Socialized Health Care: good or bad

[Monk-Eye]

Cynicism

"Cynicism"

The US already has socialized health care for poor illegal's births; first prenatal care, then a social security card, then onto the WIC station, etc.

 

[BWG]

No, they don't.
My sister went through this hastle with her recent sugary for cancer. She couldn't see who she wanted because SS wouldn't cover that facility for that treatment.

Even today, SS gives her a restrictive list of where she can go, who she can see, and what treatment/tests she can have.

I see people make claims as you just did and I know it’s a flat-out LIE.

Of course, not knowing anything about your sister's situation, I can't comment, although I'm a little puzzled about SS's involvement.

I couldn't C&P from the medicare.gov pdf, but here's the link, it's on page 5 under the heading MEDICARE OPTIONS

http://www.medicare.gov/Publications/Pubs/pdf/11034.pdf


WebMD's site says the same thing...

Medicare Parts A and B are sometimes called "Original Medicare". Original Medicare allows you the freedom to see any doctor who accepts Medicare. Most do. It’s not like an HMO, where you can only see doctors in the plan’s network.

Medicare Part B: Doctor Costs and Lab Tests

Original Medicare allows you to see just about any doctor and go to any hospital that accepts Medicare payments, which most providers accept. But Medicare Advantage plans may restrict you to the doctors and hospitals in the plan's network. You might need referrals to see a specialist.

Medicare Advantage: Private Health Insurance Plans Through Medicare

Medicare Advantage plans are health plans sold by private insurance companies.

Imagine that. Private insurance restricts the doctors and hospitals you can see, but government insurance doesn't.

 

[RiverDad]

I think that the false choice between UHC and privatized health care is impeding our path towards an improved health system.

The problem at the heart of the issue is a movement away from health insurance towards health plans. Imagine what consumer behavior would be if every person with a motor vehicle paid the same "insurance" premium which funded their liability exposure, but also paid for unlimited gasoline consumption, oil changes, new tires, tune-ups, etc. Such an "insurance plan" would remove all consumption constraints on automobile usage for why would anyone minimize their use of their cars when their one annual fee paid for unlimited usage?

Health car premiums would go down considerably if they only covered catastrophic care and excluded the personal consumption of ordinary medical care.

A government monopoly on the provision of a basic health package could keep costs constrained, for actuaries know, to the first degree, what to expect in terms of cancer, heart attacks, trauma, etc from a population. For the personal care, a mandatory withholding on each paycheck but controlled by the taxpayer with rollforward and eventual withdrawal privileges would put control of costs within the hands of the consumer and reward them for judicious use of scare health care resources.

 

[Jerry]

Of course, not knowing anything about your sister's situation, I can't comment, although I'm a little puzzled about SS's involvement.

I couldn't C&P from the medicare.gov pdf, but here's the link, it's on page 5 under the heading MEDICARE OPTIONS

http://www.medicare.gov/Publications/Pubs/pdf/11034.pdf

WebMD's site says the same thing...

Medicare Advantage plans are health plans sold by private insurance companies.

Imagine that. Private insurance restricts the doctors and hospitals you can see, but government insurance doesn't.

As a quick side note: The President’s agenda on healthcare is not credible as Obama supports killing born-citizens, and further, today actively supports forced abortions. Beware of what “health” plans he wishes to place *you* under....the global population isn't getting any smaller, ya hear me?

No source anyone could provide can counter my experiences and personal knowledge regarding how socialized medicine is currently today a failed system.

I am completely closed to any argument in support of socialized medicine and will act against any attempt to maintain or expend the current system with every opportunity I get.

Since my mind cannot be changed, your time is better spent making a sandwich. I recommend rare roast beef with smoked American/Swiss on white garlic toasted, mayo, pepper, and nothing else.

 

[bilbus]

Have you ever been to the DMV or post office?

Thats what Socialized Health Care would be like.

 

[metreon]

Half the cost of healthcare is malpractice insurance.

Wrong. As a percentage of US healthcare spending, malpractice costs represent only 0.46% of such spending (2001 data). It is not much different today. One half of one percent is extraordinarily different from "half".

