Yes, hospitals do lie in reporting

[snakestretcher]

That is ridiculous on so many levels. Your insurance policy is a contract. You pay a given rate for a given amount of coverage. That some items are not covered does not mean that they are unavailable to you. That is not rationing. Rationing is the government limiting goods or services based on availability, not cost. As for your suggestion that only emergency care cannot be refused, that's bogus as well. The majority that show up in emergency rooms are not emergencies and most end up as outpatient.

If you can't get cover for a pre-existing condition because you're considered an unacceptable insurance risk, that's rationing. You can call it commercially prudent or whatever, but it changes nothing. America remains the only advanced Western nation without universal health coverage. It's a disgrace.

 

[MAGAnificent]

No it isn't rationed; where did you read that? You've been duped if that's what you believe, and ALL my medical needs are free at the point of delivery including complex surgery. I walk in to hospital, get fixed, walk out, wallet intact-and I don't have to pay exorbitant rates in private insurance with all the attendant caveats for pre-existing conditions. As for taxation it isn't quite as cut and dry as you think...

Comparison of UK and USA take home | The Salary Calculator

.

However you have waiting lists for certain tests and procedures. That is rationing,

 

[snakestretcher]

However you have waiting lists for certain tests and procedures. That is rationing,

No it isn't rationing-and there are only waiting times for elective, non-emergency procedures. If you're an emergency case you're dealt with immediately. The US also has waiting lists.

Fed up with NHS waiting times? It’s even worse in the US | Mary O’Hara

The idea that private systems mean greater efficiency is simply unconvincing. I have pretty good US health insurance and yet the shortest waiting time to see my designated doctor has been five weeks – much worse than under the NHS

www.theguardian.com

 

[MAGAnificent]

If you can't get cover for a pre-existing condition because you're considered an unacceptable insurance risk, that's rationing. You can call it commercially prudent or whatever, but it changes nothing. America remains the only advanced Western nation without universal health coverage. It's a disgrace.

No it's not. Not getting insurance coverage does not translate to treatment unavailable to you. And under the fascist healthcare bill often referred to as Obamacare, pre-existing conditions are covered.

 

[snakestretcher]

No it's not. Not getting insurance coverage does not translate to treatment unavailable to you. And under the fascist healthcare bill often referred to as Obamacare, pre-existing conditions are covered.

"Fascist healthcare"? More absurd hyperbole. Oh, and here's some more on waiting times...

What the NHS 'A&E crisis' looks like in comparison to America's private healthcare

"This Rolls Royce isn't moving fast enough!"

www.businessinsider.com

 

[snakestretcher]

No it's not. Not getting insurance coverage does not translate to treatment unavailable to you. And under the fascist healthcare bill often referred to as Obamacare, pre-existing conditions are covered.

If you can't afford to be treated or get coverage, what then? Your abysmal 'system' fails millions of people because the only motive is profit. I'll stick with the amazing NHS.

 

[MAGAnificent]

So many fallacies in this post.

Please use your favorite search engine to educate yourself about the prevalence in the US of medical bankruptcy, medical financial hardship, surprise medical bills and people skipping medical care because of cost.

People go into bankruptcy for many reasons not all having to do with medical financial hardship. And with the latter in the majority of cases, it's the medical issue preventing you from making a living that leads to bankruptcy. Either way, it's still not rationing. Financial hardship does not translate to rationing.

 

[MAGAnificent]

If you can't afford to be treated or get coverage, what then? Your abysmal 'system' fails millions of people because the only motive is profit. I'll stick with the amazing NHS.

I am not suggesting that the American Healthcare system is perfect. It is damned expensive. Common sense market based reform is needed. Socialized medicine is not the answer. And the American Healthcare system, with it's faults still does not have rationing.

 

[joko104]

You made it sound like there was no follow up. In general discharge instructions are given that tell you to follow up. My guess is that she instructions told her to follow up. The hospital can help with an outside referral if the patient does not have a clue where to go.

I still call bs on your "story" about the hospital billing medicare on her behalf. Aside from the fact that she did not have medicare......she would have needed to authorize billing - it is SOP. Medicare and billing fraud is a big ass deal.

In terms of Covid payments.....you clearly have zero idea how covid has financially affected the hospitals.

You really need to dig in a realize how DRGs and medicare works. I know our ICU is similar to many -many of this patients on medicare lingering in ICUs chronically critically ill. There are places that accept patients on long term ventilation, but not when they are unstable needing critical care. I think you are under the assumption that the long term chronically critically ill patients are beds filled and money in pocket. Days become weeks and weeks become months in ICU.

