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  1. #1901  
    Quote Originally Posted by KAM1138 View Post
    So, to review--it is a partial step towards direct payer that maintains the "safety net" of insurance for catastrophic issues. It eliminates to a large degree indirect payer systems (and the overhead that comes with them). The poor are subsidized in a way that makes them exactly like anyone else--providers may not even be able to discern a poor patient from another--in regards to payment and insurance.

    Now, alternatively, I think the no-payer concept could possibly be merged with some of these others, but as I said at the beginning--it wasn't my preference.

    Now, is it just that simple? Of course not, however, studies could be performed and values and estimates created to project savings and benefits. Perhaps someone has a different take on some element of this that would make it a better idea--fine, I'd be happy to hear it.

    Bottom line--I think it is essential to eliminate as much overhead (no matter if from government or insurance companies) as possible, and the best way to do that is from my perspective is to move towards a direct payer system.

    KAM
    The areas that we agree on (kind of....and let's pretend we are in congress; why not?) are that the role of the middleman should be limited. Insurance companies,if they are to provide health care insurance, should be limited to low cost catastrophic policies. Obviously the definition of "low cost" depends on which side of the minimum wage (or less) standard you dwell upon. There are a helluva lot of waitresses out there who would be hard pressed to buy any insurance if there aren't additional controls.

    The remainder of your argument, which would essentially provide direct care (in case you didn't see my earlier link, this is to Qliance, which is a forme fruste of what may occur in the future: Qliance Health Care

    The key determinant here is controlling charges. Not only that, but this kind of care, which emphasized primary care and prevention, can lower costs, but the largest increases (and percentage of costs) are from high tech subspecialty practices with doctors who make large incomes. Things get a little dicier there, as it does when people need to be admitted for something "minor". Thus, the actual amount of coverage that will keep someone from going bankrupt is specifically the assurance that the "catastrophic" plan will cover whatever the "direct payment plan" doesn't. That will not be easy, and it will not be cheap. Even if you control fees, which Qliance argues are less because they don't have to pay anything to an insurance agency, the costs of new technology tend to be disconnected from rational fee systems. One way of controlling those costs is to use rigid price controls, but in that situation physicians just won't buy expensive useful machines if it will put them in debt. They have to pay their employees as well. There needs to be a guarantee that patients will not be bankrupted by unexpected medical expenses. I think that the easiest and least painful way to do that is to simply expand Medicare, which does suck in some ways, but as I said, it's better than private companies in terms of dealing with reimbursement issues. Any cobbling together of private insurance (with hundreds of different plans to deal with) plus direct pay plus reorganizaing Medicare plus additional price controls that will need to be implemented....you're talking about a huge inefficiency of scale, and the cost of that alone would be essentially wasted. Why make something unwieldy because some people are afraid that the government won't provide good health care or good health care insurance, when patients are very satisfied with Medicare, most with the VA, and all of congress seems delighted with their public option. We can save money by decreasing fraud, yes, and possibly by tort reform....but then we'd waste it on adminsitrative costs trying to get all these complexities to fit into one plan. It's just not a rational way to approach this problem, IMHO.

    Add: And since someone is certain to bring up the fact that Medicare is looking dicey long-term, here's what can be done to fix it. Do away with the republican drug benefit/handout to drug companies. That would save a bunch right there. Limit reimbursement to interventions proven efficactious. Require reasonable documentation before reimbursing for expensive technology. Reduce duplication in treatments by having a gatekeeper coordinate care and limit access to subspecialists. I suspect that these changes would clearly save considerable money for Medicare.
    Last edited by davidra; 09/11/2009 at 02:03 PM.
  2. 1thing2add's Avatar
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    #1902  
    Quote Originally Posted by KAM1138 View Post
    You are asking for a comparison of costs? I'd suggest the CBO.

    When I say "what things do cost, what they will cost"--that's referring to a comparison. See--there are two categories--what they do cost, and what they will cost. When you consider those two things its called a comparison. Did you get all confused because I didn't use the world "comparison"?

