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The great Health Care debate!

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vespergirl

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Date: 3/13/2009 9:30:09 PM
Author: coatimundi

Date: 3/12/2009 8:45:48 PM
Author: vespergirl
I don''t think that we should punish the people who can afford good health insurance by making health coverage equally bad for everyone. I would rather see it work very well for most of the country than poorly for everyone. (The current statistic is that there are 48 million uninsured Americans in a country of 310 million people - that means 262 million are insured).

So you''re ok with collateral damage?

If so, 14,000 Americans die every year from lack of coverage.

Is that an ok number for you?
In countries with social medicine, many covered people die from not being able to see specialists or receive treatments in time, or from not having access to the cutting edge treatments we have here - so there is vast collateral damage in those systems as well. In many of those countries, once you hit a certain age, they won''t even treat certain diseases, because it''s considered a waste of resources. So either way, there are going to be people who suffer from the flaws of the system.

Do I think our system is flawed? Yes. I also think that it needs reform. However, I don''t think that social medicine is the answer. I would rather see a flawed capitalist system that works well for the majority than a flawed socialist system that works badly for everyone.
 

Jas12

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Vesper--i am a canadian and can only speak from my own experience, but i have never known of anyone being denied treatment based on age and i have never waited to get care from a specialist (i''ve had a few surgeries for non life threatening issues and waited a few months but this was mostly due to the timing in my schedule and not the health care system.). My grandmother is 88 and just had 3 house calls this week from a doctor due to degenerative neck pain--of course, this was no ''cost'' to her. My dad received life saving heart surgery last year within 30 mins of arriving at a hospital in another province (he was away for work). My sister is type 1 diabetic and sees several specialists a month, just for precaution --no waiting. I live in the north and yes, there is certainly a shortage of Dr''s up here (no one wants to live in the cold) so the government luckily pays for our travel costs to see dr''s in the city. I have no problems with my tax dollars going toward health care--i value this system.
Is our system perfect--far from it, but i have luckily encountered few issues and nor has my extended family. It *is* suffering in canada, and there is talk and movement toward a 2-tier system, but IMO this would be a sad sea change!!! I could not even fathom a private health care system.
 

Maria D

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Here's an interesting graphic that shows "healthy" life expectancy, defined as the average number of years people can expect to live without serious health problems, vs. per capita healthcare expenditure. The bigger the country's bubble, the larger the percentage share of private healthcare funding (over gov't funding). The chart compares the U.S. to European countries.

http://www.petersoninstitute.org/images/fig-kirkegaard20090310-1.gif

If health coverage in countries that spend less money and less private money on healthcare than the U.S. does is so bad, why do these countries enjoy better aggregate healthy life expectancy than we do?

Jas12, I lived in Canada from 1989 to 1995 and had the same experience you describe. My husband and I were relatively healthy to begin with and thought the Canadian healthcare system was fantastic. My daughter was born there and I got excellent pre and postnatal care. Pediatric care was not only very good but pro-active. The city's health department had classes for new moms and access to services such as lactation specialists. People I knew/worked with that were older and had actual health problems also got very good care.

During the years that we lived there the great healthcare debate was going on in the U.S. after Clinton was elected. Our friends and family would ask us how bad was it in Canada -- aren't people waiting years for (name treatment)? There was so much fear of going to the awful socialized medicine program and they pretty much had the same reasoning as you do vespergirl. Of course they were all insured, happy with what they had, and not willing to change it for some unknown that they were being told would lead to catastrophic deficiencies.

Now the pendulum is starting to swing. Even people *with* insurance are worried that they could lose their job and lose their insurance, or that their insurance won't provide the best treatment/care for them, or that they can be cancelled from their plan just when they truly need it. Even though the documentary "Sicko" distorted facts (like implying that the hospital in Havana is for the general public), it also brought to light some very important points about the darkside of our own insurance industry. (This is why I can't stand Michael Moore by the way -- he always ruins a good thesis by basically lying for dramatic effect.) In my opinion, it's not just an issue of insured vs. uninsured. Even the currently insured have plenty of reason to worry.
 

coatimundi_org

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Single payer is the epitome of the capitalist system.

An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.

Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.

The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.

Opponents of Single Payer prefer corporate handling of healthcare.

Why do you think a corporation can do it better than a government agency?

Doesn't the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.

Who benefits from corporate healthcare? The corporations--not the people.
 

coatimundi_org

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Date: 3/14/2009 11:37:13 AM
Author: Jas12
Vesper--i am a canadian and can only speak from my own experience, but i have never known of anyone being denied treatment based on age and i have never waited to get care from a specialist (i''ve had a few surgeries for non life threatening issues and waited a few months but this was mostly due to the timing in my schedule and not the health care system.). My grandmother is 88 and just had 3 house calls this week from a doctor due to degenerative neck pain--of course, this was no ''cost'' to her. My dad received life saving heart surgery last year within 30 mins of arriving at a hospital in another province (he was away for work). My sister is type 1 diabetic and sees several specialists a month, just for precaution --no waiting. I live in the north and yes, there is certainly a shortage of Dr''s up here (no one wants to live in the cold) so the government luckily pays for our travel costs to see dr''s in the city. I have no problems with my tax dollars going toward health care--i value this system.

Is our system perfect--far from it, but i have luckily encountered few issues and nor has my extended family. It *is* suffering in canada, and there is talk and movement toward a 2-tier system, but IMO this would be a sad sea change!!! I could not even fathom a private health care system.

