Just when you thought socialised medical care was the answer . . .

[Unicron]

I'm not sure if America can support universal health care. Universal health care was invented for an entirely different national reality.

America is almost a 3rd world country...but with debt.



Then again, I could be wrong. Maybe health care could work for you too.

Sometimes I'm glad my grasp of maths and economics is so shallow. I just don't want to know how bad things really are.

 

[jbander]

Yes.. I understand my own comment.. the problem is you don't understand how healthcare and insurance work.

You are right.. the physician that makes the decision for the hmo is NOT your doctor..

That's GREAT for you.. because in the American system.. in general.. you have a doctor THAT WORKS FOR YOU. So.. the insurance company's doctor may say one thing.. and your doctor says another.. and then it goes to independent review so on and so forth. And usually.. if its medically necessary, your physician wins and YOU win.. because at the end of the day.. in America , in a lawsuit.. very few support the insurance company..

In a socialized system.. the physician that makes the decisions for the public insurance is NOT your physician.. and guess what? The physician that is treating you? In general THEY WORK FOR THE PUBLIC SYSTEM... not for you. Its that public system that pays them.. its that public system that determines what they get paid. and therefore the needs of the patient are often secondary.

In America.. if an insurance company is bending over my patients, I can refuse to take that insurance... and so can the other physicians.. and often that insurance has to come around because patient choice and the free market curbs it all depending on cost and profit.

As far as making a profit? You are right.. one is trying to make a profit and the other doesn't. Which means that the one that tries to make a profit.. only makes profit if it keeps its customers happy. Because if it doesn't.. then people will go elsewhere for that product and they LOST money.


In a non profit single payer? the government could care less about making the customer happy, most people aren't sick, and besides.. where else can they go? Well, unless they have enough money.. then they can go elsewhere... but otherwise.. they are stuck with a government system that possible could give a rip.. or whose only concerns is being CHEAP. Because the politicians in general have the means to step out of their system whenever they want.

And before you wish single payer... answer this.. do you want a michelle bachman, or a rick perry, or a santorum or even a Jeb Bush in charge of your healthcare? And before you answer.. please note that currently.. there is a government prohibition on letting government insurance pay for a woman to have an abortion.. and that has stayed in place with both democrats AND republicans.

The doctor, depending on the government program, can be exactly as determent and caring and as personally concerned as a private doctor. My experience in fact has been that they are more helpful. There is simply one thing that you can't get around and if you are the Conservative I think you are you will understand and that is that There is no conscience in capitalism or as it has been put by many conservative economist, there is no place for conscience in American capitalism. I believe that has been achieved and all that is left is a balance between Money on one side of the scale and conscience on the other side. I know you know that physicians across this country have moved towards larger and larger corporate structures and I would submit that every step in that direction is the same amount of steps away from conscience.
You have the normal hatred and express your feeling of the incompetence of government , well in the last 5-6 years I'd rather have the government take care of many things , medical being one of them. Your beloved American capitalism is as sick as it has been during my 70 years . Our first countries economist Adam Smith in 1776 put it plainly and accurately, there is times in our history when prices and wages are not set by the demand but by business themselves , this is one of those times.

 

[iangb]

You didn't have the confidence to quote me directly so I'd notice a response?

I didn't negate its existence.. just injected some reality into the conversation. Its not like all of America is going bankrupt without healthcare insurance or getting healthcare. And as I point out.. it makes more sense to bring that 10% up onto insurance.. rather than lower the quality of insurance for 85% of americans.

I never claimed 'all of America is going bankrupt'. On the other hand, you did claim that "The us is not really a two tiered system because the folks that don't have insurance are a tremendous minority". So I repeat - that ten percent is a significant number of people. And in any system of healthcare, the existence of a private system does not lower the quality of the public system.

Yeah no... it shows that your wealthy and upper middle class have a system that the rest of the public doesn't enjoy.

Nonsense - as I've already pointed out (and you've not included in your quoted reply), the cost of private medical insurance for a UK family of four is £700 to £1650 ($1,000 to $2,500) - entirely affordable for the vast majority. In the US, the average family insurance premium is $13,400. If anyone is guilty of having a system which the poor cannot afford, it is the US.

Categorically false... In the US, if you don't pay anything.. you still get care (often expensive because its emergency care)..

If it was the case that you got a comparable level of care without paying, people would not need to buy health insurance.

and paying more if you have insurance does not give you more care than other people with insurance which is most people.

Different companies will charge you different amounts for different services, including level of cover, deductibles, etc. The more you pay, the more you get.

Unlike your system in which there is one for the rich.. and then another for everyone else.

False - there is one system for everyone, the rich included, plus an extra option if you want it. As mentioned above, it is hypocritical in the extreme to make this comparison with the US, where the barrier to entry is far higher and the quality of care for those who fall below the barrier is far lower.

Yeah,,.again, that's false because we have public insurance systems here as well.. Medicare, Medicaid and VA.. In addition we have laws that require providers to provide emergency and lifesaving care. In fact.. in many cases we are forced to provide other care even though we know the patient has no ability or no intention of paying.

I'm not going to feel sorry for you because you are forced, in your role as a medic, to save someone's life even though they can't afford it.

As your own argument describes the US system, there isn't much difference between it and the UK. The only differences are that 1) The UK's state system is open to everyone, not just a certain few, and 2) It costs much, much more to get into the private system in the US.

Yep.. 45,000 with 30 million uninsured? Okay.. lets put that in perspective..

Your quote is uncited, unlinked and as such unimportant. Try again when you can actually reference something, and I'll comment on the thing being referenced.

Sure it does... that's why your wealthy choose to step outside the system. While in America, the ceo with Blue Cross blue shield is getting the same care as the janitor with blue cross blue shield.

In the UK, the CEO with the BUPA coverage will get the same care as the janitor with the BUPA coverage. The only difference, as mentioned before, is that in the UK the janitor is more likely to be able to afford it - and if he can't, he still gets care with an 80% level of patient satisfaction.

You erroneously think that your cheaper healthcare doesn't come at some cost to care. I suppose you believe in fairies and unicorns as well. But your system has a cost to cover all those people with a public system.. whether you want to believe it or not.