    I'm sorry I didn't realize that you needed to have it spelled out for you, by me specifically no less. Let me state it again, so you won't have any more confusion. Yes, comparing costs is important. I've confirmed for you what is obvious to everyone who has the most basic understanding of the topic of healthcare reform.

    Now go ahead and figure out what other sort of irrelevant distracting nonsense you can come up with. Perhaps you can start accusing me of racism--that's a popular one.

    KAM
    For your information, the CBO has not provided numbers which provide a comparison of current costs of providing equal care to uninsured/under-insured in our current healthcare system and those proposals being considered as a public option. Like to try again? Sorry that you find such fundamentals to be "irrelevant distracting nonsense", as I would only expect such speech from someone who does not have any intention of treating the subject with proper dignity.

    Lastly, your regurgitation of what is spoken to you, and acting as if it were your own original thought is quite cute in certain circles, I suppose, but it doesn't fly in reality. Is it even possible that your gamesmanship can end here and now? Yes, I'm asking the question legitimately and seriously.
  3. KAM1138
    KAM1138's Avatar
    #1903  
    Quote Originally Posted by davidra View Post
    The areas that we agree on (kind of....and let's pretend we are in congress; why not?) are that the role of the middleman should be limited. Insurance companies,if they are to provide health care insurance, should be limited to low cost catastrophic policies. Obviously the definition of "low cost" depends on which side of the minimum wage (or less) standard you dwell upon. There are a helluva lot of waitresses out there who would be hard pressed to buy any insurance if there aren't additional controls.

    The remainder of your argument, which would essentially provide direct care (in case you didn't see my earlier link, this is to Qliance, which is a forme fruste of what may occur in the future: Qliance Health Care

    The key determinant here is controlling charges. Not only that, but this kind of care, which emphasized primary care and prevention, can lower costs, but the largest increases (and percentage of costs) are from high tech subspecialty practices with doctors who make large incomes. Things get a little dicier there, as it does when people need to be admitted for something "minor". Thus, the actual amount of coverage that will keep someone from going bankrupt is specifically the assurance that the "catastrophic" plan will cover whatever the "direct payment plan" doesn't. That will not be easy, and it will not be cheap. Even if you control fees, which Qliance argues are less because they don't have to pay anything to an insurance agency, the costs of new technology tend to be disconnected from rational fee systems. One way of controlling those costs is to use rigid price controls, but in that situation physicians just won't buy expensive useful machines if it will put them in debt. They have to pay their employees as well. There needs to be a guarantee that patients will not be bankrupted by unexpected medical expenses. I think that the easiest and least painful way to do that is to simply expand Medicare, which does suck in some ways, but as I said, it's better than private companies in terms of dealing with reimbursement issues. Any cobbling together of private insurance (with hundreds of different plans to deal with) plus direct pay plus reorganizaing Medicare plus additional price controls that will need to be implemented....you're talking about a huge inefficiency of scale, and the cost of that alone would be essentially wasted. Why make something unwieldy because some people are afraid that the government won't provide good health care or good health care insurance, when patients are very satisfied with Medicare, most with the VA, and all of congress seems delighted with their public option. We can save money by decreasing fraud, yes, and possibly by tort reform....but then we'd waste it on adminsitrative costs trying to get all these complexities to fit into one plan. It's just not a rational way to approach this problem, IMHO.
    Ok, the issue of non-catastrophic, but expensive care is important. I think that's what you are talking about in the beginning of the last paragraph. A hospital stay for a "minor" problem can easily wipe out a years worth of HSA savings (or more). I know that from personal experience. However, the costs I experienced were under the indirect payer system as well. Obviously, if there is something that short-circuits this and costs remain high, we are back to square one. Costs must come down.

    What do you think about a pseudo-direct payer plan--that is HSA type savings with (relatively) high deductible insurance. That instead of having a common/catastrophic break is simply a financial limit. Unfortunately, I think this would be very similar to what we have now. Insurance would still be involved--at least in monitoring expenditures to whatever the limit is. There could still be some benefit, because they still wouldn't be paying out for the large volume of common things (office visits, and the like).

