Nationalized Healthcare?

Everyone on here has some great ideas and frankly they are hard to argue with. It basically comes down to deciding if people need health insurance. They obvious answer is yes. Personally I don't think that the government shoudl be the ones providing it because they will be terribly inefficient. I think it would be better if they wanted to pay for it for citizens and a for profit company took the money and managed the plans. At least that way there would be a ceiling on the amount of tax payer dollar that could be wasted on it. From my understanding the problem with medical care costing so much is because of medical insurance. It is complitcated and I don't feel like arguing it at the moment. In general, I do feel that individuals and families should be responsibile for their own health insurance. I have my family on private insurance plans because the group coverage through my work is way too expensive. My I can cover my wife and my son for 150 a month thru Blue Cross. It is not much more than my car insurance (which the government requires I carry and pay for myself). I feel that there are some who need help from the government or other chartiable organizations but I personnally know many who are taking advantage of goverment programs. Two men I know are on unemployment. They have been for over a year and have been offered jobs. But without any skills and a poor work history (they've been fired mulitple times) the only job offers they recieve are for less money than unemployment is paying them. So they don't accept the jobs. Because of all of this they are also on food stamps and medi-cal. If unemployment was unavalible to these two men they would work two jobs and wouldn't qualify for food stamps or medi-cal because they make too much. Instead it's easier to stay at home and collect the social services provided by the government. It makes me upset as a tax payer that there are many taking advantage of these programs. As time goes on I see more and more programs going into effect as well as the federal and state governments going further into debt to pay the bill. The fed government is currently at 1.27 trillion in debt. How can they afford to pay for nationalized health care. Somethings got to give. I'm all for charity and I give lots of money to different organiztions. But I am fed up with lazy people refusing to work and educate themselves to improve their lives. Too many people in today's society want to be taken care of instead of taking care of themselves. Even my sister in law. She could have a job but decided it was too much work so she filed for unemployment and was accepted. Now she gets a check and sits around her house all day. Her boyfriend recieves 4,000 dollars a month in state disability for becoming hurt as a police officer on the job. That is a lie. In fact, he was hurt in a drunk driving accident when he was driving home from a party. He lost control of his car and crashed into a tree killing his friend. He was fired but claimed he was hurt at work, now he too sits at home, waiting for over a year now for his trial, collecting 4,000 tax payer dollars a month for a drunk driving injury. It's all too much. Sorry for such a long post.

 

I have four simple things we must do in my opinion.

1. Find out exactly how much working capital the country has for health care, including what people can really afford and companies can really afford to pay - and all that money that goes to hospitals for indigent care. I'm an accountant so for me that is a vital step before doing anything else.

2. Cover the very poor at a basic level make Medicaid strictly needs based due to income. These working poor and homeless alike are time bombs for costs if they need expensive care due to lack of preventative care.

3. Ban fee-for-service medicine doctors and others should either get a flat fee for treating a condition that is advertised and set OR be employed for a salary. At the same time encourage new models for delivering primary care that are cheaper. And let foreign doctors and nurses who are properly trained and experienced to get them into work in their vocations.

4. Use foreign for profit tourist hospitals and work with them to get costs down with healthy competition and keeping less of a load on the American market.

 

I think both systems private and public can work. I for one liked someone's comment about never knowing when poverty will strike. I believe the government should enter the healthcare market as a competitor. Let people decide which road to take. They will definitely lower the cost that some hospitals and doctors charge. My father was in the hospital for surgery. When the bill came, they charged outrageous prices like $4.00 for a soda THEY offered visitors, $15.00 for a BOX of latex gloves when the nurse only used one pair . . .things like that. Medicaid should be offered to low income people at a higher income bracket and the unemployed. Therefore partime workers or adjuncts can work and not have to worry about spending all of their earnings on medical bills.

 

The favorite one I heard, a charge for cable TV and telephone for someone in a coma.

 

Commentary: How insurance firms drive debate

http://www.cnn.com/2009/POLITICS/08/17/potter.health.insurance/index.html

 

I agree. These private insurance companies need some sort of competition to keep them honest. The people can decide. The insurance companies themselves are what keep medical costs high. I used to work for major insurance companies in the medical and automotive industries as a Claims Adjuster. The price of medications we can get from the same companies oversees are ten times higher in this country. Why can we not compete for the lowest pharms? When you get claims that include $10.00 for two asprins, and charges of $8.00 for a tiny bag of peanuts the patient doesn't even know he received, it makes your blood boil. These damn companies are strictly for profit, not patient health care. That is why I crack up when certain party extremists start crying about the government putting private companies out of business. Nonsense. They can make money by charging what they should be charging, not by driving up the cost for all of us.

Abner

 

I support the Republicans on this we need to use competition but global competition. I still say encourage sending American patients to top quality for profit hospitals abroad after all if you just take out any treatment costing $40,000 or more that can be planned and do that, we could save a great deal of money.