Even the less sick patients with covid cost the hospital big bucks. And with all the excess staff needed....more equipment......

But I will bow out because I am talking to a brick wall . Well at least a brick wall doesn't make up crap in order to push conspiracy theories.

I am still giggling over you professing that an ER would treat an arm fracture with gauze.

GOod night.

To be more precise:

They wrapped her arm with gauze, used a splint (one) and then the same wrap used for a sprained ankle. This did not support the wrist. She was given a sheet with the name of one specialist for her to call the next day. However, when called that doctor (the next day as this was at night). said he is not accepting new patients at this time.

When she phoned the hospital with that info, she was just told to find someone else on her own. 1 bought a wrist brace at CVS to add to this for more support that was her idea. She found another specialist, but it was 3 days before she could get in. He put her in a full arm cast (wrist to most of upper arm. Both bones were broken in the middle of her forearm, but not compound fractures.

Reality is not a theory and reality you don't like does not equate to a conspiracy theory.

 

[JasperL]

That is ridiculous on so many levels. Your insurance policy is a contract. You pay a given rate for a given amount of coverage. That some items are not covered does not mean that they are unavailable to you. That is not rationing. Rationing is the government limiting goods or services based on availability, not cost.

If you don't like the term 'rationing' then substitute another one that means the same thing as I explained.

Bottom line is there are LIMITS placed on everyone with regard to what they can consume, and in the market goods are 'rationed' or 'limited' by ability to pay. I'd like to have a boat, another car, 6 or 8 more fly rods, a big farm, two or three vacation homes for winter and summer, but cannot afford that, so the 'market' rations those things by my ability to pay. If I buy a house, maybe I can't afford that bass boat, even though I'd like both! - that's rationing in the economic sense.

As for your suggestion that only emergency care cannot be refused, that's bogus as well. The majority that show up in emergency rooms are not emergencies and most end up as outpatient.

You're not making a useful point. Are you suggesting that if I hurt my knee running I can go to the ER and they'll give me an MRI and then ACL surgery if it's indicated, without insurance or other ability to pay? The orthopedic or his clinic is obligated to do the surgery for free? Or maybe they look at the knee, see I can walk on it, even if it hurts, and send me home, maybe with some pain killers.

 

[snakestretcher]

I am not suggesting that the American Healthcare system is perfect. It is damned expensive. Common sense market based reform is needed. Socialized medicine is not the answer. And the American Healthcare system, with it's faults still does not have rationing.

You can have both running in parallel, as we do in the UK. The private option is expensive and you'll be treated by the same medics with the same expertise and qualifications as those in the public sector-who, by the way, are often contracted out by the NHS to the private sector. Why go private unless flowers in your room and steak dinners are a priority? I want to be in and out of a hospital asap; I don't need unnecessary fripperies which do nothing to improve my wellbeing. It isn't a hotel.

 

[JasperL]

I am not suggesting that the American Healthcare system is perfect. It is damned expensive. Common sense market based reform is needed. Socialized medicine is not the answer. And the American Healthcare system, with it's faults still does not have rationing.

What does that look like, specifically. Reads suspiciously like a meaningless talking point, i.e. drivel, to me.

 

[MAGAnificent]

You can have both running in parallel, as we do in the UK. The private option is expensive and you'll be treated by the same medics with the same expertise and qualifications as those in the public sector-who, by the way, are often contracted out by the NHS to the private sector. Why go private unless flowers in your room and steak dinners are a priority? I want to be in and out of a hospital asap.

If you like the system in the UK, I am happy for you. We do not want anything approaching it here.

 

[joko104]

Please take a moment to explain the increase in excess mortality.

View attachment 67321499

For months nearly all elective examinations, routine annual physicals and elective surgeries were not being allowed to keep rooms available for potential covid-19 patients. Any detection of diseases in early curable stages such as cancer were not possible. Nearly all non-covid-19 medical care was discontinued unless obviously life threatening such as a heart attack. People were told do NOT go to ER. There was quite a bit of coverage of how much this also was hurting doctors financially.

Deny routine exams, wait months to detect cancer and other diseases - any you have killed people. Lots of people. With tens of millions of families without income, many people could/can not afford decent food, to pay for their prescriptions, and all the other health/death issues that poverty brings. Add suicides.

What counts for the increased death rate mostly is how many people the restrictions, rules and destruction of people's lives that the covid-19 bioterrorism campaign to make the richest corporations on earth richer has and is killing a lot of people.

