Healthcare

[dellstart]

if you ever wanted proof , why you shouldn't screw with the system and why socialized medicare doesn't work
I present http://www.telegraph.co.uk/health/79087 ... vices.html

[Fel]

Finger of death...twitching. Must...resist....

Seriously though, the health care system needed reformation.

However, I think the bill they passed sorta did everything BUT what needed to be done to fix things.

All they had to do was kill the antitrust exemptions for insurance companies, then disassemble Blue Cross right to the ground as an ugly object lesson of what will happen to any company that dares try to price fix. The survivors would have gotten the message. Slightly less profit and real attention to customer needs is better than your executives going to prison and your insurance company being chopped up and sold to other companies.

A few other little things would need to be done, but that's the big thing right up there. And unfortunately, this bill doesn't remove antitrust, nor does it mandate real competition within states between insurance carriers.

Why? Simple. The insurance companies poured millions and millions of dollars into Congress to strip out every aspect of reform that would actually reform the system. And money talked.

I see a major overhaul of it within 4 years, once even the stupid idiots in Washington finally admit the truth.

[DigitalMaestro]

I think we all like the idea of healthcare that magically takes care of everyone without costing anything. Since we live in the real world, we have to realize that everything costs money, including healthcare. I have no objection to charity funding healthcare for the poor. What I have a problem with the government taking money out of my pocket, by force, to pay for some random person's care. I won't even go into the issues of funding procedures I find morally objectionable or medically unnecessary.

In addition to the whole socialist redistribution of wealth aspect, the healthcare "reform" has actually put innovative, cost-saving companies out of business by instituting one-size-fits-all "accountability" measures like the 80/20 ratio of health spending to admin spending. Let me have my 401k and my own choice of health insurance or not. It's my problem, not Obama's. BTW- I happen to fall into that demographic that uses almost ZERO healthcare because of my age and my wonderful mother who taught me how to use tylenol and cough syrup, so I find this all even more crazy.

And if anyone brings up the mandate that requires hospitals to provide care regardless of ability to pay, that definitely needs reform to life-saving care only rather than this crap of going to the ER with a freakin headache!

I'm gonna hop off my soapbox and try to shut up about this now.

-DigitalMaestro

[Spec8472]

What I have a problem with the government taking money out of my pocket, by force, to pay for some random person's care.

Then by the same token you shouldn't have a problem with me not paying taxes to fund roads (I don't drive), schools (I've already got my education), a military (I don't like wars), or any number of other things.

It's the same principle.

if you ever wanted proof , why you shouldn't screw with the system and why socialized medicare doesn't work
I present http://www.telegraph.co.uk/health/79087 ... vices.html

Sorry, false statement.
If you cut funding drastically, then yes, it'll "stop working" because you've yanked funding from it.

It's like saying "If you wanted proof that jet engines don't work -- here's what happens when you cut the fuel line".

The NHS, like many large organisations, has many many layers of bureaucracy which sucks up money and gets in the way of running an efficient service.
In Australia it's equivalents are no different.

Socialised healthcare services DO work in principle AND practice. It requires careful management, and regular outside auditing to ensure that it's not being mismanaged or failing to service the population correctly.

Public healthcare services's primary role is to keep the population healthy, and when people are unwell - to do what is necessary to make them well again. That is: it optimises for a healthy population.

A corporation run where it's primary goal is to maximise profits will not achieve the same results. They might treat a lot of people very well, but their goal isn't to reduce the number of cases as that would kill the bottom line.

[DigitalMaestro]

What I have a problem with the government taking money out of my pocket, by force, to pay for some random person's care.

Then by the same token you shouldn't have a problem with me not paying taxes to fund roads (I don't drive), schools (I've already got my education), a military (I don't like wars), or any number of other things.

You have a point that I agree with. I'm trying not to make this tread a full dissertation of my political beliefs, but I'll give you a few more since you brought it up.

I'm a minimalist when it comes to government. I want the Govt to provide emergency services, law enforcement and the military. (Maybe roads, but there are privatized models of roadway ownership that look very interesting to me.) I think we should stop providing 75% of the government services that we currently provide. Those that are necessary can be absorbed into the private sector (education- yes, I went to a private school that didn't accept any Govt funding including vouchers). Those that are not necessary can be left to die or prosper as the market plays.

As to the military: the US governing documents include clauses providing for "the common defense." I can't speak to AU, but here in America, the Govt is obligated to provide military protection. The scale of that military can be adjusted based upon the nature of the global political scheme of things.

