For those that think our healthcare needs fixing

Ross in Ventura

Great post Clark, no emotion just the facts

Ross

Misippi Egger

Chris,

A retired doc (good doc) who now works for disability evaluation says when the docs turn down patients, they are often able to get an administrative judge to overrule the doc and grant the disability (friend, family, etc connections in small towns). They are supposed to have regular re-evaluations, but as the retired doc told me, if you don't have a real disability, it's hard for the doc to show improvement, which is what it takes to get them off disability. Lots of freeloaders taking up money that should be going to real problems - like Gator.

Another one today - 54 yrs. old and on disability. Had a stroke last year, but has no, repeat NO, residual effects or limitations from the stroke. I saw no other reason for disability - I didn't push my questioning any further.

bitslammer

10) IMHO we need:
a) Tort reform
b) Insurance regulation
c) Pharmaceutical regulation
d) Easy access for ALL to health care
e) Fairness in physician reimbursement

Agreed but where are b) & c) going to come from if not the government? Also who is going to stop the few bad apples you mention that are gaming the system?

I don't want the government deciding the course of treatment any more than I do the **** from my plans administrator are now, but if you have people ripping off the system someone has to step in and say "NO." Who is that going to be?

Misippi Egger

Look, we have a small group (24 members plus family members). We have a Medical Savings Account with a $5500 deductible and my premiums for just me and the Princess wife run about $1000 per month. I can feel y'alls premium pain!

With my bike accident, I had an old group number - same policy. All my claims (ER, doctors, Xrays, PT) were denied due to policy termination. I called and gave the providers the correct group number. Now getting denials as duplication of claim submissions. Ahhhhhhh ! Insurance reform!

Misippi Egger

Government could set standards for insurance and pharmaceutical companies - not fixed prices, but minimal standards, kind of like in the auto insurance industry. True portability, picking up pre-existing after x time period, or with higher premium, no denial if get 'really sick', etc.

Also could increase number of people covered by Medicaid to pick up the uninsured.

The CHIP program works pretty well picking up the kids between Medicaid and true insurance.

Don't have an easy fix for drug companies. They spend fortunes on research and new drug development. First thing I would do would be to prohibit advertising to the public. The cost of drugs has skyrocketed since they started advertising on TV a few years ago - billions spent on ads.

Semolina Pilchard

You have made a bunch of great points, and I hope this does not sound like nit picking, but I doubt the increase in prescription drug prices is needed to recoup ad costs. The giant profits the drug companies make has not dipped since the tv ads came along. I do not believe that Novartis is the largest drug company, and their net profit for 2007 was $12 billion (I don't have the 2008 and 2009 numbers). I am a capitalist, but if all the drug companies combined made 12 billion in profit that would be bad enough, but ONE company? In the old days we went to the doctor, told them what was wrong, and then the doctor decided if we needed a prescription, and if so, which one. Now it is "ask your doctor if ______ is right for you." The pharmaceuticals companies seem to want to reduce the doctors to drug dealers.
There are many reasons why drugs and everything related to health care are so expensive. In my opinion, the main reason drugs are so expensive is because most politicians are deep into the pockets of Big Pharma. That is also one reason insurance costs so much, and then the insurance company is allowed to weasel out of paying a legit claim.
I won't pretend to know what the answer is, and how to implement proper restrictions on drug prices, insurance, etc., but if that was all in check we probably would not have a broken health care system, and it is indeed broken. Sorry for the rant.

Misippi Egger

No apology needed. I just skimmed on the drug company issue. I have seen graphs in the past showing that a dramatic increase in prescription prices parallels the allowing of direct advertising to the public. A simple analogy, but go figure! The profits of these huge companies is obscene (you can figure I'm not a shareholder). Sure the development and litigation costs are high, but look at the profits!
Insurance companies keep raising premiums, but they are NOT raising what they pay the individual doctors. They do everything they can to delay or avoid paying a claim, the whole time collecting interest (though small) daily on the money they are not paying out. Just look at the HUGE incomes of the CEO's (United jumps to the front of my mind). I've been told that insurance co. profits have jumped from 2-3% to 25% in recent years. What businesses make 25% profits? I'm sure not!