    Insurance systems break down when they try to cover things that are highly likely to occur, and that's what we have now. I believe that's why insurance costs continue to skyrocket.

    I'm trying to digest what you said about cobbling different plans together and medicare. Why does this have to happen? What I suggested didn't involve medicare--or rather an expansion of medicare to non-elderly. I'm not following where the necessity to combine that comes into play.

    Again--my idea isn't for managed price controls, but rather market controls. I think we continue to differ on this. If a given medical service is priced out of the range of its customer, and there is no insurance company (or government) to pay it (possible due to indirect payments that spread out the costs) then it won't be economically viable. Meaning--the price will have to come down. This is an imperfect example, and I know you dislike this in regards to medicine, but picture a car--the best car in the world. If no one can afford it, no one can buy it, so an enterprising business will find a different alternative. Basically--its a disincentive to gouge.

    I'm not suggesting something that is unwieldy. It might end up being unwieldy and thus not viable.

    As far as medicare--well, what happens when you expand the scale of it by several times. Does it remain somewhat efficient or does it gain overhead at a faster rate? I don't know.
    I'm not sure how similar Massachusetts plan is, but I hear that costs have climbed significantly. The VA--well, I hear mixed reviews about that. Congress--well, no surprise there, but it is also a VERY small group.

    The essential element that I see as being vital to control costs is to eliminate or greatly reduce indirect pay systems. Medicare is an indirect payer system, so it seems that unless it had some really core changes to how it worked, that problem will remain.

    It sounds like we agree that there are benefits to direct pay. I'll have to read up on that link you posted.

    KAM
  4. KAM1138
    KAM1138's Avatar
    #1904  
    Quote Originally Posted by 1thing2add View Post
    For your information, the CBO has not provided numbers which provide a comparison of current costs of providing equal care to uninsured/under-insured in our current healthcare system and those proposals being considered as a public option. Like to try again? Sorry that you find such fundamentals to be "irrelevant distracting nonsense", as I would only expect such speech from someone who does not have any intention of treating the subject with proper dignity.

    Lastly, your regurgitation of what is spoken to you, and acting as if it were your own original thought is quite cute in certain circles, I suppose, but it doesn't fly in reality. Is it even possible that your gamesmanship can end here and now? Yes, I'm asking the question legitimately and seriously.
    Yes, I'll happily end this. Watch.

    KAM
  5. #1905  
    Thoughts from across the pond. From outside our borders looking in. I pulled these comments from the BBC site: BBC NEWS | Have Your Say | Is Obama right about healthcare?

    President Obama is spot on about health-care. But trying to convert his Republican opponents to his way of thinking is virtually impossible. They are determined to oppose him tooth and nail.

    Pancha Chandra, Brussels; Belgium
    For 8 years the Repblicans did NOTHING.At least Obama is doing something & he said he would welcome Republican input. Sarah Palin's comment about a death panel is scaremongering ignorance. The truth is that people are dying every day because their insurance companies wont cover pre-exisiting conditions.The uninsured can get care in hospitals but ultimately its the tax payer who pays.Say what you want about the NHS but people in the UK dont die because they cant afford healthcare.

    Annie Sousa, Paget, Bermuda
    I think Obama is right. The health care in US is a shame. The government is just spending a lot of pubblic money for the health care but a lot of citizens aren't sure to be safe in case of grave illness.

    Anni, Merano
    Health Care should be a human and universal right. Society ought to provide for the needy. However, this could easily be afforded the world over if we stopped paying out benefits to life-style claimants. ie CAN WORK- WON'T WORK. How can we justify supporting families with generations of unemployment yet fail the sick. A gross distortion of social care at work.

    jimley murmer, edinburgh, United Kingdom
    I saw my Consultant today at the Southampton University Hospitals NHS Trust, I was there to hear the results of my colonoscopy and blood tests. I was told that I am not suffering any kind of cancer, but that I have irritable bowel syndrome, a common problem. My consultant assured me that if it had been otherwise I would have been treated immediately. I am eternally grateful and proud that Clement Attlee's Labour government created it for all of us.