Is the US Govt perfect? Heck no! Is our model of govt perfect? Probably not. I still believe that our founding principles are almost as refined as we can get in our day and I'd like to see us going back and taking another look at the directions of our Founding Fathers.

I could continue on this thread for pages, but I think I might get banned so I'll stop here.

-DigitalMaestro

[Bigwind]

if you ever wanted proof , why you shouldn't screw with the system and why socialized medicare doesn't work
I present http://www.telegraph.co.uk/health/79087 ... vices.html

This is a bit of sensationalist reporting. While I agree there will be some cuts, the majority of people who have to use the NHS won't notice the difference. A friend was taken to emergence last week and it was decided he need his appendix out. He went straight to theatre for the operation and was home two days later. His main comment, "Thank God for the NHS!". Twenty years ago, an elderly lady I know waited over two years for a new hip. In January of this year, I was diagnosed as needing a new hip. I went into hospital inside 3 months! Came out after 3 days and am now recovering well.

I don't think the NHS is broken or will be broken by this government!

[Fiferguy]

Alright, I can't not comment on this one.

One serious problem with both sides of the argument in the United States goes back to pure politics. The US has developed such a schism between the two dominant political parties that no matter what idea comes out of one, it's wrong to the other.

Health care is a perfect example of that. Personally, I believe that economic status shouldn't be an inhibitor or whether or not you can get health care. I work full time currently, and I still can't afford health care. I also have a terminal disease. Should I be made to suffer and die simply because I'm not rich enough to afford health care? For the moral and belief arguments--abortion, for instance--I don't really see where that's a decision someone can make for another person. Personally, I don't believe in abortion (since we're using that as an example), but IT'S NOT MY DECISION. That's a decision between a woman and her doctor. Should I have to pay for it? If it means that someone else will help me pay for my nephrectomy when it comes time for it, you bet. I have no problem helping someone when it will in turn help me. "Do unto others," and so on. Same goes for drug addicts and other arguments that have been run against the system.

That being said, however, are there going to be people that abuse the system. Of course. Are there people that abuse the system we currently have? You bet. Are there always going to be people that abuse any system we can come up with? Without a doubt. But we can't make major policy choices based on 10% of the population. We have to make policy choices based on the 90% of the population that won't abuse it, and the 15% of Americans without any health insurance are desperate for something. Anything.

Point and case: in 2008 I sprained my ankle. I got two x-rays taken--one from the top, and one from the side--a brace, and an ace bandage. The doctor didn't even look at it. With no health insurance, the cost to me was $3000. At the time, I was working 20 hours a week at about $9 an hour. No way in the world could I pay that. I found out later that if I'd had health insurance, the cost would've been around $1500 for the treatment, because insurance companies can negotiate lower fees for themselves. But since I couldn't afford insurance, my cost was double. I'm not saying this is in every occurrence, but it happened to me. Why should people like me be overcharged simply because we have no insurance?

There is no system in this world that is perfect. They all have their flaws. But why do honest, hard-working people suffer while health insurance executives take home $13 million paychecks? How many people have to suffer and die from not having health insurance before people wake up and have a bit of a heart?

One of the guiding principles in the world today is the ethic of reciprocity, also known as The Golden Rule. "Do unto others as you would have them do unto you." If you were poor and dying, would you want someone else to help you, or would you want them to pass you on the road and leave you to die, as the priest and Levite did in the story of the Good Samaritan?

[GBLW]

First off, lets start by saying I'm old and I'm Canadian. I'm not sure when Health Care in Canada started, but I know I've been paying income tax here all my working life -- (except for the time I worked in the USA and before you ask, I had a green card while I worked 'south of the border.')

In 1966, while in San Diego, I had a boil lanced - I waited in line for seven hours and was in a 'treatment' for about 4 or 5 minutes - cost "$368.67 - over a week's wages at the time. (I saved the d*** bill and just dug in my medical files to get it - now I know why I used the name 'Ordonez' for the vetrinarian in my story 'Thor's Child' - the quack that treated me then was Dr. Ordonez.) Two weeks later I headed back to Canada, in fact I gave notice at my job in the US of A the day after having my first and only medical treatment down there.