See the previous graph I posted - the US spends far more per person than the UK (double the amount!), but has a lower life expectancy - whereas pretty much every other developed country follows the pattern of more expenditure = higher LE.

 

[iangb]

Sure.,,. you complain about things you love... right.....

Brit psychology. Come and see, one day

"you most often get yoru choice of physician when it matters"...

The problem is that you aren't even away of when it really matters.. because you have little choice from the get go.

See below..

Most of the time the decision is made by people with a far better medical and professional knowledge than the patient. Even then, an option is normally given.

Bingo.. and that's the difference between the US and the UK.. You just justified why your rate of death from cancer is so much higher and why the US survival rate of cancer is much higher. The us is willing to spend more money to help the individual...

While the UK would rather make it cheaper.

Did you not read all of what I wrote? Part of the time the medication that is proscribed to patients in the US is not only unnecessary, but causes complications which require further treatment.

The US is not willing to spend more money 'to help the patient', the US is willing to spend more money because it makes more profit.

Yeah.. except that fellow with cancer? He is most likely covered since we have public insurance that covers him when he gets that ill.. and he still gets livesaving surgery even without insurance.

'When he gets that ill', the UK system would already have noticed, diagnosed and treated. Your advantage in cancer diagnosis levels is due to over-diagnosis at a very early stage, which will not happen with an uninsured patient because they won't go for the scans.

I do know.. that's why your 5 year survival rate is half of the US survival rate.. its why your rate of death from cancer is significantly higher. Because you opt for cheaper..

See the graph previously. People in the UK die older, on average, than in the US - and without all that money being spent either. Of course everyone is going to die of something eventually - so it just means that if we have a higher proportion of cancer deaths, we have a lower proportion of deaths from other causes.

 

[Somerville]

In post #74, is an unattributed quote, as noted by one of our British comrades (not a communist)

the Chief Medical Officer for England estimated that 60 000 to 255 000 NHS patients each year suffer serious disability or death as a result of healthcare interventions
Department of Health. An Organisation with a Memory: Report of an Expert Group on Learning from Adverse Events in the NHS. Chaired by the Chief Medical Officer. London: Department of Health, 2000.

for those interested, here's a link to the archived paper but it probably isn't worth clicking as a more recent study found it to be useless in actually determining the number of preventable deaths in British hospitals

Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study

Results: Reviewers judged 5.2% (95% CI 3.8% to 6.6%) of deaths as having a 50% or greater chance of being preventable. The principal problems associated with preventable deaths were poor clinical monitoring (31.3%; 95% CI 23.9 to 39.7), diagnostic errors (29.7%; 95% CI 22.5% to 38.1%), and inadequate drug or fluid management (21.1%; 95% CI 14.9 to 29.0). Extrapolating from these figures suggests there would have been 11 859 (95% CI 8712 to 14 983) adult preventable deaths in hospitals in England. Most preventable deaths (60%) occurred in elderly, frail patients with multiple comorbidities judged to have had less than 1 year of life left to live.

Conclusions The incidence of preventable hospital deaths is much lower than previous estimates. (CI) = Confidence Interval

Compare with the number of preventable hospital deaths in the US

Hospital Errors are the Third Leading Cause of Death in U.S., and New Hospital Safety Scores Show Improvements Are Too Slow

Washington, D.C., October 23, 2013 – New research estimates up to 440,000 Americans are dying annually from preventable hospital errors. This puts medical errors as the third leading cause of death in the United States, underscoring the need for patients to protect themselves and their families from harm, and for hospitals to make patient safety a priority.

A journalist's look at the problem provides a decent summary

With these latest revelations, medical errors now claim the spot as the third leading cause of death in the United States, dwarfing auto accidents, diabetes and everything else besides Cancer and heart disease. Harvard’s Dr. Lucian Leape, the father of the patient safety movement and one of the experts behind the original IOM report, says the numbers in this new study should supplant the IOM estimates from 1999. That means hospitals are killing off the equivalent of the entire population of Atlanta one year, Miami the next, then moving to Oakland, and on and on.

These people are not dying from the illnesses that caused them to seek hospital care in the first place. They are dying from mishaps that hospitals could have prevented. What do these errors look like? The sponge left inside the surgical patient, prompting weeks of mysterious, agonizing abdominal pain before the infection overcomes bodily functions. The medication injected into a baby’s IV at a dose calculated for a 200 pound man. The excruciating infection from contaminated equipment used at the bedside. Sadly, over a thousand people a day are dying from these kinds of mistakes.
<snip>
The reason many hospital leaders fail to put a priority on safety is that we as a country haven’t forced them to do so. On the contrary, we haplessly pay them for these errors. We tolerate hospital lobbyists insisting on hiding their error rates. We fail to insist on safety when we choose where to seek care or when we put together our business’ health benefits. When we don’t demand safety, they don’t supply it.

 

[jaeger19]

The doctor, depending on the government program, can be exactly as determent and caring and as personally concerned as a private doctor. My experience in fact has been that they are more helpful. There is simply one thing that you can't get around and if you are the Conservative I think you are you will understand and that is that There is no conscience in capitalism or as it has been put by many conservative economist, there is no place for conscience in American capitalism. I believe that has been achieved and all that is left is a balance between Money on one side of the scale and conscience on the other side. I know you know that physicians across this country have moved towards larger and larger corporate structures and I would submit that every step in that direction is the same amount of steps away from conscience.
You have the normal hatred and express your feeling of the incompetence of government , well in the last 5-6 years I'd rather have the government take care of many things , medical being one of them. Your beloved American capitalism is as sick as it has been during my 70 years . Our first countries economist Adam Smith in 1776 put it plainly and accurately, there is times in our history when prices and wages are not set by the demand but by business themselves , this is one of those times.

Have you ever worked in a socialized medicine country as a provider? I have.. and have observed.. and have hired here providers from other countries. There is much more freedom for a provider to provide the care that they feel the patient needs in the US than in socialized countries. In a socialized country.. you are bound by the system.. and whats the protocol or "standard set by the government"... that's in part how they contain their costs.

