Biggest problem in Healthcare today?

[Jcrown]

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What would you guys say is the most important issue/problem in the current state of healthcare? I'm just trying to interview prep. Would you say it is the large amount of people lacking any health coverage? I think this might have been discussed before, but I couldn't find it via the search function.

 

[-Goose-]

i dunno... maybe it would be the 43.6 million people lacking health coverage in this country...
or the 10.6 million children that lack it...

that would be my answer.

 

[crys20]

lack of access baby.

 

[FutureDocDO]

What if the school you're interviewing at asks what can you do to change the aforementioned problems? What does that have to do with you wanting to become a doctor? I'm afraid they will pile questions like these if I were to answer health coverage.

 

[Jcrown]

i dunno... maybe it would be the 43.6 million people lacking health coverage in this country...
or the 10.6 million children that lack it...

that would be my answer.

Thanks for the condescending answer. 🙄

 

[crys20]

I guess they just want you to seem educated with medical related issues. You could say things like offer a tax credit for purchasing insurance or tax favorable health savings plans, federal help to insure children in state administered health plans, expand coverage through employment and government plans to encompass more people, etc. But honestly I am so worried about these types of questions!

 

[medstu2006]

What would you guys say is the most important issue/problem in the current state of healthcare? I'm just trying to interview prep. Would you say it is the large amount of people lacking any health coverage? I think this might have been discussed before, but I couldn't find it via the search function.

The following link should help you:

http://forums.studentdoctor.net/showthread.php?t=215977

 

[Jcrown]

The following link should help you:

http://forums.studentdoctor.net/showthread.php?t=215977

excellent. thank you! 👍

 

[SOUNDMAN]

I think abuse of the current system is a HUGE issue. I don't think ANYONE should get absolutley free health care. You should have to pay something for it. Even if it's a 5 dollar copay or whatever. All we've done with medicaid/"free health care" is just enabled every one to abuse the system with out any consequences. Wait till you see your 5th bugbite in the ER at 2AM, or a sunburn in the ER. Ahh the stories I could tell.

Costs and useless testing that is done by physicians just to cover their own butts, because the current climate is so sue-happy. I don't know how many people I see with MRI's that don't need them, or are not indicated in a 85 year old patient with knee pain. Mix in a simple X-ray people!!!

/soapbox

 

[Lady Tokimi]

why is the most important issue in healthcare always coverage and expenses?? Cant the fact that kids are gettin obsessed be an important issue also?? the fear that H2N5 could become pandemic?? Would these be alright to use to answer the important issue question??

Any suggestions?

 

[FutureDocDO]

I think abuse of the current system is a HUGE issue. I don't think ANYONE should get absolutley free health care. You should have to pay something for it. Even if it's a 5 dollar copay or whatever. All we've done with medicaid/"free health care" is just enabled every one to abuse the system with out any consequences. Wait till you see your 5th bugbite in the ER at 2AM, or a sunburn in the ER. Ahh the stories I could tell.

Costs and useless testing that is done by physicians just to cover their own butts, because the current climate is so sue-happy. I don't know how many people I see with MRI's that don't need them, or are not indicated in a 85 year old patient with knee pain. Mix in a simple X-ray people!!!

/soapbox

Thanks for the suggestion! I think this a major healthcare issue, now that you mention it. Good one!

 

[internetwop]

I think abuse of the current system is a HUGE issue. I don't think ANYONE should get absolutley free health care. You should have to pay something for it. Even if it's a 5 dollar copay or whatever. All we've done with medicaid/"free health care" is just enabled every one to abuse the system with out any consequences. Wait till you see your 5th bugbite in the ER at 2AM, or a sunburn in the ER. Ahh the stories I could tell.

Costs and useless testing that is done by physicians just to cover their own butts, because the current climate is so sue-happy. I don't know how many people I see with MRI's that don't need them, or are not indicated in a 85 year old patient with knee pain. Mix in a simple X-ray people!!!

/soapbox

😉 exactly!

 

[Buckeye(OH)]

i dunno... maybe it would be the 43.6 million people lacking health coverage in this country...
or the 10.6 million children that lack it...

that would be my answer.

This is correct.

 

[hmasters5]

Any other problems that anyone else can think of?

 

[hmasters5]

Any other problems that anyone else can think of?