And the plus side this would encoruage more global competition to lower prices and make more opportunities available for our citizens for even more care at lower prices.

Its so simple and no one is even mentioning this we outsource everything else overseas and this is flawless, unless your a higher end specialist in medicine or benefit from the system.

But I point out standard primary care, many common procedures, emergency care and the like would be unaffected. And I would make it mandatory form people on Medicaid and optional but available under law as an option for everyone else. But if one has to pay a percentage the difference between a foreign option and a domestic hospital would be rather impressive as to savings I think.

 

The solution to our nation's rapidly rising healthcare costs is not to put sick people on a plane and ship them (and the money used to pay for their treatment) overseas. That is throwing up your hands and admitting defeat, plus it simply isn't practical.

There are real ways that we can control costs and expand coverage. The first way is to reform Medicare so that we are not spending so much money on expensive but theraputically questionable treatments for seniors. We spend a lot of money on radical treatment for prostate cancer (that is, the surgical removal of the prostate), when most prostate cancers are so slow moving that it is statisitically likely that the patient will die of something else before the cancer kills them. We put titanium knees into people who are in their late 80's and 90's. Almost all of these treatments are paid for 100% by Medicare, but are the benefits worth the cost?

Second, if we can achieve universal coverage, we will stop (or at least reduce) the practice of people using emergency rooms for primary care. It will reduce waits for those who really need emergency care and it will encourage people to seek treatment for ailments before they become severe, thus reducing costs. A nice side effect will be a rise in demand for primary care services, which should lead to better salaries in primary care, and thus more and better primary care docs graduating from medical schools.

Third, we can improve healthcare outcomes in this country by changing our policy of subsidizing production of cheap food. There is no reason to continue our policies of using tax dollars to pay giant corporations to produces tons and tons of corn that ends up being used to make the processed foods that are making us sick by contributing to the nation's obesity epidemic. If we're going to have agricultural subsidies, they need to go towards the production of fruits and vegetables that actually nourish us instead of just providing calories.

There are no quick fixes, but this is the country that put a man on the moon. We should be able to have a healthcare system that provides better outcomes than the one in Costa Rica.

 

I have three procedures done in India, and trust me Senators and the like would only get the care I had for a fraction of the cost in the US. I didn't saysend ALL patients overseas just offer it along with care here as options. Are you saying private hospitals that are internationally respected are bad just because they are in India or Thailand?

It should be part of the plan. But take that 80 year old with the knee replacement what if that cost instead of $40,000 just $12,000 with travel costs it becomes more practical to offer.

I would do three things:

1. Far better primary health measures to all citizens especially the poor who often work and if they get sick its likely not to be treated now right away, costing more money later.

2. Grant Soveriegn Immunity to any medical provider and group taking government money so to sue you must prove that the side effects or problem was something not expected and/or seriously negligent. Before allowing a lawsuit I think its wrong to sue for side effects of a drug under normal use that is to be expected in a small number of people. Same for things that go wrong due to risks for surgery. Just make suing hard and then demand that any malpractice insurance take that risk reduction in the rates.

3. Send some patients overseas if Medicaid demand it since they are on government welfar to top international hospitals. If everyone else make it one of the options and let them decide since they will have to pay some sort of portion of the bill. They might prefer to go to India and pay say under Medicare rates 20% of $20,000 over 20% of $100,000 and people should have that right.

 

Hi Thomas - Admins are not supposed to drag threads off-topic but I'm gonna do it anyway. I'm a bit curious about your D.Th. Can you say something about ETS and what it means to be an Esoteric Minister. I'm just curious.

 

I'm not sure this is the only reason. As a high school student, I interned for a pair of OB/GYNs. (Yeah, weird job for a teenage guy, I know.) Shortly after I left to go to college, both of them had to drop their OB practice because they simply couldn't afford the malpractice insurance. Neither were bad doctors and neither got sued a lot, but the problem is that for those doctors who had been sued, the courts awarded ungodly amounts of settlement, and thus the insurance had to be high to cover these amounts. They also told me that for OB's a parent could sue over something that happened at child birth up until the "child" turned 21. That's ridiculous.

At the same time all of this happened, our hospital closed its maternity ward. This closure was completed unrelated to the doctors having to stop practicing OB, but was actually the result of major financial losses over the years. I live in a very rural area, and many folks are on medicaid. Medicaid paid virtually nothing for child birth and care, but the hospital had to accept it. As a result, the hospital continuously lost money, and it eventually it just said it couldn't handle it any more and closed the maternity ward. Now if anyone gets pregnant they have to drive 2 hours to the nearest maternity facility.