That's the problem with you liberals.. you think its a free lunch and don't realize that lower cost of care.. comes with a price.

You are right.. there is no conscious in capitalism and that's a good thing. Because do you want your medical care be government by someone who say has the conscious of Michelle Bachman or Rick Santorum who think its morally wrong for a woman to have an abortion or use birth control?

Do you want a government official in charge of your healthcare whose conscious tells him that your HIV treatment shouldn't be covered because you got your disease from being immoral.

Hatred of government? Far from it. Conservatives BELIEVE in government.. small and efficient government. Government certainly has a role... but we understand reality and that reality is that government is not always the benevolent protector that you liberals think it is.

One only has to look at the VA to realize just how problematic government can be. And of course you liberals used to tout the VA as a wonderful example of how well government can take care of your medical needs... well until it was found out that the VA was lying about how well they were doing.. that they were cooking the books to look better politically.

As far as moving toward larger and larger corporate structures.. you are certainly right.. and do you know WHY? Because that's the result of moving toward a more socialized system and lower costs. That's the irony of your complaint of moving toward a larger corporate structure. That's in response to declining reimbursement and more socialization of the market. There is efficiency in large systems.. that's how they make it.
Its exactly why socialized countries do the same thing.. large hospital systems that control how many providers can be in an area etc. Again.. that's how they keep costs down. The more choice that the patient has.. the more expensive the care because of the loss of efficiency.
So that's the irony... if you decry a large "corporate structure"... your socialized medicine ends up with that very thing. Its how they control costs.

 

[jaeger19]

.

You didn't have the confidence to quote me directly so I'd notice a response?

Please.. I used your direct quotes.. I just don't "reply with quote" because I don't want to use up character limit with your post.

On the other hand, you did claim that ". So I repeat - that ten percent is a significant number of people. And in any system of healthcare, the existence of a private system does not lower the quality of the public system.

10% is still a vast minority... no matter how much you try to wiggle around it.

Nonsense - as I've already pointed out (and you've not included in your quoted reply), the cost of private medical insurance for a UK family of four is £700 to £1650 ($1,000 to $2,500) - entirely affordable for the vast majority. .

Except the vast majority of americans get their healthcare through their employer, so that "average premium" is certainly skewed. See that facts just don't support your diatribe... we certainly have more than 10% of America that is poor, lower middle class or middle class... yet only 10% don't have healthcare insurance. And we have government programs that cover the poor as well especially medicare and Medicaid.
The difference is that when the poor patient with medicare goes in for a total knee.. he is in the same room with the rich person with private insurance ( or they have medicare.. because our government program is so good that rich people like it)..

While in your country.. the poor person waits and waits for his knee and maybe doesn't get it.. while the rich person trots out and pays privately and gets what he needs.

If it was the case that you got a comparable level of care without paying, people would not need to buy health insurance.

Well and that's the problem with the American system... because we do provide that care without buying health insurance.. which has encouraged many to NOT purchase health insurance. Which raises the prices for the rest of us. not to mention that its pretty inefficient because you get that good care after you are really sick.
But the fact is.. that many in that 10% of americans go without healthcare insurance not because they cannot afford it.. but because the CHOOSE not to afford it. Because they are not sick..and if they really go south.. their are multiple safety nets that will provide that care.

Different companies will charge you different amounts for different services, including level of cover, deductibles, etc. The more you pay, the more you get.

No.. again that's not really true. Provider contracts are based on whats medically necessary and when we accept insurance we have to treat patients equally.

False - there is one system for everyone, the rich included, plus an extra option if you want it..

Nice try.. that "extra option" is for the rich that can afford it.. not people that "want it".. and its not hypocritical to make the comparison because its what you value. 90% of americans have better choice and access than all your poor and middle class.

I'm not going to feel sorry for you because you are forced, in your role as a medic, to save someone's life even though they can't afford it.

One.. not a medic... that was funny...

And second, its not about feeling sorry for me.. its pointing out the reality that's America.. which is that we do care for those that don't have the ability to pay.

As your own argument describes the US system, there isn't much difference between it and the U

K.
As my argument shows.. there is a difference in the US system. we have more choice, less wait times, and availability of top notch care.

Your quote is uncited, unlinked and as such unimportant

It was cited. Here I will do it again:

Department of Health. An Organisation with a Memory: Report of an Expert Group on Learning from Adverse Events in the NHS. Chaired by the Chief Medical Officer. London: Department of Health, 2000.

In the UK, the CEO with the BUPA coverage will get the same care as the janitor with the BUPA coverage

Until he decides screw this this sucks and goes private.

See the previous graph I posted - the US spends far more per person than the UK (double the amount!), but has a lower life expectancy - whereas pretty much every other developed country follows the pattern of more expenditure = higher LE.

That's not because of our health system.. in fact its because of our health system that we do so well.. when you consider our stress rates, our obesity rates, how long we work, so on and so forth. Our social factors are the largest factor in our life expectancy

 

[jaeger19]

Brit psychology. Come and see, one day

Most of the time the decision is made by people with a far better medical and professional knowledge than the patient. Even then, an option is normally given.

Did you not read all of what I wrote? Part of the time the medication that is proscribed to patients in the US is not only unnecessary, but causes complications which require further treatment.

The US is not willing to spend more money 'to help the patient', the US is willing to spend more money because it makes more profit.

'When he gets that ill', the UK system would already have noticed, diagnosed and treated. Your advantage in cancer diagnosis levels is due to over-diagnosis at a very early stage, which will not happen with an uninsured patient because they won't go for the scans.


See the graph previously. People in the UK die older, on average, than in the US - and without all that money being spent either. Of course everyone is going to die of something eventually - so it just means that if we have a higher proportion of cancer deaths, we have a lower proportion of deaths from other causes.

