Health Care Reform

[Klingsor]

I am 100% behind a nationalized, single payer health care system. Medicare for all.

Ah. Well, then . . . no argument here! :smile:

 

[umami_tsunami]

The biggest problem with our health care system is that it is entirely a for profit enterprise. The stated mission of the major health care companies is to deliver value to their share holders. Of course, they say it’s to provide quality care blah, blah, but it’s really to make money. Period. That means taking as much money as they can from employers’ contributions and individuals’ premiums and withholding as much care and paying out the least amount they possibly can to actual providers.

It’s the simplest accounting principle of all: asset and liability.

The biggest healthcare companies: Humana, Wellpoint, Cigna, Blue Cross, United Health, Aetna are all publicly traded, for profit businesses. Anyone can see how they are doing financially. I’ll give you a hint- Their making fucking billions and all trading close to there 5 yr highs. Some will complain that profit motive drives innovation and attracts talent, but far more breakthroughs have come from publicly funded, government research than for profit enterprise.

Combine this dynamic with the industrially-farmed, chemically-treated, antibiotic and growth-drug-laden shit people shovel into themselves and you get a great big (and I mean BIG) nation of sick people who just might be OK if they can get their hands on a scrip for some Plavix or some other shit that will keep them alive, and not make them confront their true health issues or change their lifestyle. Why should I not have that double cheeseburger? It only costs $1 and I can just take a pill when my cholesterol hits 300! Of course, the lobbyists for giant shit producers like Monsanto, Con Agra, Nestle and Cargill make sure they get plenty of funding and subsidies so their crap is not only maximizing profit, but also able to undercut responsible producers’ pricing.

It’s all about money and NOBODY gets paid when people are healthy. The entire food and healthcare industry is based on greed, gluttony, laziness and ignorance. We seem to like it this way.

 

[umami_tsunami]

I am 100% behind a nationalized, single payer health care system. Medicare for all.

+1

 

[OhWiseOne]

New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs


Americans for Insurance Reform, a coalition made up of Consumer Federation of America, ConsumerWatchdog.org and nearly 100 other public interest organizations, released a major study Wednesday on the state of the medical malpractice insurance industry. It found that insurance rates for doctors have dropped significantly while the medical malpractice insurers are earning record profits. The conclusion is that the cost of medical malpractice insurance is not crippling doctors and that large profits are going to the insurance industry.
Specifically, the study found, adjusting for inflation, that:

• Medical malpractice premiums are nearly the lowest they have been in 30 years.
• Medical malpractice claims are down 45 percent since 2000.
• Medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been very profitable over the last five years.
• In states that have substantially limited consumers’ ability to go to court for medical malpractice, the insurance premiums for doctors are basically the same as in other states.

New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs


Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office. Defensive medicine, the practice of ordering extra tests or procedures to protect against lawsuits, might add another few percentage points, according to some estimates.

Health-care security, who is to blame for high costs

I wonder who funds these groups? hmmmmm...And the Congressional Budget Office....There is a solid source...politics...

 

[Mensch1351]

So let's be blunt (and brutal). If the bottom line of a health care industry/ company is to maximize profits and minimize expenses, ANY system which makes sure that the sickly children, the elderly (those over 85) and those too poor to afford the cost of health care are denied QUALITY care is preferable! It's just corporate capitalism's subtle way of weeding out those whom they consider a "drain" on the overall system! The sooner they (those listed above) die --- the greater the profits of insuring the healthy! It really has nothing to do with any "morality" of preserving life (kind of ironic don't you think -- given the Conservative Right's intrenchable stance on abortion?)

 

[dandelion]

How about some facts instead of supposition:
Costs Of Defensive Medicine May Be Overstated


Costs Of Defensive Medicine May Be Overstated : Shots - Health Blog : NPR

Yes, sensible, but that doesnt contain any. It does have some more assertions. It says malpractice premiums constitue about 1% of costs, but that is about the only fact. It quotes an estimate by Michelle Mello that defensive medicine costs an additional 1.5%. It suggests that doctors worry disproportionately about being sued, but I dont see that says anything except that they will act more defensively than the real risk would require.

FactCheck.org: President Uses Dubious Statistics on Costs of Malpractice Lawsuits

Your second link says the president reckons his bill will save the country 4% of costs (taking the two articles together to equate % with amount) It says a 1996 study, one of the few to consider the issue, found between 5-9% costs attrributable to defensive medicine comparing heart patients in states with more or less risk of litigation. The article then says several other studies, presumably from the 'few' to have considered this, found little or no relation. A 1990 study found no correlation, a 1999 study on cesarean sections found no difference. A 1994 study oncaesarian sections found a small correlation, but apparently concluded it was impossible to disentangle the costs of defensive medicine. GAO and CBO (whoever they are) apparently accept the 1996 study, but argue it only applies to heart medicine. CBO further challenged the 1996 result when the same method was applied to a different set of data. This would suggest there are competing base statistics about costs, but I couldnt from this conclude what those might be or why there would be a disparity.

