Prepare for healthcare abuse to the Nth degree

[sparky11point5]

Star,

Two points. You made an unsupported assertion that a problem is insufficient capacity is a problem.

Do you have anything to back that up? Every healthcare professional I know point to overcapacity in most regions of the country and under capacity in only some rural areas. We also have more doctors per capita than most countries. (Although too few general practitioners and way too many specialists.)

Moreover, as I asserted earlier (although too lazy to reference, sadly, it is a workday) the uninsured are *already* in the system using resources, just inefficiently. I know your overheated mind probably conjures hordes of unwashed, probably illegal, exotic rabble standing outside the doors of your pristine health care enclave. The truth is they are generally in the waiting room already, waiting for routine care. There is no flood waiting for universal healthcare.

One more comment, perhaps care should be given to people based on need and not who can pay more. Now, that would be civilized. Or, would you open organ transplants (the ultimate scarce resource) to an auction? That would be a true winner take all system that would make Ayn Rand proud.

I agree that we need to improve drastically, but jamming 40 million people into a system that can't handle their current patients is not the answer.

That's my point.

 

[B_VinylBoy]

C'mon.

What do you have to say to the guy that's paying $2K per month? Tough luck, dude?

How would you suggest they set the priority..alphabetical order?

Some of you treat people that pay for things like they are evil.

I say responsible. You say evil.

How about we treat cases based on severity, regardless of whether or not someone has a $2000/mo health insurance plan or not? If someone with no insurance was brought to a hospital in a critical situation that could be life threatening and they were pushed aside for the person whose there just for a routine physical because they have expensive medical insurance, I'd raise hell about it for sure.

Funny how people care so much about life in a womb, but when it's outside of one it becomes purely about the money? I digress, of course...

 

[SEXXXX]

From the posts I get a grip on who favors SOCIALISM and who favors CAPITALISM

 

[sparky11point5]

Star --

This is important. I think you actually know this, but to emphasize, the employee does not pay, but the employer does pay. This is essentially a tax on employers.

Thus, the fundamental flaw is that the people most closely involved in health care decisions (patients and doctors) do not pay under our current system. In fact, patients are incented to get *as much care as possible, independent of whether this improves their health or not*. Doctors are incented to provide as many services as possible to increase their income.

Not exactly free market.

As employers have had to shift costs to employees, this has broken the system. Finally, consumers feel the impact of their decisions.

 

[D_Tully Tunnelrat]

Do you have anything to back that up? Every healthcare professional I know point to overcapacity in most regions of the country and under capacity in only some rural areas. We also have more doctors per capita than most countries. (Although too few general practitioners and way too many specialists.)

Health, and health care are such complex issues... Sparky makes a very good point about GPs vs. Specialists; we presently have a huge dichotomy in how we look at health care.

The US is better equipped to handle massively expensive life extending care, such as cancer, which Star correctly points out, than we are general health care: check ups, minor care, etc. This is because of reimbursement distortions in the health insurance system. If health care insurers paid providers as much (per time spent) for check ups, as to perform angioplasty, you'd see a surge in general practitioners.

Much of the insurance reimbursement system is based on progressively more expensive medical technology, since each charge for high tech equipment makes the visit more profitable, and theoretically provides a better diagnosis, or medical solution, but not always.

Health care premiums are totally out of control now as everyone agrees. Try insuring a family of four in NYC, while being self-employed. It's unaffordable, even if you increase your deductibles to $1K per person. So, how to lower them other than a one size fits all approach?

For starters, general fitness (What ever happened to the President's Council on Physical fitness anyway?). America, in general, is massively obese. Until we address this, we will continue to be unhealthy no matter how much we spend. Getting the general populous to loose just 10% of their excess weight would lower our "collective" health care premiums, since obesity makes otherwise healthy people diabetic, prone to heart attack, joint pain, failure, etc.

Health care isn't only about money, it's a mindset. Around the world, many people are able to treat chronic conditions with regular, inexpensive noninvasive preventative care. Chinese medicine, Ayurveda, and Homeopathic forms of medicine have used this approach for hundreds, even thousands of years. Only our western Allopathic approach treats human as disembodied cases studies.