1. been there.. your food is terrible.. history is great though.. and I would love to hunt in Scotland.. of course.. if you trust your population with something other than a sharpened stick
2. Most of the time the decision is made by people that have no interest in the individual but in reducing costs. And since the patient has no advocate outside the system.. they don't know the options
3. Yeah.. I read what you wrote. first.. its not medications.. its a PSA test.. which costs money.. which your government does not want to spend to screen people. Now.. a portion of those that have a PSA will have a false positive and here in the states.. that can mean an unnecessary biopsy that has COST and has a risk though extremely low of complication.
And when you compare the risk of a unnecessary biopsy.. with the benefit of catching a cancer early and not dying of a long and painful death... its a pretty easy risk versus benefit. In your country however, the monetary cost is not worth fewer people dying from cancer or living longer.

4. Yes.. that's one thing that your system tends to do.. is better preventative medicine.. of course in the US.. many of the insurances that do a terrible job at preventative medicine are our government socialized systems.. so the fact is that being socialized single payer is no guarantee of preventative medicine..

In fact look at cancer prevention in your country. You have decided NOT to spend the money on PSA tests and biopsies because catching those few that have cancer that don't fit your paradigm is simply not worth it to you.

5. See reality. The UK folks die older because of social factors.. as the US has high obesity rates, higher stress rates, tend to work longer and work harder with less time off, which are by and large social factors. Whereas the UK has higher cancer deaths due directly to its medical system.

 

[jaeger19]

In post #74, is an unattributed quote, as noted by one of our British comrades (not a communist)

for those interested, here's a link to the archived paper but it probably isn't worth clicking as a more recent study found it to be useless in actually determining the number of preventable deaths in British hospitals



Compare with the number of preventable hospital deaths in the US

A journalist's look at the problem provides a decent summary

Just to point out.. it was an attributed quote.

Second of all its relevant to the discussion because even if you take the lowest figure.. shows how deaths from medical malpractice are at or exceed the number of folks that die do to lacking healthcare insurance

 

[iangb]

1. been there.. your food is terrible.. history is great though.. and I would love to hunt in Scotland.. of course.. if you trust your population with something other than a sharpened stick

Clearly not that well informed - shotguns are entirely legal for sporting or hunting purposes.

2. Most of the time the decision is made by people that have no interest in the individual but in reducing costs. And since the patient has no advocate outside the system.. they don't know the options

Utter nonsense, patient care is the primary concern of any medic. There are indeed very rare situations where some drugs are not available on the NHS - these are generally insanely expensive for only a tiny increase in quality of life, and I doubt very much that you would get them in the US either without paying out of pocket.

3. Yeah.. I read what you wrote. first.. its not medications.. its a PSA test.. which costs money.. which your government does not want to spend to screen people. Now.. a portion of those that have a PSA will have a false positive and here in the states.. that can mean an unnecessary biopsy that has COST and has a risk though extremely low of complication.

Clearly you didn't read. To quote the article: "This ‘overdiagnosis’ inflates the survival statistics, at the expense of ‘overtreating’ men – which is expensive and can cause long-term side effects (which can need further treatment).".

And when you compare the risk of a unnecessary biopsy.. with the benefit of catching a cancer early and not dying of a long and painful death... its a pretty easy risk versus benefit. In your country however, the monetary cost is not worth fewer people dying from cancer or living longer.

No, it's that we don't feel the need to make money by selling false positives to people that don't need it.

It's also the case that in the US, higher costs mean people don't get cover. Otherwise you would have an NHS of your own - medicare and medicaid expanded to everyone.

5. See reality. The UK folks die older because of social factors.. as the US has high obesity rates, higher stress rates, tend to work longer and work harder with less time off, which are by and large social factors. Whereas the UK has higher cancer deaths due directly to its medical system.

Not the case - it's simple maths. If a patient doesn't die of obesity, high blood pressure-related afflictions etc, they are more likely to die of cancer instead. You are taking an oversimplistic view of a complex situation because it suits your agenda, nothing more.

 

[jaeger19]

Clearly not that well informed - shotguns are entirely legal for sporting or hunting purposes.

Yes.. clearly you are not well informed.. a shotgun is not appropriate for all species hunted.

Utter nonsense, patient care is the primary concern of any medic.

utter truth.. patient care is the primary concern.. WITHIN THE PARAMETERS OF THE NHS SYSTEM PROTOCOLS.

Clearly you didn't read. To quote the article: "This ‘overdiagnosis’ inflates the survival statistics, at the expense of ‘overtreating’ men – which is expensive and can cause long-term side effects (which can need further treatment.

Clearly I did read.. and you illustrate the problems with your system. You obviously don't have medical knowledge.,. where I do. There is no "overdiagnosis".. you either have cancer or you don't. The difference is that in the US we are more aggressive in ordering tests to rule out cancer.. and that increased testing.. does two things.. number one.. it catches cancers earlier than your physicians do.. because they can't order the testing... AND it does create some false positives that get biopsies that they don't need. However the benefits of catching cancer early far, far outweigh the risks of a biopsy for a false positive.
Now your country has decided because of COST.. that the cost of more testing.. simply to catch a few more cancers (and saving their lives) is not worth the testing.

.

No, it's that we don't feel the need to make money by selling false positives to people that don't need it.

Yeah.. we don't in general make money by ordering the tests.. We aren't "selling false positives"... heck,,you can't sell a false positive anyway.. you don't know what you are talking about. What happens is that in the US we don't want our patients to have cancer and miss it.. so we are on the side of catching the cancer.. despite the cost.

It's also the case that in the US, higher costs mean people don't get cover. Otherwise you would have an NHS of your own - medicare and medicaid expanded to everyone.

Yeah.. I am not sure what you are stating but here is the reality. Medicare can't be expanded to everyone because it would go bankrupt. Our medicare for our elderly is far, far, far better than your NHS system. And to insure everyone with that coverage would be too costly. The only reason that it works is because you pay your whole life, and then use it when you are elderly.

Your system is much more like the Medicaid system... which anyone would admit is the worst insurance out there except for perhaps the VA. So to put everyone on Medicaid would be a huge decrease in the quality of coverage that the vast majority of the working population have now.

Not the case - it's simple maths. If a patient doesn't die of obesity, high blood pressure-related afflictions etc, they are more likely to die of cancer instead. You are taking an oversimplistic view of a complex situation because it suits your agenda, nothing more

.

