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RE: Universal Healthcare Now! - 9/21/2006 5:38:45 AM

peterK50

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The VA system of hospitals had the highest employee satisfaction rating of any hospital groups [2003]. The reason hospitals claim they have to charge such high fees is paying for the unisured. If everyone had some basic insurance that reason would be eliminated. Doctors are now paid by the test, proceedure, supply used etc. A major incentive to do more & pad the bill. If Dr's were paid a salary, & a damn good one I imagine, the incentive to over utilize services would be gone. The VA shows the G'ovt can run a healthcare system. Knee-jerk conservatives who think the G'ovt does nothing right should reconsider.

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Post #: 21

RE: Universal Healthcare Now! - 9/21/2006 6:11:24 AM

BBBTBW

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There are PRO's and CON's in every system. HOWEVER Universal Healthcare in the US is a MUST. Several years ago I was in a car accident, I was severly injured and the medical costs were rising as I was laid up not able to walk or work for the better part of 3 years. I had insurance, but the nickle and dimey attitude of the company still didn't pay for everything they were supposed to pay for. I didn't have the energy to argue the point and ended up paying almost 75% of my ongoing medical costs over the course of those 3 years. THANK GOD for CAR INSURANCE, and THANK GOD the young woman who caused the accident had a rich daddy. We eventually settled and the settlement paid for the $150,000.00 worth of medical expenses that were incurred. I would NEVER have been able to pay that. I would be sweating blood if I had been faced with having to pay that out of pocket. This was something that happened that was deemed not my fault, I was 100% not at fault in this accident but the expenses incurred to get better would have been 100% my responsibility.

I would GLADLY pay a little more in taxes so that no one else would have to face such hardship in thier lives. Give me a card that says I pay taxes for the Universal Health Care and if you don't want it, the taxes are not deducted out of your paycheck and you don't get the card. Plain and Simple.

The debate about whether it is good or not is pointless. ANYTHING has to be better than what we have now. I can't remember who stated it earlier but State of the Art Healthcare is worthless if you can't afford it.

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(in reply to peterK50)

Post #: 22

RE: Universal Healthcare Now! - 9/21/2006 6:19:19 AM

LadyEllen

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I also cannot believe the situation in the US with regard to healthcare. I forget which band it was now - I think Rage Against The Machine, made a video with a Who Wants To Be A Millionaire sequence in it. The one question was "how many Americans have no health care insurance?" and the answer was something horrendous like 50 million - about 1 in 7?

But - inferring even, that Americans are idiots for not having universal healthcare is just plain stupidity. The US has a different history, and maybe if they had had on the home front what the UK had in WWII, they might have opted for universal too. And it is wrong to hold the UK National Health Service up as a model to follow.

I think a lot of the problems with healthcare are coming from the fact that so many new treatments come in at such high prices from research companies and drugs companies. Everyone wants the best, latest treatment if it will take away the pain better, solve their problem more easily or increase their life expectancy - thats human nature after all. So, if the costs of providing the newer, better treatments are higher, then clearly cost to the patient in a paid at delivery service will rise, regardless of any other factors.

And the problem that these new treatments come in at such high prices stems from the marketplace for such treatments, given that everyone wants them. There are high costs to development of course, but I do not believe that any pharma company with shareholders and financiers to please is ever going to sell the results of their research simply to recoup the cost of their investment in development. They sell the new treatment for as high a price as will be paid, and in many cases can sell the treatment for any figure they choose, since people will want it and do anything to get it.

In the UK we have had the great benefit of the National Health Service since the late 1940s/early 1950s. I pay 9% of my earnings at source and the company pays another 11% for this, but even then this has proved not to be sufficient to pay for the growing demands on the system as new, expensive treatments come in. As things are I get to see my GP for nothing, but in recent years dentistry and many other services have been stripped from the NHS principle of "free at point of delivery" in order to save money - now even an NHS dentist requires payment, if you can find one that is as most have gone to private practice where they are freed from bureaucracy and charge pretty much what they like. I cannot afford to see a dentist anymore, which as a company CEO is a bit crazy. I also have to pay for my spectacles (blind as a bat!), I also have to pay for my scripts - which even at GBP 40-00 per month is cheap compared to buying the medicine myself. Previously, all such items were free of charge at delivery, but the growing costs have meant such savings, by way of levying charges, has been necessary.