About 15 years ago I was tailgated by a LARGE truck while driving a small car - result: whiplash, multiple broke bones, various cuts & bruises, a skull fracture, as well as a concussion and I stayed in a hospital bed for almost a month, but it was here in Canada - cost to me: "00.00. Medicare and accident insurance not only paid for my treatment and medications, but it repaid my employer the time I was off work - almost six months.
I recovered well enough to be able to once again play soccer in the 'over forty league' and hockey in the 'oldtimers' league.

About 11years ago I had a faulty extension ladder collapse under me while at work - result, an extremely bad back injury - in and out of hospital for a year - finally forced retirement - medical costs to me: $00.00 (barring prescription drugs and even they were subsidized.)

Presently I'm fully disabled, but do NOT collect a disability pension, although I qualify. I can live on the pensions I paid into during my working life here in Canada, so I do and I opted out of the disability pension. I do accept the Pharmacare discount on medications though.

So am I glad I left the US of A over a medical bill? YOU BETCHA!

[dellstart]

GBLW- let me respectfully disagree , you might not be paying directly but through taxes and other means your supporting it.plus when they need all those life threatening operations(That HC will not use due to age , cost availability etc ) , why do so many Canadians use US doctors and hospitals?


I quote (sorry , if its a bit long winded


Wait times

Health Canada, a federal department, publishes a series of surveys of the health care system in Canada based on Canadians first hand experience of the health care system.[52]

Although life threatening cases are dealt with immediately, some services needed are non urgent and patients are seen at the next available appointment in their local chosen facility.

The median wait time in Canada to see a special physician is a little over four weeks with 89.5% waiting less than 3 months.[52]

The median wait time for diagnostic services such as MRI and CAT scans [53] is two weeks with 86.4% waiting less than 3 months.[52]

The median wait time for surgery is four weeks with 82.2% waiting less than 3 months.[52]

Another study by the Commonwealth Fund found that 57% of Canadians reported waiting 4 weeks or more to see a specialist, broadly in line with the current official statistics; 24% of Canadians waited 4 hours or more in the emergency room.[54][55]

Dr. Brian Day was once quoted as saying "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."[56] Day gave no source for his two to three years claim. The Canadian Health Coalition has responded succinctly to Day's claims, pointing out that "access to veterinary care for animals is based on ability to pay. Dogs are put down if their owners can’t pay. Access to care should not be based on ability to pay." [57] Regional administrations of Medicare across Canada publish their own wait time data on the internet. For instance in British Columbia the wait time for a hip replacement is currently a little under ten weeks.[58] The CHC is one of many groups across Canada calling for increased provincial and federal funding for medicare and an end to provincial funding cuts as solutions to unacceptable wait times [59]. In a 2007 episode of ABC News's 20/20 titled "Sick in America," host John Stossel cited numerous examples of Canadians who did not get the health care that they needed.[60] The Fraser Institute, a conservative think tank, claims to do its own research and found that treatment time from initial referral by a GP through consultation with a specialist to final treatment, across all specialties and all procedures (emergency, non-urgent, and elective), averaged 17.7 weeks in 2005.[61][62] However, the report of the Fraser Institute, an organization advocating a "prosperous world through..markets"[63] is greatly at odds with the Canadian government's own 2007 report.[64] Canadian psychiatrist Dr David Gratzer, who is also employed by the libertarian Cato Institute, was once asked by U.S. congressman Dennis Kucinich if he knew what the wait time for diagnostic imaging procedures such as CT scans and MRIs was across Canada. Gratzer began his reply "I can tell you what the Ontario government said it was for cancer and..." when Kucinich cut him short and gave him the true figure of 3 weeks, just as Gratzer was uttering the answer of "six months" to his preferred question.[65]

Criticisms have been laid during the administration of H1N1 shots in 2009, in parts of Canada, including Hamilton and Toronto. "Wait times for flu shots continued to be hours long yesterday [October 29] as Hamiltonians lined up for the only protection from H1N1 that public health can offer. Waits were about five hours at the clinic on the West Mountain, with 1,000 people in line. The Dundas clinic wasn't much better, with 700 waiting for a shot."[10] "Hundreds of people who lined up in Toronto today were given slips of paper with a time on it so they could return for their vaccination without standing around for hours on end." [11]

Since 2002, the Canadian government has invested $5.5 billion to decrease wait times.[66] In April 2007, Canadian Prime Minister Stephen Harper announced that all ten provinces and three territories would establish patient wait times guarantees by 2010. Canadians will be guaranteed timely access to health care in at least one of the following priority areas, prioritized by each province: cancer care, hip and knee replacement, cardiac care, diagnostic imaging, cataract surgeries or primary care.[67]