Great post--thank you Jas.
 

elle_chris

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Date: 3/14/2009 1:26:35 PM
Author: coatimundi
Single payer is the epitome of the capitalist system.

An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.

Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.

The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.

Opponents of Single Payer prefer corporate handling of healthcare.

Why do you think a corporation can do it better than a government agency?

Doesn''t the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.

Who benefits from corporate healthcare? The corporations--not the people.

Coati- I absolutely disagree with this.


I work with the Center for Medicare and Medicaid services (CMS). I''m a compliance officer for my company which provides medical equipment to residents in skilled nursing facilities as well as homecare patients.


All a single payer system does is reduce reimbursement rates and sets even tougher regulations on what''s considered medically necessary.
As of this year, they''ve already cut Medicare payments by over 9%. As is it, providers are having a tough time providing patients with items prescribed by the doctors because the cost and reimbursement rates are either too close or less than the manufacturer is charging us.
ThIS in turn requires us to tell the doctor, sorry- while we know it''s still in the best interest of the patient to receive these items we just can''t supply them. This lowers quality of care.
The manufactures’ (Novartis, Smith&Nephew etc.) will not discount their rates because the costs involved in producing these items don’t allow it. We''ve already been down this road with these companies last year when the cut was first announced. The only thing that''s going to change now is that they''re slowly stopping production on items that have PROVEN to help treat various conditions such as Diabetes and Pulmonary disease in our elderly.
This is just one example of what''s going when the government runs our healthcare.
The other is Medical Necessity. We had an audit for something called a trach tube shiley. We were supplying many residents with three per day because due to their heavy secretions, suctioning and trach care were required every shift by the nurses. When a shiley gets taken out of the tube, you need a new one to replace it. It clearly states so on the manufacturers’ directions. Medicare wanted to know why they weren''t being re-used?? THEY''RE NOT supposed to re-used.
The audit went on for almost a year. Went through three different levels of appeals until I had enough and took it to an administrative law judge hearing which is not bound by our governments rules and regulations. We won. Why? Because no matter what the bureaucrat said, supplying the patients with a new shiley after trach care was done, was necessary. But in the end it wasn''t worthwhile. So much time was spent taking it that far, that the cost involved just wasn''t worth it. So we decided to supply one per day just the way Medicare wants. The nurses will have to re-use them even though that’s not proper care.

This is how our government is running a single payer system today. And these were just two examples of the idiocy that goes on.


I do agree that the system as it stands today is broken. Something needs to be done. I just don’t think a government system is the answer after working within it for ten years.


 

coatimundi_org

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Date: 3/14/2009 2:58:08 PM
Author: elle_chris
Because no matter what the bureaucrat said, supplying the patients with a new shiley after trach care was done, was necessary. But in the end it wasn't worthwhile.

Instead of "bureaucrat" insert "corporate executive, company administrator etc." It's the same thing. When profit is removed their will be no need to dispute anything between two different bureaucrats, because the doctors will decide.

I fail to see the difference, and I choose non profit.

The profit system is what makes everyone second guess the care provider.
 

LtlFirecracker

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Date: 3/14/2009 3:35:17 PM
Author: coatimundi
Date: 3/14/2009 2:58:08 PM

Author: elle_chris

Because no matter what the bureaucrat said, supplying the patients with a new shiley after trach care was done, was necessary. But in the end it wasn''t worthwhile.


Instead of ''bureaucrat'' insert ''corporate executive, company administrator etc.'' It''s the same thing. When profit is removed their will be no need to dispute anything between two different bureaucrats, because the doctors will decide.


I fail to see the difference, and I choose non profit.


The profit system is what makes everyone second guess the care provider.

The good thing about for profit is that there is some competition. Going back to the military hospital. There are finally starting to update their maternity ward because now the women can go where they want, and they were all going to a very patient focused private hospital. Remember Washington Post article about the VA hospital in Walter Reed? That article was shocking (and this was when a Republican was in power). Yeah the rats were horrible, but what was worse to me was the picture of these brain damaged people walking around alone trying to work through this bureaucracy. The article described a wife doing the paper work only to find out the bureaucrat lost it. She had to do it again, there was not on to complain to about the behavior of this employee (not like they could fire her anyways). That is a really good article to read, it really shows you how ineffective and heartless bureaucrats can be. And no, the doctors will not decide. In the example about the trach, it dose not sound like the doctor had a say, they had to reuse the piece even though it poses a horrible infection risk.

As I said before, it would be nice if insurance companies could be private non-profits, but that will never happen. I don''t want to see private hospitals and clinics disappear, those are really the best ones, for both the doctors, nurses, and patients. And as several people said before, we would need to chance our mentally about end of life care as well as start pushing other parts of the world to start sharing the costs of these drugs. 90% of all medical costs are spent in the last year of life. Think about that. We are spending most of our money fighting a battle we can''t win, trying to stop death when it can''t be stopped. And for the drug companys, all those countires with socialized medicine just tell the drug companies "hey I know you are charging x for this drug, we will give you half." Well guess who ends up making the difference? If we could address these 2 issues, this would reduce the cost of medicine without needing to go to a government run system. We would need to address them anyways even if we did go to a government run system.
 

zhuzhu

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Date: 3/14/2009 4:07:49 PM
Author: LtlFirecracker

The good thing about for profit is that there is some competition. Going back to the military hospital. There are finally starting to update their maternity ward because now the women can go where they want, and they were all going to a very patient focused private hospital. Remember Washington Post article about the VA hospital in Walter Reed? That article was shocking (and this was when a Republican was in power). Yeah the rats were horrible, but what was worse to me was the picture of these brain damaged people walking around alone trying to work through this bureaucracy. The article described a wife doing the paper work only to find out the bureaucrat lost it. She had to do it again, there was not on to complain to about the behavior of this employee (not like they could fire her anyways). That is a really good article to read, it really shows you how ineffective and heartless bureaucrats can be. And no, the doctors will not decide. In the example about the trach, it dose not sound like the doctor had a say, they had to reuse the piece even though it poses a horrible infection risk.