However, despite the reality of malpractice costs, people like MrVicchio must be like most doctors fearing it: they falsely assume it is higher that it is, or simply want to manipulate popular perception in order scapegoat it for less noble reasons. For example, the widespread worry about malpractice has been frequently cited as the reason for excessive "defensive medicine".

A few months ago I read in the Boston Globe that 83% of the doctors in Massachusetts said they've practiced defensive medicine and that some 18-28% of tests, procedures, referrals and consultations and 13% of hospitalizations were ordered to avoid lawsuits. This is true nationwide. It is not much of a stretch to realize that those self-same doctors are also benefiting financially from such excesses, as if it were some sort of punitive compensation for the fear they are forced to suffer.

I am not reading too much into this either, since this de facto quid pro quo is often insinuated if not directly suggested in medical law and malpractice seminars, where doctors learn from malpractice lawyers how to avoid a lawsuit. The notion that it is profitable to keep lawyers at bay is a learned classroom fact. As a result, for some doctors, malpractice "fear" simply becomes a convenient excuse to over-treat.

So if you include all the more nebulous "defensive medicine" costs to the actual legal bill, malpractice may in fact represent a substantial chunk of healthcare costs, - but the actual legal bill is less than 1% of healthcare spending. Therefore, MrVicchio's misstatement indirectly becomes an example of how the profit motive has failed healthcare, on the surface appearing to encourage better medical practice under the fear of legal threat, but instead ending up as an excellent excuse for profiteering.

 

[bilbus]

In the UK 1/3rd of children have never seen a dentist.

In some areas (25% of the uk) the Socialized Health Care system is not permiting new patients from reciving dental care due to a lack of doctors.

Bad teeth - the new British disease - Telegraph

Why can't we just reform the system ... do we really need to thow freedom out the window?

 

[Harry Guerrilla]

I think that the false choice between UHC and privatized health care is impeding our path towards an improved health system.

The problem at the heart of the issue is a movement away from health insurance towards health plans. Imagine what consumer behavior would be if every person with a motor vehicle paid the same "insurance" premium which funded their liability exposure, but also paid for unlimited gasoline consumption, oil changes, new tires, tune-ups, etc. Such an "insurance plan" would remove all consumption constraints on automobile usage for why would anyone minimize their use of their cars when their one annual fee paid for unlimited usage?

Health car premiums would go down considerably if they only covered catastrophic care and excluded the personal consumption of ordinary medical care.

A government monopoly on the provision of a basic health package could keep costs constrained, for actuaries know, to the first degree, what to expect in terms of cancer, heart attacks, trauma, etc from a population. For the personal care, a mandatory withholding on each paycheck but controlled by the taxpayer with rollforward and eventual withdrawal privileges would put control of costs within the hands of the consumer and reward them for judicious use of scare health care resources.

This is exactly what I was talking about in the SCHIP thread. I'm glad you pointed it out here to.

We are USERS of health care and only consumers of health insurance are shielded from the price mechanism that doctors charge. We are NOT consumers of heath care in this country!!!

This is why we pay so much and this started with non other than government intervention.

 

[googooflexy]

Who says the government will be your doctor? Medicare/Medicaid patients see the exact same doctors, use the exact same hospitals that I see and use.

Do you really think we're going to fire all current doctors, nurses, hospital staff, etc. and have government bureaucrats perform heart transplants?

oooh...this one hurts me on the inside a little bit.

Let me take a whack at it...

Suppose you are a successful doctor...perhaps the best. Where are you going to do your business? Where you make more money.
Don't feed me "where they need it most" BS. I'm not buying it. Successful people find ways to make money...plain and simple.

Now, suppose the country you are practicing in moves to socialized healthcare. Your paycheck comes from the government instead of you being payed by how good you are. I.E. you may be getting payed the same as a doctor that sucks.

So, no...they aren't going to fire all of their doctors. They are just going to lose their good ones. Because their good doctors are going to go wherever it is that they are payed fairly(by their skill).

Take Canada for instance...
Canada does not rank anywhere near first in any of the seven health care outcome categories or in any of the comparisons of access to care, supply of technologies, or supply of physicians metrics used to rate health care systems. As a matter of fact, when compared to other industrialized nations, it's health care, in a word, sucks.
Canada has only 2.3 doctors per 1,000 people for a total of 66,583 doctors. That's pretty pathetic.
The average Canadian family alos pays about 48 percent of its income in taxes each year, partly to fund the health care system. As you well know, rates vary from province to province, but Ontario, the most populous, spends roughly 40 percent of every tax dollar on health care, according to the Canadian Taxpayers Federation.