Ideally those in the greatest need would always be treated first, but first everyone should be responsible for their diet, exercise, and weight. Those who are should possibly get a slight discount on their premiums for trying, or being height/weight appropriate.

One more piece of the puzzle in trying to reduce health care premiums is malpractice insurance. Large jury awards in medical cases increase premiums by 4-5% a year. However, insurers increase doctors rates by 10-20% a year. It's even worse in some state run insurance systems, such as NY, where last year law makers (or is it breakers?) looted the general med-mal insurance fund for $690M to fill in spending "gaps" elsewhere.

If the government used a single payor system such as Medicare, which most of my friends in the medical community espouse, you would probably see an overnight drop in the injury awards for medical malpractice cases since it is so hard to win large judgments awards from the government. (BTW Star even if we did have a national health care policy, socialized countries such as Holland, do allow for private practitioners, if you want to pay out of pocket.)

Lastly we have a notion in this country that doctors must be highly paid people. Whereas in Russia this is not true, and it shows in their reduced life expectancy, in Germany doctors salaries are comfortably middle class (although they have been declining due to gov. managed care over the last ten years) yet their life expectancy has slightly increased. If our med schools grads were not so encumbered with debt, there would be less motivation to immediately earn gobs of money. Somehow it always come back to education.

The solutions need common sense metrics, a stream lined approach, and bipartisanship. Obama knows this, and it shows in his general outline for reforms. Organizing for America | BarackObama.com | Health Care But the devil is always in the details. Do we have the political will to collectively get up off the couch?

Apologies for the length of the post.

 

[sparky11point5]

Excellent post, Duc. Malpractice insurance is another key problem -- how to cut the cost and still provide a recourse for patients that have been mistreated.

I will acknowledge the following. If I were sick and insured or wealthy, the US is the best place for treatment by far. In particular, cities with several teaching hospitals like Boston. However, with no or limited insurance, I would far prefer to be in a nationalized system such as the UK NHS. (I lived there, so know the pros and cons.)

The real conflict for Americans is, if we do nothing, or allow Congress to water down reform on behalf of insurers, more people will find themselves in this later group. The system we have now is the product of a rigged system and the beneficiaries are those that get to reap annual cost increases of 15% or more -- insurers, large providers, and specialists. The people getting squeezed are patients, sole practitioners, and employers.

If the GOP is looking for a way back to it's roots, which side will it pick Big Insurance or individuals? Sadly, I think the GOP and Corporatist Dems will side with insurers.

 

[D_Bob_Crotchitch]

Some of the answer lies with the public. People have got to start living healthier lifestyles. For generations, people in the USA have eaten wrong, indulged in health damaging habits, and not properly exercised. Couch potatoes have increased the use of the system and driven costs to an extreme. If you abuse your body, you are going to feel awful. That's just a fact of life.

 

[D_Ireonsyd_Colonrinse]

I think it would pretty helpful at this point if somebody could write up a detailed thread or post showing exactly how the insurance lobby manipulates (1) votes and (2) policy.

Especially how for-profit Insurance & Medical influences dem congresspersons who are elected in lower middle class/middle class areas -- the exact type of areas that would favor a single-payer option.

 

[sparky11point5]

Star, true enough, but I am not really sure this is the best measure of whether the US has a better health care system or not. I had suggested general measures of health or *chronic* disease and not *acute* disease, which would of course include cancer.

I said in another post that the US is the place to be sick. This is true but not necessarily a measure of the overall effectiveness. One of the facts about US healthcare is that it is really optimized for those with insurance and acutely sick. This is why the vast majority of health care spending (I think the percentage is something like 80% - 90%) is in the first year of life and the last year of life. Anyone from 1 year old to 1 year from finding out what comes after this party is not the source of the cost problem.

In other words, treating cancer is almost the perverse 'goal' of US healthcare -- heroic, costly, and resource intensive. (I hope this does not sound heartless, I have lost several immediate family to cancer, so I don't deny the importance of this care.) Yet, we argue about how to pay for preventative screening and other basic services for the uninsured.

Yes, cancer treatment is better here, but we get more cancer and more types of cancer than many other countries. Thus, I really don't know what to make of this vis a vis the effectiveness of a system. (Personally, I think it's pesticides affecting every generation more and more.)

