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Thread: Sicko

  1. #21
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    Quote Originally Posted by TheRainman
    Murrey

    You got it all wrong about America. The weak and the poor oppress themselves by not acting responsible before something bad happens. The weak and the poor oppress the responsilbe people like Kate and I who are responsible and have to pay extra high premiums and other cost for the ones that don't want to.
    Both because of and in spite of the American Way of War, we demonstrate that there is plenty of money for socialized medicine to cover each and every one of us from the cradle to the grave, even the "slackers". A small fraction of what's being expended to keep troops killing and dying on foreign soil, soil they have no justification for being on other than the twisted rationale that it's got "our oil" under it, such a fraction would cover all Americans with excellent health insurance.
    "The world will not perish for want of wonders but for want of wonder."
    J.B.S.Haldane

  2. #22
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    Quote Originally Posted by TheRainman
    Kate

    Read what I wrote again. I basically said the slackers are killing the system. The slackers which are many of them don't care to pay for health care or save for their retirement. They want Uncle Sam to do it for them. Thats what socialism is all about.

    Kate, I don't know the answers. But I do know socialize medicine wont work here. I'm all for what Michael Moore is doing as far as raising awareness of the problem. But he's an artist. He doesn't understand the budget can't support it.
    We have had universal health care in australia since the 70s, everybody pays a percentage through the taxation system to support it. It depends what priority you want to put on healthcare. Perversely you say that those who dont wish or are too lazy to pay are killing your healthcare system, but its obvious that this would not happen if you had universal healthcare. Its quite simple, all who receive a wage or salary would automatically pay into the system, how can this be worse than what you have now? Really the main opponents of such a system are those that feel their social status should accord them a better standard of healthcare than the proletariat and those that benefit financially from the status quo. ie, wealthy medical professionals and insurance companies. Which of these are you? Ironically the biggest damage to our health system has been done by our current government seeking to emulate the US by attempting to force middle and high income earners to opt for private health insurance, this is just creating a tangled mess. How good is our health system? Well my uninsured daughter when she had her accident received exactly the same top notch medical care in ICU and hospital that any privately insured person would have recieved, she is alive because of it.
    There is however a very long waiting period for elective surgery for those whom are uninsured and facilites such as rehabilition units are grossly underfunded. Heres an article that makes a comparison.
    http://www.commonwealthfund.org/publ...?doc_id=482678
    The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. This report, which includes information from primary care physicians about their medical practices and views of their countries' health systems, confirms the patient survey findings discussed in previous editions of Mirror, Mirror. It also includes information on health care outcomes that were featured in the U.S. health system scorecard issued by the Commonwealth Fund Commission on a High Performance Health System.
    Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity. The 2007 edition includes data from the six countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care.
    The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term "medical home." It is not surprising, therefore, that the U.S. substantially underperforms other countries on measures of access to care and equity in health care between populations with above-average and below average incomes.

  3. #23
    Senior Member lynnifer's Avatar
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    The doctors within the States would never allow universal health care. Perhaps we in Canada would get a few of our physicians and nurses back!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  4. #24
    Cheesecake. What is the reason you have to "wait" for an MRI if you don't mind my asking?

  5. #25

    A perfect Society

    Quote Originally Posted by TheRainman
    Murrey

    You got it all wrong about America. The weak and the poor oppress themselves by not acting responsible before something bad happens. The weak and the poor oppress the responsilbe people like Kate and I who are responsible and have to pay extra high premiums and other cost for the ones that don't want to.
    Rainman , so you want a perfect society, no slackers. I believe parts of your system, like insurance companies are taking advantage of hard working innocent honest working people, who have worked hard all their lives. I have seen documentries on this. A woman worked hard her whole life,had life insurance , payed her way every day, then got cancer. She had money for her retirement. Eventually she lost everything she ever worked for. The insurance would not carry her after a number of visits to the hospital. They kept raising the premiums. So if you don't like slackers what about thieves? So when the old or crippled get old and can no longer contribute to society what do you suppose should happen to them?
    It is easy to have a certain point of view at different times in our life.
    Hopefully our views change so even the poor and downtrodden are included and are considered worthy of help. Money is a physical promise, but the person that loses compassion has lost it all.
    Just some thoughts to consider.
    Last edited by murrey; 07-03-2007 at 09:50 AM.

  6. #26
    Having worked with the U.S. medical health care system for 30 years and, for the past year, lived and observed two different approaches to medical care over the past year (Hong Kong and China), maybe I can offer some perspective.