Or are you claiming that really no one ever needs a medical exam and no one should go to the doctor or ER unless already clearly on their death bed - as that is the level that medical care was denied for months?

 

[snakestretcher]

If you like the system in the UK, I am happy for you. We do not want anything approaching it here.

"We"? Speak for yourself old chum; don't presume to be representative of your population.

 

[JasperL]

It's still not rationing. There is more then enough healthcare available in the US, at least during normal times. The pandemic is an exception. at some points hospitals have been overwhelmed. Otherwise, all services are available and cost for goods and services does not translate to rationing. The only healthcare rationing that exists in the US is organ transplants.

We're splitting hairs on the term. In economic terms, price rations all scarce goods. How many houses do you want? 12? If you're like me, you can only buy one. Call that limit imposed by our ability to pay what you want.

The same dynamic exists in healthcare. We actually have a very low number of doctors per capita. If we had 'free' healthcare, there are not enough to go around to accommodate all those folks who don't have a family doctor, etc. because they have no insurance and don't ever see a doctor until there's a serious problem, often way past the best time to treat it. A couple of years ago, an acquaintance of mine died from cancer - he was young, about 35 or so. Well, he'd been having stomach pains for weeks and ignored it because he had no insurance, and thought it would go away, The pain was cancer that by the time he noticed it was likely already advanced. Weeks later when it was diagnosed after he started crapping bloody stools, it was too late to treat and he's now dead. That's how rationing works in real life. Substitute undiagnosed early diabetes or heart disease, and therefore not treated until it's a crisis, times 100s of thousands and you've got the idea.

No, he wasn't denied care explicitly, but if he'd had a regular GP and gotten regular checkups maybe that cancer is diagnosed 6 months earlier with a simple stool test I get once a year at my annual physical. And then he gets a full blown cancer treatment, and almost surely lives far longer than the weeks he survived after advanced cancer way past treatment was finally diagnosed. Saved the system 6 figures easy, because all he got was pain control.

 

[joko104]

The medical industry now seems to almost entirely operate on perceiving there are 3 kinds of patients:
1. People with health insurance
2. People on Medicare/ObamaCare - which many facilities and doctors will not accept such patients
3. People who can not pay.

It is like they don't even know what to do with self-paying patients, so tend to now put self-pay patients into the same oft inferior indigent care category. This can be frustrating because it is difficult to stress we can pay in full, whatever the amount is, by bank card or literally by cash without seeming arrogant. However, the fact is often the care for patients seen as indigent is awful and the absolute bare minimum. That was the instance for my wife.

I've told the story of the difference at one hospital between if they see you as rich verses see you as indigent. It was the difference between being instantly given a luxury private room for 2 days for a chest pain complaint that turned out only to be an anxiety attack for one person. The other having waiting almost 2 hours in the ER waiting room for a person with a history of severe heart issues complaining of intense chest pain and having stated he is a heart patient before anyone even did an EKG - and it turned out that person was having a heart attack for which delay increases the potential of death or permanent heart damage.

MONEY has a LOT to do with how patients are treated at least at most medical facilities and hospitals I've been at - with this having gotten much worse over the last few years.

 

[MAGAnificent]

What does that look like, specifically. Reads suspiciously like a meaningless talking point, i.e. drivel, to me.

Undoing decades of government tinkering with the healthcare system would be a good start. That tinkering is largely what has made healthcare in the US so expensive. The one size fits all approach in Obamacare to health insurance for instance is insane as was the individual mandate before it was repealed. When the insurance providers have a captive customer base, there is no incentive to offer competitive rates. That's why so many of the exchanges are failing. It would also help if insurance providers were not prohibited from selling insurance across state lines. Tort reform would also be helpful. The average surgeon has to carry million dollar medical malpractice insurance policies, just to ward off the frivolous malpractice suits. Same with the pharmaceutical companies. They have to keep billions of dollars in reserve for the same reason. Yet everyone screams about the cost of prescription drugs.

 

[JMB802]

People go into bankruptcy for many reasons not all having to do with medical financial hardship. And with the latter in the majority of cases, it's the medical issue preventing you from making a living that leads to bankruptcy. Either way, it's still not rationing. Financial hardship does not translate to rationing.

Nice try at spin and cherry-picking. Please re-read my ENTIRE post.

