ER treatment too costly

[PharmDstudent]

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So this guy walked out of the ER after a bicycle accident without treatment, because he feared the price tag. I think it's really sad that people have to think like this... 🙁
http://www.msnbc.msn.com/id/30628634

Has anyone else come across this? What would you do as a health care provider if someone who needed immediate attention wanted just to walk out?

 

[confettiflyer]

Haha, I'm reading this same article right now.

There's not much you can do once they walk out the door...the MD said it best when he said he was a physician, not an accountant.

 

[Transformer]

So this guy walked out of the ER after a bicycle accident without treatment, because he feared the price tag. I think it's really sad that people have to think like this... 🙁
http://www.msnbc.msn.com/id/30628634

Has anyone else come across this? What would you do as a health care provider if someone who needed immediate attention wanted just to walk out?

This happens all the time. It's really sad.

Like many people, I grew up with no health insurance and was told by my parents that health care is for people with money.
That's not entirely true. We have special health care programs for the poor and people in this society do have generous hearts and will sometimes help those in need.

For example, last night, a patient discharged from urgent care came to pick up her medications. She had no money so the urgent care staff came up with $10 to help cover her medication costs. But she was short one dollar, so I gave her a dollar.

If someone wanted to walk out without treatment, as a health care provider, I would refer them to a social worker or give them information for special programs that will cover or reduce their medical / prescription costs. If the patient is not endangering anyone else, and still chooses to walk out, I don't think I can do anything about it.

 

[pharmacyanalyst]

Ultimately, we live in a country of choice and if someone chooses to refuse medical care there is nothing to be done. Personally, I don't think the crisis is people that can't afford healthcare (like a pp mentioned there ARE programs in place for some), it's those that can and instead choose to spend their money on toys, cars, houses, etc. Do we force a huge socialized program on everyone because some choose to be uninsured? I sure as heck hope not.

 

[confettiflyer]

For example, last night, a patient discharged from urgent care came to pick up her medications. She had no money so the urgent care staff came up with $10 to help cover her medication costs. But she was short one dollar, so I gave her a dollar.

Yeah, but you can't keep doing this either. If this happens once a day, I'm out $20 over the month...that's like two meals, and I already contribute to charity. There just needs to be institutional changes, hitting up employees for a dollar here or there isn't exactly effective health policy.

 

[janeno]

Ultimately, we live in a country of choice and if someone chooses to refuse medical care there is nothing to be done. Personally, I don't think the crisis is people that can't afford healthcare (like a pp mentioned there ARE programs in place for some), it's those that can and instead choose to spend their money on toys, cars, houses, etc. Do we force a huge socialized program on everyone because some choose to be uninsured? I sure as heck hope not.

Unfortunately, some people might not be qualified for programs for people in need if they are just about few dollars above the cut-off bracket. Many small business owners cannot buy private insurance because insurance will reject them due to having any medical conditions. There are tons and tons of cases where people went bankrupt because of hospital bills or because they have reached their life-time maximum thru their insurance.

Watch this video and then tell me if you still think there is no need for universal health care in us:
http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/view/

 

[chibipinkbunny]

If we do move to universal health care I sure hope its not like Canada's! There are different methods of universal health care, and I dislike Canada's system the most. If we do move to universal health care its going to be a lot more like Medicare than private insurance. I don't know if everyone understands that part either. Medicare isn't very good insurance either. Mortality outcomes of those on Medicare are much closer to those that are uninsured, than those with private insurance. Also in other countries with universal health care dental is not necessarily covered. I'm sure people will complain about that too. . . Also in Canada pharmacists get paid like $60,000 a year. Pharmacists in universal health care systems do tend to get paid less. Not that anyone in pharmacy is doing it for the money 🙄. We would also need to make a distinction between who qualifies for universal health care. In Sacramento, CA, last I heard was that illegal immigrants qualify for free health care. I don't think this happens in most other countries with universal health care. So yeah, universal health care has its issues. Just putting some thoughts out there.