That's funny.. "its simply math" in one sentence and then you accuse me of "oversimplifying a complex situation".

That's whats funny and ironic. Its you that's oversimplifying a complex situation. Age of when people die has tons of factors.. the genetic makeup of the population, its social characteristics such as obesity, stress, warfare and violence, environmental factors such as smog, pesticides, natural disasters, so on and so forth.

and yet you lump all of that onto.. "well, it must be the American health system".. please.

 

[jbander]

Have you ever worked in a socialized medicine country as a provider? I have.. and have observed.. and have hired here providers from other countries. There is much more freedom for a provider to provide the care that they feel the patient needs in the US than in socialized countries. In a socialized country.. you are bound by the system.. and whats the protocol or "standard set by the government"... that's in part how they contain their costs.

That's the problem with you liberals.. you think its a free lunch and don't realize that lower cost of care.. comes with a price.

You are right.. there is no conscious in capitalism and that's a good thing. Because do you want your medical care be government by someone who say has the conscious of Michelle Bachman or Rick Santorum who think its morally wrong for a woman to have an abortion or use birth control?

Do you want a government official in charge of your healthcare whose conscious tells him that your HIV treatment shouldn't be covered because you got your disease from being immoral.

Hatred of government? Far from it. Conservatives BELIEVE in government.. small and efficient government. Government certainly has a role... but we understand reality and that reality is that government is not always the benevolent protector that you liberals think it is.

One only has to look at the VA to realize just how problematic government can be. And of course you liberals used to tout the VA as a wonderful example of how well government can take care of your medical needs... well until it was found out that the VA was lying about how well they were doing.. that they were cooking the books to look better politically.

As far as moving toward larger and larger corporate structures.. you are certainly right.. and do you know WHY? Because that's the result of moving toward a more socialized system and lower costs. That's the irony of your complaint of moving toward a larger corporate structure. That's in response to declining reimbursement and more socialization of the market. There is efficiency in large systems.. that's how they make it.
Its exactly why socialized countries do the same thing.. large hospital systems that control how many providers can be in an area etc. Again.. that's how they keep costs down. The more choice that the patient has.. the more expensive the care because of the loss of efficiency.
So that's the irony... if you decry a large "corporate structure"... your socialized medicine ends up with that very thing. Its how they control costs.

I get your point but we are just going in circles again ,read your own comment in America your bound by a system and whats the practical"standard set by the health insurance company" thats in part how they contain cost. You know this conversation didn't need a conservatives lecture on the free lunch they perceive all liberals want. Do you want a health insurance company who decides on what care you can have for your HIV because of their bottom line concern. Hatred of corporations not so I believe in capitalism 100% but I understand reality and that reality in 2015 says their corporate conscience level is at a deteriorating low and if the right gets it's way it will just get lower. I'm a Christian my God is the God of the bible. Conservatives their God is first capitalism and corporation, then their next God on down the line is the God of the Bible. Va's cooking the books Ok at about 1/10 the rate that corporate American health service cook the books. As a matter of fact do you know before Obama came into office Health insurance companies weren't bound by the antitrust laws , they could legally sit down with their competitors and set price, They were the only industry other then baseball that didn't have to abide by anti trust laws. So are you going to try to tell me under those circumstances that they gave a dam about us and set prices fairly. I'll say it again in 2015 I would rather have the government taking charge of our countries health care system, way over corporations doing it. When corporations do it ,only the people that can afford it gets health insurance and the poor get their health care almost never and when they do I pay for it. If you want anyone who isn't blind to support what your selling , you will have to explain/justify health care cost here with horrible statistical results being more expensive then any where else in the world, some times 4 and 5 times the cost and with worst statistical results. If you can't do that then I believe your points and arguments are empty.

 

[jaeger19]

I get your point but we are just going in circles again ,.

No.. you are going in circles.. not me.

I am NOT bound by the system in America nearly as much as I was and would be bound in a socialized medicine system (single payer). Number one.. I can tell the patient what I would recommend for them.. whether covered by their particular insurance or not. Where there is discouragement of that in the socialized systems.
2. The patient has options to switch insurances and in most cases to petition the insurance for a service to be covered. AND since insurance companies do at some level need to keep customers happy, they do change their policies.
I unfortunately have had to treat many patients with HIV.. who had full blown AIDS. Its not a good thing for anyone. So HIV patients are getting covered care. And that's largely because the number of cases with HIV is relatively small. And there are laws that govern the insurance companies decisions. And those laws were strengthened in Obamacare when it comes to pre existing conditions.
Now.. that's a much better system than having Rick Perry, or Donald trump in charge of deciding what should be covered and what should not be for everyone.
By the way.. insurance companies still are except from federal anti trust laws (well in a way, Mcarran- Ferguson Act 1945 is limited in scope and applies to only portions of insurance companies business) . however they can be still regulated under states.
However, lets look at that... so you complain that you think insurance companies are acting like monopolies.. and think that's a bad thing.. and your answer is to give the government that could have Jeb Bush in charge, a monopoly?

Do you see your own disconnect? I do. See you have the liberal disconnect... you think that government is always benevolent.. when the reality its not. Right now.. if you compare private healthcare insurance with its big bad corporations with VA insurance? Private healthcare insurance wins hands down.

And you are wrong about "only the people that can afford healthcare insurance"...
I treat tons of people who are poor that have insurance. Medicare, Medicaid and insurance through their employer. Despite your diatribe, only about 10% of folks don't have insurance.. and a portion of them, a good portion CHOOSE not to have insurance.
In fact I have a patient who chooses not to have insurance (and they get free care anyway through our charity program). they claim that can't afford the 150 a month they would have to pay after the Obamacare subsidy. I sat down and talked with them about their smoking habit.. which costs them 225 a month. They still smoke and they still don't have health insurance because "they can't afford it".
but back to the poor... Only 10% of americans don't have insurance... do you claim that 90% of americans are "rich"...
Come now.. its an emotional diatribe that you are speaking.. not facts and reality.