 

[dbth77]

I think the biggest problem in health care is a group of schools with very low admissions standards giving out an alternative degree to kids who can't get into real school.

 

[hamandcheese]

I just watched a segment on PBS's The News Hour with Jim Lehrer where they talked about the disparities between healthcare administration to blacks and whites. There is a New England Journal of Medicine article out about it (I haven't read it yet). It is very interesting to note that between blacks and whites with equal access to healthcare, blacks systematically received much worse treatment. I would encourage everyone to watch this segment on www.pbs.org/newshour/ (the segment is entitled "Studies Show Racial Disparities in Medicine").

 

[goinverted]

I think the biggest problem in health care is a group of schools with very low admissions standards giving out an alternative degree to kids who can't get into real school.

Ima trollin' just a trollin'.....

 

[medstu2006]

The oncologist I shadowed said that sometimes insurance companies do not pay the doctors for all chemo treatment, even though the treatment is necessary. As a result, the doctor has a choice to incur a loss or place the patient on a less effective, cheaper medicine. Usually, it's the second since doctors have to pay their bills too. I think that the insurance companies should quit acting like they know the treatments better than the doctors and pay the doctors what they deserve. Doctors must be also responsible and NOT corrupt themselves by performing unnecessary tests.

Patients, on the other hand, must quit suing the doctors unless there is a legitimate reason for it. Most cases just want money. It seems that some patients dont trust doctors which leads them to performing unnecessary tests to cover their back, which increases cost and the insurance companies dont want to pay these costs. There is no trust whatsoever in this system and thats the core problem.

 

[hamandcheese]

The oncologist I shadowed said that sometimes insurance companies do not pay the doctors for all chemo treatment, even though the treatment is necessary. As a result, the doctor has a choice to incur a loss or place the patient on a less effective, cheaper medicine. Usually, it's the second since doctors have to pay their bills too. I think that the insurance companies should quit acting like they know the treatments better than the doctors and pay the doctors what they deserve. Doctors must be also responsible and NOT corrupt themselves by performing unnecessary tests.

Patients, on the other hand, must quit suing the doctors unless there is a legitimate reason for it. Most cases just want money. It seems that some patients dont trust doctors which leads them to performing unnecessary tests to cover their back, which increases cost and the insurance companies dont want to pay these costs. There is no trust whatsoever in this system and thats the core problem.

...And this vicious cycle is prepetuated by all parties to the delight of the government as everyone blames those within the circle except the government. I think this contributes largely to the problem. We, as students and future doctors, must push the government to provide healthcare to all. I don't agree with the post that puts the blame on "free healthcare" because such a thing is possible with proficiency if only our hawkish "leaders" would relinquish some funds from defense and put it toward healthcare and disease prevention. Why not earmark some money for promotion of a better American diet. I have a simple start to a solution: instead of placing candy in front of kids at the doctor's office, give them fruit. Let's teach people that eating healthy is an imperative part of a healthy society. This is a solution that we must all partake in.

 

[CircleTheDrain]

I think it is Insurance company beancounters deciding what medical procedures are called for in a treatment plan. Another problem is the fact that a third of medical spending goes towards administration costs. 😱 🙄

 

[Shredder]

I think the biggest problem in health care is a group of schools with very low admissions standards giving out an alternative degree to kids who can't get into real school.

in fact, i think this a solution to healthcare problems. if theres a shortage of docs, as they say there currently is and will be in the future, what is the solution but to churn our more docs, regardless of quality? if youre dying, something is better than nothing.

i think all "problems" in healthcare stem from one fact: life is not treated like a commodity as other goods and services in society are. for example, if you cant afford a maid, you dont get a maid. if you cant afford filet mignon, you get meatloaf. or soybeans. if you cant afford healthcare, instead of dying as evolution predicts, in the USA we try to make ppl live, whether they can afford it or not. when you have ppl consuming goods and services whose costs they are not shouldering, problems arise.

do you ever hear about crises in any other sector of the economy? the automobile crisis, the textiles crisis, the movie crisis? people say free market economics wont solve the healthcare crisis. i think it would, IF we made people actually pay up or die otherwise. but things dont work that way, so a purely free market approach may be bound to fail. not that im advocating letting people die. hey, how about this solution--graduating highly substandard docs to tend to the poor for very low costs. its already like this at free clinics, but make it even more extreme. eh, i dunno, its late, im just throwing out the possibility.