 

[Quiksilver]

 

[type b pharmD]

nice!

 

[confettiflyer]

http://www.msnbc.msn.com/id/30687221/

And in other news, women value looks over health (not surprised). No wonder xenadrine/et al are selling briskly!

 

[pharmacyanalyst]

Unfortunately, some people might not be qualified for programs for people in need if they are just about few dollars above the cut-off bracket. Many small business owners cannot buy private insurance because insurance will reject them due to having any medical conditions. There are tons and tons of cases where people went bankrupt because of hospital bills or because they have reached their life-time maximum thru their insurance.

Watch this video and then tell me if you still think there is no need for universal health care in us:
http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/view/

Sorry, still think there is no need for universal healthcare. Let's look at Social Security as an example. Gov't thinks people are unable to provide for their own retirement so they step in and create a huge program. Now the system is unsustainable and our generation will probably not get much out of it despite the many years of paying in. So we also contribute to our 401Ks and other investments. Same thing will happen with healthcare, the gov't will build a huge, unsustainable system and in the meantime we will be paying into it and probably buying supplemental insurance on the side.

Why create a huge monster when there are ways to fix the system we have? I just don't understand the blind faith some people have in the government.

 

[Doctor M]

I provide services to whom ever can pay for the product that I have purchased...If others want to make donations to the pharmacy so that others can get their meds free, so be it...But I sell a service and if you cant afford it, them there is little that i can do. I already provide tax money for medicare, medicaid...We sell a service...it's a service industry...someone has to pay...

 

[Doctor M]

Sorry, still think there is no need for universal healthcare. Let's look at Social Security as an example. Gov't thinks people are unable to provide for their own retirement so they step in and create a huge program. Now the system is unsustainable and our generation will probably not get much out of it despite the many years of paying in. So we also contribute to our 401Ks and other investments. Same thing will happen with healthcare, the gov't will build a huge, unsustainable system and in the meantime we will be paying into it and probably buying supplemental insurance on the side.

Why create a huge monster when there are ways to fix the system we have? I just don't understand the blind faith some people have in the government.

Eventually, we will run out of money...sooner or later we're gonna realize there is no one behind the curtain...all we're doing is moving money around...If you keep on taking from those who earn, eventually we're gonna say "f--k this"...and i for one am close...

 

[Fuzzychickens]

http://www.pnhp.org/news/2009/may/why_we_risked_arrest.php

We will not see single payer because our representatives are owned by the major players in the health care field.

 

[Pharmavixen]

If we do move to universal health care I sure hope its not like Canada's! There are different methods of universal health care, and I dislike Canada's system the most.

Like one of your senators said, where are the dead Canadians? Show me the dead Canadians.

 

[chibipinkbunny]

Like one of your senators said, where are the dead Canadians? Show me the dead Canadians.

When I said that statement I was not referring to universal health care per se, but the way that Canada has implemented it. Its a single payer system, and everyone is covered under the system. You're not allowed to buy private insurance or pay for medical health care. Everyone MUST have equal treatment!!! That doesn't sound so bad but what if you have hypothyroidism like I do. What if your PCP thinks its fine that you're Free T4 is in the dumps, and your TSH is around 5. Can you go see another one? You might be able to see another PCP, but you certainly aren't allowed to see a specialist unless they deem it necessary. I'm paying $400 out of pocket 2x a year to see an endocronologist who treats me to a TSH of 1, with a normal to high normal Free T4. In Canada I wouldn't be allowed to do that. I would have to suffer with my TSH of 5. It's not life threatening, but it sure is unpleasant. There are thyroid forums dedicated to finding qualified doctors. Take another case, spinal surgery. I have a relative that had a ruptured disk. She suffered for 20 years before its discovery. She could afford it, and she had good insurance so she went to one of the best spinal surgeons in the state. Could she do that in Canada? She may/or may not have been able to get spinal surgery, but her ability to seek out the best and the brightest surgeon would be limited. Think it doesn't matter? Talk to several people with failed spinal surgeries from incompetent doctors to realize the quality of the surgeon does matter. If I remember correctly the mortality rates in Canada are less than the US, and they have a longer life span than us. I never implied that mortality rates in Canada were higher. However, I haven't heard much about the cases I just mentioned above. . . What I meant from that quote you mentioned is if we do impliment Universal Health Care, I would prefer it to be more like Germany's, and much less like Canada. There's more than one way to implement Universal Health Care, and I dislike Canada's the most. If I want to pay out of pocket to see a doctor I should be able to do so! FYI: I have fairly good insurance by the way. Ha, ha, I see you're a Canadian citizen so correct me if I'm wrong on this; this is what I learned in class. We also learned that most Canadian citizens prefer their health benefits/insurance to America's so I'm not surprised that you think I'm wrong.