I would think a more relevant comparison than state to state might be country to country. Are doctors in one state really unaffected by stories about doctors in different states, or given different professional advice on how to treat patients depending on where they practice? This seems to me pretty unlikely! But I suspect international comparisons would immediately be very difficult because if you compared costs in the US and Uk, the Uk seems likely to be way lower. It would then be difficult to disentangle what part of this is due to fear of litigation and what part to other differences.

New Study Finds Medical Malpractice Insurance Premiums have Minimal Effect on Health Care Costs

Says that litigation insurance premiums are falling, which suggests to me that doctors are indeed practicing defensively so that they never get into a situation where they can be sued. That is evidence that defensive medicine is indeed occurring. What we are really talking about is a balance of risk for patients. We all know that if you get absolutely first class care your chances of something going wrong will fall, but the point is we cannot all afford first class care. What is needed is more rough and ready care but consistent care. This may lead to things going wrong which could have been avoided, but also means the money will stretch further where you really need it. Falling litigation premiums is bad news!

Health-care security, who is to blame for high costs

Says there is abundant evidence that some expenditure by doctors and hospitals is unnecessary. That doctors and hospitals make money from treating patients, not from keeping them healthy. 12% of costs are insurance company administration and profits. 46% of the money for healthcare is paid by governments, who set industry rates for various things, not necessarily getting the best deal. The health sector spends more lobbying politicians than any other. 25% of healthcare costs are due to lifestyle choices, but that seems a rather different issue whether people would be better off avoiding getting sick.

Once the generic versions are out that will drop to like $40.

But dont think you are being ripped off! A fair summary of all medical research trials is probably that all out of patent medicines are useless and only those in patent are worth using. It is only after patents lapse that evidence emerges about the problems with a drug. Also drug companies choose not to make out of patent medicines, so you cant get them anyway. Drug companies have a vested interest in rubbishing non-patent drugs and in making them unavailable.

 

[dandelion]

So let's be blunt (and brutal). If the bottom line of a health care industry/ company is to maximize profits and minimize expenses, ANY system which makes sure that the sickly children, the elderly (those over 85) and those too poor to afford the cost of health care are denied QUALITY care is preferable! It's just corporate capitalism's subtle way of weeding out those whom they consider a "drain" on the overall system! The sooner they (those listed above) die --- the greater the profits of insuring the healthy! It really has nothing to do with any "morality" of preserving life (kind of ironic don't you think -- given the Conservative Right's intrenchable stance on abortion?)

Any system of health care rationing will inevitably affect the most sickly worst. And be clear, the name of the game everywhere is health care rationing because there is virtually no limit on how much you could spend on every person. Those who come off best under the US system are the rich. In the Uk most health care does not depend on your personal wealth but rather on whether it is affordable to treat your condition. You can of course buy additional private care if you are rich, as is true everywhere. However, the differences in treatment are much less marked than in the US, where the baseline care you get is better the richer you are, or the more insurance you have (which pretty much amounts to the same thing as being rich). The real problem in the US seems to be the big chunk of of the population getting poor care.(and the cost of it, of course)

 

[Horrible]

So let's be blunt (and brutal). If the bottom line of a health care industry/ company is to maximize profits and minimize expenses, ANY system which makes sure that the sickly children, the elderly (those over 85) and those too poor to afford the cost of health care are denied QUALITY care is preferable! It's just corporate capitalism's subtle way of weeding out those whom they consider a "drain" on the overall system! The sooner they (those listed above) die --- the greater the profits of insuring the healthy! It really has nothing to do with any "morality" of preserving life (kind of ironic don't you think -- given the Conservative Right's intrenchable stance on abortion?)

I think this is not an idea from the right. From what I have found, it is something put into effect by a democratic president.

http://www.newsmax.com/Headline/obama-death-panels-medicare/2010/12/26/id/381043

 

[FuzzyKen]

There are so many factors in the health care mess that it almost becomes mind boggling.

The FDA is for example a joke. I know that "Industrial" who is better at data wrangling than I may be able to do it, but if you doubt what I have to say, look at where the various heads of the FDA departments regulating drugs all came from. Look at what their positions were prior to their entrance into service with the FDA and where their loyalties lie.

Right now, our biggest problem with health care is as the old saying goes" "The Fox watching the henhouse".

Until we remove a number of people because of "conflict of interest" we will never clean up medicine.

How many of you knew the big but now quiet mess over AZT?

When people were dying of complications from HIV in record numbers, there was out and out FRAUD committed and nothing was ever done about it.

The first thing that needs to be done in virtually all levels of government is a major house cleaning and a complete restructuring of what constitutes "conflict of interest".

That has taken such a beating and abuses have gotten progressively worse over the past four decades to the point that morally wrong is now considered "status quo".

 

[dandelion]

I think this is not an idea from the right. From what I have found, it is something put into effect by a democratic president.

Obama Embraces 'Death Panel' Concept in Medicare Rule

I dont see how anyone can think health care has not always been rationed. Though if you look at medicine through history and what doctors now would say about past treatments, sometimes less is more. Funny thing is, this process of weeding out useless treatments still continues.