oh, and about spiraling drug costs? thats also bogus. ive read that its a result of foreign governments regulating drug costs, meaning the unregulated US market has to bear the brunt of the costs for big pharma to survive profitably. again, you never hear about spiraling costs anywhere else, do you? sigh, more regulation, more problems

hmm, im actually starting to feel slightly more knowledgeable about all of this. slightly. could have misunderstandings about some points. im terrified of what they will grill me on in interviews i wonder if death/evolution theory will fly. after all, i think it is the biggest problem facing healthcare. nobody said anything about solutions!

 

[Shredder]

I think it is Insurance company beancounters deciding what medical procedures are called for in a treatment plan. Another problem is the fact that a third of medical spending goes towards administration costs. 😱 🙄

the insurance companies are looking out for themselves, its what you have to expect and account for when youre dealing with the business world. a problem is that insurance companies rather than patients are doing the consumer research and making the decisions. typically its the consumers job to do the research in most industries, such as purchasing a car.

the paperwork is a big problem. i guess thats a simple answer to the biggest problem question. well, its not the biggest but its big. healthcare needs to get with the times and integrate technology into the administration. like making the paperwork electronic and setting some standards.

 

[hamandcheese]

IF we made people actually pay up or die otherwise.

Boy, sounds like you're going to make a compassionate and empathetic doctor one day. American capitalism/"free market" is the cause of our healthcare problems. It surely is not the answer to them.

 

[Shredder]

Boy, sounds like you're going to make a compassionate and empathetic doctor one day. American capitalism/"free market" is the cause of our healthcare problems. It surely is not the answer to them.

ill be a tough love doctor. no mercy for ppl who slowly and willingly let themselves die. what they need is discipline. i would rather hurt their feelings than see them perish.

capitalism and the free market never cause problems if they are applied correctly. they are the ideal way of doing things. but with all of the regulations, welfare, and government intervention in healthcare, the free market is not being allowed to take hold. and it probably cannot, otherwise people will die. the healthcare problem is a battle between capitalism and socialism where we are trying to find compromises. why dont we ever hear of crises in any other industry? the free market takes care of them

organ transplant waiting lists, blood shortages? capitalism would solve them both too, but our quest for egalitarianism is not allowing that to happen. queues and shortages are hallmarks of socialism

 

[medhacker]

capitalism and the free market never cause problems if they are applied correctly. they are the ideal way of doing things. but with all of the regulations, welfare,

I guess you never came accross U.S. history of the 1920's and 1930's. Did you not know that government regulation came in because the model of free market that you are advocating was a disaster for the U.S. economy? google it under "Inconspicous consumption" - It is a basic of capitalistic economic history and it is exactly what happens when you let the free market run wild.

 

[hamandcheese]

I guess you never came accross U.S. history of the 1920's and 1930's. Did you not know that government regulation came in because the model of free market that you are advocating was a disaster for the U.S. economy? google it under "Inconspicous consumption" - It is a basic of capitalistic economic history and it is exactly what happens when you let the free market run wild.

And for that matter all of US history. Right now American society is going through a massive deregulation of all industries and problems are coming from every corner; everything from large layoffs at GM and HP to an unacceptably large number of people without healthcare. Where is the equality in that? It's time for this country to get off its illusory horse and get real. The answer doesn't lie in the dogmatic institutions of socialism or capitalism. We have to get over our naive notions of politics and realize that human life is at risk and will soon be in our hands. Uncle Sam doesn't care about anyone including those with money. It just so happens that Uncle Sam is another dumb American image created by the rich to suppress the poor.

 

[EricH]

253 million being awarded to the first of 4000 plaintiffs in a drug suit cant be helping.

It is very sad that this man died, but how does this justify 253 million?

Billions are projected to be paid in settlements, which will mean that the drugs will become proportionately more expensive to maintain profitability.

 

[-Goose-]

Thanks for the condescending answer. 🙄

chill out dude.
don't be so sensitive. i was only trying to get a pt across...

