about 20 yrs ago, the hospitals and doctors have had their costs capped (and many have gone bankrupt) while the consumer has paid more and more in premiums, and higher and higher co-pays, for what has seemed to be a more limited scope of medical care. So where's that money been going? To HMO execs and stockholders? What's your belief?


I'm sure some court somewhere held that someone in some specific case couldn't sue their insurance company for denial of coverage. Indeed I'm sure many such cases and decisions have been through the system. But there is not a blanket inability or law (or case law so far as I know) that holds that people can not sue their insurance carriers for denial of coverage as a general matter. It seems there is at least one major case of this type each year in the news. I can only assume it happens every day. Often such matters don't rise to the level of suing, instead people petition for mediation of a claim dispute or engage a lawyer to threaten such civil action in order to pressure the insurance carrier.

With the federal government it is a different thing all together. First, they have to grant the right to sue the government or an agency of it. Second, they control the jurisdiction of the federal courts, meaning they get to set what claims can be brought against it when they do allow it to be sued. Third, as with the much vaunted Patient's Bill of Rights type legislation that has been batted around for a while now, they can set max caps on damage amounts. While it's one thing to set a cap on what can be extracted from a private entity, it is quite the conflict of interests to both be provider and be be the those that set how accountable (as in what claims are valid and how much can be extracted in damages) the provider must be. I'd much rather have competing insurance carriers, on a more open market, fighting both for their own profitability and to be as attractive a carrier as possible to customers. Universal schemes eliminate these embedded/natural competing interests or at least house all those interests in a single entity which not only plays the game but determines the rules and rigs it as they see fit.

It is too much power and control placed in the government. It is foolish.

That said, I'm not enamored with the current state of health insurance in this country. There is room for improvement. But it should be incremental improvement, based on the current system of multiple privately owned and operated insurance carriers. I'm for regulation of the industry and for opening the market to more competition. I'm for breaking the employer/insurance bond that has formed and making people responsible for finding and purchasing their own coverage just as they do with life, identity theft, cars, homes, boats, snowmobiles, etc. I'm for insurance companies being able to stratify their premium schedules so that people like me who don't make regular doctors visits for preventative care can be charged higher premiums or get forced into higher co-pay schedules.

Bottom line: sure, there are all kinds of problems with engineering a new solution. But I'm sure we can do better than what we have. We can hardly do worse.


That's absurd. We can do a lot worse, and fairly easily too. Universal health care, as I've seen it executed in other countries and as proposed by democrats here in the US is a fine example of what I'd consider to be much worse. What's more, aside from the possibly worse care (in terms of quality, availability, responsiveness and accountability), some schemes actually result in lower liberty in exchange for a perceived increase in medical security. Liberty is traded in the form of dollars; all these schemes involve medical insurance care dollars going from us to the government or its appointed actors and would be a tax unlike any fathomed before, think Soc Sec and Medicare on steroids. Liberty is traded in the form of choice, particularly with so called "single payer" schemes where there there is no such thing as out-of-system care available at any price, not without going outside the country. Liberty is traded in the form of information, putting the government or its actor in either direct or indirect possession of every single citizen's medical records, begging for abuse, corruption, espionage, and crime. And as mentioned, liberty is traded in the form of reduced recourse when these forseen problems come home to roost.

We have a decent system. We should be tweaking it and modifying it to make it more available to those who truly can not get access without new assistance programs, not throwing it out wholesale to replace it with a socialistic, All-for-One One-for-All scheme that ultimately puts the people at the mercy of a government HMO. That would be a lot worse.
pvolcko
 

Re: U.S. Healthcare

PostBy: Ed.A On: Sat Mar 01, 2008 7:43 pm

It's all about the Nanny State, ever more power over people. New York passes a law against Trans fat, California wants to regulate Bar-B-que days, they are banning smoking even in your own home. This makes perfect sense for Socialists, creeping incrementalism in it's insidious best.
The political lesson that Mrs. Clinton learned in 1994 wasn't about compromise or market forces. It was that a government health-care takeover can only be achieved gradually and by stealth. Her individual mandate is an attempt to force everyone to buy into a highly regulated and price-controlled system where government redistributes income and dictates coverage. We assume the McCain campaign is paying attention.

http://online.wsj.com/article/SB1202349373...=googlenews_wsj
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Re: U.S. Healthcare

PostBy: ktm rider On: Sat Mar 01, 2008 8:08 pm

stockingfull wrote: so few get Hopkins-quality care in our country that the level of care falls to where other countries are doing a better overall job.