How about this metric:

The 5-year survival rate for all cancers in Europe was 47.3% for men and 55.8% for women.
In the US those numbers are 66.3% for men and 62.9% for women

-Lancet Oncology Magazine

Either way, I'm all for improving the healthcare system.

Obama's answer will make it worse. Just wait.​

 

[B_starinvestor]

Not exactly free market.

As employers have had to shift costs to employees, this has broken the system. Finally, consumers feel the impact of their decisions.

I'm with you here.

This was the tide that capsized the system as we knew it - pushing the burden of cost onto employees.

Look, even upper-middle class folk now think about office visits and prescriptions, etc. I remember ten years ago, it was $5 out of pocket for damn near everything. Now, you get hammered on silly stuff.

I think there is an argument to be made for simple economics: too much demand, and not enough supply. Hence, astronomical price increases every single year.

And Obama's system will continue to bolster demand - exponentially - with no counter to accommodate it with revisions/enhancements to supply.

It gets back to his diseased [pun] habit of pandering to the masses without any thought to a workable solution.

Very frustrating.

Sparky - help me understand how he can come up with a $2 trillion spending plan inside of 4 months, and cannot allocate a dime to expansion of health care facilities to reconcile with his universal healthcare agenda.

It makes no sense.

 

[B_starinvestor]

And some people treat others who CAN'T pay like garbage.

True.

But assume you're a doctor.

One guy has been paying tens of thousands into your HMO...you, in turn, pay for your house, your kids' educations, your food/shelter from the income from the HMO.

Who do you treat first? Those who financed that...or those that didn't?

Both patients being in dire medical condition. Of course neither is more important than the other, but honestly, who do you treat first?

Flip a coin?

 

[Phil Ayesho]

this guy is a fucking retard.

More of the same deluded, disinformed imbecility we've come to expect from conservatives....

Of course... All the abuse doen unto us in the 'privatized' system is being done BY the insurer ON the insured...

Like claims denial, and lawsuits where the payouts all come with a gag order preventing you from telling everyone about the illegal and unscrupulous practices that you just got an award over....



Please, Star, give it a fucking rest.... EVERYONE with a brain can see that privatized health insurance DOESN'T WORK.

We have to have medicare ANYWAY because the insurers WON'T insure anyone old enough to actually NEED insurance...

And only half of those who need insurance can even get insurance... and the costs of medical care has gone UP 3 times faster in privatized care than in medicare.

Its STUPID. And you have yet to provide one iota of evidence that what we have is effective./.. and you have never put forth a single workable alternative plan.


We ALL need to start agitating RIGHT THIS FUCKING MINUTE for a single payer, government run system,--- its EAAAASSSYYY just extend medicare across the whole board.

Everybody pays and costs per person will FALL to 1 third their current level.
US employers will become competitive again with the rest of the modern world, ALL of whom have nationalized health care.



Get this everybody and get it good.... EVERY FUCKING THING that comes out of the mouths of Conservatives is crafted to ROB YOU of your earnings at the highest possible costs.... so some 'investor' can make a profit off of NOT WORKING.

That profit comes out of someplace... its not invented weatlh, its not added value, its not productivity... its a dead cost on everything you buy, plain and simple.

Not a problem for them to make money selling me something I don't HAVE to buy...

But it is immoral for any people to allow profiteering on the fear and suffering of those who MUST pay for medical care.

AND- it is a positive drain on the rest of the economy.

The stupidest thing about conservative obfuscation of healthcare reform is that folks being able to better afford health care will result in MORE discretionary cash, and HELP the economy.

 

[D_Tully Tunnelrat]

I think there is an argument to be made for simple economics: too much demand, and not enough supply. Hence, astronomical price increases every single year.

Sparky - help me understand how he can come up with a $2 trillion spending plan inside of 4 months, and cannot allocate a dime to expansion of health care facilities to reconcile with his universal healthcare agenda.

Star every time you say something so off the wall I think you'll never bounce back to the middle, you surprise me with a nugget that makes me think you really are trying to figure it out like the rest of us.

