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  1. cardio's Avatar
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    #61  
    Quote Originally Posted by aprasad
    I have to admit: I haven't discussed this with doctors at any great length. Why don't doctors who don't like dealing with Medicare drop out and not see Medicare patients? My guess is that they do make money on them, albeit less than they do with patients on private plans. If more and more doctors drop Medicare, Medicare will have to raise payments.
    Clearly, such universal plan (which is augmented by private plans for those who can afford it) will have to come with significant tort reform and paperwork reduction. The overhead costs for such universal coverage is less in the countries that have it, from what I understand.
    More and more are dropping out, at an alarming rate. It just does not get much coverage on the evening news.
    "If It Weren't For The United States Military"
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  2. #62  
    Quote Originally Posted by cardio
    When the gov't tells you what they cover and what they don't you do not have the choice. BIG difference.
    And you indeed expect your government to make it illegal to get additional coverage via additional health insurance?

    I really don't get what the big deal about health insurance is supposed to be. Most if not all other industrialized countries have health care systems for everybody, why not you? You make a big fuss about something which is commonplace everywhere else in the civilised world.
    “Reality is that which, when you stop believing in it, doesn't go away.” (Philip K. ****)
  3. cardio's Avatar
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    #63  
    Quote Originally Posted by clulup
    And you indeed expect your government to make it illegal to get additional coverage via additional health insurance?

    I really don't get what the big deal about health insurance is supposed to be. Most if not all other industrialized countries have health care systems for everybody, why not you? You make a big fuss about something which is commonplace everywhere else in the civilised world.
    What is your first statement mean?

    The fuss is all about examples such as the original topic of the thread. Why does the gov't choose what care/medication is provided. I am sure it was not a physician that reviewed her case and determined the medication would not provide any benefit for her. I am fully aware that insurance companies disallow some medications, however there is a process in place to either have a suitable substitue or to receive authoriaztions to cover the needed medication in the majority of cases (I actually can not give you an example of complete denial of coverage on required meds).

    You stated in an earlier post that you pay close to $5,000.00 per year for basic insurance. If you want additional you pay an additional premium, that is called insurance my friend. You have a gov't program to assist those that can not afford it. We also have programs for those who can not afford the insurance, a lot of individuals do not meet the requirement for assistance and decide not to purchase insurance, that is their choice.
    "If It Weren't For The United States Military"
    "There Would Be NO United States of America"
  4. #64  
    Quote Originally Posted by cardio
    You stated in an earlier post that you pay close to $5,000.00 per year for basic insurance.
    It's a bit less than that, and for a family of four. "Basic" means it covers everything medically usefull. Extra coverage includes things like single room in the hospital, the right to go to a hospital in another corner of the country because you like that doctor better, etc. My father in law had a bypass heart surgery on "basic" insurance a while ago, treatment was perfect and included a one week stay in a nice health resort in the countryside after his one week stay in the hospital (double room).
    “Reality is that which, when you stop believing in it, doesn't go away.” (Philip K. ****)
  5. cardio's Avatar
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    #65  
    Quote Originally Posted by clulup
    It's a bit less than that, and for a family of four. "Basic" means it covers everything medically usefull. Extra coverage includes things like single room in the hospital, the right to go to a hospital in another corner of the country because you like that doctor better, etc. My father in law had a bypass heart surgery on "basic" insurance a while ago, treatment was perfect and included a one week stay in a nice health resort in the countryside after his one week stay in the hospital (double room).
    I hope your father in law is doing well.

    I used your $400 per month x 12 to come up with the number close to $5,000 it is actually $4,800, but close enough. That is still insurance. I pay $460 per year for a family of 4 and it covers everything to include medications, outpatient visists, ER visists, inpatient stays, surgical procedures to include a vast array of elective surgeries, visits to specialist as needed, etc. Of course this is because of serving my country for over 20 years in the military. I could have elected not to take the insurance offered and be considerred uninsured as a lot of individuals do here in the states. This is one reason why the % of uninsured really is not a true indicator of who can not afford insurance, and if they really can not afford the gov't programs take over and they get the coverage the gov't determines they qualify for (medicaid, medicare, medical etc).
    "If It Weren't For The United States Military"
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  6. #66  
    Quote Originally Posted by cardio
    Only a 50-80 hour week, where do I sign up.
    Hey cardio, we all stood at the same precipice in med school when it came to choosing residencies- I guess I chose better! I don't know about you but I'm pretty fed up after a 60 hour work-week. Maybe ther is something to be said for nationalized healthcare- imagaine having to fight against fee reductions with only one payor!
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    #67  
    [QUOTE=Gasmeister]Hey cardio, we all stood at the same precipice in med school when it came to choosing residencies- I guess I chose better! I don't know about you but I'm pretty fed up after a 60 hour work-week. Maybe ther is something to be said for nationalized healthcare- imagaine having to fight against fee reductions with only one payor![/QUOTE