 

[Shredder]

problems are coming from every corner; everything from large layoffs at GM and HP to an unacceptably large number of people without healthcare. Where is the equality in that?

whoa, layoffs are a problem? layoffs are called trimming the fat. let the fat go work elsewhere where it is best suited, which is obviously not at those companies. thats called economic efficiency.

something people forget about america is that the goal has never been equality of outcomes. it has been equality of rights and opportunities, and equality under the law.

 

[Dorkus Maximus]

I think the biggest problem in health care is a group of schools with very low admissions standards giving out an alternative degree to kids who can't get into real school.

This guy is just hilarious! He thinks he's all high and mighty and better than everyone in these forums, yet here he is, trollin' away!

Get a life, loser! Go somewhere else with your condescending attitude. We don't need or want you here.

BAN THE TROLL!

 

[Shredder]

I guess you never came accross U.S. history of the 1920's and 1930's. Did you not know that government regulation came in because the model of free market that you are advocating was a disaster for the U.S. economy? google it under "Inconspicous consumption" - It is a basic of capitalistic economic history and it is exactly what happens when you let the free market run wild.

btw this is a fallacy. the depression was caused by bungled Fed policies. it was ended by WW2. caused by govt, solved not by govt. the free market works.

what shouldve been a normal recession (economics is sinusoidal naturally--booms and busts), was exacerbated greatly when the Fed contracted the money supply instead of loosening it. look it up, its informative. check milton friedman

 

[hamandcheese]

Shredder,
Obviously you've been brainwashed by the system and you think you can be saved by it. Good luck to you...It's no use to carry on discourse with someone who cannot think for himself. For the sake of everyone else in the United States stay in Texas along with all the other brainwashed fools.

 

[Shredder]

Shredder,
Obviously you've been brainwashed by the system and you think you can be saved by it. Good luck to you...It's no use to carry on discourse with someone who cannot think for himself. For the sake of everyone else in the United States stay in Texas along with all the other brainwashed fools.

excellent cop out

 

[medhacker]

btw this is a fallacy. the depression was caused by bungled Fed policies. it was ended by WW2. caused by govt, solved not by govt. the free market works.

what shouldve been a normal recession (economics is sinusoidal naturally--booms and busts), was exacerbated greatly when the Fed contracted the money supply instead of loosening it. look it up, its informative. check milton friedman

Dude on one hand you appeal to the heterodox theory of the causes of the depression and on the other hand you appeal to Friedman who defended the "maldistribution of purchasing power" theory which I sustain. My point is that beyond all the availaible theories one thing is true about the U.S. economy pre-depression , The Rich were getting richer and the poor were not making enough to consume products - this is not a consequence of government regulation - this is by any logical rationale the result of letting the free market go wild.

 

[Shredder]

Dude on one hand you appeal to the heterodox theory of the causes of the depression and on the other hand you appeal to Friedman who defended the "maldistribution of purchasing power" theory which I sustain. My point is that beyond all the availaible theories one thing is true about the U.S. economy pre-depression , The Rich were getting richer and the poor were not making enough to consume products - this is not a consequence of government regulation - this is by any logical rationale the result of letting the free market go wild.

one of the criticisms of capitalism is that wealth progressively skews to the high end. this is natural--the profiteers, creators, and innovators are much more valuable than the proletariat. mindless workers are a dime a dozen, brilliant entrepreneurs arent. but everyone has the opportunity to reach the wealthy ranks if theyre willing to try for it. and there is no robin hood redistribution of wealth by stealing from the rich and giving to the poor through subtle government guises such as welfare, medicare, and medicaid. the poor did not have enough to consume bc there was not enough money circulating in the economy as a result of contraction by the Fed. friedman proposed this notion. the free market does not go wild, it just works.