 

[PHARMDhope2b]

its so easy for more fortunate people to scream that we dont need universal healthcare. this country just doesnt get it. walk a mile in the shoes of a person who works hard and still cant buy health insurance and then make your decisions.

I personally think that if you work and pay taxes then some level of healthcare should be provided for you. furthermore, I think that a lot of people in here are young and do not realize that everyone that is without healthcare is not some poor and uneducated person that wont work. there are students in my class who cannot afford health insurance and currently some that have gotten hurt badly and cannot have surgery until mounds of paper work can be filled out in hopes of maybe getting help.

Its a sticky situation. I used to think like a lot of you in here. Until i grew up and realized that not everyone is trying to F*** the system and that some hard working people just need a little help. Dont get me wrong I am absolutely against my tax dollars being poored into too many government programs and the government ruling every aspect of our lives.

 

[bigpharmD]

I provide services to whom ever can pay for the product that I have purchased...If others want to make donations to the pharmacy so that others can get their meds free, so be it...But I sell a service and if you cant afford it, them there is little that i can do. I already provide tax money for medicare, medicaid...We sell a service...it's a service industry...someone has to pay...

And what services are you charging for? and how are you being reimbursed? please tell us the amount billed vs. payed.

 

[bigpharmD]

its so easy for more fortunate people to scream that we dont need universal healthcare. this country just doesnt get it. walk a mile in the shoes of a person who works hard and still cant buy health insurance and then make your decisions.

I personally think that if you work and pay taxes then some level of healthcare should be provided for you. furthermore, I think that a lot of people in here are young and do not realize that everyone that is without healthcare is not some poor and uneducated person that wont work. there are students in my class who cannot afford health insurance and currently some that have gotten hurt badly and cannot have surgery until mounds of paper work can be filled out in hopes of maybe getting help.

Its a sticky situation. I used to think like a lot of you in here. Until i grew up and realized that not everyone is trying to F*** the system and that some hard working people just need a little help. Dont get me wrong I am absolutely against my tax dollars being poored into too many government programs and the government ruling every aspect of our lives.

Now here is someone with a good plan...just reading your
school/degree

 

[PHARMDhope2b]

How is the residency going, BIG?

Now here is someone with a good plan...just reading your
school/degree

 

[pharmacyanalyst]

its so easy for more fortunate people to scream that we dont need universal healthcare. this country just doesnt get it. walk a mile in the shoes of a person who works hard and still cant buy health insurance and then make your decisions.

I personally think that if you work and pay taxes then some level of healthcare should be provided for you. furthermore, I think that a lot of people in here are young and do not realize that everyone that is without healthcare is not some poor and uneducated person that wont work. there are students in my class who cannot afford health insurance and currently some that have gotten hurt badly and cannot have surgery until mounds of paper work can be filled out in hopes of maybe getting help.

Its a sticky situation. I used to think like a lot of you in here. Until i grew up and realized that not everyone is trying to F*** the system and that some hard working people just need a little help. Dont get me wrong I am absolutely against my tax dollars being poored into too many government programs and the government ruling every aspect of our lives.