Anyone can go to Hopkins. I took my mother there right out of the blue and she was seen by some of the best doctors in the world in 3 days from the time i called.
Hopkins is not the only good hospital in the US, Mayo Clinic, Cleveland Clinic, etc...
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Re: U.S. Healthcare

PostBy: stockingfull On: Sat Mar 01, 2008 8:54 pm

Look boyz, the private insurance scheme has had its chance and people overwhelmingly are unsatisfied with it. Issues related to remedies and accessibility are legitimate ones for discussion but we simply can't have 46 Million people without healthcare, which most people believe is a right every bit as basic as those to safe streets and public education.

I have no doubt that, like the right to send our kids to private schools, there will be no prohibition to obtaining private medical services on a fee basis if you want more than the program provides, just like our parents did before the HMO's came in. And I'm sure there'll be supplemental types of insurance offered by the insurance industry. But we've been subsidizing all the un- and under-insured people all along, at great cost because they're not treated preventatively, so it's gotta be fixed. And it will be.

(BTW, pvolcko, the right to sue your HMO over a disputed coverage decision in fact was severely limited by the U.S. Supreme Court in Pegram v. Herdrich, 530 U.S. 211 (2000).)
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Re: U.S. Healthcare

PostBy: Richard S. On: Sun Mar 02, 2008 12:30 am

stockingfull wrote:C'mon katoom, nobody said Colombia was better than Hopkins. What the WHO found is that, apparently, so few get Hopkins-quality care in our country that the level of care falls to where other countries are doing a better overall job.


I'd suggest reading that report or at least some of it because that is not what it says at all. At most it suggests that the U.S is wasting a lot money. I'll go back to the one quote I made from the beginning of this thread:

In designing the framework for health system performance, WHO broke new methodological ground, employing a technique not previously used for health systems. It compares each country’s system to what the experts estimate to be the upper limit of what can be done with the level of resources available in that country


The key phrase here is "upper limit of what can be done with the level of resources available". You may not receive John Hopkins care if you have no insurance, poor insurance etc. However that doesn't mean the care you do receive is going to be equal or less than that of what Columbia can provide... The very worst hospital in the U.S. could very well be better than the best in Columbia or other countries using that criteria and the U.S. could still rank lower.

I'm still wondering if research and development is included in that report... :? Take a look at th Nobel Pizes awarded for medicine it the last three decades, I went through about 25 years and of about 50-60 people listed all but about 10 of them were U.S. scientists/doctors. :D

http://www.nobelprize.org/nobel_prizes/ ... laureates/
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Re: U.S. Healthcare

PostBy: gaw On: Sun Mar 02, 2008 12:46 am

Health care or no health care we all finish the game of life dead. Some sooner than others but all of us will die of something some day and I'll promise you that. At least these "bottom of the board" forums can be exciting and hopefully encourage us all to think but for me thinking makes my brain hurt. If for the sake of argument we accept that France has the worlds best health care we should at least see what the best is like and not dismiss it out of hand. Here are four articles if you want to get a little perspective on how the French do things.
http://www.medicalnewstoday.com/articles/9994.php

http://www.ambafrance-us.org/atoz/health.asp
This link is broken, either the page no longer exists or there is some other issue like a typo.


http://www.businessweek.com/globalbiz/content/jun2007/gb20070628_579158.htm?chan=top+news_top+news+index_global+business
This link is broken, either the page no longer exists or there is some other issue like a typo.

http://news.bbc.co.uk/2/hi/europe/3423159.stm
After looking at these four somewhat diverse perspectives I think you can see that even if we copied the "best system in the world" we will still be arguing and or complaining about health care.