    The U.S. has an insurance-based system that is supplemented by government (state and federal) health care insurance (medicare) for children old people, disabled, and indigent (welfare). Young and middle-aged people have to cover their medical insurance by being employed and employers pay for the health insurance by deducting it from the pay of their employees. The U.S. system had litte or no price controls until the 1970's and the medical system was essentially non-profit (except for the pharmaceutical companies) and professional fee based system. Pharmaceutical companies and private hospitals began to charge as much as the market will bear. Non-profit hospitals also increased their prices. While both state and federal govenrments tried to regulate the cost, none were successful. The price of health care went up precipitiously, to the point that 20% of the population now no longer can afford to buy insurance. The United States is the only major country in the world that does not have universal health care for its citizens. Health care in the United States is more expensive than any other place in the world. Employees are paying from 10-25% of their salaries for health insurance. Even now, most people have no idea how much their health care costs.

    Hong Kong has a cradle-to-grave health care for its citizens, providing state-of-the-art care at its university hospitals. There is of course long waits for appointments and procedures, with a triage system for emergent situations. If people want to shorten their wait, have a wider choice of doctors, or would like additional diagnostic and other care, they can pay for it directly.

    When I first went to China in 1999, they were just beginning to make a transition from a completely government supported hospital system where most doctors and medical personnel were on salary and essentially government, provincial, or city employees. There were of course some private physicians and hospitals but most people could not afford them. Starting around 2000, most hospitals switched to a cash-based payment system where if you don't have the money up front, you are not admitted to the hospital. Even the military hospitals began to take paying patients. By 2004, only 10% of the patients who worked for the government or large companies had health insurance. By 2006, in the large cities, nearly 90% of the employed patients had some kind of health care insurance. However, it is a 50% co-pay system. In other words, the patients and their families pay for half of the costs, particularly treatments that are not part of the basic service of the hospital. The hospital rooms themselves are remarkably low-priced, on the order of 100 RMB per night at a private hospital. So, when a doctor makes a diagnosis, he/she presents three treatment options to tha patients: A, B, and C. Plan A is the high cost, often using the latest western drugs and procedures. Plan B is less costly and uses generic drugs and less costly procedures. Plan C is usually the least costly and involve usually low-cost Chinese medicine and acupuncture. Thus, in China, there is tremendous price pressure. Expensive therapies that do not have beneficial effects are seldom applied.

    Hong Kong, the United States, and China represent three extremes. In my opinion, Hong Kong has the best system. First, it has very low costs because the government is the major buyer and controls the price. Second, it delivers state-of-the-art care because the government hospitals are part of the government-supported universities. Third, employers in Hong Kong benefit tremendously. For example, I pay less than US$10,000 for all fringe benefits for 3 employees of ChinaSCINet. A similar health care benefits package would cost minimally US$50,000 or more in the United States. Fourth, it provided basic and catastrophic care. if people wanted additional care, they can pay for it themselves.

    The Chinese system is better than the U.S. system in three respects. First, they are much more efficient in China and there is little or no waste. Second, people receive the best care they can afford. Third, market forces control the cost of health care. If people cannot afford certain medicines, the drugs are simply not purchased. Therefore, procedures, services, and drugs are priced very competitively.

    In the United States, we have separated the payer from the decision-making. At the same time, the govenrment refused to apply price controls. As a consequence, the cost of medical care has gone up precipitously. Some people think that it is all going to doctors. This is not true. Many doctors are working twice as hard now for half the pay, compared to two decades ago. Quality control is maintained through lawsuits. Physicians, companies, and hospitals all practice defensive medicines. As a result, the quality of care has fallen, the cost of care has increased, and the nation can no longer afford this approach.

    I believe that the U.S. medcial care system needs drastic reform. The current system is becoming increasing unable to provide care for all the people. It has priced itself out of the range of what this nation can afford. Something has to give. The amount of money needed for medical care must increase, the quality of quality of care must fall, or the number of people receiving care must decrease. The U.S. Congress' decision to fund prescription drugs without allowing any negotiation of prices has ended up with a huge costly program. Because people are not paying directly, there is no market pressure placed on the prices. The manufacturers always charge as much as they can get away with. While insurance companies have been trying to reduce the costs to some extent, they have not been successful.

    If you were an employer, think of the tremendous advantage of not having to pay for the health insurance of your employees in Hong Kong or 50% in the case of China. Because of market pressures, costs are kept low. Becaue there are few lawsuits, wasteful defensive medicine is not emphasized. Finally, the doctors are much more productive and efficient. Surgeons, in China, for example, operate much more than typical U.S. surgeons. Of course, in the United States, medical doctors are becoming much more productive. They see and take care of more patients than every before.

    If you are a patient, the system in Hong Kong is probably the best. Because the government pays for all basic and catastrophic care, you pay only for luxuries. You get state-of-the-art in the university hospitals. The private hospitals, in order to compete successfully, are like well-organized hotels that provide services. They are clean and filled with service people who are waiting on your every wish. They introduce innovative things like handing you a DVD disc of all your procedures, MRI scans, or other tests, so that you have your own record and you don't have to ask them for copies. In the private hospitals, because you are paying for it, they are very solicitious and actually encourage you to stay in the hospital until you feel better.