As I said before, it would be nice if insurance companies could be private non-profits, but that will never happen. I don't want to see private hospitals and clinics disappear, those are really the best ones, for both the doctors, nurses, and patients. And as several people said before, we would need to chance our mentally about end of life care as well as start pushing other parts of the world to start sharing the costs of these drugs. 90% of all medical costs are spent in the last year of life. Think about that. We are spending most of our money fighting a battle we can't win, trying to stop death when it can't be stopped. And for the drug companys, all those countires with socialized medicine just tell the drug companies 'hey I know you are charging x for this drug, we will give you half.' Well guess who ends up making the difference? If we could address these 2 issues, this would reduce the cost of medicine without needing to go to a government run system. We would need to address them anyways even if we did go to a government run system.

Using human behavior (the inherent laziness in some) as an excuse to to not reform the existing healthcare system is not good enough IMO. Undesirable human behavior is not an indication of bad system, rather indication of bad management and education. The organizational objectives have to be set straight for the whole organization, for profit or not. Just because the existing VA system is imperfect does not mean the reformed healthcare system is going to work inefficiently.

Do you know why those counties with socialized medicine can bargain to pay less for the brand name drug and we can't? Because of volume. If our system requires everyone pay a small part of the health insurance so everyone became insured, we will soon have the same "volume" to bargain with pharma to get the same drug for a lot less.

I work with doctors from VA, Scripps hostpital, and US Marines as genetics researcher. I applaud VA for having the electronic system even when I recognize how imperfect it is right now. It is still FAR BETTER than the paper system which takes days and weeks to retrieve some medical record from 5 years ago, and sometimes the doctor's writing illegible.

Also, the big difference between a non-for-profit and for-profit hospital is the wallet biopsy. Someone said earlier that those who are uninsured can get treated in ER? Not so! At for-profit hospitalz you get a wallet biopsy the first 2 minutes you walk into their ER. If you are not insured - sorry you have to go elsewhere. THIS is why for profit hospital seems so much "better" overall. Of course they are performing better, they only select the privileged group of patients to treat, and because so they can afford to keep it small and still pay doctors well and give staff less work to do. However is this elitist mentality appropriate for healthcare, a basic human right to every living person? I personally do not think so.
 

strmrdr

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Date: 3/14/2009 5:03:13 PM
Author: zhuzhu



Do you know why those counties with socialized medicine can bargain to pay less for the brand name drug and we can''t? Because of volume.
not true it is because the US consumers pay for the r&d and the drug trials.
Then they benefit.
Many medications that are still effective have been discontinued because of other countries low balling the bids on them others are being produced to sub US standards in China for the rest of the world.

Then you have enviro-wackos raising the price of inhalers many people cant live without from $10 to $80 each and they are less effective in an emergency.
 

elle_chris

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Date: 3/14/2009 5:03:13 PM
Author: zhuzhu


Using human behavior (the inherent laziness in some) as an excuse to to not reform the existing healthcare system is not good enough IMO. Undesirable human behavior is not an indication of bad system, rather indication of bad management and education. The organizational objectives have to be set straight for the whole organization, for profit or not. Just because the existing VA system is imperfect does not mean the reformed healthcare system is going to work inefficiently.

Do you know why those counties with socialized medicine can bargain to pay less for the brand name drug and we can''t? Because of volume. If our system requires everyone pay a small part of the health insurance so everyone became insured, we will soon have the same ''volume'' to bargain with pharma to get the same drug for a lot less.

I work with doctors from VA, Scripps hostpital, and US Marines as genetics researcher. I applaud VA for having the electronic system even when I recognize how imperfect it is right now. It is still FAR BETTER than the paper system which takes days and weeks to retrieve some medical record from 5 years ago, and sometimes the doctor''s writing illegible.

Also, the big difference between a non-for-profit and for-profit hospital is the wallet biopsy. Someone said earlier that those who are uninsured can get treated in ER? Not so! At for-profit hospitalz you get a wallet biopsy the first 2 minutes you walk into their ER. If you are not insured - sorry you have to go elsewhere. THIS is why for profit hospital seems so much ''better'' overall. Of course they are performing better, they only select the privileged group of patients to treat, and because so they can afford to keep it small and still pay doctors well and give staff less work to do. However is this elitist mentality appropriate for healthcare, a basic human right to every living person? I personally do not think so.
I''m not sure where you''re talking about, but I know in NYS that is simply not true. No hospital is allowed to turn away an ER patient due to lack of insurance. http://hospitals.nyhealth.gov/psa.php.
zhuzhu- The rest of the world doesn''t pay less because of volume. They pay less because like strm said, we pay for the research and development.

Coati- The whole problem is doctors will not deicde. My example above regarding our audit showed that. What a doctor prescribes and what the government wants to pay for, are two very different things. The patients won''t win in the end.
 