It's not about supply and demand, we have more doctors & hospitals, except in rural areas, than most industrialized countries, it's about the type of medical care we choose to practice.

We specialize in high profit, beginning/end of life healthcare. Whereas that's not a bad thing, it should not be the emphasis of the system. The only reason it is, is because that type of care makes the most money.

We have a for profit health care system. Most other western democracies do not. We spend more, yet rank lower than all those other countries ranking us 37th, depending on who's numbers you read, in the world. Yet we have 15% of our total population uninsured compared with .4 in France. In fact the government already spends, and often to for profit providers, 19% of their total budgets on healthcare. In effect we already have socialized medicine, it's just without a coherent plan. This allows private parties to game the system. Thus making it more expensive.

Here's an '07 editorial that appeared in the Athens-Banner Herald, which provides more details. http://www.uga.edu/globis/director/articles/10272007.pdf

 

[D_Tully Tunnelrat]

I think it would pretty helpful at this point if somebody could write up a detailed thread or post showing exactly how the insurance lobby manipulates (1) votes and (2) policy.

WT, here's one group you may wish to find out more about, they are called America's Health Insurance Plans (AHIP). Homepage - America's Health Insurance Plans They area lobby for the 1300 health care plans in the US. You can infer simply by the number of their plans to "choose" from, they are against a single payor option. The rhetoric on their site sounds pretty good, but all you need do is take a look at some of their commercials to get an idea of who they think is the driving up healthcare costs. It's (feigned surprise) the lawyers. AHIP Campaign Pushes for Liability Reform Since profits from these 1300 companies amount to about $11B a year, by one estimate, you can see why they want you to look at the lawyers bottom line, not theirs.

According to opensecrets.org, the insurance lobby gave $9M to all the various Presidential candidates during the last election. It was split pretty evenly. Here's a link: Presidential Candidates: Selected Industry Totals, 2008 Cycle | OpenSecrets

Watchdog.net is another good source. Here they report what NY Life gave last year. I have not counted all the politicos, or amounts, but it looks as if they contributed to almost everyone's campaign.

Lobbyist Contributions (watchdog.net)

 

[B_starinvestor]

More of the same deluded, disinformed imbecility we've come to expect from conservatives....

Like claims denial, and lawsuits where the payouts all come with a gag order preventing you from telling everyone about the illegal and unscrupulous practices that you just got an award over....

Please, Star, give it a fucking rest.... EVERYONE with a brain can see that privatized health insurance DOESN'T WORK.

I never said it did.

Its STUPID. And you have yet to provide one iota of evidence that what we have is effective./.. and you have never put forth a single workable alternative plan.

I didn't say it was effective.

I did put forth a plan.

Did you read one single word of this thread before you vomited all over it?

Everybody pays and costs per person will FALL to 1 third their current level.
US employers will become competitive again with the rest of the modern world, ALL of whom have nationalized health care.

where are you coming up with these statistics? Because Phil's Fantasy World of Made Up Statistics isn't a reference that any of us are interested in.

That profit comes out of someplace... its not invented weatlh, its not added value, its not productivity... its a dead cost on everything you buy, plain and simple.

Not a problem for them to make money selling me something I don't HAVE to buy...

But it is immoral for any people to allow profiteering on the fear and suffering of those who MUST pay for medical care.

AND- it is a positive drain on the rest of the economy.

The stupidest thing about conservative obfuscation of healthcare reform is that folks being able to better afford health care will result in MORE discretionary cash, and HELP the economy.

Please get back on your insurance-paid meds (pun intended)

 

[mikeyh9in]

Star... your ignorance is showing again.

Most doctors actually favor a single payer system. I would say that if a doctor went into the profession to make $$, it is a doctor you do not want. I discussed this a great deal with my doctors, and they do not hestiate to say that single payer would benefit the doctor *and* the patient. The loser would be the for-profit insurance companies and their CEO's pulling in million$$ per year.

Do you actually understand the amount of $$ of the current medical system is wasted on billing, collections, insurance forms, etc. An incredible waste of resources.

Your fear-mongering of "everyone is going to go see a doctor for a stubbed toe" is ridiculous and bigotted. You're implying that the poor would suddenly make up illnesses to prevent the rich from receiving care. Wow... what State are you in? You do realize it is 2009, right?