You see healthcare as a right which it is not. The only rights afforded to everyone are life, liberty and the pursuit of happiness. Healthcare is nowhere to be found there. Should everyone have healthcare? Yes. Is it the governments role to make that happen? No. I'm not saying "you" think the government should step in but it's become the popular albeit lazy way to deal with the problem. "Healthcare is too complex, let's allow the government to deal with it."

Let's use the automobile industry as an example. Before Ford was created, cars cost as much as a house so in today's terms that is $206,000. Car ownership was incredibly low. Ford came along and improved the quality and quantity of automobile being produced pushing ownership from the mid thousands to the millions. Then Alfred Sloan came along and started GM to introduce a choice of brands- Chevy, Cadillac, etc. Today 70% of the poor own a car and 30% own two or more. Why? Because the government provides cars for them? No, because they see a car as an absolute necessity and use the few dollars they have to purchase it. Because consumers said we want to buy cars, give us a way to do it. We need people who will take the healthcare system and it's $206,000 policies and improve the quality and quantity of what's being offered. As long as insurance is purchased "for" people by employers and costs are masked by copays, nothing is going to change.

And that is my soapbox.

 

[trailrider400]

Heres a question. Can the government do it any better? Does the government ever really do it better? I'm not totally against some form of universal healthcare but what makes people think that a handful of elected policy makers who know nothing about healthcare can solve a problem as complicated as this. And theres already a form of universal healthcare for people who can't afford it. Its called medicaid.

 

[janeno]

You see healthcare as a right which it is not. The only rights afforded to everyone are life, liberty and the pursuit of happiness. Healthcare is nowhere to be found there. Should everyone have healthcare? Yes. Is it the governments role to make that happen? No. I'm not saying "you" think the government should step in but it's become the popular albeit lazy way to deal with the problem. "Healthcare is too complex, let's allow the government to deal with it."

Let's use the automobile industry as an example. Before Ford was created, cars cost as much as a house so in today's terms that is $206,000. Car ownership was incredibly low. Ford came along and improved the quality and quantity of automobile being produced pushing ownership from the mid thousands to the millions. Then Alfred Sloan came along and started GM to introduce a choice of brands- Chevy, Cadillac, etc. Today 70% of the poor own a car and 30% own two or more. Why? Because the government provides cars for them? No, because they see a car as an absolute necessity and use the few dollars they have to purchase it. Because consumers said we want to buy cars, give us a way to do it. We need people who will take the healthcare system and it's $206,000 policies and improve the quality and quantity of what's being offered. As long as insurance is purchased "for" people by employers and costs are masked by copays, nothing is going to change.

And that is my soapbox.

Many small private employers cannot purchase health insurance for their employees because it is too expensive for small companies. What should these people do then?

What if you loose your nice job with a good health insurance, who will cover you medical bills then?

Every industrialized country has affordable access to medical care except US. I do think that every everyone deserves to have health insurance. There are obviously more than one way to implement coverage for every one, and that what our government needs to figure out.

 

[pharmacyanalyst]

Many small private employers cannot purchase health insurance for their employees because it is too expensive for small companies. What should these people do then?

What if you loose your nice job with a good health insurance, who will cover you medical bills then?

Every industrialized country has affordable access to medical care except US. I do think that every everyone deserves to have health insurance. There are obviously more than one way to implement coverage for every one, and that what our government needs to figure out.

Take a look at Switzerland's system. It is a great model for what our system could be.
If I lose my job, I would purchase a HDHP on my own. They have lower premiums and then I would put pre-tax money into a HSA account to cover the deductible. That is what I would do, in fact it's what I do now.

 

[MountainPharmD]

I just finished watching the last half of Sicko on Showtime. I think all health care should be provided by the government and should be free to all. Just like the great countries of France, The UK and Cuba. Gosh I wish I lived in France!

 

[PumpkinSmasher]

I just finished watching the last half of Sicko on Showtime. I think all health care should be provided by the government and should be free to all. Just like the great countries of France, The UK and Cuba. Gosh I wish I lived in France!