 

[tridil2000]

one of the criticisms of capitalism is that wealth progressively skews to the high end. this is natural--the profiteers, creators, and innovators are much more valuable than the proletariat. mindless workers are a dime a dozen, brilliant entrepreneurs arent. but everyone has the opportunity to reach the wealthy ranks if theyre willing to try for it. and there is no robin hood redistribution of wealth by stealing from the rich and giving to the poor through subtle government guises such as welfare, medicare, and medicaid. the poor did not have enough to consume bc there was not enough money circulating in the economy as a result of contraction by the Fed. friedman proposed this notion. the free market does not go wild, it just works.

one very important aspect in healthcare, that capitalism can not relate to, is the moral and ethical dilemma that present when you take the attitude "pay up or die." as humans, we have the right to treatment... the standard of care, as it were, when we need it. no one 'needs' a maid. no one 'needs' filet. however, when one is sob, they need oxygen (along with many other standards of care) that should not, and can not be denied, simply due to lack of payment.

capitalism is a result of demands. demands are a result of wants. how does a living organism's needs for basic elements of life even fit into such an equation???

we all exist as a society, the world over, with the obligation to treat others in need...not in "want"... and once you're out there intubating someone with a co2 of 84 turning gray, you'll clearly see the difference.

i hope where ever you decide to persue your education, you take the time to take bioethics. you need to learn sooooo much more before you ever touch a real patient.

good luck with your interviews. you're going to need it.



_______________
when you have your health, you are indeed one of the wealthy ones.

 

[Shredder]

one very important aspect in healthcare, that capitalism can not relate to, is the moral and ethical dilemma that present when you take the attitude "pay up or die."

biggest problem in healthcare, period. healthcare is being converted from a service to a right. ill ignore the personal attacks.

 

[1viking]

Shredder,
Obviously you've been brainwashed by the system and you think you can be saved by it. Good luck to you...It's no use to carry on discourse with someone who cannot think for himself. For the sake of everyone else in the United States stay in Texas along with all the other brainwashed fools.

He is absolutely correct about this. Believe it or not, you may be the one "brainwashed". The depression could have been stopped with a different strategy, but then again, hindsight=20/20

 

[1viking]

The Rich were getting richer and the poor were not making enough to consume products

You need to take a course in American Economic History. This is just NOT true. People keep singing this song today, and it just isn't true. Very few economists will even give an ear to this statement. The rich are getting richer and the poor are getting richer. Look up GDP growth charts per capita as well as through income distributions. I have a neuroscience test this morning, so, gotta go.

 

[Anasazi23]

as humans, we have the right to treatment...

This is the basic difference in philosophy. Is it truly a right? I'm still not quite sure. What about other basic human needs like housing? What about clothes? How do we force drug addicts to get new clothes or go the new SRO for the 8th time when they keep getting kicked out?

The U.S. still has arguably the best healthcare available in the U.S. No one is flying to Canada for life-saving surgery. The "access to care" mantra is a fallacy. My hospital is half filled with non-paying uninsured patients. They HAVE access to healthcare. They're there...right now...getting care. And they don't pay for it. Ask the other residents here in their city hospital clinics. Nobody's busting out their checkbooks - and they're getting care.


_______________
when you have your health, you are indeed one of the wealthy ones.[/QUOTE]

 

[tridil2000]

This is the basic difference in philosophy. Is it truly a right? I'm still not quite sure. What about other basic human needs like housing? What about clothes? How do we force drug addicts to get new clothes or go the new SRO for the 8th time when they keep getting kicked out?


ok, I'll play.
give me your arguement on why someone diagnosed with, let's say, cancer of the colon, should not be treated since he doesn't have health insurance. let's say this individual works at your local bookstore and has no benefits thru his employer. also, let's say, he makes $32,500 yearly and doesn't qualify for medicaid. he is 29 years old and has worked everyday, full time, for 5 years there.

then compare your reasons to this patient:
a 72 year old female with end stage renal disease and heart failure. she was a teacher, so in addition to medicare, she has private suplement insurance thru a private company. she is in and out of the hospital about 5 times a year and started on hemo about 6 months ago.
let's say she presents to the hospital today with a small bowel obstruction and requires surgery.
although she is quite ill, include in your arguement why she is entitled to 'red carpet treatment' because she is insured.

i look forward to your p.o.v.




_______________
when you have your health, you are indeed one of the wealthy ones.

[/QUOTE]

 

[DD214_DOC]

What would you guys say is the most important issue/problem in the current state of healthcare?

That I'm not a student doctor yet.

 

[djnels01]

That I'm not a student doctor yet.

Nice one... I wonder if that would get laughs from the admissions committee!?

 

[Jcrown]

I find it interesting that no one has brought up the issue of illegal aliens in this country. I believe that several hospitals in So.Cal had to close up shop due to treating patients that can not and will not pay.