[DigitalMaestro]

Health care is a perfect example of that. Personally, I believe that economic status shouldn't be an inhibitor or whether or not you can get health care. I work full time currently, and I still can't afford health care. I also have a terminal disease. Should I be made to suffer and die simply because I'm not rich enough to afford health care? For the moral and belief arguments--abortion, for instance--I don't really see where that's a decision someone can make for another person. Personally, I don't believe in abortion (since we're using that as an example), but IT'S NOT MY DECISION. That's a decision between a woman and her doctor. Should I have to pay for it? If it means that someone else will help me pay for my nephrectomy when it comes time for it, you bet. I have no problem helping someone when it will in turn help me. "Do unto others," and so on. Same goes for drug addicts and other arguments that have been run against the system.

I believe that you have the right to pool resources with other consenting people to achieve the supply of healthcare to those in need. I also believe that I have the right to abstain from participation. I have no problem with you contributing into a public health pool, but when your freedom to associate infringes on my right to my own hard earned property, I believe that my right must hold firm.

I HAVE NO PROBLEM WITH GROUP HEALTH PLANS. I think they are a great idea and I may contribute to one some day. At this point, I am not financially able to afford health insurance, but I also can't afford an increase in my taxes to pay for some bloated govt healthcare program that will waste massive amounts of money in bureaucracy. I want independent, efficient health plans (yes they do exist) to continue to be available when I am able to afford health insurance.

Even as a person with a very low income, I don't want to steal from those with more money than myself. If they want to contribute to a fund that happens to benefit me: great, but how can I force them to pay for my well being?

-DigitalMaestro

[Spec8472]

I HAVE NO PROBLEM WITH GROUP HEALTH PLANS.

See, public healthcare IS a group health plan. That everyone contributes to according to their ability to do so.

Spread the cost of a an expensive proposition out over the entire population, and each individual's cost of contribution is relatively minor.
With a series of smaller private healthcare schemes which have only partial takeup - the takeup rate is lower, and cost to contributors is by necessity higher*.

For me, in Australia, I earn a fairly decent wage, so I contribute about AUD$1,500 per year (USD$1300). If I were married, had children, and my wife was a stay-at-home mum, that $1,500 would be the total contribution for all of us.

---
I cbf'ed drawing up the models to demonstrate this - but it's fairly easy to figure out that if you've got the entire working population contributing 1-2% of their wages over some lower-bound, then that's obviously going to have a larger pool of resources than an opt-in scheme where people are more likely to opt-in if they're actually going to get sick. So, the average premium rate for opt-in schemes is going to be higher when it has to support higher claim rates.

[GBLW]

GBLW- let me respectfully disagree , you might not be paying directly but through taxes and other means your supporting it.plus when they need all those life threatening operations(That HC will not use due to age , cost availability etc ) , why do so many Canadians use US doctors and hospitals?

Please reread my FIRST sentence! I KNOW I pay for health care with my taxes. My comment is that I would far rather pay a small amount each month than pay more than a HUNDRED THOUSAND as one lump sum for the various operations I have had in the last twelve or fifteen years. Hell, considering all the operations, x-rays, cat scans, MRIs, body casts, medications, bed time, etc. that I had following even one of my accidents, I'd probably have paid a hundred grand or more both times and I don't know about you, but my pocket book aint that deep. Without the medical procedures I had, I would probably be dead by now -- instead, I can still walk well enough to care for myself, even if I have some days when it's darn hard.

Now I KNOW our health care system is far from perfect, but dammit, you people have a chance to do it right the first time and instead, you're SCREWING IT UP, even worse than it was before! But then, I guess that's the way your political system works -- and no, I'm not saying our political system is one iota better than yours. It ain't, it's just slightly different. Both of our systems need to be cleaned up. 'Pork barrel' politicians and influence pedaling lobbyists need to be kicked out, but I'm not smart enough to tell anyone how to do it. If I knew how to do that, I'd be a (rich?) politician - not a crotchety old fart who writes for his own amusement.

[DigitalMaestro]

I HAVE NO PROBLEM WITH GROUP HEALTH PLANS.

See, public healthcare IS a group health plan. That everyone contributes to according to their ability to do so.