The other factor of the growing costs of course is an aging population which is living longer. This combined with the need to make savings has led to more than a few battles now with regard to care for the elderly and who should pay for what. And thats not to mention the fraud that is currently being perpetrated by the NHS against the elderly, forcing them to sell their homes to pay for care, for which they already paid in their working life.

The UK NHS provides a great safety net, and it provides services which, if one wished to obtain them privately, would be impossible to afford even for the middle classes. But it would be wrong to pretend that its brilliant. The bureaucracy involved, the enormous wasting of resources in the organisation, the lack of sufficient funding to meet the requirements as it would like, the long waiting lists to see a specialist and then to get treatment (several months to several years in some cases), do not make for a service of which we can be proud, though however bad it gets it is something which I think every Brit is more than pleased to have.

Yes, the US needs something like the NHS to be a safety net for the poor - and anyone can become poor; ask a cancer patient who has had to give up work - but at the same time, any NHS service for the US would run into the very same problems that it has in the UK - the costs will keep on rising, regardless of doctors' salaries, lawsuits and the like, and in the end those who can pay to go privately will do so in order to avoid long waiting lists and comparatively poor options.
E

seeks - I loved your "get hit by a London bus" suggestion. Maybe we could start a tour company for US citizens who need medical treatment but cant afford it, but could afford to travel here? We could make a lot of money if we got a share of the lawsuit compensation from the bus company!

(in reply to peterK50)

Post #: 23

RE: Universal Healthcare Now! - 9/21/2006 6:30:38 AM

Archer

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quote:

ORIGINAL: seeksfemslave

Archer..I assume you have no objection to the Federally initiated/financed Interstate Highway system.Lobbied for incidently by the private enterprise automobile industry !!! I take it you are somewhat satisfied with the results of Federal expenditure on the armed services, why then are you so anti Federal involvement in a resource as major as the health of the nation ?

Because Healthcare is fractionable, while Roads and Military are not.

(in reply to seeksfemslave)

Post #: 24

RE: Universal Healthcare Now! - 9/21/2006 6:31:08 AM

meatcleaver

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quote:

ORIGINAL: LadyEllen

The bureaucracy involved, the enormous wasting of resources in the organisation, the lack of sufficient funding to meet the requirements as it would like, the long waiting lists to see a specialist and then to get treatment (several months to several years in some cases), do not make for a service of which we can be proud, though however bad it gets it is something which I think every Brit is more than pleased to have.

I agree with the problem of reducing bureaucracy though some is necessary in such an organisation but private healthcare has a greater % of bureaucracy and America spends twice as much on medical bureaucracy than Britain (ratio).

Edit - Britain has one of the most efficient if not the most efficient health services in the world. As for the best, there are just too many criteria to choose from to make a realistic call on that one and all health services have their structural weaknesses.

< Message edited by meatcleaver -- 9/21/2006 6:42:37 AM >

(in reply to LadyEllen)

Post #: 25

RE: Universal Healthcare Now! - 9/21/2006 7:09:23 AM

LadyEllen

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MC - definitely. I just wanted to make the point that just because one has an NHS, it does not and can never solve all the problems.

Its the waste of it all that gets me most though. Any commercial organisation that wasted money and resources like the NHS does would be out of business within a year.
- new cars for the management every year, all financed by the system
- new PCs, new furniture every year or other year
- IT projects that run well over budget because of poor purchasing and scrutiny
- operative procedures which are traditional, but no longer needed (tonsilectomy a prime example)

Dont get me wrong, I dont pretend to have an answer for all the problems of the NHS; many people with more experience and intelligence than I have tried to solve them for several years now, but succeeded only in moving the problems round if anything.

And I wouldnt be without it either.

E

(in reply to meatcleaver)

Post #: 26

RE: Universal Healthcare Now! - 9/21/2006 7:27:45 AM

seeksfemslave

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Lady E: I am full of good ideas, so if you agree to drive the bus, you said you were blind as a bat, and I will collect the legal payouts, we cant lose.

Archer I dont know what you meant by fractionable so I cant asses your response.

The UK NHS is by no means perfect and in fact over the last few years millions have been fed into it and basically produced only more managers and bean counters, not wider based treatment.

The real danger for patients is if you have something seriously wrong, but in the early stages of slow development. Then delays probably will cause problems. Also believe it or not ...ward cleanliness, but that feeds back to lack of social discipline due to dopey PC thinking.