So, on the one hand, limiting malpractice settlements could help with physician's insurance costs and help lower medical costs. Now, in regards to Medicaid, if the government does go about offering some sort of health plan, it has to pay facilities enough to cover costs. Of course, these costs have to be reasonable. My wife and I had to pay $1,500 for an anesthesiologist to take 20 minutes to stick a needle in her back, and I find that absurd. Mind you, that did NOT include the cost of the actual medicine. It was just for the service. Clearly the government has a lot to fix, though I'm not sure how it can be done.

-Matt

 

I said nothing of the sort. I'm sure that there are excellent hospitals all over the world. I just don't believe that medical tourism is the solution to the US's healthcare problems.

I can tell that medical tourism has benefited you personally to a great extent, and that you are enthusiastic about the potential it has to reduce costs for the system overall. What you and other medical tourists are doing is exploiting a unique arbitrage opportunity that exists because much of the local population in India cannot afford advanced medical procedures, while their medical schools are some of the best in the world, turning out lots of highly qualified doctors. Lots of competition plus low demand equals lower prices.

If Medicare/Medicaid began reimbursing Americans for medical tourism and actively encouraged patients to go overseas to seek treatment, then the arbitrage opportunity would end and costs for overseas treatment would rather quickly begin to approach parity with costs for similar procedures in the US. The spike in demand would cause prices to rise in overseas markets such that it would price locals out of the healthcare market and possibly provoke the local government to close their borders to Americans seeking care. The one good outcome is that it would tend to push down prices Americans pay for care received locally, but at the cost of denying care to large numbers of people in other countries. At the same time, we would be sending large amounts of taxpayer dollars overseas, further worsening our trade deficit.

 

First of all these in the main are private hospitals and I think what would happen is more countires in the region and elsewhere would want to compete for our money, more competition in a global market will keep prices low. And nations like Singapore NEED foriegn patiants to pay for the free care for their people, and as a government system we could cut a deal nation to nation. And since they are an advanced nation, with an amazing health care system and we could still save up to 55% on most treatments its a fine option to. I have a relative who is there for cancer care.

And I will point out the Apollo Hospital Group I did business with offers free care to their citizens in various specialities that wouldn't be available otherwise. They have a pediatric neural surgeon the second in the nation who does a large number of free procedures for children.

I never said this is ideal but until OUR medical facilities have to compete with WORLDWIDE options they won't take this seriously. The second they get that they better in this country cut costs and offer better service a nice percentage of their bread and butter business will leave.

You want real health care innovation hit their bottom line and lets be blunt we outsource lots of other things abroad this is no different.

 

As you would expect MDs have a lot to say about changes in the US healthcare system. There are several MDs in my bike club and chat about this topic over coffee after our bike rides; what they all agree on that the three big cost drivers are insurance, repayment of medical tuition, and dealing with insurance company paperwork.

One was a USN doctor, then went into private practice, got fed up with insuarnce companies, and went back to his old USN position (he is now retired).

One MD stated there has not been a proportionate increase in the number of MD graduated over the last several decades commensurate with the population increase.

Another MD told me that the lowest cost place in the world to get good prosthetics is the USA (he has one leg and competes in triathlones).

 

This agrees with what I've read and understand about the situation. It is primarily the health insurance companies and secondarily the pharmaceutical companies that have the most to gain by fighting health care reform and thereby keeping the status quo. They are feeding the stories, e.g., death panel nonsense or illegal immigrants getting free medical care nonsense, to the right wing talk show hosts, the Republican members of congress and the senate. They are pushing the town hall meeting disruptions and letter writing campaigns. The health insurance and pharmaceutical companies are in collusion to keep prices high. For example, the pharmacuetical companies sometimes payoff companies threatening to make a generic medicine to not make the generic medicine. Both companies have increased profits at the cost of us, the consumers.

 

I read somewhere that some pharmaceutical companies spend as much on advertising as on research

 

More, if you count all the boozing and schmoozing that drug reps do to woo docs and call "promotion":

http://www.zmescience.com/big-pharma-spends-more-on-advertising-than-research

 

Exactly.

Abner

 

One issue in Australia that will drive costs is the now requirement in most universities that Doctors have a degree before starting medicine. One University, James Cook, does not require that, nor did any university, until relatively recently. Admittedly, the JCU option is still six years in duration, but at least it is still one year less than the others.

"The School of Medicine and Dentistry offers a six-year undergraduate MBBS with clinical exposure from the first year of the program."
http://www.jcu.edu.au/medicine/JCUdev_010537.html

The University of Queensland runs a four year graduate degree. Assuming that the student has to have at least a three year undergraduate degree with the accumulated costs, it requires 7 years of education.
http://www2.som.uq.edu.au/som/FutureStudents/MBBS/Pages/default.aspx

One year of extra costs per person is not insignificant when examined over a whole industry. There is one area here where costs can be reduced. It is arguable who is the better trained. The person with six years of dedicated education in medicine or a person who does four years of medicine and has an education in an unrelated discipline?