healthcare reform is coming

[Kruse]

Originally Posted By: Pablo
This might be a good thing. In the short run.


I guess the same could be said for a V.A. hospital. If a V.A. hospital is so good, why isn't everybody wanting to use their service?

I wonder how many politicians who vote for a government-run health care will actually use the same system that they set up for everybody else?

Probably about as many as use the social security system that they set up. Oh, wait. They have their own pension and free healthcare.

 

[Gary Allan]

We had incredibly slow ER care at our hospital. I gashed my arm ..the ONE other person in the waiting room also had a serious cut (finger =tendons). No one saw us. I have a pressure bandage holding the gash closed. The triage nurse went to break. They had just gotten 3 ambulance delivered seniors that were waiting to go to CCU. That meant that everyone in the ER walked around in a holding pattern with clip boards doing NO TREATMENT. At the 3 hour point (we're still the same two people) I'm whining like a baby (actually growling like a Rottie) . The PR Nurse and the NS come out in some attempt to calm me. I described exactly what was going on inside the ER ..just people walking around with clipboards in a holding pattern (waiting for paperwork or phone calls to move the seniors to CC/IC.

I pointed out that if they had a "Doc in a box" (immediate care) right next door, 90% of the ER load would be gone. When I said that, the Triage nurse blurted out "the one down the road went out of business" ..I said, "Nope. Another hospital bought it out and closed it".

So, after a year of ridiculous waiting times in the ER every weekend, what did they do? They expanded the ER! Millions in construction costs, millions more in idle static costs. While any number of "doc in a box" outfits would have done it far cheaper.

They always keep the ball in their court. Any hint of reduced costs always equates to reduced services. The same service always costs more.

 

[CivicFan]

Originally Posted By: digitalSniperX1
Originally Posted By: stockrex
true medicare does not pay enough, but that is for OFFICE VISITS.


Since she's (or perhaps was) in a lowly general practice...I suppose it's predetermined that she is to simply donate her time as charity and leave the real medicine to the heel bone spur specialists, lol.

Oh, and without exception those few NHS pro's I know universally claim it sucks and sucks badly.

They openly admit our standards are much higher.

And Grandma's over 65 in the Netherlands will find their dignity in the form of the euthanizer's needle.

Some system to aspire to.

It's La Jolla by the way. Although they call it La Joya in Kentucky. Have your pick.


GP and pediatricians are at the bottom of the physician pay scale. I think it's wrong but that's what the system is.

 

[CivicFan]

Originally Posted By: stockrex
to quote one family practice resident who was about to graduate on my question, dr lalala what are your plans after you graduate?
his response: I am going back to Indianapolis and going to print money. and he could not stop laughing. ;-)

now I am off to bill the hospital for my work!


Yes, Indiana is a very pro-business state for health care. There are basically no patient rights like the more developed states in the union.

 

[eljefino]

Originally Posted By: IndyIan
I think this thread ties into the "happiest nations in the world" thread quite well. It's hard to be happy when you know you are a broken ankle away from bankruptcy... Let alone a semi serious illness...

I don't really know how much more money I'd have in my pocket if I lived in the US and had to pay health insurance or have my employer pay it. $200-300 a month? Seems pretty cheap considering my healthcare doesn't change wether I'm employed or not, or if I've had an illness before, I am still covered as I don't have to apply for health insurance again...

Of course the Canadian system isn't close to perfect, and there is lots of room for improvement. I had a friend go to Sweden and he was amazed how fast they saw him, ran a few tests, and had the results right away to decide what to do. Hopefully Obamas folks are looking to see what works in other countries.
Ian


A lot of us would be happy to tell our boss to F off and start our own businesses doing the same thing more efficiently, but feel locked down doing that boring stuff like providing benefits for our families. Surely they love keeping us subserviant.

 

[PandaBear]

Originally Posted By: Gary Allan
We had incredibly slow ER care at our hospital. I gashed my arm ..the ONE other person in the waiting room also had a serious cut (finger =tendons). No one saw us. I have a pressure bandage holding the gash closed. The triage nurse went to break. They had just gotten 3 ambulance delivered seniors that were waiting to go to CCU. That meant that everyone in the ER walked around in a holding pattern with clip boards doing NO TREATMENT. At the 3 hour point (we're still the same two people) I'm whining like a baby (actually growling like a Rottie) . The PR Nurse and the NS come out in some attempt to calm me. I described exactly what was going on inside the ER ..just people walking around with clipboards in a holding pattern (waiting for paperwork or phone calls to move the seniors to CC/IC.

I pointed out that if they had a "Doc in a box" (immediate care) right next door, 90% of the ER load would be gone. When I said that, the Triage nurse blurted out "the one down the road went out of business" ..I said, "Nope. Another hospital bought it out and closed it".

So, after a year of ridiculous waiting times in the ER every weekend, what did they do? They expanded the ER! Millions in construction costs, millions more in idle static costs. While any number of "doc in a box" outfits would have done it far cheaper.