LtlFirecracker

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Date: 3/14/2009 5:54:23 PM
Author: elle_chris
Date: 3/14/2009 5:03:13 PM

Author: zhuzhu




Using human behavior (the inherent laziness in some) as an excuse to to not reform the existing healthcare system is not good enough IMO. Undesirable human behavior is not an indication of bad system, rather indication of bad management and education. The organizational objectives have to be set straight for the whole organization, for profit or not. Just because the existing VA system is imperfect does not mean the reformed healthcare system is going to work inefficiently.


Do you know why those counties with socialized medicine can bargain to pay less for the brand name drug and we can't? Because of volume. If our system requires everyone pay a small part of the health insurance so everyone became insured, we will soon have the same 'volume' to bargain with pharma to get the same drug for a lot less.

I am working in an ER right now. This is not true. There are signs everywhere saying that the patient will be seen by a doctor and treated regardless of ability to pay. I am also near the border. We are not allowed to ask any questions about immigration status. Even if the patient states that they were in mexico when an injury happened, we still treat it. When I see a patient, I do not know their insurance status.

I agree the health care needs reform, but I don't think that a government run system is the answer. Addressing the cultural issues and the drug companies would be a more effective first step.


I work with doctors from VA, Scripps hostpital, and US Marines as genetics researcher. I applaud VA for having the electronic system even when I recognize how imperfect it is right now. It is still FAR BETTER than the paper system which takes days and weeks to retrieve some medical record from 5 years ago, and sometimes the doctor's writing illegible.


Also, the big difference between a non-for-profit and for-profit hospital is the wallet biopsy. Someone said earlier that those who are uninsured can get treated in ER? Not so! At for-profit hospitalz you get a wallet biopsy the first 2 minutes you walk into their ER. If you are not insured - sorry you have to go elsewhere. THIS is why for profit hospital seems so much 'better' overall. Of course they are performing better, they only select the privileged group of patients to treat, and because so they can afford to keep it small and still pay doctors well and give staff less work to do. However is this elitist mentality appropriate for healthcare, a basic human right to every living person? I personally do not think so.
I'm not sure where you're talking about, but I know in NYS that is simply not true. No hospital is allowed to turn away an ER patient due to lack of insurance. http://hospitals.nyhealth.gov/psa.php.

zhuzhu- The rest of the world doesn't pay less because of volume. They pay less because like strm said, we pay for the research and development.


Coati- The whole problem is doctors will not deicde. My example above regarding our audit showed that. What a doctor prescribes and what the government wants to pay for, are two very different things. The patients won't win in the end.

EDTED: I am not sure what happened, but I lost lost my post

What I had written was something like this. I am rotating in an ER right now, and patients are not turned away based on insurance status or immigration status. In fact, there are signs all over the ER saying this. We as the providers do not ask any questions about their insurance status, and offer everyone treatment. The only exception is the Kaiser patients, because they are supposed to go to their own ED (unless it is life or death), but they have somewhere to go.

I agree that our system needs reform. I do not agree with a government run system as the answer. I think we need to address the culture issues of our health care issues and the drug companies first. These can be both addressed without going to a government run system.

Also, I am not against the electronic medical record. But I think that doctors and nurses should choose the best one for the hospital. There are far superior ones than the ones the VA and military use. Doctors have been fighting this for years, and they still not have won (another example of how Doctors will NOT get the final say).
 

vespergirl

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Date: 3/14/2009 1:26:35 PM
Author: coatimundi
Single payer is the epitome of the capitalist system.

An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.

Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.

The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.

Opponents of Single Payer prefer corporate handling of healthcare.

Why do you think a corporation can do it better than a government agency?

Doesn''t the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.

Who benefits from corporate healthcare? The corporations--not the people.
Well, I don''t think this is a fair statement to make of most businesses. My husband''s company has been making money hand over fist for the past 10 years. They are an electrical contractor that handles large govt. contracts, and also private contracts. I think part of the reason that they do so well, in fact, is because they are not a union shop. He is a top level executive at the company, but he told me that many of their field electricians make over $100K per year with overtime, so the fact that they aren''t union doesn''t mean that they''re being exploited.

You mention that many large companies are failing - very true of the American automakers, with their inflated union compensation plans. The Japanese automakers with factories in the US are doing very well. It''s because their workers are paid salaries and benefits more commesurate with the skill sets.

I heartily believe that businesses become far less efficient when govt. gets involved.
 

zhuzhu

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Date: 3/14/2009 5:54:23 PM
Author: elle_chris


zhuzhu- The rest of the world doesn''t pay less because of volume. They pay less because like strm said, we pay for the research and development.

My work is in the R&D of novel diagnostic tools and treatment strategy, and my salary is paid by the government (NIH), not by any pharmaceutical companies. My European and Asian colleagues who do excellent works are also funded mostly by their government agencies. It is not just US who is "paying for research". In fact because of Bush''s policy on stem cell research restriction, US is now behind European nations in many scientific front.
 

icekid

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Date: 3/14/2009 9:41:13 PM
Author: zhuzhu

Date: 3/14/2009 5:54:23 PM
Author: elle_chris


zhuzhu- The rest of the world doesn''t pay less because of volume. They pay less because like strm said, we pay for the research and development.