    In my opinion, the U.S. system should adopt the following features:
    1. Higher co-pay. I think that U.S. patients should have 25% co-pay for non-catastrophic illnesses. Employers should deposit 25% of the health care fees that they pay to insurance companies into the medical health insurance accounts of their employees. This will subject costs of drugs, procedures, and tests to market pressures. It will make doctors explain to the patients why they are doing the tests and what the information will provide. It will also force the doctors to provide a choice of alternatives to the patients and families. The government should pay for half of the cost of the medical care. Employers should pay for 25%.
    2. Children should get free medical care until to age 18. Companies should pay the 25% of the health care costs of retirees. Government should continue to pay 50% . People need to pay 25%. If people cannot pay, then they can apply to the govenrment for medical welfare to cover their 25%.
    3. The government should be allowed to negotiate with drug companies and service providers to reduce the costs. The benefits of these negotiated prices should be made avaiable to the employer and the people.
    4. I think that we should expand the health care facilities so that hospitals compete with each other for business and therefore will lower their prices instead of being in short supply and therefore costly.

    I know that the above are radical ideas but it is the only way that i can see the system being able to apply market forces to reducing the costs and quality of health care, meeting the needs of the people.

    Wise.
    Last edited by Wise Young; 07-03-2007 at 12:01 PM.

  7. #27
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    Kate,
    I have to agree about the middle class being squeezed. I have insurance for the big stuff-but still have to pay a $5000 deductible before it kicks in. Fighting just about everything we have needed (slideboard, theraband-not DME-only one wheelchair in a lifetime-they better hurry to find a cure). In Minnesota, we pay a tax (or fee as Gov. Pawlenty calls it) on all medical costs. It has been on the books for over 10 years. Noone knows about it-just read it on a bill. It pays for the Minnesota Care, etc. I don't qualify for anything because we own our own business, have a house, etc. I didn't even qualify for SSDI because I haven't "worked" in the last two years-at home mom's dont work, right? The whole system is run by profit margins-sad state of affairs. Sorry if I hijacked the thread-planning to see the movie soon.

    Kathy

  8. #28
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    Wise... Your post was great... I work as an ophthalmologist in private practice and accompanied my hubby Don (T11) for his SCI consult a couple of weeks ago at the Denver VA and was amazed... the whole team was great and we were very pleased. They are building a new VA hospital here and it will have an inpatient SCI unit and it will be completed by 2011. I am glad that Don is now getting his care at the VA.

    Sieg

  9. #29
    Quote Originally Posted by Juke_spin
    Both because of and in spite of the American Way of War, we demonstrate that there is plenty of money for socialized medicine to cover each and every one of us from the cradle to the grave, even the "slackers". A small fraction of what's being expended to keep troops killing and dying on foreign soil, soil they have no justification for being on other than the twisted rationale that it's got "our oil" under it, such a fraction would cover all Americans with excellent health insurance.
    Juke

    Your numbers are way off. It would cost a whole lot more to insure everyone in america then we spend in iraq. Second we can't afford this war with Iraq. We are running a large deficit the way it is now.

  10. #30
    Quote Originally Posted by IanTPoulter
    We have had universal health care in australia since the 70s, everybody pays a percentage through the taxation system to support it. It depends what priority you want to put on healthcare. Perversely you say that those who dont wish or are too lazy to pay are killing your healthcare system, but its obvious that this would not happen if you had universal healthcare. Its quite simple, all who receive a wage or salary would automatically pay into the system, how can this be worse than what you have now? Really the main opponents of such a system are those that feel their social status should accord them a better standard of healthcare than the proletariat and those that benefit financially from the status quo. ie, wealthy medical professionals and insurance companies. Which of these are you? Ironically the biggest damage to our health system has been done by our current government seeking to emulate the US by attempting to force middle and high income earners to opt for private health insurance, this is just creating a tangled mess. How good is our health system? Well my uninsured daughter when she had her accident received exactly the same top notch medical care in ICU and hospital that any privately insured person would have recieved, she is alive because of it.
    There is however a very long waiting period for elective surgery for those whom are uninsured and facilites such as rehabilition units are grossly underfunded. Heres an article that makes a comparison.
    Ian

    We have several problems with that system here. If we adopted that system here it would kill our economy. We would have to raise taxes on the rich and middle class. We would go into a reccession then we would have a bigger problem. JOBS.

    Another thing you don't know about americans, we don't like waiting. You put rich or middle class income people on a waiting list you'll have a real problem.

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