    Gasmeister, some days are longer than others and long weekends on call , but I knew that going in (a lot younger then). I could get used to only having to argue with one payor.
    "If It Weren't For The United States Military"
    "There Would Be NO United States of America"
  8. #68  
    Both of you are implying that there is nothing that needs fixing (those without insurance are that way because it's their choice!!). Let the uninsured masses eat cake (or buy insurance).

    Cardio paints a misleading picture of the insurance costs. As a public employee, my yearly premium is almost $5000 (check it out, GEHA HIGH plan in FEHBP), with it's deductables and co-pays extra. And I am one of the lucky ones!!
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  9. cardio's Avatar
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    #69  
    Quote Originally Posted by aprasad
    Both of you are implying that there is nothing that needs fixing (those without insurance are that way because it's their choice!!). Let the uninsured masses eat cake (or buy insurance).

    Cardio paints a misleading picture of the insurance costs. As a public employee, my yearly premium is almost $5000 (check it out, GEHA HIGH plan in FEHBP), with it's deductables and co-pays extra. And I am one of the lucky ones!!
    I was not trying to paint a picture, my example stated my insurance was because of being retired military, plain and simple. Yes, there are things that need fixing, however in my opinon gov't healthcare is not the solution. There are a lot of people who can afford health insurance, but decide not to do so. In my experience it is the younger, single person who still feels they are invincible and do not see the need to spend their money in that direction at the present time. I have seen plenty of people who made that choice and then when they end up in the ER and get the first bill, they quickly change their mind.

    Believe it or not the insurance companies are in it to make money, and the investors invest in insurance companies because they are profitable.
    "If It Weren't For The United States Military"
    "There Would Be NO United States of America"
  10. #70  
    Could Cardio and Gasmeister provide us with their plan to have universal coverage of basic health needs?

    Do you (both) think it is desirable to have universal coverage (regardless of who provides or controls it)?

    Would either of you abolish Medicare and replace it with ... nothing (let the old folks buy insurance if they want to .. or can afford it)?
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  11. cardio's Avatar
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    #71  
    Quote Originally Posted by aprasad
    Could Cardio and Gasmeister provide us with their plan to have universal coverage of basic health needs?

    Do you (both) think it is desirable to have universal coverage (regardless of who provides or controls it)?

    Would either of you abolish Medicare and replace it with ... nothing (let the old folks buy insurance if they want to .. or can afford it)?
    To be honest, I do not think universal coverage is the way to go. As was posted by the OP, there is a problem when the gov't decides which service to provide. I know you may see it differently, but from my perspective (as I teach all my students/staff) how would you feel if this was your grandmother? Yes insurance companies have the ability to guide which service is offered, but there are ways for us to justify what needs to be done and move forward in obtaining an authorization. If the gov't says no, the courts back up the gov't and say they can say no to cancer treatment where is the alternative?

    I would like to see certain industries be required to pay for treatment of disease process that their product causes. I am thinking of a couple of specific but it could apply to a lot of industries (tobacco, alcohol, fast food, junk food), I would also like to see all siezed drug monies be put into a health care fund. As much as all would like it there is no free lunch.