The NHS has always rationed health care. There used to be and presumably still is a tally system to compare the cost of something to the number of quality life years likely to be provided for the patient by a treatment. There is presently a review panel to assess whether expensive new treatments are cost effective. Fancy new cancer drugs seem to particularly fall into the category of 'expensive'.

In the US there seems to have been some fuss about formalising ways to allocate money to different patients. Why this fuss? At the moment you get treatment according to how rich you are or until the insurance runs out, not according to whether you really need it compared to the next guy. How is this better?

I would say in the UK children tend to rate well on scales of benefit from treatment because they have the potential for a full life ahead of them. Old people probably do not, but it is noticeable that older and older people now get things like hip replacements which help keep them active and able to enjoy life as long as possible. There is no issue in the UK about whether old people are being denied treatment in order to get rid of them. Rationing of health care is generally seen as fair, but care is anyway naturally slanted towards those groups which need it most including the old. If there is a debate at all about the treatment of people with terminal illnesses (which I think would include 'old age') it is a growing call from people in a bad situation to be allowed to end their lives straight away rather than dragging on to the inevitable end.

 

[Redwyvre]

Yes, Yes, Yes. Everything on this planet is rationed. It a natural fact. Unfortunately, Americans easily lose sight of this since we live with mind-boggling abundance everyday.

 

[Mensch1351]

I think this is not an idea from the right. From what I have found, it is something put into effect by a democratic president.

Obama Embraces 'Death Panel' Concept in Medicare Rule

"The new provision, which goes into effect Jan. 1, allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex decisions families face when a loved one is approaching death. Critics say it is another attempt to limit healthcare options for the elderly as they face serious illness." 4 days before my dad died of lymphoma, they gave him a chemo treatment! Without "paliative care" --- they were going to dismiss him. I interpreted that simply, "spend more money here or get out!" There is a big difference between a reasonably healthy 85 year old getting a hip replacement and a 65 year old re-curring cancer patient under-going expensive tests and treatment when the prognosis is "grim." The irony I find in the Conservative stance on abortion is their mantra "ALL life is sacred!" Even when that child has been conceived through rape/incest and will probably end up costing society a great deal more than it ever MAY contribute to it. OR their support of insurance companies who systematically deny coverage for a NEEDED surgery just because the person has a pre-existing condition or has poor coverage. I also find it ironic that the MORALITY of preserving life always seems to be weighed over against the COST of preserving it (but not it seems, with the "newborn"!)

 

[Horrible]

Ironically, I am a HUGE proponent for abortion.

 

[Redwyvre]

I was very disappointed when Obama gave complete control of the "Death panel" discussion to Right Wingnuts. Sure a certain percent of the population will always be like Terri Schiavo's parents, but just a certain percent. Some people, myself included, have spent the time and money drawing up a durable power of attorney for health care. I should get a break on my healthcare insurance premium for taking this step. Btw I didn't opt for the feeding tube and a the reruns of "The Price is Right" option.

 

[Thedrewbert]

Europe with its inefficient socialized medicine kills 1 in 122 with a hospital caused infection. We are much more efficient, killing 1 in 7.

 

[Bbucko]

I wonder who funds these groups? hmmmmm...And the Congressional Budget Office....There is a solid source...politics...

Are you seriously doubting the reliability of Consumer Reports?

 

[travis1985]

One problem that not everyone considers is that certain things would be covered under this system that many Americans would find objectionable from a moral and religious standpoint. Obligating them to either purchase the insurance or not purchase it but pay anyway in the form of a fine violates their freedom to practice religion. Whatever your feelings toward religious people may be, the truth is that that is unethical. "Separation of church and state" is always a popular idea when it is felt that religious citizen are imposing values on others, but it seems to be mostly forgotten when they are the imposees. If the goverment is going to start up such a system, and it seems that it is determined to one way or another, every citizen should have the right to review all services and procedures covered by it and make one of many possible choices: 1) Accept the program and purchase the insurance; 2) Reject it and be insured by a private plan that is harmonious with their personal values; 3) Reject it and be uninsured. And when I suggest the possibility of being uninsured, I mean that the government doesn't step in if misfortune falls on someone who took that road; everyone wants choices these days, so we must grow up and own them.

 

[Thedrewbert]

Are you seriously doubting the reliability of Consumer Reports?

I don't even know what you're talking about, but I don't consider C R to be reliable. Buying a $15 toaster? sure I'll take their advice. Anything more complicated or expensive than that, they've proven to me that I'm going to need a second and third opinion.

 

[Bbucko]

I don't even know what you're talking about, but I don't consider C R to be reliable. Buying a $15 toaster? sure I'll take their advice. Anything more complicated or expensive than that, they've proven to me that I'm going to need a second and third opinion.

This is honestly the first I can recall hearing critical of CR. I've always considered them to be the gold standard in consumer safety concern.

 

[B_enzia35]

The thing about a source like CR, for the most part, people are apathetic enough that if it works, that's the end of story. If it doesn't work, they raise holy hell.