Baroness Warnock has the answer, just get rid of elderly population that is expensive to care for...
http://www.telegraph.co.uk/news/ukn...ve-a-duty-to-die.html?source=EMC-new_19092008

 

[nikkai]

Before everyone gets on their soapboxes regarding universal healthcare, I think you need to understand a little bit about coding and billing first.

An understanding of just how f'd up america's healthcare coding system is, is the first step in understanding the barriers that exist to "universal healthcare."

ie: The world is about to move to ICD-11, and America is about to switch to ICD-10.

Nice.

 

[Doctor M]

And what services are you charging for? and how are you being reimbursed? please tell us the amount billed vs. payed.

Im charging for the drug...That is my service...I provide a drug for sale. Whether its a corporation or an independent, someone has to pay for the drug. That is my service. Im not sure i understand your question...or sarcasm maybe???

 

[dragonfly99]

The problem is not lack of health insurance...it is the cost of health care. The cost of health care is driven up by new technology, but also by increased gov't mandates and by private insurance companies skimming money off the top (when consumers pay their premiums). Also, when you have people who don't have health insurance of any kind (either because they can't afford it, or because they chose not to buy any...and there are people in the latter category) and they get some sort of severe illness, cancer or get into a major traumatic accident, they get care anyway, although they can't pay, and all the rest of us foot the bill for that via higher health insurance premiums. We also are all paying for the high, high rates of obesity, smoking, etc. in our society because those unhealthy people drive up the cost of health insurance.

I'm 34 and when I was a very little kid, and my folks took me to the doctor, they just paid for it. We were not rich (at all). We did not have health insurance until perhaps the early 1980's or very late 1970's...per my mom, most people didn't have health insurance, or at least a lot did not. This is because you pretty much just paid for your medical care...at first I was kind of incredulous but then she pointed out that before the 1980's or so, if you got some bad kind of cancer or you got in a really bad car accident or something, usually you just died because there wasn't the really advanced medical care that we have today. It just didn't exist. Also, if you look at things like heart attacks, back in the 1970's or so, they had beta blockers, some aspirin and probably nitroglycerin, but none of these other fancy medications we have now. All these new things cost money. There isn't an easy solution to this conflict between cost and quality...if there was an easy solution, this would be fixed already.

Personally, I think one thing that would help was if health insurance didn't pay for every minor little thing (except in the case of indigent patients). Health insurance should really be for catastrophic events, such as major trauma, cancer treatment, big surgeries, etc. That's how insurance for your home, auto, etc. is. If patients paid more of the true costs of their care, they would look for a better deal and people would not go to the doctor so much for a runny nose, etc. I see this a lot because I do primary care. I don't mind taking care of them, but I think some folks come in for minor stuff because they are only paying $5-10 and just want a note to get off work.

I do think there are a lot of docs and nurses, etc. who volunteer their time for free to take care of the uninsured. I do this a couple evenings/month, and we can take care of a lot of minor stuff that otherwise people might decide to go to an ER to get it taken care of.

 

[bigpharmD]

Im charging for the drug...That is my service...I provide a drug for sale. Whether its a corporation or an independent, someone has to pay for the drug. That is my service. Im not sure i understand your question...or sarcasm maybe???

so you are not really selling a service but a product....you provide services for free (ie counseling, drug information, dosing recs etc)...just pointing out that we provide "services" for free

 

[Praziquantel86]

so you are not really selling a service but a product....you provide services for free (ie counseling, drug information, dosing recs etc)...just pointing out that we provide "services" for free

I agree with your stance on this, but let me play Devil's advocate a bit.

We have always provided free services. Recently, MTM, disease-state management and other related services have shown that these are things people/insurance is willing to pay for, at least on a limited scale. However, given the current model of practice (where chains account for the majority of community sites) is it really feasible for these services to be expanded? I can't see the individual pharmacist being reimbursed for this very unique and encounter-specific service.

Also, how would services provided to other healthcare providers be reimbursed? If community pharmacists suddenly began charging physicians for medication information or dosing recommendations, physicians would simply stop using these services.

I can only see this working if insurance companies chose to renumerate pharmacists or pharmacies at a fixed rate, but it would be nearly impossible to gather hard data proving it would be worthwhile.