I like to tell everyone I have the best health insurance in the world...as long as I don't get sick. Now where did I put my Yuengling? :beer:

Neat!!! I think this is from France too. :chop:
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Re: U.S. Healthcare

PostBy: traderfjp On: Sun Mar 02, 2008 1:00 am

Maybe if we put caps on how much you can sue practicioners the cost of healthcare would go down. Frivilous lawsuits clog our courts and is a drain on everyone's pocketbooks.

There needs to be some way so poor people can also get treatment. Why can't we make interns do a tour in a free clinic with a subsidized education? When we stop thinking as a nation about what will benefit the individual and concentrate on what is good for the masses maybe we can conquer some of the demons in America. Our country is very about me and the almighty dollar. Screw thy neighbor and line my pockets plentiful. I'm sure we could get creative as a nation and come up with an affordable solution. I think most Americans would be in favor or allowing our less fortunate citizens access to health care but the government has mismanaged our dollars to date. They have created fear in our citizens thinking about a government agency running such an organism and that it would bankrupt this country. Middle Amercia's wages aren't increasing much but insurance, healtcare and energy is going up at a break neck pace. We are afraid that socialized medicine will take more away from our families and it probably would unless politicians got creative which is highly unlikely. I'm a very proud American but it saddens me how corporate America has sold us out and is sending jobs overseas. It saddends me that the Fed doesn't care about inflation but weakens our dollar and causes middle America to get hit at the pumps and for home energy. It saddens me after all these years and various wake up calls that we have no real energy program in effect. It saddens me that Toyota, Nissan and Hyundai can make better cars than American designers and get more MPG. It saddens me that Americans are working more and getting less. It saddens me that we spend so much of our budget as a nation on defense when we have some many problems in our own country. We have a great country but from my vantage point we need leadership that can address these issues in a take charge, focused manner. The current candidates don't seem to really focus on the real issues in this country. They will say anything to get elected. I hope we can turn all this around......
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Re: U.S. Healthcare

PostBy: traderfjp On: Sun Mar 02, 2008 1:04 am

I'm a firm believer in not re-inventing the wheel. Lets see what works and what doesn't and then go from there. Hmmmmm. :?

gaw wrote:Health care or no health care we all finish the game of life dead. Some sooner than others but all of us will die of something some day and I'll promise you that. At least these "bottom of the board" forums can be exciting and hopefully encourage us all to think but for me thinking makes my brain hurt. If for the sake of argument we accept that France has the worlds best health care we should at least see what the best is like and not dismiss it out of hand. Here are four articles if you want to get a little perspective on how the French do things.
http://www.medicalnewstoday.com/articles/9994.php

http://www.ambafrance-us.org/atoz/health.asp
This link is broken, either the page no longer exists or there is some other issue like a typo.


http://www.businessweek.com/globalbiz/content/jun2007/gb20070628_579158.htm?chan=top+news_top+news+index_global+business
This link is broken, either the page no longer exists or there is some other issue like a typo.

http://news.bbc.co.uk/2/hi/europe/3423159.stm
After looking at these four somewhat diverse perspectives I think you can see that even if we copied the "best system in the world" we will still be arguing and or complaining about health care.

I like to tell everyone I have the best health insurance in the world...as long as I don't get sick. Now where did I put my Yuengling? :beer:

Neat!!! I think this is from France too. :chop:
traderfjp
 
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Re: U.S. Healthcare

PostBy: gambler On: Sun Mar 02, 2008 1:15 am

stockingfull wrote:Bottom line: sure, there are all kinds of problems with engineering a new solution. But I'm sure we can do better than what we have. We can hardly do worse.


Get the government involved in it and it will get worse!
The government always generates the exact opposite of its intent.
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