 

[joko104]

The truth is hard for some people to take when they've swallowed the narrative hook line and sinker...the mortality rate in the UK for 2020 is no higher than the mortality rate in 2009.... Covid is clearly being assigned as the cause of death for people that are already dying of something else...that does not imply that no one is dying from Covid ...but it does imply that many of those dying are dying with it not of it...I expect this goes over your head though.

For many diseases, the disease itself is not the cause of death. For example, many people with cancer, AIDS or COPD do not die directly from the disease. They kill by shutting down organs (such as COPD) or the immune system is so weak the person is vulnerable - most often to pneumonia - a lung disease. So if the immediate cause of death was stated almost no one would be reported as dying of cancer, but rather some organ failure, not one person would have been reported as an AIDS death and few reported as COPD.

The other comment is that a covid-19 test is not required to make a covid-19 death determination. Until recently, it took a week to even get the results. A determination that the death is by covid-19 was made merely on the assertion the deceased had covid-19 symptoms - meaning any lung issue which could be the flu, pneumonia, a severe cold or COPD - all being considered and counted as covid-19 deaths.

So if a person in the last stage of cancer dies of pneumonia - probably the most common reason for many kinds of cancer - it could/would be reported as a covid-19 death because the symptoms of lethal pneumonia in an otherwise terminally weak person will similar to covid-19. The person doing the death report has to then pick. If picking covid-19, the government will pay every dollar of medical care. If stating cancer or pneumonia, the government may pay nothing. Tens of thousands of dollars at stake.

I understand why medical facilities report as many deaths as covid-19 deaths as possible. The government pays a huge bounty on covid-19 deaths - only covid-19 deaths.

 

[Airyaman]

For months nearly all elective examinations, routine annual physicals and elective surgeries were not being allowed to keep rooms available for potential covid-19 patients. Any detection of diseases in early curable stages such as cancer were not possible. Nearly all non-covid-19 medical care was discontinued unless obviously life threatening such as a heart attack. People were told do NOT go to ER. There was quite a bit of coverage of how much this also was hurting doctors financially.

Deny routine exams, wait months to detect cancer and other diseases - any you have killed people. Lots of people. With tens of millions of families without income, many people could/can not afford decent food, to pay for their prescriptions, and all the other health/death issues that poverty brings. Add suicides.

What counts for the increased death rate mostly is how many people the restrictions, rules and destruction of people's lives that the covid-19 bioterrorism campaign to make the richest corporations on earth richer has and is killing a lot of people.

Or are you claiming that really no one ever needs a medical exam and no one should go to the doctor or ER unless already clearly on their death bed - as that is the level that medical care was denied for months?

Can you explain why the spikes in excess deaths coincided with the reported spikes in death related to COVID-19?

 

[MAGAnificent]

We're splitting hairs on the term. In economic terms, price rations all scarce goods. How many houses do you want? 12? If you're like me, you can only buy one. Call that limit imposed by our ability tot pay what you want.

The same dynamic exists in healthcare. We actually have a very low number of doctors per capita. If we had 'free' healthcare, there are not enough to go around to accommodate all those folks who don't have a family doctor, etc. because they have no insurance and don't ever see a doctor until there's a serious problem, often way past the best time to treat it. A couple of years ago, an acquaintance of mine died from cancer - he was young, about 35 or so. Well, he'd been having stomach pains for weeks and ignored it because he had no insurance, and thought it would go away, The pain was cancer that by the time he noticed it was likely already advanced. Weeks later when it was diagnosed after he started crapping bloody stools, it was too late to treat and he's now dead. That's how rationing works in real life. Substitute undiagnosed early diabetes or heart disease, and therefore not treated until it's a crisis, times 100s of thousands and you've got the idea.

I don't buy the suggestion that there are not enough doctors. In some areas it may require a bit of travel. There are plenty in my area as well as 5 hospitals for a population of less then 200,000. And I live in the deep south.

No, he wasn't denied care explicitly, but if he'd had a regular GP and gotten regular checkups maybe that cancer is diagnosed 6 months earlier with a simple stool test I get once a year at my annual physical. And then he gets a full blown cancer treatment, and almost surely lives far longer than the weeks he survived after advanced cancer way past treatment was finally diagnosed. Saved the system 6 figures easy, because all he got was pain control.

That simple stool test as well as overall routine bloodwork is available to everyone as are regular GPs. Those who truly cannot afford health insurance do have other options such as Medicaid and free clinics. Ill repeat one family example. I had two aunts who both around the same time developed breast cancer. One well to do and one on Medicaid which is insurance for the poor. They both went to the same cancer clinic and hospital, and they often went together. They were both treated at the same level. Nothing was rationed.