My work is in the R&D of novel diagnostic tools and treatment strategy, and my salary is paid by the government (NIH), not by any pharmaceutical companies. My European and Asian colleagues who do excellent works are also funded mostly by their government agencies. It is not just US who is ''paying for research''. In fact because of Bush''s policy on stem cell research restriction, US is now behind European nations in many scientific front.
zhuzhu- We are referring to pharmaceutical research here, which by and large takes place within private institutions or is funded with private (pharma) money. Countries with socialized healthcare do not pay less for new designer drugs because of volume. They pay less because they REFUSE to fund the research, so the cost instead falls to Americans.
 

icekid

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Date: 3/14/2009 12:09:35 PM
Author: Maria D
Here''s an interesting graphic that shows ''healthy'' life expectancy, defined as the average number of years people can expect to live without serious health problems, vs. per capita healthcare expenditure. The bigger the country''s bubble, the larger the percentage share of private healthcare funding (over gov''t funding). The chart compares the U.S. to European countries.

http://www.petersoninstitute.org/images/fig-kirkegaard20090310-1.gif

If health coverage in countries that spend less money and less private money on healthcare than the U.S. does is so bad, why do these countries enjoy better aggregate healthy life expectancy than we do?
This wouldn''t have anything to do with our obesity and diabetes epidemics, would it? All the money in the world cannot save people who cannot do for themselves.
 

icekid

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Date: 3/14/2009 6:10:28 PM
Author: LtlFirecracker


Date: 3/14/2009 5:54:23 PM
Author: elle_chris


Date: 3/14/2009 5:03:13 PM

Author: zhuzhu

Also, the big difference between a non-for-profit and for-profit hospital is the wallet biopsy. Someone said earlier that those who are uninsured can get treated in ER? Not so! At for-profit hospitalz you get a wallet biopsy the first 2 minutes you walk into their ER. If you are not insured - sorry you have to go elsewhere. THIS is why for profit hospital seems so much 'better' overall. Of course they are performing better, they only select the privileged group of patients to treat, and because so they can afford to keep it small and still pay doctors well and give staff less work to do. However is this elitist mentality appropriate for healthcare, a basic human right to every living person? I personally do not think so.
I'm not sure where you're talking about, but I know in NYS that is simply not true. No hospital is allowed to turn away an ER patient due to lack of insurance. http://hospitals.nyhealth.gov/psa.php.

zhuzhu- The rest of the world doesn't pay less because of volume. They pay less because like strm said, we pay for the research and development.


Coati- The whole problem is doctors will not deicde. My example above regarding our audit showed that. What a doctor prescribes and what the government wants to pay for, are two very different things. The patients won't win in the end.

EDTED: I am not sure what happened, but I lost lost my post

What I had written was something like this. I am rotating in an ER right now, and patients are not turned away based on insurance status or immigration status. In fact, there are signs all over the ER saying this. We as the providers do not ask any questions about their insurance status, and offer everyone treatment. The only exception is the Kaiser patients, because they are supposed to go to their own ED (unless it is life or death), but they have somewhere to go.

I agree that our system needs reform. I do not agree with a government run system as the answer. I think we need to address the culture issues of our health care issues and the drug companies first. These can be both addressed without going to a government run system.

Also, I am not against the electronic medical record. But I think that doctors and nurses should choose the best one for the hospital. There are far superior ones than the ones the VA and military use. Doctors have been fighting this for years, and they still not have won (another example of how Doctors will NOT get the final say).
Ltl- Too funny, I am in the ED this month too (haaaaaaate it!) Anyway, just chiming in to say that I don't personally know of any states where the Emergency Dept is allowed to turn away uninsured patients. I work in a private hosptial this year and many of our patients don't have insurance. We treat them all (as much as I'd like to toss out some of them.) And they get the same expensive medications as everyone else, even though the hospital will never see a dime from them. So the insured patients have to make up the difference, thus they are charged what seem to be rather high prices.

This is also true where I went to medical school in Pennsylvania and Maryland where I will complete my training.

Is there really a state where it is legal to turn people away from the Emergency Dept????


re: EMR- Electronic Medical Records. Yeah, they are a great idea. But I absolutely agree with Ltl. Doctors are NOT NOT NOT the ones making these decisions about what to choose. It is some moron politician who does not know the first thing about medicine who is making decisions. I do not want to practice in that atmosphere.
 

strmrdr

Super_Ideal_Rock
Joined
Nov 1, 2003
Messages
23,295
There are no easy answers to the problem but it is very clear that there is a problem that needs to be solved.
The current system isn''t good for anyone and a lot of needless suffering is happening and that is wrong.
 

coatimundi_org

Ideal_Rock
Joined
Dec 9, 2007
Messages
6,281
Date: 3/14/2009 8:03:51 PM
Author: vespergirl
Date: 3/14/2009 1:26:35 PM

Author: coatimundi

Single payer is the epitome of the capitalist system.


An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.


Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.


The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.


Opponents of Single Payer prefer corporate handling of healthcare.


Why do you think a corporation can do it better than a government agency?


Doesn't the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.


Who benefits from corporate healthcare? The corporations--not the people.

Well, I don't think this is a fair statement to make of most businesses. My husband's company has been making money hand over fist for the past 10 years. They are an electrical contractor that handles large govt. contracts, and also private contracts. I think part of the reason that they do so well, in fact, is because they are not a union shop. He is a top level executive at the company, but he told me that many of their field electricians make over $100K per year with overtime, so the fact that they aren't union doesn't mean that they're being exploited.


You mention that many large companies are failing - very true of the American automakers, with their inflated union compensation plans. The Japanese automakers with factories in the US are doing very well. It's because their workers are paid salaries and benefits more commesurate with the skill sets.


I heartily believe that businesses become far less efficient when govt. gets involved.

I'm not talking about most businesses. I am talking about corporations.