So, where have all their good doctors gone?

Where they can make more money.
Capitalism at its finest folks.

 

[BWG]

So, no...they aren't going to fire all of their doctors. They are just going to lose their good ones. Because their good doctors are going to go wherever it is that they are payed fairly(by their skill).

So where are they going to go? You do realize that all the major industrialized countries have some form of UHC? Is there going to be a mass exodus of doctors that are willing to dislocate their wives/husbands and kids from their families and leave? Some might, but not on a scale large enough to have any noticeable impact.

Canada has only 2.3 doctors per 1,000 people for a total of 66,583 doctors. That's pretty pathetic.

Why choose Canada? Has any UHC proposal thus far been modeled on Canada's system?

But let's look a little farther and compare other countries with UHC and their doctor to population ratio.

Cuba is no 1 with a ratio of one doctor per 170 population.
But we'll dispense with Cuba for obvious reasons.


Here's a partial list (Inhabitants per doctor)

Belgium 220
Italy 240
Switzerland 280
Portugal 290
France 300
Germany 300
South Korea 300
Spain 300
Denmark 310
Sweden 310
Finland 320
Netherlands 320
Norway 320
Argentina 330
Ireland 360

The United States comes in with, using your description and logic, a "pretty pathetic" 390.

185 - The Patients Per Doctor Map of the World Strange Maps

While the doctor to population ratio can be interesting to look at. Of larger importance is where these doctors are located. Do you have access to them? Are they primary care physicians or specialist that you have no need for? What if quite a fair amount, as I suspect, are concentrated in large cities and you live hundreds of miles away? Then that ratio means squat to you.

So, where have all their good doctors gone?

You're assuming all the 'good' doctors have left.

Rich doctors =/= good doctors.

 

[googooflexy]

So where are they going to go? You do realize that all the major industrialized countries have some form of UHC? Is there going to be a mass exodus of doctors that are willing to dislocate their wives/husbands and kids from their families and leave? Some might, but not on a scale large enough to have any noticeable impact.

It would be irresponsible for a person with a family NOT to move where they are going to recieve more money.
And it's not always an "exodus". It may take a number of years, but that kind of socialized system only breeds on type of worker...and it's not the kind of worker I want operating on me.

Why choose Canada?

Only because I always hear about our neighbors to the north and how their healthcare is so much better. To me, that's kind of frustrating when one knows the numbers.

But let's look a little farther and compare other countries with UHC and their doctor to population ratio.

Cuba is no 1 with a ratio of one doctor per 170 population.
But we'll dispense with Cuba for obvious reasons.

But why? You've been so nice to bring it up.
Canada takes it's cues from North Korea and Cuba. Medical professionals can only but work for the government if they want to practice their skills. If their instinct for freedom overcomes them, they must flee Canada's jurisdiction. While many medical professionals have been driven away by such fascism, the perverse incentive scheme operating in a socialized system soon subdues the rest. Rewarding competency with increased workload, but no extra pay, is one hell of a way to ensure professionals become sluggish, if only for the sake of their own self-preservation.

The United States comes in with, using your description and logic, a "pretty pathetic" 390.
185 - The Patients Per Doctor Map of the World Strange Maps

I fail to see how that's pathetic. You took the very top of the list out of all the 195 countries in the WORLD. The US is in the top 17% according to your website there.

You're assuming all the 'good' doctors have left.

Rich doctors =/= good doctors.

My guess is that you're not a doctor and I dare assume that if you were a doctor you wouldn't be very good at what you do. Those are the kind of workers that enjoy working in a socialized healthcare system.

A socialist system punishes the most successful workers by paying them the same as a substandard worker.

This is you

Stealing from me to feed the weak.
I don't need government assistance to pay for my health insurance and I refuse to give my money to fund it for those who didn't earn it. Heartless? Maybe...I don't care. I guess I'm just a capitalist pig.

Let me be the first to say that a hodg-podge mix of a system that we have now is not the answer.