    Joe Paglia, Southampton, United Kingdom
    What I cannot understand is why would Obama's opponents (mostly whites with health insurance already) be upset when he is trying to help poorer Americans (46 millions at the last count!) who have no insurance at all. Call it socialism or whatever you like, but helping fellow citizens is what politicians are elected to do!

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  6. 1thing2add's Avatar
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    #1906  
    Quote Originally Posted by davidra View Post
    The key determinant here is controlling charges. Not only that, but this kind of care, which emphasized primary care and prevention, can lower costs, but the largest increases (and percentage of costs) are from high tech subspecialty practices with doctors who make large incomes. Things get a little dicier there, as it does when people need to be admitted for something "minor". Thus, the actual amount of coverage that will keep someone from going bankrupt is specifically the assurance that the "catastrophic" plan will cover whatever the "direct payment plan" doesn't. That will not be easy, and it will not be cheap. Even if you control fees, which Qliance argues are less because they don't have to pay anything to an insurance agency, the costs of new technology tend to be disconnected from rational fee systems. One way of controlling those costs is to use rigid price controls, but in that situation physicians just won't buy expensive useful machines if it will put them in debt. They have to pay their employees as well. There needs to be a guarantee that patients will not be bankrupted by unexpected medical expenses. I think that the easiest and least painful way to do that is to simply expand Medicare, which does suck in some ways, but as I said, it's better than private companies in terms of dealing with reimbursement issues. Any cobbling together of private insurance (with hundreds of different plans to deal with) plus direct pay plus reorganizaing Medicare plus additional price controls that will need to be implemented....you're talking about a huge inefficiency of scale, and the cost of that alone would be essentially wasted. Why make something unwieldy because some people are afraid that the government won't provide good health care or good health care insurance, when patients are very satisfied with Medicare, most with the VA, and all of congress seems delighted with their public option. We can save money by decreasing fraud, yes, and possibly by tort reform....but then we'd waste it on adminsitrative costs trying to get all these complexities to fit into one plan. It's just not a rational way to approach this problem, IMHO.
    One of the major issues you underscore is the area of subspecialties and the unique high costs related to those disciplines. When there are constant advancements in the development of treatments, surgical techniques, new gold standards, and the like, what do you believe will be the effect on the market that helps develop and support these areas in cooperation with physicians/surgeons with the creation of a public option and enrolling business and individuals into insurance which they could not consider before?

    The other consideration is the area of academic research and its grant funding through NIH and other sources. What effect, if any, do you foresee in that large arena? Currently, many of these new treatments and techniques are not reimbursable under the current system so my concern would be a potential chilling effect during the 4 year implementation period. Any thoughts?

    I'm certainly pro-business, but not at the expense of undermining the integrity of the healthcare delivery system for the ultimate sake of pharma's or other manufacturer's profitability and shareholder wealth. That is exactly part of the formula that landed us into this position to begin with.
  7. #1907  
    Quote Originally Posted by palandri View Post
    Thoughts from across the pond. From outside our borders looking in. I pulled these comments from the BBC site: BBC NEWS | Have Your Say | Is Obama right about healthcare?
    And, of course, we broke away from those same folks "across the pond" because we did not want to be under their system. Of course, back then, it was other issues....primarily taxation....but not sure why we want to suddenly be like them. I just don't get why folks want to bring Europe over here. If the European lifestyle is so attactive, why not go over there?
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  8. 1thing2add's Avatar
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    #1908  
    Quote Originally Posted by clemgrad85 View Post
    And, of course, we broke away from those same folks "across the pond" because we did not want to be under their system. Of course, back then, it was other issues....primarily taxation....but not sure why we want to suddenly be like them. I just don't get why folks want to bring Europe over here. If the European lifestyle is so attactive, why not go over there?
    Where is your outrage at the "temporary communist" federal income tax that has existed, in part or in whole, for well over a hundred years? What changed in order for it to be necessary as a permanent part of American life in today's world?