If you think businesses become far less efficient when government gets involved, then why is your husband's company handling large government contracts? Operating off a government contract is, in fact, a government subsidy.

In fact, if you aren't in a union, you do not have the same leverage in negotiating contracts that a union member does.

The largest corporate bankruptcies in US history have all occurred in the last 8 years.

Foreign auto makers operating in the US are subsidized by the governments of their home countries. Additionally, because they operate in "right to work" states, they are given large public tax breaks. Coincidentally, those various states have political representatives that operate on a strictly anti union agenda.


How do you feel about US representatives taking money from foreign countries to put Americans out of work? If you think putting an American out of work is worth reducing an hourly wage by a couple of dollars so the top level executives can make larger salaries, then I would suggest you research the basic tenets of capitalism.

That's not competition, that's collusion.


The opinions expressed in this thread are abhorrent to me, because they place a higher value on an individuals desire to acquire wealth, than a country's ability to provide a standard of living for everyone. That's not a trade off I am interested in.

I am out of this thread.
 

zhuzhu

Ideal_Rock
Joined
Mar 15, 2006
Messages
2,503
Just because emergency dept is not allowed to turn away uninsured patients does not mean they are not doing it:

http://www.citizen.org/pressroom/release.cfm?ID=170

"more than one in five hospitals throughout the country have violated the law (1986 Emergency Medical Treatment and Active Labor Act ), and "For-profit hospitals had a significantly higher rate of violation (1.7 times higher) than not-for-profit hospitals.

" (I wonder why).

In fact doctors do not know half of the procedures patients have to go through before they actually see them.

That fact that only a subset of us have good insurance coverage others don't, is the reason why healthcare is so expensive in this country:
http://gov.ca.gov/speech/5931/
 

beebrisk

Brilliant_Rock
Joined
Dec 18, 2005
Messages
1,000
Date: 3/14/2009 10:21:16 PM
Author: coatimundi
Date: 3/14/2009 8:03:51 PM

Author: vespergirl

Date: 3/14/2009 1:26:35 PM


Author: coatimundi


Single payer is the epitome of the capitalist system.



An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.



Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.



The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.



Opponents of Single Payer prefer corporate handling of healthcare.



Why do you think a corporation can do it better than a government agency?



Doesn't the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.



Who benefits from corporate healthcare? The corporations--not the people.


Well, I don't think this is a fair statement to make of most businesses. My husband's company has been making money hand over fist for the past 10 years. They are an electrical contractor that handles large govt. contracts, and also private contracts. I think part of the reason that they do so well, in fact, is because they are not a union shop. He is a top level executive at the company, but he told me that many of their field electricians make over $100K per year with overtime, so the fact that they aren't union doesn't mean that they're being exploited.



You mention that many large companies are failing - very true of the American automakers, with their inflated union compensation plans. The Japanese automakers with factories in the US are doing very well. It's because their workers are paid salaries and benefits more commesurate with the skill sets.



I heartily believe that businesses become far less efficient when govt. gets involved.




The opinions expressed in this thread are abhorrent to me, because they place a higher value on an individuals desire to acquire wealth, than a country's ability to provide a standard of living for everyone. That's not a trade off I am interested in.


I am out of this thread.


I couldn't agree more with Vesper here (I know, shocking...right??).

This country's foundation is BASED on individualism! If any "individual" has the desire to acquire wealth in a legal, responsible fashion, then you know what? God bless 'em. This is still America last time I looked. As far as "the country's ability to provide a standard of living for everyone", are you talking about the government's ability to provide that standard? When was it ever the job/responsibility of the government to provide anyone with anything?? Now of course, you might be talking about socialism. But that's a trade off most American's are not interested in.

Coati, your's is an interesting perspective coming from someone who has acquired one of the most amazing diamond/gem collections I've seen posted on PS to date.
 

elle_chris

Ideal_Rock
Joined
Feb 19, 2004
Messages
3,480
Zhuzhu- All I can say is people need to learn their rights so it wouldn''t happen.


Coati- I didn''t get the impression this was about the "rich" not wanting to give up their benefits. Everyone on this thread believes that there needs to be reform. Many of us have differing opinions on how it should be done. My opinion stems from the fact that I work with a government run healthcare program and see how it''s "cost effectivness" delays and lowers the quality of care.

In the end, I don''t believe there could ever be a true equal healthcare system.
In the U.K. for instance, i know people who buy private insurance so they don''t need to go on lists and spend months waiting for procedures. In Greece and Poland patients bribe doctors for better care. I''m just naming place i have family in. I''ve also met a few canadians who crossed the border into the U.S. for treatment, as well americans who go to canada to have their Rx''s filled because it''s so much cheaper.

No system is perfect. But for me, after seeing how the government runs just one portion of the populations insurance, the thought of them running the rest of ours- well it''s pretty horrifying.
 

beebrisk

Brilliant_Rock
Joined
Dec 18, 2005
Messages
1,000
Date: 3/15/2009 12:26:44 AM
Author: elle_chris
Zhuzhu- All I can say is people need to learn their rights so it wouldn''t happen.



No system is perfect. But for me, after seeing how the government runs just one portion of the populations insurance, the thought of them running the rest of ours- well it''s pretty horrifying.

Let''s not forget all these years of efficiency and fiscal responsibility they''ve exhibited with the Social Security system.
 

vespergirl

Ideal_Rock
Joined
Jan 29, 2007
Messages
5,497
Date: 3/14/2009 10:21:16 PM
Author: coatimundi

Date: 3/14/2009 8:03:51 PM
Author: vespergirl

Date: 3/14/2009 1:26:35 PM

Author: coatimundi

Single payer is the epitome of the capitalist system.