 

[jaeger19]

I certainly can justify the costs of our healthcare. We have the finest healthcare in the world. We manage to live almost as long as most countries despite having higher levels of obesity, more sedentary lifestyles, terrible diet habits, more stress, longer work hours and less time off so and so forth. If we didn't have the best healthcare in the world we would be in dire straits. Not to mention.. our higher prices subsidize the advancements in healthcare. Medical advancement and technology being one of the things that americans still excel at and export. That's how many countries lower their costs of healthcare.. they only adopt these advancements AFTER they have been perfected, and have become commonplace and therefore cheaper.
Then you add in the fact that its not surprising that our healthcare costs more.. heck.. lots of things cost more in the states.. that's what happens with an economy like ours, where people make more than they do say in mexico. Certainly, the price of a house in mexico is less than that in America. Groceries, etc are all cheaper in mexico and so on..

Consumer Prices in United States are 94.15% higher than in Mexico
Consumer Prices Including Rent in United States are 123.85% higher than in Mexico
Rent Prices in United States are 240.39% higher than in Mexico
Restaurant Prices in United States are 102.46% higher than in Mexico
Groceries Prices in United States are 110.07% higher than in Mexico

That's what you liberal don't seem to get... you scream about the price of healthcare in the us... forgetting that healthcare accounts for a VERY substantial part of our GDP. Why don't you understand what lower costs of healthcare will do to that GDP. And healthcare jobs.. are by and large AMERICAN jobs... not being outsourced to China.
AND the high cost of healthcare compared to other countries... well guess what.. those statistics don't factor in that most socialized countries pay for their physicians education... but that doesn't get counted toward "cost of healthcare".. in the us that cost is captured in the price per procedure..Most countries pay to control liability costs for physicians.. and that doesn't get counted in "cost of healthcare"... but it does get captured as cost in the US price per procedure etc.

 

[Paschendale]

No, having worked for the government I know how ridiculous and bureaucratic they can be.

That's because we allow private interests to buy it up instead of tasking it with protecting the well being of the citizens.

I don't know what Obamacare is, but it isn't what it was sold as. I am glad I have private insurance.

Obamacare IS private insurance. It's just a few regulations to make private insurance less predatory and more useful to the customers.

you also have to factor in the problems with government producing dependency on those services it provides using tax as wealth distribution.

This lie is probably the most toxic element of our discourse on economics. The rest of the world knows that this is nonsense. Why can't Americans see that?

Right so a few points. So in UK there are waiting times that the wealthy bypass. In america the fellow that cleans toilets that has blue cross insurance gets in the same time his CEO does.

The fellow that cleans toilets in America probably doesn't have insurance at all. And if he does, he only got it a couple of years ago.

Furthermore, because of the NHS being a good competitor, private healthcare in the UK is much cheaper than in the US.

Our system is so screwed up that our government isn't allowed to compete. Medicare part D included provisions that the government wasn't allowed to negotiate prices with the drug companies. It merely has to pay whatever they ask. Of course, the whole point of buying something in bulk is so you can negotiate a lower price. We are so beholden to private profiteering in healthcare that we can't even bargain to make medicine affordable.

I'm not sure if America can support universal health care. Universal health care was invented for an entirely different national reality.

America is almost a 3rd world country...but with debt.

Then again, I could be wrong. Maybe health care could work for you too.

Sometimes I'm glad my grasp of maths and economics is so shallow. I just don't want to know how bad things really are.

The dirty little secret is that things are a lot better than you think. And could be really great if we had a stronger public sector for our healthcare and less private control.

America is most definitely not almost a third world country, and we don't have a debt problem. That's another dirty little secret. The United States is owed more by other countries than we owe. About half of our debt is to foreign creditors. The other half is in the form of bonds, and the US does not default on those. If every country called in all debt today, the US would stand to make 3 or 4 trillion dollars. Of course, the world economy would collapse, so no one does that.

 

[jaeger19]

The fellow that cleans toilets in America probably doesn't have insurance at all. And if he does, he only got it a couple of years ago

Nope.. he has had insurance for years.. as has his fellow toilet cleaners. I treat these folks. The vast majority of people of healthcare insurance.. and the vast majority of people are not pro football players, ceos and doctors.. the vast majority of folks are janitors, ditch diggers, dry wall hangers, potato peelers, etc.

 

[jbander]

No.. you are going in circles.. not me.

I am NOT bound by the system in America nearly as much as I was and would be bound in a socialized medicine system (single payer). Number one.. I can tell the patient what I would recommend for them.. whether covered by their particular insurance or not. Where there is discouragement of that in the socialized systems.
2. The patient has options to switch insurances and in most cases to petition the insurance for a service to be covered. AND since insurance companies do at some level need to keep customers happy, they do change their policies.
I unfortunately have had to treat many patients with HIV.. who had full blown AIDS. Its not a good thing for anyone. So HIV patients are getting covered care. And that's largely because the number of cases with HIV is relatively small. And there are laws that govern the insurance companies decisions. And those laws were strengthened in Obamacare when it comes to pre existing conditions.
Now.. that's a much better system than having Rick Perry, or Donald trump in charge of deciding what should be covered and what should not be for everyone.
By the way.. insurance companies still are except from federal anti trust laws (well in a way, Mcarran- Ferguson Act 1945 is limited in scope and applies to only portions of insurance companies business) . however they can be still regulated under states.
However, lets look at that... so you complain that you think insurance companies are acting like monopolies.. and think that's a bad thing.. and your answer is to give the government that could have Jeb Bush in charge, a monopoly?

Do you see your own disconnect? I do. See you have the liberal disconnect... you think that government is always benevolent.. when the reality its not. Right now.. if you compare private healthcare insurance with its big bad corporations with VA insurance? Private healthcare insurance wins hands down.

And you are wrong about "only the people that can afford healthcare insurance"...
I treat tons of people who are poor that have insurance. Medicare, Medicaid and insurance through their employer. Despite your diatribe, only about 10% of folks don't have insurance.. and a portion of them, a good portion CHOOSE not to have insurance.
In fact I have a patient who chooses not to have insurance (and they get free care anyway through our charity program). they claim that can't afford the 150 a month they would have to pay after the Obamacare subsidy. I sat down and talked with them about their smoking habit.. which costs them 225 a month. They still smoke and they still don't have health insurance because "they can't afford it".
but back to the poor... Only 10% of americans don't have insurance... do you claim that 90% of americans are "rich"...
Come now.. its an emotional diatribe that you are speaking.. not facts and reality.