This whole thing is extremely complicated. It is NOT in any new crisis, in fact I heard on the radio today that the proposed changes would not take effect until 2013. What's the rush? Maybe to try to sneak in socialistic control of heath care before the general public knew what was happening. Didn't work.

Rush Limbaugh (not a fan) said in an interview with Greta that this was not so much about money or health care, but about CONTROL. Probably correct. :ohmy:

Spring Chicken

I got this from a friend in DC and thought I would pass it on just as I received it. Wonderfully simple...

A jaundiced perspective but, since many a truth is said in jest, it is savagely comic--


Let me get this straight..................

We're going to get a health care plan shoved down our throats that was written by a committee whose head says he doesn't understand it, passed by a Congress that hasn't read it but exempts themselves from it, signed by a president who will smoke cigarettes if and when he reads it, with funding administered by a treasury chief who didn't pay his taxes, overseen by a surgeon general who is obese, and financed by a country that's so broke it has been borrowing for years massive sums from China and Japan to sustain spending for services to citizens whose tax remittances don't come anywhere near paying for what they demand from the government.

What could possibly go wrong??


Spring "Simple Always Wins Over Complex" Chicken
Spring Texas USA

Little Steven

Randy,

That is fast. You are right about Canada but you may not be aware that Great Britain has a two tier system. That is if your employer, you personally or your business is or are capable and willing to pay additional premiums, you are able to use facilities that are not available under government insurance. This is something many people in Canada, including me, are in favour of. Everyone gets health care, medical professionals can be paid reasonably and neither system is over burdened.

Steve

Little Steven

Max,

My kid sister Paula, is Down syndrome and suffers frome Crohns disease. She is now 47. Since she became of age she has collected a small government pension. Paula is my trust and she has been for several years. All of her specialist visits, occasional hospital stays when the Crohns flares and the whole drug regimen are completely covered. There are problems within our health care system but I don't think it is as bad as what people are led to believe.

Steve

Misippi Egger

Steve,

Randy's experience is pretty typical, at least in my community.

Canada has a 2 tiered system, also, those who can afford it cross over into the US to get quicker care.

I just wish we could get the cost of our pharmaceuticals more in line with what our northern neighbors pay. :(

Little Steven

Clark,

They just have to follow our health care pros across.

Steve

mad max beyond eggdome

sorry steve, didn't mean to blast the canadian system, there is a lot more i don't know about it than i do know about it. . .something tells me that it probably does have a lot to offer. ...and its like i've said to you before, we sure as hell don't have all the answers here in the states. . .

Bobby-Q

The problem with this whole thing is the current sitting government. They would love to have it set exactly as Canada but without any of the "good" parts. They would create a 2 tier system that might work great until the ones that can't afford the 2nd tier treatment start naging and then we get another round of tax incresases to make the 2nd tier available to everyone because that is the fair thing to do.

I hate politicians and especially hate unqualified politicians who have a silver tongue, especially when they have been pampered their whole lives and think they can speak for the problems of the people.

Wow. Where did that soap box under me come from?!

RGBHV

I know this is an old post, but I just read it and had to jump in here.

We all know that there are many difference (good and bad) between the US and Canadian healthcare systems. I don't know enough about the UK system so I won't touch on that.

In the US, if you have money, insurance, etc. can you get healthcare quickly. Sure! But quick doesn't always mean better. My wife had an Uncle in the US - filthy rich - he had a problem, got treated immediately and still died.

And what about the millions of US citizens that don't have enough money, don't have coverage or not enough coverage? Why should they have to choose between paying for health care or paying their mortgage or food? They don't get diagnosed early because they can't afford the Dr. visits, then they suffer in needless pain without meds and may die quietly.

In Cda, everyone has coverage. If you need something, you get it. If it's not life threatening, will you have to wait. Probably! Will you get meds at a decent price to smooth out the rough edges while you wait. Absolutely! If you have something life threating, will you get treatment immediately. Absolutely - it's called emergency surgery which has a priorty over everything else and you won't have to mortgage your house to do it.