    From Treas.gov:
    Prior to the enactment of the income tax, most citizens were able to pursue their private economic affairs without the direct knowledge of the government. Individuals earned their wages, businesses earned their profits, and wealth was accumulated and dispensed with little or no interaction with government entities. The income tax fundamentally changed this relationship, giving the government the right and the need to know about all manner of an individual or business' economic life.
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    #1909  
    Quote Originally Posted by clemgrad85 View Post
    And, of course, we broke away from those same folks "across the pond" because we did not want to be under their system. Of course, back then, it was other issues....primarily taxation....but not sure why we want to suddenly be like them. I just don't get why folks want to bring Europe over here. If the European lifestyle is so attactive, why not go over there?
    Why not go over there? A couple of reasons spring to mind.....
    1) Unless you speak the language, and are happy to be treated like a 2nd class citizen, they don't want you (although they are happy to take your money when you go for a holiday).
    2) This pretty much leaves the UK, and the weather sucks!
    3) Europe sounds great to these people as a theory, but when it actually comes to living in a tiny house, driving a tiny car and paying 3 times as much for everything it turns out there are not so many takers.

    On a more serious note, I really don't know why so many people want to turn the US into Europe. I am really not impressed with the argument that they all do their health care differently than here. Sounds a bit too much a like a child complaining that all his/her friends are doing something....... i.e. that others are doing it doesn't make it right. In addition, a thoughtful person might consider that yes, the US does things differently to Europe (I personally hate referring to Europe as a single entity....but anyway) but that the US has also been vastly more successful...... perhaps there is a link somewhere???
  10. #1910  
    Quote Originally Posted by anthillmob View Post
    In addition, a thoughtful person might consider that yes, the US does things differently to Europe (I personally hate referring to Europe as a single entity....but anyway) but that the US has also been vastly more successful...... perhaps there is a link somewhere???
    The data definitely doesn't support that the US is "vastly more successful" when it comes to health care costs, coverage of its citizens, or most accepted metrics of care, such as life expectancy.

    The only real argument that shows that our health care is vastly more successful goes like this: "our health care is American.....American is better at everything....therefore our health care is better".
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  11. #1911  
    Quote Originally Posted by 1thing2add View Post
    Where is your outrage at the "temporary communist" federal income tax that has existed, in part or in whole, for well over a hundred years? What changed in order for it to be necessary as a permanent part of American life in today's world?

    From Treas.gov:
    You make the assumption I am not outraged....but that is a different topic. I am quite aware of how the federal income tax was started (Amendment XVI, 1913). What changed?....well....politicians determined that if they wanted to have more power, they needed to control more of your life, and this required more money, and "poof", we have income tax.....the more they controlled the more powerful they became.....pretty much as I see it in a nutshell.
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  12. #1912  
    Quote Originally Posted by Bujin View Post
    The data definitely doesn't support that the US is "vastly more successful" when it comes to health care costs, coverage of its citizens, or most accepted metrics of care, such as life expectancy.

    The only real argument that shows that our health care is vastly more successful goes like this: "our health care is American.....American is better at everything....therefore our health care is better".
    And yet people continue to flock to America......go figure, huh? Not sure why anyone would want to live in this capitalistic hell hole....LOL.
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  13. #1913  
    Quote Originally Posted by clemgrad85 View Post
    And yet people continue to flock to America......go figure, huh? Not sure why anyone would want to live in this capitalistic hell hole....LOL.
    Of course. I say that data supports that our country doesn't have the world's best health care, so the response is that I'm calling America a "hell hole".

    I could be wrong, but I think that you realize that people are not flocking to our country for health care, but rather there are a host of reasons why people come here. I'd be glad to hear any actual data that shows that our health care outperforms Europe: cost, life expectancy, patient satisfaction.