 

[Shredder]

I find it interesting that no one has brought up the issue of illegal aliens in this country. I believe that several hospitals in So.Cal had to close up shop due to treating patients that can not and will not pay.

thats not only with illegal aliens and not only in socal, has happened where i live in houston too, probably happens everywhere. nonpayers cause trouble, somebody must end up paying. the govt enacted some law in the 80s mandating that ERs treat patients regardless of payment, and i believe hospitals have been hurting financially a lot from this, some too much to remain open. theyre businesses too.

 

[Anasazi23]

ok, I'll play.
give me your arguement on why someone diagnosed with, let's say, cancer of the colon, should not be treated since he doesn't have health insurance. let's say this individual works at your local bookstore and has no benefits thru his employer. also, let's say, he makes $32,500 yearly and doesn't qualify for medicaid. he is 29 years old and has worked everyday, full time, for 5 years there.

I never said he shouldn't be treated. As in most of these cases, he'll receive a bill and/or the hospital will eat the cost. I see it every day. Why does he have no insurance if he works full time every day for 5 years? I find it crazy that you are responsible as an American citizen to get car insurance (it's against the law to not have it), yet people won't/can't pay for health insurance.

then compare your reasons to this patient:
a 72 year old female with end stage renal disease and heart failure. she was a teacher, so in addition to medicare, she has private suplement insurance thru a private company. she is in and out of the hospital about 5 times a year and started on hemo about 6 months ago.
let's say she presents to the hospital today with a small bowel obstruction and requires surgery.
although she is quite ill, include in your arguement why she is entitled to 'red carpet treatment' because she is insured.

i look forward to your p.o.v.

Red carpet treatment? Why would it be different? She gets the small bowel surgery. I'm not sure what your point is here.

My point is one slightly different. People are constantly talking about "access to healthcare." I just don't get it. It's constantly in journal articles, talked about in symposiums, and is even constant banter on political platforms. The clinics I work in, and in the hospital itself.....peopel are getting healthcare. They're there - so they have access to it. After that, they generally don't pay for it. This is why virtually every hospital in NYC is having severe financial difficulties, and some are threatening to close. (St. Vincent's just filed for bankruptcy). People have access. I've never kicked anyone out of the clinic or hospital because they couldn't pay.

 

[SOUNDMAN]

I find it interesting that no one has brought up the issue of illegal aliens in this country. I believe that several hospitals in So.Cal had to close up shop due to treating patients that can not and will not pay.

In Nebraska this is huge. They come to my state because it's one of the easiest to get medicaid, and then they abuse it coming to the ER all of the time. Many times they are working in the packing plants, and guess what they are offered excellent insurance there, but since they would have to pay for a portion of it, they just stay on medicaid. It's ridiculous and the system perpetuates these people to stay on the rolls.

 

[Anasazi23]

I find it interesting that no one has brought up the issue of illegal aliens in this country. I believe that several hospitals in So.Cal had to close up shop due to treating patients that can not and will not pay.

They did bring up the issue:

http://forums.studentdoctor.net/showthread.php?t=210156

 

[ShyRem]

Why does he have no insurance if he works full time every day for 5 years? I find it crazy that you are responsible as an American citizen to get car insurance (it's against the law to not have it), yet people won't/can't pay for health insurance.

When I was younger I worked full time for 10 years, no health insurance. The companies I worked for were so small they didn't qualify for those big group plan discounts. I DID look into buying my own insurance... 15 years ago insurance for me as a very healthy no ongoing issues hadn't been to a doctor for a problem in 5 years female for major medical only was going to be $200/month. My car insurance was only $40/month, my rent was $450/month. And for a major medical insurance plan (and believe me I called every company I could find) was more than my utilities and food. I just couldn't afford it. $200/month for me and only me was an awful lot of money.

I know a guy with a family that just changed jobs. His COBRA payment to continue his medical insurance on the cheapest plan available is $786/month. That's over half his take-home pay. Insurance is outrageous. You can get major medical with a $5000 deductible for about $1,000/yr for one person - but that doesn't cover anything unless your total single bill per incident is over $5,000; so if you get outpatient chemo and each bill is only $2000, no dice. If you're hospitalized and the total bill is $17,000 you get to pay $5K of it.