 

[bigpharmD]

I agree with your stance on this, but let me play Devil's advocate a bit.

We have always provided free services. Recently, MTM, disease-state management and other related services have shown that these are things people/insurance is willing to pay for, at least on a limited scale. However, given the current model of practice (where chains account for the majority of community sites) is it really feasible for these services to be expanded? I can't see the individual pharmacist being reimbursed for this very unique and encounter-specific service.

Also, how would services provided to other healthcare providers be reimbursed? If community pharmacists suddenly began charging physicians for medication information or dosing recommendations, physicians would simply stop using these services.

I can only see this working if insurance companies chose to renumerate pharmacists or pharmacies at a fixed rate, but it would be nearly impossible to gather hard data proving it would be worthwhile.

I would be talking more about hospital patients. I get consulted by physician to see a patient for whatever reason. Why cant I bill for my services just like anyone else such as ID, cardiology, etc that sees the patient on a consult basis?

 

[StaviZFingerZ]

I would be talking more about hospital patients. I get consulted by physician to see a patient for whatever reason. Why cant I bill for my services just like anyone else such as ID, cardiology, etc that sees the patient on a consult basis?

Conspiracy.

And because CMS isn't willing to reimburse for services provided by my vast knowledge and clinical skills, I decided to work where people are willing to pay for my expertise..how to run a pharmacy. Get paid for cognitive skills...not by trading products.

 

[tkim]

I would be talking more about hospital patients. I get consulted by physician to see a patient for whatever reason. Why cant I bill for my services just like anyone else such as ID, cardiology, etc that sees the patient on a consult basis?

I'm curious - do you actually examine the patient?

 

[Praziquantel86]

I would be talking more about hospital patients. I get consulted by physician to see a patient for whatever reason. Why cant I bill for my services just like anyone else such as ID, cardiology, etc that sees the patient on a consult basis?

Fair enough. However, wouldn't pharmacists have to switch to a private practice model in order for this to work? I was under the impression that hospital employees could not bill additionally for services provided under contract to another healthcare entity.

 

[Doctor M]

so you are not really selling a service but a product....you provide services for free (ie counseling, drug information, dosing recs etc)...just pointing out that we provide "services" for free

I see your point...but we are measured on service in retail...how quickly and efficiently i get my product out...and when i cant produce that service...all of a sudden, i am giving bad service...and the pt may believe that i should reimburse them for their time (GC, free product etc). So, yes my services are free, but the product i sell is a big part of service (is it in stock, is it ready when promised, is the product im providing to patients meet their needs???) So yes, i may be selling a product but that product is a huge part of my service...Its where we make our money...

 

[pharmacyanalyst]

Personally, I think one thing that would help was if health insurance didn't pay for every minor little thing (except in the case of indigent patients). Health insurance should really be for catastrophic events, such as major trauma, cancer treatment, big surgeries, etc. That's how insurance for your home, auto, etc. is. If patients paid more of the true costs of their care, they would look for a better deal and people would not go to the doctor so much for a runny nose, etc. I see this a lot because I do primary care. I don't mind taking care of them, but I think some folks come in for minor stuff because they are only paying $5-10 and just want a note to get off work.

I totally, totally agree. Doctors visits should not be covered by insurance unless they are preventative care. It would make the doctors price their services at what they are worth and not simply what the insurance will reimburse. The current system lacks competition which is driving prices up at a rate over 2x that of inflation.

 

[Doctor M]

The problem is not lack of health insurance...it is the cost of health care. The cost of health care is driven up by new technology, but also by increased gov't mandates and by private insurance companies skimming money off the top (when consumers pay their premiums). Also, when you have people who don't have health insurance of any kind (either because they can't afford it, or because they chose not to buy any...and there are people in the latter category) and they get some sort of severe illness, cancer or get into a major traumatic accident, they get care anyway, although they can't pay, and all the rest of us foot the bill for that via higher health insurance premiums. We also are all paying for the high, high rates of obesity, smoking, etc. in our society because those unhealthy people drive up the cost of health insurance.