They always keep the ball in their court. Any hint of reduced costs always equates to reduced services. The same service always costs more.


They are doing that to discourage people from visiting ER. Imagine if you have too good of a service in ER, how many uninsured patient would show up?

All the people with clipboard there are in the "show business", to make people feel like they are being treated and help is on the way. You want free health care that the government is not paying for, people cannot afford, doctors try to pad unnecessary services, and insurance try to squeeze everyone for the expensive services, this is what you get.

In the future unless I'm unconscious and someone lifted me into an ambulance. I'm going to a travel agency and get the next flight to a 3rd world country for a visit.

 

[Gary Allan]

Quote:
They are doing that to discourage people from visiting ER. Imagine if you have too good of a service in ER, how many uninsured patient would show up?


There are not too many freebee's around here. The chronic poor have their clinics and insurance. They're surely increasing in numbers, but we don't have the static urban crowd using the ER as their primary care facility. The ER was choked by weekend warriors, of all ages, spraining ankles and getting cut ..all stuff that a couple of decent field medics could handle in 5 minutes.

A sprain ankle used to cost about $75. $25 visit, $25 X-ray, $7 ace bandage, and maybe, if you didn't have a set, $25 for crutches. Now you get referred to an ortho specialist, he tells you to meet him at the ER (they try and bill you for $500 for an emergency that they aren't treating you for), the xray costs $125 in funny money ..and they hand you a brand new pair of aluminum crutches as a matter of course. Total tab, including your doctor's visit ..probably a grand ..and that's without the thieving hospital billing for an ER visit that they had nothing to do with other than providing space.

 

[Tempest]

Originally Posted By: CivicFan
Originally Posted By: Tempest
Doctors are running, not walking, away from Medicare. The pay is very poor and often doesn't cover their cost. I think it's funny the idea that doctors are getting rich from it.


Not true. You may be confusing Medicaid and Medicare. The providers like Medicare. Medicaid pays below cost so it cannot be your main payer(for most of the providers). But in order to take Medicare, a provider has to take Medicaid as well.

So the successful providers have 30% of each type of payer. Private pay is 10% and about half of that goes to charity care for people who cannot pay their bills and go bankrupt.


http://online.wsj.com/article/SB123993462778328019.html

Quote:
Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients.

Quote:
The problem is even worse with Medicaid. A 2005 Community Tracking Physician survey showed that only 50% of physicians accept this insurance. I am now one of the ones who doesn't take it. I realized a few years ago that it wasn't worth the money to file the paperwork for the $25 or less that I received for an office visit.

 

[Tempest]

Quote:
And if Amsoil was the only game in town, and no matter where you went ..Amsoil was all you could buy, with prices set by former Amsoil dealers on Amsoil price approval councils ...where ethical use of Amsoil was dictated by Amsoil dealers who set Amsoil usage code of ethics ..and the standards that Amsoil can be administered under ..the facilities where you can get Amsoil installed in your car ..all of them.

How is that any different from socialized healthcare? All of the things you complain about in the so called private system that we have would only get worse under a gov. monopoly.

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/04/AR2007030401394.html

The military health system, which is completly controlled and run by the gov., is in very poor condition...and that is for returning troops. There is no reason to expect better result for a system run for regular people. They have a track record, and it is poor.

 

[PandaBear]

Originally Posted By: Tempest
How is that any different from socialized healthcare? All of the things you complain about in the so called private system that we have would only get worse under a gov. monopoly.

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/04/AR2007030401394.html

The military health system, which is completly controlled and run by the gov., is in very poor condition...and that is for returning troops. There is no reason to expect better result for a system run for regular people. They have a track record, and it is poor.


In socialized healthcare, there are still private hospital at your own cost. Many rich people go there for privacy and enhanced services, so I don't see it as a monopoly.

Except that you are no longer in the same group waiting in the same hospital for services as today, when someone else may pay more and others pay less. Depends on which category of patients are you, you may be losing something.

 

[Tempest]

They don't have a private system in Canada, it's illegal. Same is true in the UK I believe. The system proposed here in the 90's was the same. Not "fair" don't you know.

A Congress person has openly stated that the point of the current government "reform" is to cause the complete failure of private health care in this country.

 

[Tempest]

Quote:
Under the current system, anyone moving into a nursing home or requiring home help has their finances assessed by their local council before their needs. Those who have more than £22,500 in assets receive no state help at all, and often have to sell their homes or raid their children's inheritance to pay for care. Meanwhile those who have modest incomes must put their pension and savings towards accommodation and nursing care and are only allowed to keep £3 a day to cover the rest of their living expenses.

In addition, each local authority is allowed to decide how needy people must be before they qualify for free assistance in the home. This allows councils that have large numbers of elderly or disabled residents to restrict care to only those with severe needs.

http://www.telegraph.co.uk/finance/perso...home-costs.html

It's so bad they are thinking of forcing people to take private insurance to cut costs to government.