The majority of other first world countries have single payer healthcare and it works!

The cost of our current system is:

- over 60% of bankrupcies in America are a result of healthcare expense. (guess who ends up paying for these)
- the under insured use Emergency rooms as primary care -- both very expense and a waste of resources.
- the under insured do not seek regular preventative healthcare, so by the time they do see a doctor, their condition is must more expense to treat.
- The Government already pays for a large chunk of the poor's non-preventative healthcare... if we owned all of it, we would be able to better encourage healthy lifestyles.
- small business are being heavily taxed by the for-profit health insurance companies -- this is hurting small business big time.

People who make a profit by deciding who gets treated for healthcare DO NOT have the health of the patient as their priority -- profit is.

True.

But assume you're a doctor.

One guy has been paying tens of thousands into your HMO...you, in turn, pay for your house, your kids' educations, your food/shelter from the income from the HMO.

Who do you treat first? Those who financed that...or those that didn't?

Both patients being in dire medical condition. Of course neither is more important than the other, but honestly, who do you treat first?

Flip a coin?

 

[B_starinvestor]

Star... your ignorance is showing again.

Most doctors actually favor a single payer system. I would say that if a doctor went into the profession to make $$, it is a doctor you do not want.

Why would anyone want 8 years of additional education and 100's of thousands in student loans....because they are 'nice?'

Of course, a major consideration is good money. Sorry.

I discussed this a great deal with my doctors, and they do not hestiate to say that single payer would benefit the doctor *and* the patient. The loser would be the for-profit insurance companies and their CEO's pulling in million$$ per year.

Liberal talking point. I don't care how many payers there are, the problem is the HUGE influx of patients; and yes - there will be millions with silly health issues.

Also, millions that have been holding off on treatments due to the expense. These millions will pour in as well.

Everyone is jumping on me as if I'm saying 'leave the system alone.'

I am not saying that. I repeat: I am not saying that.

I am saying the Obama and the other clowns that are crafting this change....HAVE to account for this new surge of patients; and they are making no provisions as such.

Do you actually understand the amount of $$ of the current medical system is wasted on billing, collections, insurance forms, etc. An incredible waste of resources.

Yes.

Again, who are you arguing? I have stipulated that the current system sucks.

 

[Industrialsize]

SI:
Just what makes you think that there are MILLIONS of people just waiting to flood the health care system with their "silly" problems? Is this just your opinion or do you have something to back this up?

 

[vince]

I can't believe there is still a debate about this. The statistics are pretty clear. The USA has more people without insurance, higher costs, and a less healthy population, than any other industrialized nation. It's healthcare is worse than in some of the countries populated by the "lessor peoples", as someone we know calls us.

The cost/benefit ratios just do not make sense in the US.

The sad part is that Star is probably right, but for the wrong reasons. I'd be willing to bet that any attempt at reform in the US is going to get watered down to appease the special interests in the industry, and wind up a mess. I'll be shocked if Congress has the balls to pass the revolutionary reforms that are needed and cut the middle men and parasitic insurers out of the system. Members of congress have to be re-elected and that takes money and special interest groups have a lot of clout as to who gets the paylola at election time.

I really doubt that you'll ever see a single payer system in the USA. Or even a system with a partial private side to it. Which is too bad, because it's the best model. It's been proven time and again around the world. It ain't rocket science, it's been done before. But there is too much ignorance, fear and money floating around in this debate for it to have a good outcome.

 

[lucky8]

We don't have near the capacity to serve this gigantic contingency without a massive expansion of medical facilities. They are overcrowded already.


If Obama were serious about implementing an effective system, he would direct some of his Trillions of spending to build government hospitals; and all those that will be added to a public healthcare system could utilize those hospitals.

Those that choose to continue on private health insurance can continue to seek their treatments at private facilities, without being stampeded by a mother and her 14 kids zooming up and down the hallways of the doctors office because one kid has a bee sting.

I believe I said this same thing...3 months ago... http://www.lpsg.org/124695-universal-healthcare-in-america.html#post2025951

...but of course, if this actually happend, it'd just be another thing to bitch about.