An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.


Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.


The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.


Opponents of Single Payer prefer corporate handling of healthcare.


Why do you think a corporation can do it better than a government agency?


Doesn''t the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.


Who benefits from corporate healthcare? The corporations--not the people.

Well, I don''t think this is a fair statement to make of most businesses. My husband''s company has been making money hand over fist for the past 10 years. They are an electrical contractor that handles large govt. contracts, and also private contracts. I think part of the reason that they do so well, in fact, is because they are not a union shop. He is a top level executive at the company, but he told me that many of their field electricians make over $100K per year with overtime, so the fact that they aren''t union doesn''t mean that they''re being exploited.


You mention that many large companies are failing - very true of the American automakers, with their inflated union compensation plans. The Japanese automakers with factories in the US are doing very well. It''s because their workers are paid salaries and benefits more commesurate with the skill sets.


I heartily believe that businesses become far less efficient when govt. gets involved.

I''m not talking about most businesses. I am talking about corporations.

If you think businesses become far less efficient when government gets involved, then why is your husband''s company handling large government contracts? Operating off a government contract is, in fact, a government subsidy.

In fact, if you aren''t in a union, you do not have the same leverage in negotiating contracts that a union member does.

The largest corporate bankruptcies in US history have all occurred in the last 8 years.

Foreign auto makers operating in the US are subsidized by the governments of their home countries. Additionally, because they operate in ''right to work'' states, they are given large public tax breaks. Coincidentally, those various states have political representatives that operate on a strictly anti union agenda.


How do you feel about US representatives taking money from foreign countries to put Americans out of work? If you think putting an American out of work is worth reducing an hourly wage by a couple of dollars so the top level executives can make larger salaries, then I would suggest you research the basic tenets of capitalism.

That''s not competition, that''s collusion.


The opinions expressed in this thread are abhorrent to me, because they place a higher value on an individuals desire to acquire wealth, than a country''s ability to provide a standard of living for everyone. That''s not a trade off I am interested in.

I am out of this thread.
In response to your highlighted comment, I think the better question would be, why does the government hire private companies for contracts? The reason is because private, non-union companies get the job done better, faster, and more efficiently. If a union shop would have done a better job, then they would have won the bids.

Have you ever lived in a socialist country, where the idea is that "everyone gets the same standard of living"? My parents have, and they escaped under risk of being shot if they were caught trying to leave. They can tell you that it wasn''t a case of everyone enjoying a nice, middle-class lifestyle. Instead, everyone devolves to the level of the poor, and people are no longer motivated to try and achieve, because any extra effort is not rewarded. Like most federal jobs in this country, mediocrity is rewarded, and exceptional talent is ignored.

There are some socialist countries, like Sweden, where the system seems to be working well. However, that is a homogeneous cultures in a country with a small population, with a culture that values hard work and responsibility towards each other. In Sweden, everyone benefits, but everyone also contributes. In this country, there are millions of people that were raised in a culture of entitlement - they have lived for generations with their hands out, and the entitlement mentality is passed down through the generations. These people do not contribute, but they are the recipients of all the social programs. Socialism only works if everyone contributes, but it''s not fair for the hardworking and educated to have to provide for everyone else - this is a capitalist country, not a socialist one (yet). I will note that in countries like France, that used to have a thriving socialist system, once they started accepting refugees from cultures that are happy to take advantage of entitlements, now the socialist systems are being taxed and no longer working as well.

I think it''s really interesting that some people who espouse the utopian systems of socialist countries have never necessarily lived in one. I know that there are some folks on here who live in Canada or other places with social health care systems who are fine with the health system there, and that''s fine if they are happy with it. However, as an American with a PPO, I don''t want the quality of my health care to be compromised, or not be able to see specialists in a timely manner. It isn''t progress if most people end up with a less efficient and effective system than they have now.
 

beebrisk

Brilliant_Rock
Joined
Dec 18, 2005
Messages
1,000
Date: 3/15/2009 4:01:20 PM
Author: vespergirl
Date: 3/14/2009 10:21:16 PM

Author: coatimundi


Date: 3/14/2009 8:03:51 PM

Author: vespergirl


Date: 3/14/2009 1:26:35 PM


Author: coatimundi


Single payer is the epitome of the capitalist system.



An insurance company is successful, because the larger the customer base, the less its product costs. Higher quality care is the result.



Currently, the federal government is prevented from operating in this way, because the insurance companies are violating the practices of free trade. The Single Payer system would allow Medicaid to play on the same playing field with the insurance companies. All the same doctors--all the same patients. The result is coverage for everyone.



The crux of the issue is that Single Payer would eliminate for profit health care. Money spent on healthcare would go to healthcare rather than CEO pay, marketing budgets, overhead expenses and perks. Money will go to doctors, nurses, hospitals, labs etc.



Opponents of Single Payer prefer corporate handling of healthcare.



Why do you think a corporation can do it better than a government agency?



Doesn''t the last 8 years suggest that corporations left to their own devices will not, in fact, deliver a better product?. They hoard the wealth. They do not create jobs. If fact, they take jobs away from Americans and ship them overseas--in their pursuit of higher profits which benefit only the top tiers of management.



Who benefits from corporate healthcare? The corporations--not the people.