    Y'know, something other than "America is perfect...love it or leave it."
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  14. Micael's Avatar
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       #1914  
    Quote Originally Posted by Bujin View Post
    Of course. I say that data supports that our country doesn't have the world's best health care, so the response is that I'm calling America a "hell hole".
    You've provided data, but not that supports your premise. I believe the US has the world's best health care.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  15. 1thing2add's Avatar
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    #1915  
    Quote Originally Posted by clemgrad85 View Post
    You make the assumption I am not outraged....but that is a different topic. I am quite aware of how the federal income tax was started (Amendment XVI, 1913). What changed?....well....politicians determined that if they wanted to have more power, they needed to control more of your life, and this required more money, and "poof", we have income tax.....the more they controlled the more powerful they became.....pretty much as I see it in a nutshell.
    No assumptions were made whatsoever. The imbalance of ideals held is the point being made.

    Although its history began prior, it was actually President Lincoln who first instituted federal income tax as a means of conducting large-scale war. In order to become a world power, militarily and economically, it became an addiction in the 20th century. Why is it still necessary?
  16. #1916  
    Quote Originally Posted by KAM1138 View Post

    What do you think about a pseudo-direct payer plan--that is HSA type savings with (relatively) high deductible insurance. That instead of having a common/catastrophic break is simply a financial limit. Unfortunately, I think this would be very similar to what we have now. Insurance would still be involved--at least in monitoring expenditures to whatever the limit is. There could still be some benefit, because they still wouldn't be paying out for the large volume of common things (office visits, and the like).

    Insurance systems break down when they try to cover things that are highly likely to occur, and that's what we have now. I believe that's why insurance costs continue to skyrocket.

    I'm trying to digest what you said about cobbling different plans together and medicare. Why does this have to happen? What I suggested didn't involve medicare--or rather an expansion of medicare to non-elderly. I'm not following where the necessity to combine that comes into play.

    Again--my idea isn't for managed price controls, but rather market controls. I think we continue to differ on this. If a given medical service is priced out of the range of its customer, and there is no insurance company (or government) to pay it (possible due to indirect payments that spread out the costs) then it won't be economically viable. Meaning--the price will have to come down. This is an imperfect example, and I know you dislike this in regards to medicine, but picture a car--the best car in the world. If no one can afford it, no one can buy it, so an enterprising business will find a different alternative. Basically--its a disincentive to gouge.


    As far as medicare--well, what happens when you expand the scale of it by several times. Does it remain somewhat efficient or does it gain overhead at a faster rate? I don't know.
    I'm not sure how similar Massachusetts plan is, but I hear that costs have climbed significantly. The VA--well, I hear mixed reviews about that. Congress--well, no surprise there, but it is also a VERY small group.

    The essential element that I see as being vital to control costs is to eliminate or greatly reduce indirect pay systems. Medicare is an indirect payer system, so it seems that unless it had some really core changes to how it worked, that problem will remain.

    It sounds like we agree that there are benefits to direct pay. I'll have to read up on that link you posted.

    KAM
    I have never been impressed with HSA's, in whatever guise they have been sold. I realize they are the backbone of many conservative approaches, but the details of how the money is actually handled is bothersome. If I had invested my HSA with Lehman Bros., I would not be happy. Additionally, as is well known to anyone who has studied HSA's, the major selling point is a tax break. That's fine if you have a decent income, but waitresses will not benefit very much from a tax break. And people with chronic disease will cruise through an HSA in no time unless there are concomitant cost controls.

    What I said was that if your direct pay plan was to include seniors, it would require a major reshuffling of Medicare in addition to all the other changes that need to be made, and we have no experience as to whether these will work. Direct pay has been a demonstration project at best. Implementing it right now with little experience in a complicated system seems foolhardy.