My mother had heart problems that were diagnosed during one of her regular visits. Yes, regular visits that she didn't pay for. The Dr's, specialists, etc. scheduled her for surgery. I believe it was a few weeks to a month. They said "if you absolutely want this done this week, we'll send you to the US and it will be completely paid for - BUT - in our opnion the need isn't that critical". They monitored Mom on an ongoing basis seeing Dr's, specialists with different tests, meds, etc. while she changed her life style. 10 + years past and as she needed other surgeries, they were scheduled according to severity / need. Everything was taken care of. If it wasn't, we could have lost the house, etc.

I think this issue comes down to money.

American's want the same level of service they currently enjoy, but they don't want to pay more taxes to expand coverage to those less fortunate.

In Canada, we have a similar problem. The level of care we get is great, but we all want a reduction in wait times. In an emergency, there are no wait times. We could have shorter wait times, IF we're willing to pay for it. As we already feel over taxed it's a hard sell.

At the end of the day, it would be great to have everything. Great service, shorter wait times, fewer taxes. That's unrealistic.

But, if I had to make the choice between a small percentage getting great service while others don't get any service at all versus everyone getting good service, I'll take the latter.

I'm a Canadian proud of our health care system with compassion for those less fortunate.

Michael

Misippi Egger

Michael,

It sounds like you and your family have had good experiences with the Canadian system, as have many Canadians, I'm sure. The same is true of the US system, as evidenced by many of the grass-roots people at these town hall meetings on TV. Many are happy with their insurance and the system (not rich people, but middle class ones). It's hard and probably unfair to make generalizations about either system.

Recently reports have been released showing overall lower cancer survival rates in both the UK and Canada compared to the US for similar cancers. Just facts.

I can remember many years ago (maybe in the mid to late 80's?) when one Canadian province 'ran out of' their alloted money for that fiscal year and I distinctly remember doctors offices closing, leaving doctors and their employees on a month or so vacation (out of work) until the next fiscal year started. Only urgent/emergent care was available during that time.

Despite what you see on the television, there are only actually about 17 million people in the US (out of 300+ million) who cannot afford insurance (who want it or don't qualify for a gov't program). These people can call 911 and an ambulance shows up . They can come to the ER with a problem and they get treated. Granted they might have trouble getting seen in a private doctor's office for a non-emergent problem, but there are thousands of health clinics available throughout the US where they can be seen.

I am in private practice and yet I treat many uninsured patients every week. Once in the system, they get the same care as the President of any large
corporation.

Yes, health insurance in the US need reform (or at least regulation)...badly. All those things talked about in the news is correct - portability, pre-existing disease, lower premiums, etc. We also drastically need medical tort reform (one thing Canada doesn't have out of control), but the White House and the Democratic party is 'in bed' with the trial lawyers so we won't see any meaningful reform coming from this administration - politics! Not in the best interests of the patients, the country or the health care system.

What we don't need is a 1.2 -1.5 trillion dollar bank-breaking program to solve the problems of the 17 million without insurance.

As for me, it's not doctor's fees that are driving this debate. Doctor's fees make up 5% or less of the total health care expenses. We have contracted fees with most insurance companies (that rarely get raised) and the government plans are pitiful. Most doctors with office practices cannot actually pay their office expenses on the fees paid by Medicare or Medicaid. I was paid 20% more for the same services in 1992 than I get paid in 2009. The math shows that can't be the reason for the increasing costs. New, super expensive technology as well as defensive medicine (to try to prevent law suits), plus the irresponsible, unhealthy way most Americans chose to live, are the main cause for the costs being so high.

Enough soapbox. Very complex, multifaceted national problem with no easy fix in sight!

RGBHV

Thanks for the additional insight.

I've seen a lot of Cdn medical bashing lately and it's really getting under my skin. Could it use improvement - yes - there are very few things in life that couldn't use some improvement.

These days, there are a lots of educated people, news papers, etc. that look at isolated incidents in both systems and then claim that those incidents are the norm.

That's unfortunate for both of us.

I think the money issue you refered to in the 80's was a "work to rule" situation - the government claimed there was no more money and the Dr's called their bluff.

I don't know for a fact, but I wonder if the increases we're experiencing are due to the many new procedures available, new drugs, high end equipment and our population living longer? These are issues that medical systems aropund the world are going to have to deal with. We can only hope that they will deal with them in a fair and equitable manner.

Michael