    Medicare, medicaid, state funded agencies (MediCal) all have their place, but they were not intended to cover individuals who have the ability to work and provide for themselves and their families. If there is an adult in the household that is able to work and decides it is easier to draw welfare, unemployment and abuse the system, no they should not receive free healthcare. I would also like to see families be responsible for the healthcare of family members that are incarcerated. I know this may seem harsh to some, but in my opinon the definition of an adult is someone who provides society more than they take from the society. I fully understand and support a short term assistance program for those who find themselves in an unfortunate situation, but short term only. There are oppurtunities for those who will take advantage of them. Yes I support programs to take care of those who are not able to take care of themselves (the elderly, metally handicapped, physically diabled etc), but not those who elect not to have insurance even though they can afford it and would rather drive a new Hummer, or have the latest and greatest toys at the expense of insurance.
    "If It Weren't For The United States Military"
    "There Would Be NO United States of America"
  12. #72  
    Although she doesn't provide any suggested solutions, Jane Bryant Quinn's column in the 02/27/06 issue of Newsweek("Health Care's New Lottery") http://www.msnbc.msn.com/id/11434805/site/newsweek/, the discussion highlights some of the dilemmas in US health care delivery.
    Zane
  13. #73  
    This is a circular discussion, because we keep getting back to the same points: No healthcare solution will work unless the costs are cut, but the quality we expect and, through the industriousness of the litigious legal profession, demand will wither up and go away if the compensation provided to doctors is limited. Every single existing and proposed-government controlled healthcare system has at its core methods for being financially viable, and they always include fee cuts for providers. It's already happening with Care/Caid, and that's why more and more physicians are shutting it out of their practices when they can. When you create a system where quality care is expected but not compensated, then you'd better get ready for lesser experienced, lesser trained and less devoted docs. hey, we're outsourcing just about everything else in this country, why not our healthcare providers too? Perhaps a quick call to New Delhi will help diagnose that nagging pain in your chest and tell you if it's important or not!
  14. #74  
    I'm originally from India, so elective procedures over there may well in my future.. Besides, isn't some outsourcing (radiology, pathology) already happening?

    Healthcare is not suitable for an entirely market driven solution. that is because:

    1. we want to take care of sick human beings, however poor or stupid or old they may be.

    2. there will always be people that no private insurance will want to touch. The risk must be spread over the largest possible population otherwise the insurance companies will drop the risky folks (or raise their premiums to unsustainable levels). I cannot imagine any private insurance covering (voluntarily) people with terminal disease or people in their old age .. when their medical needs will always exceed their premiums.

    Thus, because I expect some universal health care for all, I don't see a solution coming from the current system.

    As for quality of care going down, not for those who can afford the boutique doctors and hospitals.. and it can only go up for those who have nothing in the present system.
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  15. NRG
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    #75  
    Quote Originally Posted by cardio
    I hope your father in law is doing well.

    I used your $400 per month x 12 to come up with the number close to $5,000 it is actually $4,800, but close enough. That is still insurance. I pay $460 per year for a family of 4 and it covers everything to include medications, outpatient visists, ER visists, inpatient stays, surgical procedures to include a vast array of elective surgeries, visits to specialist as needed, etc. Of course this is because of serving my country for over 20 years in the military.
    Who is your insurance through?
  16. cardio's Avatar
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    #76  
    Quote Originally Posted by NRG
    Who is your insurance through?
    Tricare. It is the insurance you can get when you retire from the military. Even this is a hot topic for a lot of retirees since it was implied that if you served 20 years you would receive free healthcare for the remainder of your life (to included dependants).
    "If It Weren't For The United States Military"
    "There Would Be NO United States of America"
  17. #77  
    Quote Originally Posted by cardio
    The fuss is all about examples such as the original topic of the thread. Why does the gov't choose what care/medication is provided. I am sure it was not a physician that reviewed her case and determined the medication would not provide any benefit for her. I am fully aware that insurance companies disallow some medications, however there is a process in place to either have a suitable substitue or to receive authoriaztions to cover the needed medication in the majority of cases (I actually can not give you an example of complete denial of coverage on required meds).
    The government does not choose, the decision is taken by the hospital management (the NHS Trust). Some Trusts prescribe the drug concerned, others don't - or not routinely anyway. The only goverment involvement in decision making is to publish a set of guidelines, the case concerned revolved around whether those guidelines allowed the Trust to deny the medicine. The guidelines say that cost shall not be the sole criteria on which treatment is denied, the plaintiff's argument was that cost was the only reason she was being denied treatment.
    Animo et Fide
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    #78  
    Quote Originally Posted by PeterBrown
    The government does not choose, the decision is taken by the hospital management (the NHS Trust). Some Trusts prescribe the drug concerned, others don't - or not routinely anyway. The only goverment involvement in decision making is to publish a set of guidelines, the case concerned revolved around whether those guidelines allowed the Trust to deny the medicine. The guidelines say that cost shall not be the sole criteria on which treatment is denied, the plaintiff's argument was that cost was the only reason she was being denied treatment.
    Thanks for the clarification. Did the patient have an alternative with equivalant results prescribed?
    "If It Weren't For The United States Military"
    "There Would Be NO United States of America"
  19. #79  
    Quote Originally Posted by cardio
    Thanks for the clarification. Did the patient have an alternative with equivalant results prescribed?
    No, I've not followed the case closely but I believe she has terminal cancer and there is no completely effective drug. She believes that Herceptin would have some chance of being effective, the Trust don't. I'm no doctor so I don't have an opinion on that.
    Animo et Fide
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