The reason your going around in circles is literally everything you charge government would do or does is exactly what insurance companies do now, You repeating your points over and over doesn't change that point one bit. Our capitalistic system in this country is as sick as it has been in decades, under that circumstance I will repeat myself one more time. I would rather have Government controlled health care in 2015 rather then corporate health care that we have now. The middle class and poor that make up 90% of the population would be way better off. Single payer is next, it will take a Democratic house , senate and president to do that. Demographics will make that happen soon. next 2 decades.

 

[jbander]

Nope.. he has had insurance for years.. as has his fellow toilet cleaners. I treat these folks. The vast majority of people of healthcare insurance.. and the vast majority of people are not pro football players, ceos and doctors.. the vast majority of folks are janitors, ditch diggers, dry wall hangers, potato peelers, etc.

I'm sorry but to prove your point your willing to distort the facts. Simply what you say isn't true. The profile of the millions of people who didn't have insurance before Obama Care is readily available for anyone who is interested, nobody has to just take your word for it. It's at everyones fingers with Google. The fellow that cleans toilets as a generic example didn't have insurance and had little chance of having it, Thats the facts. He has it now because people that make over $250,000.00 a household a year are taxed to supplement these people. AS far as I am concerned if the system comes up short , just raise the tax higher on these people.

 

[Absentglare]

Look at every other developed nation in the planet. They all spend less per capita on health care and endure longer life expectancies. Maybe lifestyle (obesity, smoking, alcoholism) may play SOME role in that, but there's no reason why it should cost more than twice as much per person.

Some people argue we receive better care. I call these people "lucky fools" because they've obviously never been unfortunate enough to have health issues that demonstrate our systems deficiencies.

For one, the hospital charges per quantity of service, not quality of service. In Chicago, insured seniors were being overly sedated, on purpose, until they needed unnecessary surgery (a tracheotomy) to breathe. Each one raised roughly $160,000 for the hospital- very profitable, and very fatal for a significant number of patients. It's not always dangerous for the patient, but, if your insurance is good, they'll be quick to give you a cat scan.

Another deficiency is fear of lawsuits. A woman was partially paralyzed and in severe, constant pain from a spinal injury. Spinal surgery could restore her motor function and reduce the pain. American doctors refused to do it because of the liability. She flew to China and had it done there. Another example. My friends girlfriend had kidney issues. The doctors didn't want to do a kidney transplant because they said it was an unnecessary risk. Now, she is in such terrible condition that she has no remaining option but to die.

 

[jaeger19]

The reason your going around in circles is literally everything you charge government would do or does is exactly what insurance companies do now, You repeating your points over and over doesn't change that point one bit. Our capitalistic system in this country is as sick as it has been in decades, under that circumstance I will repeat myself one more time. I would rather have Government controlled health care in 2015 rather then corporate health care that we have now. The middle class and poor that make up 90% of the population would be way better off. Single payer is next, it will take a Democratic house , senate and president to do that. Demographics will make that happen soon. next 2 decades.

No.. because what you don't understand that insurance companies TRY to control care.. no doubt.. but because there are choices for people in their healthcare insurance.. they are held accountable to their customers.. AND because by and large physicians are NOT employees of the insurance company.. they can be advocates for patients.

You are fool.. a FOOL if you think government single payer healthcare would be better. Thats a liberals premise for sure. Heck.. take a look at Medicaid and the VA.. and they are NOT better than private insurance by a long shot.

But you are right.. single payer is probably coming.. and you know why.. (wait you don't).. well let me tell you who is going to cheer the loudest when single payer comes to fruition. Its going to be the big corporate insurance companies. They are going to cheer the loudest.. because you know who is going to administer that single payer plan? THEY ARE... just as they do NOW for Medicare and Medicaid.

And it will be great.. for those corporate entities.. and nice fat check to administer a crappy program for the poor and middle class.. and then offer the rich high end supplement and private plans.

 

[jaeger19]

I'm sorry but to prove your point your willing to distort the facts. Simply what you say isn't true. The profile of the millions of people who didn't have insurance before Obama Care is readily available for anyone who is interested, nobody has to just take your word for it. It's at everyones fingers with Google. The fellow that cleans toilets as a generic example didn't have insurance and had little chance of having it, Thats the facts. He has it now because people that make over $250,000.00 a household a year are taxed to supplement these people. AS far as I am concerned if the system comes up short , just raise the tax higher on these people.

of course the profile of the millions of people that didn't have insurance before obamacare is available.. and of course many of them were poor people..and some were middle class and some were rich that had chosen not to have healthcare insurance.

THATS NOT WHAT I WAS TALKING ABOUT... I was talking about the 85-90% of americans that HAD INSURANCE BEFORE OBAMACARE... and 85% -90% of americans ARE NOT RICH.. they are poor or middle class. People that worked cleaning toilets, that dug ditches etc.

Sorry sir.. but you don't have a clue.. Do you realize that I am a large employer? That my janitors and housekeepers all have health insurance.. as do all my competitors employees.. and my patients.. that have health insurance... do you think that they are all RICH...

Of course not.. prior to Obamacare some 85 percent of America had health insurance.. well 85% of America IS NOT and WAS NOT RICH... and so that included a lot of people that cleaned toilets..and they had excellent chances of having healthcare insurance BECAUSE 85% of americans had health insurance..

You sir are the one that wants to distort the facts.. not me.

 

[Absentglare]

No.. because what you don't understand that insurance companies TRY to control care.. no doubt.. but because there are choices for people in their healthcare insurance.. they are held accountable to their customers.. AND because by and large physicians are NOT employees of the insurance company.. they can be advocates for patients.

You are fool.. a FOOL if you think government single payer healthcare would be better. Thats a liberals premise for sure. Heck.. take a look at Medicaid and the VA.. and they are NOT better than private insurance by a long shot.