 

[JasperL]

Undoing decades of government tinkering with the healthcare system would be a good start. That tinkering is largely what has made healthcare in the US so expensive.

You start with more drivel. That's not telling us anything at all. Undoing what tinkering, how?

The one size fits all approach in Obamacare to health insurance for instance is insane as was the individual mandate before it was repealed.

If there is no rationing then the essential benefits mandated by the ACA don't matter - everyone gets all the care they want or need, whether it's covered by insurance or not.

And, sure, the mandate is stupid because why not allow someone to be uninsured, and if they get sick, go to the ER which takes care of all their needs, per you, and then make the rest of us pay the bill?

When the insurance providers have a captive customer base, there is no incentive to offer competitive rates. That's why so many of the exchanges are failing. It would also help if insurance providers were not prohibited from selling insurance across state lines.

They're not prohibited from selling insurance across state lines. They just have to arrange networks with local providers, and comply with state laws. Even when states waive the state requirements, the local networks kill that 'across state line' business. My doctor might agree to treat BCBS patients for $50 per visit, because BCBS controls 40% of this market. ACME insurance from Nevada with 0.2% won't get the same deal, and so won't compete with BCBS on price - my local providers will charge ACME customers far more than the big dog who can threaten my local doc with their massive customer base.

Government could "tinker" with the system and require my doctor to accept $50 from ALL insurers if they accept that from BCBS but you want to eliminate the tinkering. So I'm not sure what the solution you're proposing is. What I know is talking points like 'sell insurance across state lines' fail at the first contact with reality. That's the problem with the entire GOP approach - it's a bunch of empty talking points like that that everyone in the system knows are stupid/ignorant/dishonest.

Tort reform would also be helpful. The average surgeon has to carry million dollar medical malpractice insurance policies, just to ward off the frivolous malpractice suits. Same with the pharmaceutical companies. They have to keep billions of dollars in reserve for the same reason. Yet everyone screams about the cost of prescription drugs.

Great, more tinkering by government - in this case government arbitrarily limiting recoveries from lawsuits. But maybe you can put numbers to that. What are the total costs of malpractice, including insurance, and how would your proposal limit them? What would we save? I've run the numbers and it's not a whole lot of money, especially when you assume that malpractice does happen, and victims should be compensated. The savings is the 'excess' - compensation above damages. Well, how much is that?

The point is that sounds good, until you start getting into specifics, then it's difficult.

 

[MAGAnificent]

Nice try at spin and cherry-picking. Please re-read my ENTIRE post.

I did read your entire post. And none of it disputes my point. The only existing healthcare rationing in the US is for organ transplants. Ability to pay does not translate to rationing. If it did, then all commerce on the planet is rationed. Expensive automobiles and homes are rationed. We are not all at the same income level. Rationing is limiting the amount of goods and services based on availability, not cost. For instance during the Arab oil embargoes in the 1970s, gasoline was rationed for a short period. Had nothing whatsoever to do with cost. It was all based on availability. That's rationing.

 

[snakestretcher]

I don't buy the suggestion that there are not enough doctors. In some areas it may require a bit of travel. There are plenty in my area as well as 5 hospitals for a population of less then 200,000. And I live in the deep south.



That simple stool test as well as overall routine bloodwork is available to everyone as are regular GPs. Those who truly cannot afford health insurance do have other options such as Medicaid and free clinics. Ill repeat one family example. I had two aunts who both around the same time developed breast cancer. One well to do and one on Medicaid which is insurance for the poor. They both went to the same cancer clinic and hospital, and they often went together. They were both treated at the same level. Nothing was rationed.

You "don't buy it" because of your personal experience? US AAMC begs to differ...

U.S. physician shortage growing

A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. Among the factors: older patients and retiring doctors.

www.aamc.org

U.S. Doctor Shortage Could Hit 139,000 By 2033

The nation’s shortage of doctors will rise to between 54,000 and 139,000 by 2033 as the U.S. population grows and ages, making it even more difficult to fight public health threats like today’s spread of the coronavirus strain Covid-19.

www.forbes.com

We’re Devastatingly Short on Doctors. Why Doesn’t the US Just Make More? - Washingtonian

In the summer of 2019, a flurry of articles appeared in the press in rapid succession. They each described what healthcare experts were warning was a fast-approaching disaster: a “devastating” shortage of doctors in the United States. Just months later, amid the coronavirus pandemic, shortages...

www.washingtonian.com