However, going in the direction of socialism is not any better. Cutting off your nose to spite your face is hardly a good move.

EDIT:
Take a peek at this...not for facts or anything, just for another perspective. Pretty funny too.
YouTube - DRUGS ARE AWESOME!! Socialized Healthcare Sucks.

 

[bandaidwoman]

Regarding tort reform, as one poster commented , the direct measure of cost in this country's health care dollars is miniscule but it's indirect costs comes about in two ways:

1) With such a culture of fear of lawsuits, it becomes very hard for practioners and institutions to be transparent with their errors, which is the first step in tackeling and improving medical errors.

2) As one poster pointed out, in this country, we doctors engage in what's called "assurance behavior" to minimize our risk for lawsuits

It is real and I have enclosed an abstract.

JAMA. 2005;293:2609-2617.

ABSTRACT

Context How often physicians alter their clinical behavior because of the threat of malpractice liability, termed defensive medicine, and the consequences of those changes, are central questions in the ongoing medical malpractice reform debate.

Objective To study the prevalence and characteristics of defensive medicine among physicians practicing in high-liability specialties during a period of substantial instability in the malpractice environment.

Design, Setting, and Participants Mail survey of physicians in 6 specialties at high risk of litigation (emergency medicine, general surgery, orthopedic surgery, neurosurgery, obstetrics/gynecology, and radiology) in Pennsylvania in May 2003.

Main Outcome Measures Number of physicians in each specialty reporting defensive medicine or changes in scope of practice and characteristics of defensive medicine (assurance and avoidance behavior).

Results A total of 824 physicians (65%) completed the survey. Nearly all (93%) reported practicing defensive medicine. "Assurance behavior" such as ordering tests, performing diagnostic procedures, and referring patients for consultation, was very common (92%). Among practitioners of defensive medicine who detailed their most recent defensive act,43% reported using imaging technology in clinically unnecessary circumstances.The incidence of procedures and patients that were perceived to elevate the probability of litigation was also widespread. Forty-two percent of respondents reported that they had taken steps to restrict their practice in the previous 3 years, including eliminating procedures prone to complications, such as trauma surgery, and avoiding patients who had complex medical problems or were perceived as litigious. Defensive practice correlated strongly with respondents’ lack of confidence in their liability insurance and perceived burden of insurance premiums.

Conclusion Defensive medicine is highly prevalent among physicians in Pennsylvania who pay the most for liability insurance, with potentially serious implications for cost, access, and both technical and interpersonal quality of care

It's interesting, contrary to urban myth most doctors in this country endorse a national health insurance since we are so fed up with the private carriers.

http://www.pnhp.org/news/2004/februa...cians_endo.php

Nearly two-thirds (64%) of physicians favor single-payer national health insurance, far more than support managed care (10%) or fee-for-service care (26%) according to a Harvard Medical School study published today in the Archives of Internal Medicine. National health insurance (NHI) received majority support from physicians of virtually every age, gender and medical specialty – even among surgeons, a plurality supported NHI.

Before any talk of national health care, obama must also address tort reform ( which he hasn't) , the latter will help bring down the cost of overall health care spending, which will expedite embracing a universal health care model of some sort and contibute to its financial solvency.

 

[bandaidwoman]

It is not much of a stretch to realize that those self-same doctors are also benefiting financially from such excesses

1. The STARK laws prevent doctors from profiteering from this.

These regulations (the "Stark II Regs"), clarify self-referral prohibitions under section 1877 of the Social Security Act, often referred to as the "Stark law," which bar physicians from making referrals to entities in which the physician has a financial relationship, and for which no statutory exception applies. "Click here for the Final Rule Addressing Physician Self-Referrals (Stark II)."

Thus when I order a head cat scan to rule out brain tumor, I don't get any kickback from the hospital imaging center for these referalls. If I own a cat scan machine facility, I cannot send any of my patients there for diagnostic imaging so I can pad my pockets. Of course there are some ways around it , otherwise cardiologists would not be able to do stress tests in their offices.


2. Our reimbursements from HMO's are actually reduced as we order more tests or refer to specialists. Our fear of malpractice is much higher so we order the necessary tests or the necessary referals regardless of the financial punishment the HMOs impose on us.