But you are right.. single payer is probably coming.. and you know why.. (wait you don't).. well let me tell you who is going to cheer the loudest when single payer comes to fruition. Its going to be the big corporate insurance companies. They are going to cheer the loudest.. because you know who is going to administer that single payer plan? THEY ARE... just as they do NOW for Medicare and Medicaid.

And it will be great.. for those corporate entities.. and nice fat check to administer a crappy program for the poor and middle class.. and then offer the rich high end supplement and private plans.

You really need to check your facts. Look at the state of health care in every other developed nation in the world.

You'd have to be a complete moron to conclude that single payer would be worse for Americans.

 

[jbander]

of course the profile of the millions of people that didn't have insurance before obamacare is available.. and of course many of them were poor people..and some were middle class and some were rich that had chosen not to have healthcare insurance.

THATS NOT WHAT I WAS TALKING ABOUT... I was talking about the 85-90% of americans that HAD INSURANCE BEFORE OBAMACARE... and 85% -90% of americans ARE NOT RICH.. they are poor or middle class. People that worked cleaning toilets, that dug ditches etc.

Sorry sir.. but you don't have a clue.. Do you realize that I am a large employer? That my janitors and housekeepers all have health insurance.. as do all my competitors employees.. and my patients.. that have health insurance... do you think that they are all RICH...

Of course not.. prior to Obamacare some 85 percent of America had health insurance.. well 85% of America IS NOT and WAS NOT RICH... and so that included a lot of people that cleaned toilets..and they had excellent chances of having healthcare insurance BECAUSE 85% of americans had health insurance..

You sir are the one that wants to distort the facts.. not me.

Your information is so bad and untrue that I have come to the conclusion that You are no doctor nor do you have a business or anything that you have been saying about your credentials to support your ideas. Sorry buddy, I don't believe you. Your just another guy with a opinion and you like most regressives , won't let facts get in the way of a your opinion.

 

[jaeger19]

Look at every other developed nation in the planet. They all spend less per capita on health care and endure longer life expectancies. Maybe lifestyle (obesity, smoking, alcoholism) may play SOME role in that, but there's no reason why it should cost more than twice as much per person.

Some people argue we receive better care. I call these people "lucky fools" because they've obviously never been unfortunate enough to have health issues that demonstrate our systems deficiencies.

For one, the hospital charges per quantity of service, not quality of service. In Chicago, insured seniors were being overly sedated, on purpose, until they needed unnecessary surgery (a tracheotomy) to breathe. Each one raised roughly $160,000 for the hospital- very profitable, and very fatal for a significant number of patients. It's not always dangerous for the patient, but, if your insurance is good, they'll be quick to give you a cat scan.

Another deficiency is fear of lawsuits. A woman was partially paralyzed and in severe, constant pain from a spinal injury. Spinal surgery could restore her motor function and reduce the pain. American doctors refused to do it because of the liability. She flew to China and had it done there. Another example. My friends girlfriend had kidney issues. The doctors didn't want to do a kidney transplant because they said it was an unnecessary risk. Now, she is in such terrible condition that she has no remaining option but to die.

Number one.. that cost per person comes at a cost as well... it comes with less choice, longer wait times and rationing. Its how they get that lower cost.. its not some magic wand that they wave around.

Number two.. that cost per patient is a poor statistic because in most cases it doesn't factor in costs that countries make for example in training their doctors. The "cost of healthcare" in America reflect the cost of education because that's how a surgeon recoups his costs.. and liability costs as well. etc. Well in most socialized nations.. that cost is not reflected in "cost of healthcare" because that country pays for its physicians educations and pays to control their liability costs.
It also doesn't factor in that research etc is rolled into that cost in America.. while in Europe research is often funded by the government out of a separate fund.

Third:

the hospital charges per quantity of service, not quality of service

.

Well two thoughts... one.. since its "insured seniors".. do you realize that the hospital is being reimbursed by Medicare? So that billing system is established BY THE FEDERAL GOVERNMENT. So blame the feds for that billing system..

In addition:

In Chicago, insured seniors were being overly sedated, on purpose, until they needed unnecessary surgery (a tracheotomy) to breathe. Each one raised roughly $160,000 for the hospital- very profitable, and very fatal for a significant number of patients. It's not always dangerous for the patient, but, if your insurance is good, they'll be quick to give you a cat scan.

.
Yeah.. this is bull. Thats because for one.. Medicare (for seniors remember) reimburses on a DRG level.. not per procedure. So if you over sedate a patient.. and they need more care, you don't get reimbursed for it.. it comes out of your reimbursement for your DRG. Secondly, If you were to oversedate a patient.. a tracheotomy would not make a difference. In fact it would not be indicated and would result in a charge of malpractice. IF they were oversedated they would be given an antagonist to the sedation and if that wasn't fast enough they would be intubated.. which would not require surgery... and they certainly would not be given a "cat scan"..

Lastly,

Another deficiency is fear of lawsuits

Yes... that is an issue. And that cost is another reason that the cost in healthcare is higher in the US.. because its recouped in our reimbursement rates.. while that cost in other countries is borne by the government as another expense.

 

[jaeger19]

Your information is so bad and untrue that I have come to the conclusion that You are no doctor nor do you have a business or anything that you have been saying about your credentials to support your ideas. Sorry buddy, I don't believe you. Your just another guy with a opinion and you like most regressives , won't let facts get in the way of a your opinion.

Yep.. typical.. when you are confronted with reality you have to run. Thats okay.. its the liberal thing to do. My information is spot on... if it REALLY was untrue.. you would be able to find all sorts of sources that debunked what I have said.. but you can't.. and that's because its all true.

So funny.. its simply fact.. 85% of americans or so had health insurance before Obamacare...

85% of Americans were not and are not rich. So the claim that poor and middle class don't have any access to health insurance.. including my housekeeping staff that clean toilets. is pure bunk.

Tell you what Jbander.. if what I said is "so bad and untrue".. then it should be easy for you to find sources to discredit me...

Cue the crickets.