    We know where the problems are with Medicare, from the patient's standpoint, from the financial standpoint, from the fraud standpoint, from the doctor's standpoint. Expansion would be much easier, with much less risk, again in my opinion. And although it is true that the overhead for Medicare is slightly underrepresented because other parts of the government are used for parts of the Medicare system it is still more efficient, more nimble and more responsive than most private insurance companies....although some of my colleagues would dramatically disagree, I'm sure.
  17. #1917  
    Quote Originally Posted by Micael View Post
    You've provided data, but not that supports your premise. I believe the US has the world's best health care.
    You're absolutely right. It does have the world's best health care. That is, for everyone who has almost unlimited access to it. When you count the 45 million or so who don't, and the millions on Medicare who can't find a doctor to treat them, and average it out, we are miserable, and there are tons of data that show that. Of course, conservatives don't like the measures that are used, and complain bitterly about how those outcomes are biased and not relevant to our population. Manure. We do not compare favorably in our ability to provide health care for our population. There is no argument about that from anyone that can read.
  18. #1918  
    Quote Originally Posted by Micael View Post
    You've provided data, but not that supports your premise. I believe the US has the world's best health care.
    Where else in the world have you lived and exprience their health care system? I'm just curious.
  19. #1919  
    Quote Originally Posted by 1thing2add View Post
    One of the major issues you underscore is the area of subspecialties and the unique high costs related to those disciplines. When there are constant advancements in the development of treatments, surgical techniques, new gold standards, and the like, what do you believe will be the effect on the market that helps develop and support these areas in cooperation with physicians/surgeons with the creation of a public option and enrolling business and individuals into insurance which they could not consider before?

    The other consideration is the area of academic research and its grant funding through NIH and other sources. What effect, if any, do you foresee in that large arena? Currently, many of these new treatments and techniques are not reimbursable under the current system so my concern would be a potential chilling effect during the 4 year implementation period. Any thoughts?

    I'm certainly pro-business, but not at the expense of undermining the integrity of the healthcare delivery system for the ultimate sake of pharma's or other manufacturer's profitability and shareholder wealth. That is exactly part of the formula that landed us into this position to begin with.
    One of the issues with technology is not that it's too expensive but that it's too prevalent. There is no reason for five private practices that are in the same building to each own their own MRI. The machines sit empty, they're never used at night or during off hours, but they can still generate a lot of money for their practices. Controlling costs means that doctors have to give up some independence, and that patients can't always get what they want. When you twist your knee kicking your dog, there is no reason to do an MRI in most cases, but it's amazing how frequently patients demand them. There are excessive procedures done for defensive medicine, but as I've said, I think more are done because of a lack of knowledge basem, patient demand, and the profit motive. People might have to come after hours for an MRI. Doctors might have to work shifts. Hospitals become very quiet on the weekends. Why? Given the investment in materials and technology, if you're making a profit (or breaking even) 5 days a week, are the personell costs going to make you lose money if you work 7 days a week? Oh, you don't want to come in on Saturday for your exercise test? Fine, then it will cost you and everybody else more. This is an exaggeration, but it's true as a general principle. Technology needs to be controlled. That will,by necessity,mean that manufacturers won't be able to sell as many MRI's and some of their employees might be jobless. There's no easy way out of the mess we've gotten ourselves into, but we have to do something.

    NIH funding is the backbone of medical discovery in this country. If you think that the US has a great health care system, you can look to the NIH as the reason (and not private industry research funding, as someone mentioned early in this thread). It would be incredibly short-sighted to limit NIH funding (as was done by many presidents, most of them republican, including Bush and Reagan). And hey, you know what? The NIH is the government.
  20. 1thing2add's Avatar
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    Quote Originally Posted by clemgrad85 View Post
    And yet people continue to flock to America......go figure, huh? Not sure why anyone would want to live in this capitalistic hell hole....LOL.
    It's only my opinion, but I believe that may have more to do with the breakup of the former Soviet Union nations and the increasing openness of China. Does the US still shine as a beacon to the rest of the world? Certainly. However, it is the responsibility of its people to keep kicking it in the seat of its pants in order to fulfill its promise of progress.

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