I'm 34 and when I was a very little kid, and my folks took me to the doctor, they just paid for it. We were not rich (at all). We did not have health insurance until perhaps the early 1980's or very late 1970's...per my mom, most people didn't have health insurance, or at least a lot did not. This is because you pretty much just paid for your medical care...at first I was kind of incredulous but then she pointed out that before the 1980's or so, if you got some bad kind of cancer or you got in a really bad car accident or something, usually you just died because there wasn't the really advanced medical care that we have today. It just didn't exist. Also, if you look at things like heart attacks, back in the 1970's or so, they had beta blockers, some aspirin and probably nitroglycerin, but none of these other fancy medications we have now. All these new things cost money. There isn't an easy solution to this conflict between cost and quality...if there was an easy solution, this would be fixed already.

Personally, I think one thing that would help was if health insurance didn't pay for every minor little thing (except in the case of indigent patients). Health insurance should really be for catastrophic events, such as major trauma, cancer treatment, big surgeries, etc. That's how insurance for your home, auto, etc. is. If patients paid more of the true costs of their care, they would look for a better deal and people would not go to the doctor so much for a runny nose, etc. I see this a lot because I do primary care. I don't mind taking care of them, but I think some folks come in for minor stuff because they are only paying $5-10 and just want a note to get off work.

I do think there are a lot of docs and nurses, etc. who volunteer their time for free to take care of the uninsured. I do this a couple evenings/month, and we can take care of a lot of minor stuff that otherwise people might decide to go to an ER to get it taken care of.

An excellent excellent point!

 

[Pharmavixen]

When I said that statement I was not referring to universal health care per se, but the way that Canada has implemented it. Its a single payer system, and everyone is covered under the system. You're not allowed to buy private insurance or pay for medical health care. Everyone MUST have equal treatment!!! That doesn't sound so bad but what if you have hypothyroidism like I do. What if your PCP thinks its fine that you're Free T4 is in the dumps, and your TSH is around 5. Can you go see another one? You might be able to see another PCP, but you certainly aren't allowed to see a specialist unless they deem it necessary. I'm paying $400 out of pocket 2x a year to see an endocronologist who treats me to a TSH of 1, with a normal to high normal Free T4. In Canada I wouldn't be allowed to do that. I would have to suffer with my TSH of 5. It's not life threatening, but it sure is unpleasant. There are thyroid forums dedicated to finding qualified doctors. Take another case, spinal surgery. I have a relative that had a ruptured disk. She suffered for 20 years before its discovery. She could afford it, and she had good insurance so she went to one of the best spinal surgeons in the state. Could she do that in Canada? She may/or may not have been able to get spinal surgery, but her ability to seek out the best and the brightest surgeon would be limited. Think it doesn't matter? Talk to several people with failed spinal surgeries from incompetent doctors to realize the quality of the surgeon does matter. If I remember correctly the mortality rates in Canada are less than the US, and they have a longer life span than us. I never implied that mortality rates in Canada were higher. However, I haven't heard much about the cases I just mentioned above. . . What I meant from that quote you mentioned is if we do impliment Universal Health Care, I would prefer it to be more like Germany's, and much less like Canada. There's more than one way to implement Universal Health Care, and I dislike Canada's the most. If I want to pay out of pocket to see a doctor I should be able to do so! FYI: I have fairly good insurance by the way. Ha, ha, I see you're a Canadian citizen so correct me if I'm wrong on this; this is what I learned in class. We also learned that most Canadian citizens prefer their health benefits/insurance to America's so I'm not surprised that you think I'm wrong.

If you learned this in class, your professor is an ignorant tool.

In Canada, you can go to any dr you like. If you don't like the care you're getting from one dr, you can find another who provides care more in line with that you would prefer to receive.

In Canada, you can buy private health insurance. I do. It's just over and above the basic coverage, paying for stuff like semi-private or private rooms, prescription drugs, massage tx. I had hernia repair surgery at a private clinic, and most of the bill was picked up by the public system, and an extra $250/day charge was picked up by my private plan.