Well, I don''t think this is a fair statement to make of most businesses. My husband''s company has been making money hand over fist for the past 10 years. They are an electrical contractor that handles large govt. contracts, and also private contracts. I think part of the reason that they do so well, in fact, is because they are not a union shop. He is a top level executive at the company, but he told me that many of their field electricians make over $100K per year with overtime, so the fact that they aren''t union doesn''t mean that they''re being exploited.



You mention that many large companies are failing - very true of the American automakers, with their inflated union compensation plans. The Japanese automakers with factories in the US are doing very well. It''s because their workers are paid salaries and benefits more commesurate with the skill sets.



I heartily believe that businesses become far less efficient when govt. gets involved.


I''m not talking about most businesses. I am talking about corporations.


If you think businesses become far less efficient when government gets involved, then why is your husband''s company handling large government contracts? Operating off a government contract is, in fact, a government subsidy.


In fact, if you aren''t in a union, you do not have the same leverage in negotiating contracts that a union member does.


The largest corporate bankruptcies in US history have all occurred in the last 8 years.


Foreign auto makers operating in the US are subsidized by the governments of their home countries. Additionally, because they operate in ''right to work'' states, they are given large public tax breaks. Coincidentally, those various states have political representatives that operate on a strictly anti union agenda.



How do you feel about US representatives taking money from foreign countries to put Americans out of work? If you think putting an American out of work is worth reducing an hourly wage by a couple of dollars so the top level executives can make larger salaries, then I would suggest you research the basic tenets of capitalism.


That''s not competition, that''s collusion.



The opinions expressed in this thread are abhorrent to me, because they place a higher value on an individuals desire to acquire wealth, than a country''s ability to provide a standard of living for everyone. That''s not a trade off I am interested in.


I am out of this thread.

In response to your highlighted comment, I think the better question would be, why does the government hire private companies for contracts? The reason is because private, non-union companies get the job done better, faster, and more efficiently. If a union shop would have done a better job, then they would have won the bids.


Have you ever lived in a socialist country, where the idea is that ''everyone gets the same standard of living''? My parents have, and they escaped under risk of being shot if they were caught trying to leave. They can tell you that it wasn''t a case of everyone enjoying a nice, middle-class lifestyle. Instead, everyone devolves to the level of the poor, and people are no longer motivated to try and achieve, because any extra effort is not rewarded. Like most federal jobs in this country, mediocrity is rewarded, and exceptional talent is ignored.


There are some socialist countries, like Sweden, where the system seems to be working well. However, that is a homogeneous cultures in a country with a small population, with a culture that values hard work and responsibility towards each other. In Sweden, everyone benefits, but everyone also contributes. In this country, there are millions of people that were raised in a culture of entitlement - they have lived for generations with their hands out, and the entitlement mentality is passed down through the generations. These people do not contribute, but they are the recipients of all the social programs. Socialism only works if everyone contributes, but it''s not fair for the hardworking and educated to have to provide for everyone else - this is a capitalist country, not a socialist one (yet). I will note that in countries like France, that used to have a thriving socialist system, once they started accepting refugees from cultures that are happy to take advantage of entitlements, now the socialist systems are being taxed and no longer working as well.


I think it''s really interesting that some people who espouse the utopian systems of socialist countries have never necessarily lived in one. I know that there are some folks on here who live in Canada or other places with social health care systems who are fine with the health system there, and that''s fine if they are happy with it. However, as an American with a PPO, I don''t want the quality of my health care to be compromised, or not be able to see specialists in a timely manner. It isn''t progress if most people end up with a less efficient and effective system than they have now.


36.gif
36.gif
36.gif
x 2 !
 

LtlFirecracker

Ideal_Rock
Joined
Feb 29, 2008
Messages
4,837
Icekid: I am in CA - and the only ED that I know of that was turning people away got shut down. Yesterday, the nurses actually tried to find a patient who they thought left the waiting area (just turned out she was in a room and the computer didn't move her). Where I work, it is a big deal if a patient who checks in isn't seen. And the EMRs that the private hospitals I have worked with are very good. But there is a ton of physician and nursing input. That is the way it should be. We are the ones using it.

I went to medical school in PA. Remember MCP Hospital?? It was a hospital the served the poorest of the poor (well there and Temple). The year Clinton had promised everyone he would balance the budget, he did that by not paying any medicare bills for one year. That was really the final straw for a hospital that had only medicare patients, and it had to shut down. So a hospital in a much needed area closed, and one of the big reasons was because of a government run insurance company refusing to pay. I can't stand medicare, they just keep lowering standards. They are the leaders for all the insurance companies. Medicare decides they are not going to pay for something, guess what? All the HMO's follow (well if medicare is not paying it, why should we?). I don't understand why the payer who is the first to say "no" is who so many want as the single payer.

Vespergirl: You make a lot of good points. I think a lot of this is idealism vs reality, and while socialism is a nice idea, in most places, it does not seem to work so well in practice. Most people I have talked to from England prefer our health care system over theirs.
 

zhuzhu

Ideal_Rock
Joined
Mar 15, 2006
Messages
2,503
Ask them if they would still like to have our healthcare system in a economy where so many people are being laid-off, used-up all their COBRA, and can not purchase (or can not afford to buy) individual insurance due to pre-existing conditions.
 

ksinger

Ideal_Rock
Premium
Joined
Jan 30, 2008
Messages
5,078
If the elderly, the chronically ill, and the poor, who are a total drain on the rest of us and clearly have either never, or are no longer contributing anything to society, would simply have the decency to die - and quickly for god''s sake - no taking resources better spent on younger more productive people, we wouldn''t be having this discussion.
 
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