(in reply to LadyEllen)

Post #: 27

RE: Universal Healthcare Now! - 9/21/2006 7:37:17 AM

Archer

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It is easy to divide who uses how much healthcare that means it is easily fractionable. It is not easy to determine who uses how much of the military nor who uses how much of the highways. The more indirect the benifit the harder it is to fraction a cost, the more direct the benifit the easier it is to fraction a cost.

(in reply to seeksfemslave)

Post #: 28

RE: Universal Healthcare Now! - 9/21/2006 7:39:41 AM

meatcleaver

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Privatisation of cleaning was one of the most stupid things introduced into the health service. I have a Dutch frined who was a doctor in a NHS hospital in England and she said that the cleaners had a list of things to do and they had no time to do all the list. However, they had to work from the top of the list to the bottom each day so the things on the bottom of the list never got done. When the cleaning company was challenged, they said that if they worked any other way they would break their contracts. No doubt with the cleaners getting paid 30% less for the private company than when they were with the NHS, they were 30% less efficient. This was the pattern I noticed when the cleaners were privatised in the Probation Service and they couldn't fire the cleaners because no one else was stupid enough to do the job for the money they were paying.

(in reply to seeksfemslave)

Post #: 29

RE: Universal Healthcare Now! - 9/21/2006 8:01:00 AM

LadyEllen

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MC - bang on correct. Just another way to save money, and another false economy.

seeks - good point too about the delays making people more ill before they ever get treatment. If I were cynical I might think it another way of saving money; people who die or are no longer treatable because of the wait must save the system millions every year.

E

and seeks - I may be as blind as a bat, but I can still do a Paddington Bear style hard stare. Be careful youre not on the end of it!

(in reply to meatcleaver)

Post #: 30

RE: Universal Healthcare Now! - 9/21/2006 9:46:47 AM

seeksfemslave

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Archer explained fractionable with regard to healthcare thus
It is easy to divide who uses how much healthcare, that means it is easily fractionable

How about the percentage of the fraction who dont use Health Care to the extent necessary because they cant afford it.?
Surely they deserve some consideration dont they ?

No bleeding heart Liberal me, but I just think appropriate medical treatment is something we all deserve, without being reduced to poverty.

This CAN be organised on a collective basis, as is primary education, up to 11 years old and secondary education up to 16 or 18 years old.
The failures of the educational system are again down to PC thinking, not the method of financing.

< Message edited by seeksfemslave -- 9/21/2006 10:00:50 AM >

(in reply to LadyEllen)

Post #: 31

RE: Universal Healthcare Now! - 9/21/2006 12:19:33 PM

NorthernGent

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I am all for universal healthcare personally. I have to laugh or cry depending on my mood when people bring up the subject who are against it. Often these are the same people who wrap themselves up in the American flag and blindly talk how much better America is compared to all other countries and then this subject comes up and all of a sudden the greatest country in the history of the world is not capable of desiginng a system that would work and point to the problems but never the good things about other "inferior" countries who have universal healthcare. If we are so much better how come we cannot do better in this? It is a contradiction that always confuses me. Are we a can due or can't do country?

Because, like Britain, the US doesn't need to offer quality public services for its people to be content. My guess is that day after day, year after year, the media and the establishment have presented consistent information of a great United States - the effect being your Government can totally and utterly take the piss out of the people because you have repeatedly been told about the great US and so, as a society, you believe it, regardless of the facts staring you in the face (for example, the fact that the US refuses to provide basic social welfare which is in anyone's language is primitive). The US may be strong militarily but then so was Germany for a 10 year period starting 1935 so does that make the US a great nation?

Regards

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RE: Universal Healthcare Now! - 9/22/2006 11:27:21 AM

Amaros

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quote:

ORIGINAL: toservez

I work in the medical field and there is not one problem that is driving the costs up. The biggest problem is everyone from the medical field, lawyers and insurance companies have zero incentive to control costs and all of us get rich in the process. Medical people get sued, insurance company settles, raises rates to medical people who pass it on to the customer. Everyone gets richer as the percentage of the increase revenue is pocketed. Hospitals who cry poor are only poor because everyone is paid an obnoxious amount of money. We have secretaries at our hospital making more then a 100k but they have been there a long time and they work for an important doctor type stuff. We have first year residinets debating whether to buy or rent a 500k condo. Hell, I am overpaid. What we do others cannot due and/or do not understand so it becomes sacred and free market principals do not hold up.