What we don't allow is the basic health coverage to be picked up by private insurers - we only allow extended coverage to be privatized. The reason for that (as I understand it; I'm not an expert on international trade agreements) is NAFTA. Currently, our public health care service is exempt from NAFTA as long as it stays public. But if we allow the purchase of totally private health care plans, then under NAFTA, we'd have to allow the big American insurance companies to come in. And that could lead to the destruction of our public system.

So we give up one freedom, the freedom to choose a totally private health care plan, in exchange for another: autonomy of our health care system.

 

[chibipinkbunny]

If you learned this in class, your professor is an ignorant tool.

In Canada, you can go to any dr you like. If you don't like the care you're getting from one dr, you can find another who provides care more in line with that you would prefer to receive.

In Canada, you can buy private health insurance. I do. It's just over and above the basic coverage, paying for stuff like semi-private or private rooms, prescription drugs, massage tx. I had hernia repair surgery at a private clinic, and most of the bill was picked up by the public system, and an extra $250/day charge was picked up by my private plan.

What we don't allow is the basic health coverage to be picked up by private insurers - we only allow extended coverage to be privatized. The reason for that (as I understand it; I'm not an expert on international trade agreements) is NAFTA. Currently, our public health care service is exempt from NAFTA as long as it stays public. But if we allow the purchase of totally private health care plans, then under NAFTA, we'd have to allow the big American insurance companies to come in. And that could lead to the destruction of our public system.

So we give up one freedom, the freedom to choose a totally private health care plan, in exchange for another: autonomy of our health care system.

Hmmm, that sounds like the Medigap policy in America, no?

 

[Pharmavixen]

Hmmm, that sounds like the Medigap policy in America, no?

I didn't know what that was, and just looked it up...yeah; it does kind of sound like Medigap policy.

Our system doesn't have free rx drugs outside of hospital, and I support that. We used to have a generous system that provided totally free drugs for seniors and people on social assistance, and it was massively abused; now they pay a small co-pay.

 

[PharmDstudent]

... now they pay a small co-pay.

That's been proven/shown to limit abuse. 👍

 

[Pharmavixen]

That's been proven/shown to limit abuse. 👍

Yes, totally; I've seen it. There's some criticism of copays up here from your activist types who go on about how marginalized people can't afford even a small fee. But there are plenty of pharmacies that waive the copay for schizophrenics on daily dispense, disabled folks, etc., and they get sufficient volume of customers to make up for the loss.

I'm a promoter of single-payer systems, but if the US goes that way, I would warn against a totally free system. When something's free, the psychological reaction is that it isn't worth anything.

 

[pharmacyanalyst]

I'm a promoter of single-payer systems, but if the US goes that way, I would warn against a totally free system. When something's free, the psychological reaction is that it isn't worth anything.

Oh yeah, you can see it with the Medicaid system here. My husband is the office manager for a primarily Medicaid office and their business never slows down. It's primarily the same people in there week after week.

Instead of a single payor system, why don"t they offer a tiered version of Medicaid based on income? That way people who can't afford to buy their own insurance but can afford to pay something could buy into the Medicaid pool. It would also help to spread the risk because people paying for their insurance tend not be extremely high utilizers.

 

[fhx06]

Yes, totally; I've seen it. There's some criticism of copays up here from your activist types who go on about how marginalized people can't afford even a small fee. But there are plenty of pharmacies that waive the copay for schizophrenics on daily dispense, disabled folks, etc., and they get sufficient volume of customers to make up for the loss.

I'm a promoter of single-payer systems, but if the US goes that way, I would warn against a totally free system. When something's free, the psychological reaction is that it isn't worth anything.

I definitely would vote for a single-payer system but with limits and restrictions. Having such a system would make life easier for the insured and health care providers. I can just picture diminished the confusion and complications would be if there was only one organization to deal with for insurance rather than the numerous amounts we currently have.