And if it remained entirely voluntary (not "voluntary" like paying income tax is supposed to be in the US) then I wouldn't have a big problem with it. Part of the free market is being able to spend all of one's income in a manner that one finds valuable. I should be able to spend my hard earned dollars on whatever I want (short of infringing on someone else's rights). Before someone brings up that I am paying taxes that fund X, Y, and Z, anyone who looks at my previous posts in this thread will see that I object to ALL govt spending outside of a few basic areas.

Here are the foundations of what I'm saying:
>>Capitalism means I should be able to spend my money without interference by an outside party.
>>>>This incudes the right not to spend my money.
>>I believe the private sector can provide a better product (in this case: healthcare) than any government.
>>>>Bureaucracy tends to stifle innovation and simply grow more and more bloated.

Basically, I want the government to enforce peace by way of military and police force, and then I want it to leave me alone to live as I see fit.

-DigitalMaestro

[Spec8472]

I believe the private sector can provide a better product (in this case: healthcare) than any government.

A standard corporation optimises towards profit for it's shareholders.

This means:
- Find new revenue sources
- Increase prices to what the market can support
- Reduce or eliminate costs wherever possible.
- Don't kill off your revenue sources

A health insurance provider is not going to try and fund broad-scale initiatives to reduce overall illness in the population. (eg: Immunisation, education to encourage exercise, healthy eating, etc).

It will try to extract the maximum profit from it's paying customers by refusing 'non-critical' or 'excessive' coverage. (eg: It's not really a life or death situation if you don't have ALL your toes re-attached if someone runs a mower over them... So we'll pay for one. You can pick which one.)

A health insurance provider will also have less than the whole working population as paying members, so those who ARE paying members will necessarily pay higher premiums as there will be a higher claimant to subscriber number. Because of the higher cost of healthcare, those who are on lower incomes may not be able to afford it.

A system where everyone has a social obligation to pay for certain common resources (health, education, public transport, police, fire, etc) is, in my opinion, a better system than a pure capitalistic system. Everyone shares the load, everyone benefits.

It used to be that if you didn't have fire insurance on your house, then noone would come to help put the fire out.
Going back to that system seems to me to be just as barbaric as not having the ability to walk into an emergency room and have some issue seen to, without someone asking for my insurance/credit card.

[DigitalMaestro]

A standard corporation optimises towards profit for it's shareholders.

This means:
- Find new revenue sources
- Increase prices to what the market can support
- Reduce or eliminate costs wherever possible.
- Don't kill off your revenue sources

A health insurance provider is not going to try and fund broad-scale initiatives to reduce overall illness in the population. (eg: Immunisation, education to encourage exercise, healthy eating, etc).

It will try to extract the maximum profit from it's paying customers by refusing 'non-critical' or 'excessive' coverage. (eg: It's not really a life or death situation if you don't have ALL your toes re-attached if someone runs a mower over them... So we'll pay for one. You can pick which one.)

I'm not saying that MassiveInsuranceCorpXYZ is the answer. If you look at the banking system there are corporate banks with all the evils we complain about therein and then there are credit unions. (I don't know if they exist outside of the US, but we have them and they rock!) I use a local credit union for my banking needs. As a member (account holder), I am a shareholder of the company (ie: a partial owner). The credit union exists to serve me and the other members, not some random board of unattached shareholders. I pay in deposits which provide me with great interest rates through my various accounts. If I choose to take out a loan, I can do so at relatively low interest rates. The organization serves me.

I think there are healthcare models like this and allowing them to flourish with their lower admin costs is beneficial to society as a whole. A good insurance company can promote best practices by doctors which also reduce waste, like those X-Rays someone else mentioned that were never even looked at, without legislating options away from a doctor. Medical decisions should be made by the doctor and the patient. I think we all agree on that.

Spec, as to barbarity, I'm not always interested in being arbitrarily "fair" to the whole human population. I contribute to charities for the needy both as a volunteer and as a donor to organizations on a regular basis, but I don't see the legislated redistribution of wealth as appropriate. I agree that some of the older ways, like private fire departments are not practical. Fires like the Great Fire of Chicago taught us that fires are a community issue just like criminals. I see the line in that illustration as being the community funds the fire dept to stop the fire, but the homeowner must provide the funding (possibly through fire insurance) to rebuild. The same applies to healthcare. If you have an immediately life threatening condition (heart attack, stroke, 2x4 through your chest) you should be able to receive care regardless of ability to pay. All conditions which are not immediately life threatening should be dealt with by the private citizen and any cooperative he has entered into voluntarily.

-DigitalMaestro