If you want to try to fix the system within, people actually have to vote in severe tort reforms and get some regulations on insurance companies and hospitals. Even then good luck.

I am all for universal healthcare personally. I have to laugh or cry depending on my mood when people bring up the subject who are against it. Often these are the same people who wrap themselves up in the American flag and blindly talk how much better America is compared to all other countries and then this subject comes up and all of a sudden the greatest country in the history of the world is not capable of desiginng a system that would work and point to the problems but never the good things about other "inferior" countries who have universal healthcare. If we are so much better how come we cannot do better in this? It is a contradiction that always confuses me. Are we a can due or can't do country?

I believe youare absolutely correct in targeting the incentive system - it's a problem you're going to get in any kind of status system.

I haven't devoted all that much thought to this, but the simplest answer is just to put everybody who isn't insured on medicaid or medicare, via HMO's which doesn't interfere with the free market operation of the medical industry in anyway, except of the problems you mention that are already there.

At the same time, incentives need to be provided for employers to extend their coverage to part time employees - a large proportion of the uninsured, I'm guessing, are people who aren't employed full time for the very reason that if they were, their employers would have to offer them health insurance - instead, they're scheduled to work 35 hours a week, and never allowed to get more than 40 so they can still be considered part time employees.

W/regards to the health care profession industry itself, one solution to the skewed priorities is possibly something like the Scottish system, where providers are paid regardless of how much treatment they provide - this shifts the incentive from profit to preventitive measures, since if your patients are healthy, you've got more time to go golfing, and getting paid regardless.

I'm not sure how this would work, being applied directly to our current system, but time vs. money is one area where incentives could be shifted, i.e., health based rather than procedure based profit incentives.

The real block to reforming the healthcare system is oversight: the fear that hypochondriacs will overwhelm the system has led to the opposite, where bean counters in the HMO's deny care when it's really needed in order to save a buck.

Archer's tort reform is essentially a lobbying effort to make it easier for them to do this - lawsuits, I'm afraid, are part of the market system, shielding manufacturers and providers is a form of market distortion that undermines the practical foundations of market capitalism.

You don't want to get sued, don't fuck up.

(in reply to toservez)

Post #: 33

RE: Universal Healthcare Now! - 9/22/2006 12:07:53 PM

Amaros

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W/regard to the OP, the reason individual health insurance is more expensive and less comprehensive is that individuals have less clout to haggle with HMO's - i.e., time, money, and expertise.

Firms have more of this clout, it's essentially a form of collective bargaining - and thre is nothing in the definition of capitalism that precludes colective bargaining - it's a market force like any other. Labor markets can, and probobly should, organize to negotiate with other organized entities when individual negotiations put them at a disadvantage.

(in reply to Amaros)

Post #: 34

RE: Universal Healthcare Now! - 9/22/2006 12:23:13 PM

philosophy

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"It is easy to divide who uses how much healthcare that means it is easily fractionable. It is not easy to determine who uses how much of the military nor who uses how much of the highways. The more indirect the benifit the harder it is to fraction a cost, the more direct the benifit the easier it is to fraction a cost."

......just because a thing can be done does not mean it ought to be done. If we concede the logic of funding a vital communal infrastructure, such as a decent transport network, then why not see healthcare as the same class of infratructure. If we only focus on fractionating the consumers of healthcare, not all the beneficiaries of healthcare contribute. Decent healthcare knocks on into the economy in countless ways. No medical insurance bills and red tape for industry. Less sick days. More productivity. More wealth.
Seen as infrastructure, decent healthcare goes some way to paying for itself. Seen morally, its almost an imperative for most. i fail to see a coherant argument against it, that doesn't seek to deny our essentially communal nature.

(in reply to Amaros)

Post #: 35

RE: Universal Healthcare Now! - 9/23/2006 8:51:29 AM

Chaingang

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"Survey: Most Want Health Care Overhaul"
http://www.cbsnews.com/stories/2006/08/17/health/webmd/main1905144.shtml

"More than three-quarters of those surveyed said the U.S. health care system is in need of fundamental change or complete rebuilding."

-----

Interesting. So more than 75% of us *ARE NOT* getting what we want. Why is that?