Big stars are helping the last survivor of the Titanic to pay her bills...in the UK social system.
http://www.independent.ie/national-news/...at-1734464.html

 

[IndyIan]

Originally Posted By: Tempest
They don't have a private system in Canada, it's illegal. Same is true in the UK I believe. The system proposed here in the 90's was the same. Not "fair" don't you know.

A Congress person has openly stated that the point of the current government "reform" is to cause the complete failure of private health care in this country.


UK has actually partially privatized their system and is pointed out as an example of why we don't want to do this in Canada.
Initially the private places were slightly more cost effective but eventually they started choosing only the most profitable services to provide and shoved the rest back to the public system.

Personally I think healthcare requires to many moral judgements to be effectively run on an amoral for profit business model.
The fundemental difference is that government healthcare should be designed to do the greatest good to the public in general. Private healthcare businesses are only concerned with the bottom line and shareholders, getting people healthy is only a tool to attract more business or avoid bad press.

 

[PandaBear]

Originally Posted By: Tempest
They don't have a private system in Canada, it's illegal. Same is true in the UK I believe. The system proposed here in the 90's was the same. Not "fair" don't you know.


Since when do we have to follow how Canada runs? Who say we have to outlaw private practice?

Taiwan and Japan has a reasonable public health care and no one is complaining about it.

Quote:

A Congress person has openly stated that the point of the current government "reform" is to cause the complete failure of private health care in this country.


Do you follow our Congress person and started calling fried potatoes Freedom Frys too?

 

[Gary Allan]

Quote:
How is that any different from socialized healthcare?


We have socialized health care. It's just at variable availability of services. All costs are paid by producers (how many times does this need to be said?).

We're the ones rationing it not the socialized health care countries.

..but my depiction was exactly what we have today. Doctors sitting on committees and certification boards dictating what's appropriate services for physicians and facilities to provide.

You object to my blanket term "AMA" since it doesn't have any authority. Yet the same AMA members are boards of director and chair people of every certifying agency that insurance companies and public funding require for paying for the services.

It's a closed box game of fleecing with the fox guarding the hen house. The hen house is a smorgasbord for foxes.

 

[Tempest]

Quote:
Personally I think healthcare requires to many moral judgements to be effectively run on an amoral for profit business model.

So you are saying that government does a better job at moral decisions than the people do?

Do you understand that you do not have a right to medical care in Canada? And that the current spending levels are not sustainable? Your own government has stated this.
When the money runs out, do you believe that the government will have your best interest at heart?

Do you also believe that the government is best suited to make moral decisions on the distribution of food and shelter?

 

[Tempest]

Quote:
We're the ones rationing it not the socialized health care countries.

Oregon's system was specifically set up to ration care.

They offer assisted suicide rather than cancer treatment.
http://www.worldnetdaily.com/?pageId=67565

And is so effective that they ran out of money in 2004 and closed the program to new people. Until recently when they conducted a lottery to take in new people.
http://drwes.blogspot.com/2008/03/lotteries-to-ration-healthcare.html?showComment=1205286240000
Isn't government great at making moral decisions when their money is on the table?

Also:
Quote:
When the Oregon Health Plan was established in 1994, it was expressly intended to ration health care. A prioritization list was drawn up, with diagnoses and ailments deemed most important — pregnancy, childbirth, preventive care for children — placed at the top of the list. At the bottom are procedures such as cosmetic surgery, which would not be covered.

“We can’t cover everything for everyone,” said Dr. Walter Shaffer, medical director of the state Division of Medical Assistance Programs, which administers the Oregon Health Plan.

“Taxpayer dollars are limited for publicly funded programs. We try to come up with polices that provide the most good for the most people.”

Most cancer treatments are high priority on the list, Shaffer said. “But there’s some desire on the part of the framers of this list to not cover treatments that are futile, or where the potential benefit to the patient is minimal in relation to the expense of providing the care.”

http://whatthecrap.wordpress.com/2008/08...e-drug-company/

 

[Gary Allan]

Quote:
So you are saying that government does a better job at moral decisions than the people do?


Didn't look like it to me.

He posted:
Quote:
Personally I think healthcare requires to many moral judgements to be effectively run on an amoral for profit business model.



Didn't seem that hard to read and understand

So, are you saying you can't read?

 

[Tempest]

He also said:
Quote:
The fundemental difference is that government healthcare should be designed to do the greatest good to the public in general. Private healthcare businesses are only concerned with the bottom line and shareholders, getting people healthy is only a tool to attract more business or avoid bad press.

So my question was quite appropriate. He is clearly stating that gov. does a better job.

 

[Gary Allan]

I think he said that government health care should be designed to do the greatest good to the public in general.

aka: If one has government health care, it should serve the largest segment of your population to produce the greatest outcomes

He also said:

Private health care businesses are only concerned with the bottom line and shareholders (in many cases, practice/group partners), getting people healthy is only a tool to attract more business and avoid bad press.

I don't see a melding of the two statements that formed the conclusion you drew.

The difference between the two is one is health care providing at some cost ..and the other is money making using health care as a modality. The motivations are totally different.