Hrm...

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Post #: 36

RE: Universal Healthcare Now! - 9/23/2006 11:11:19 AM

EnglishDomNW

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quote:

ORIGINAL: Archer

LOL Please Uncle Sugar I will trade freedom for healthcare.

Why not have both, we do.

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Post #: 37

RE: Universal Healthcare Now! - 9/23/2006 2:55:45 PM

Chaingang

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Because it's better to bitch about the pretended limits to freedom while you are simultaneously being taxed as if you lived in a socialist country but are also too stupid to demand value for the tax monies collected. People who oppose Universal Healthcare need to see a doctor - they need eye-holes cut through their colons so they can see where they are going.

_____________________________

"Everything flows, nothing stands still." (Πάντα ῥεῖ καὶ οὐδὲν μένει) - Heraclitus

(in reply to EnglishDomNW)

Post #: 38

RE: Universal Healthcare Now! - 9/23/2006 3:16:36 PM

Dtesmoac

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Couple of experiences of the US medical system since we have been out here compared with UK

There is a grand piano in the reception area of the maternity ward in the US and the birthing suites are like hotel rooms...........much better than the UK...... most of the people we've met do not have medical care that would allow them to use that hospital.......typical if your not rich your'e just a piece of shit attitude of the US

Got to see a doctor straight away in the US wihout any lengthy wait, or stupid questions from the receptionist or being told I had to book an apointment for the same day .......better customer service in the US but then received a bill for $115 for a 5 minute consultation and $80 for the prescription. Good medical insurance covered most of this and "company transfer from UK contract" covered the rest but I spoke with someone who is retired and is terrified of getting ill because they can not afford the drugs

Single biggest negative about US is the medical system, it's costing companies to much, people too much and only making money for drug companies and the politicians that are getting the back handers - no other reason can explain why they have'nt tackled this issue properly.

US spends higher amount of national wealth on medical than most other developed countries but a lot of people have no medical cover........is that a waste of money or what.

(in reply to Chaingang)

Post #: 39

RE: Universal Healthcare Now! - 9/23/2006 4:25:06 PM

Takethiswaltz

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Nobody has mentioned this, and I realize I will appear bigoted,
but here goes.

Scenario#1: Jesus Ramirez has lived all his life in DR. He is 80 years old and his health is failing. Recently, he has become short of breathe with even the slightest exertion. Knowing that American medicine is free in certain government-subsidized hospitals, his wife calls her sister in NYC and they fly him over. He is admitted to hospital in NYC 2 days later, spends over $10,000 in medical bills, and when he is better, he returns to his beloved home country.

Scenario#2: Juan Alverez lives in PR. He is 42 years old. He is an alcoholic and IV drug user. He has advanced cirrhosis and hepatitis B. His sister, who resides in Massachusetts, goes to Puerto Rico and brings him back. The first place they stop is an emergency room.
Juan is admitted. His attending physician runs the local family clinic which provides free-care if needed and his doctors at the hospital are residents. Because these residents are still being educated in medicine, they keep Juan for 2 weeks and has what we call
"the million dollar work up".

Scenario#3: Eddie Vargas is a 17 year old illegal alien who stabbed in a bar fight. During his stay in the hospital, he devloped a thrombus in his leg which traveled to his lung. The thrombus broke in several peices and was occluding his pulmonary artery. He had to be med flighted to town where surgery was neccesary to remove the peices of clots otherwise he would die. He developed pneumonia and sepsis. Bedbound for 2 weeks, it was neccesary to send him to a rehab hospital for 3 weeks before they could discharge him to home.
Total cost of Eddie's care: $147,000. Who pays these bills?
We do, my friends.
Next time a vote on border closings comes up, think about where your taxes are going and why citizens of this country can't afford their own medical care.

BTW: these stories are true and happen EVERYDAY. I'm an RN, I am paid pretty well, I earn every penny I make, and pay taxes so the government can pay the bills of people who are NOT paying taxes.

Disclaimer: This is not meant to offend the hispanic population. Many of my coworkers and friends are Hispanic; they work, they pay their taxes. But my experience with illegals is not favorable.

My two cents,
T.

_____________________________

Ring the bells that still can ring
Forget your perfect offering
There is a crack in everything
That's how the light gets in...

~Leonard Cohen~

(in reply to Dtesmoac)

Post #: 40

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