Free healthcare

[NHS1]

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I've taken up the challenge and started a thread on free healthcare! Well, I say its free, there are a few things that you have to pay for - the current (English) prescription charge is £7.10 per item - but you'd never be refused NHS treatment on the grounds of not being able to pay.

Its funded through taxes - last month my National Insurance contribution was £233.12, taken straight out of my wages. How does this compare to paying for private healthcare in the US? With insurance, if I was ill anywhere in the US, could I go to the nearest hospital and get treatment, or am I restricted to certain institutions?

 

[Fuzzychickens]

I've taken up the challenge and started a thread on free healthcare! Well, I say its free, there are a few things that you have to pay for - the current (English) prescription charge is £7.10 per item - but you'd never be refused NHS treatment on the grounds of not being able to pay.

Its funded through taxes - last month my National Insurance contribution was £233.12, taken straight out of my wages. How does this compare to paying for private healthcare in the US? With insurance, if I was ill anywhere in the US, could I go to the nearest hospital and get treatment, or am I restricted to certain institutions?

In the US, if you have the insurance I have and you need emergency treatment and end up at the wrong hostpital - expect to eat the bill. I ate a bill for 1800 bucks. I had acute kidney stone attack and was hardly interested at the time if I was "in network" when I crawled in the ER.

Give us a list of pros/cons about health care over there.

 

[NHS1]

Pro's:

If I'm ill - anywhere, anytime - I'm entitled to medical care.
I would get continuing care for longstanding medical conditions, such as diabetes, without worrying about money.
My GP (general practioner - not sure what this is in the US. Family doctor maybe?) is strongly encouraged to practice primary preventative medicine. Lots of people on statins, aspirin and anti-hypertensives over this side of the pond!
If I don't have to have insurance that is provided by my work, I am freer to move around if I get grief at work.
National breast, cervical and (new) bowel cancer screening programs.
Free vaccinations (not travel ones).

Con's:

New expensive medicines mean that prescribing decisions have to be cost effective. ie, you can only have lenalidomide (one month = £4500) if you have failed on thalidomide. You get daily filgrastim injections for 10 days (cost ~£200) instead of one injection of pegfilgrastim (cost ~£750).

Slightly restricted access to newer radiotherapy techniques/equipment.

Waiting lists.

Private companies getting the hospital cleaning contracts and trying to do it on the cheap.

There isn't a lot of money about at the moment to upgrade facilities - this is changing.

 

[Fuzzychickens]

Wow, you got to come up with something worse than that to kill my desire to see a national system here.

Plus pharmacy hasn't been degraded to the "fast-food" 4 dollar a script insult that Walmart let loose on us here.

 

[charfdorn]

I've taken up the challenge and started a thread on free healthcare! Well, I say its free, there are a few things that you have to pay for - the current (English) prescription charge is £7.10 per item - but you'd never be refused NHS treatment on the grounds of not being able to pay.

Its funded through taxes - last month my National Insurance contribution was £233.12, taken straight out of my wages. How does this compare to paying for private healthcare in the US? With insurance, if I was ill anywhere in the US, could I go to the nearest hospital and get treatment, or am I restricted to certain institutions?

Why don't we have this over here? Seriously! Between my employer and I, insurance for me, my wife, and our son is about $1400 a month. There's a huge deductible, large co-pays, network hassles, and pretty spotty prescription coverage. You would think that the weight of the federal government would make it more expensive... but when they're trying to perform the best possible service, instead of make the most possible money, it's funny how that stops being a problem.

 

[pharmdinfl]

NHS1 - Could you please expand on the waiting lists? How long does it take to get an appointment?

Also, what is the process for being referred to a specialist (e.g. OBGYN, Dermatologist, etc)

 

[Quiksilver]

Pro's:

Con's:

New expensive medicines mean that prescribing decisions have to be cost effective. ie, you can only have lenalidomide (one month = £4500) if you have failed on thalidomide. You get daily filgrastim injections for 10 days (cost ~£200) instead of one injection of pegfilgrastim (cost ~£750).

Slightly restricted access to newer radiotherapy techniques/equipment.

Waiting lists.

Private companies getting the hospital cleaning contracts and trying to do it on the cheap.

There isn't a lot of money about at the moment to upgrade facilities - this is changing.

I dont know, these are bigger flaws then other people are willing to admit or at least think about. Capitalism and free market go a long way.

It certainly seems like getting newer drugs out on the market may be a little more difficult to do in that sort of environment. If there are cheaper medications out there, what is the incentive in a company wasting billions of dollars in drug research design? Companies loose incentive to search for the new statin or penicillin. Think about this with antibiotics, antineoplastics, and biologics. What happens then? I do see that drugs that have marginal benefits over existing medications on the market exist here, but companies need to take chances.

Equipment is also an issue as you mentioned. There again looses incentive to develop more sophisticated and sensitive equipment because there is no incentive or guarentee that anyone will ever use the equipment you produce. Especially if you mention how outdated facilities are.

Lets not also forget that the government controls healthcare. Instead of a bunch of corrupt people running the show, theres only a few that make all the important decisions. If you aren't "in" with them, forget it. I think politicians running the show is worse then businessmen

And something that catches a little closer to home. How are salaries for pharmacists, if you don't mind asking. Profit is not a dirty word after all.

 

[FarscapeGirl]

So I know a bit about socialized health care from friends from other countries, classes in college, and my own research. I think there are problems with both these programs and ours.

What would you guys think about something between the two? Something like very basic care is covered by the government, but extra insurance could be bought/supplied for more care. I do think a potential problem with this solution is then even fewer employers would supply insurance and everyone but the super-rich would have more limited care than the average now.

On a side note, I recently found a kind of interesting blog, called The Skeptical OB. This doctor/science writer wrote one post earlier this month about the fact that America does have socialized medicine, i.e. Medicare, at least for the elderly. She also stated some potential ethical issues in giving care to certain parts of the elderly population. She mentioned an example of giving a man with severe dementia heart surgery. She strongly stated that we shouldn't be giving these people such invasive, basically useless procedures, potentially causing them lots more pain, while children at the beginning of their lives go without health care. It is true that we can't care for everyone, but I don't know anyone who wants to start turning the elderly out on the streets, either.

Most of us think we need a change with our health industry, but no one seems to know how best to change it!

 

[Farmercyst]

I've taken up the challenge and started a thread on free healthcare! Well, I say its free, there are a few things that you have to pay for - the current (English) prescription charge is £7.10 per item - but you'd never be refused NHS treatment on the grounds of not being able to pay.

Its funded through taxes - last month my National Insurance contribution was £233.12, taken straight out of my wages. How does this compare to paying for private healthcare in the US? With insurance, if I was ill anywhere in the US, could I go to the nearest hospital and get treatment, or am I restricted to certain institutions?

How many people is that 233.12 covering? 1, 2, 5? I only wonder because, right now, I'm paying ~$400 (267)for my wife and 2 kids/mo for Kaiser HMO.

 

[charfdorn]

How many people is that 233.12 covering? 1, 2, 5? I only wonder because, right now, I'm paying ~$400 (267)for my wife and 2 kids/mo for Kaiser HMO.

Is that through your employer? Because I bet they're paying at least that much, too.

 

[WVUPharm2007]

Well, this is me Mr. UK man:

I live in the state of West Virginia (not to be confused with regular-ass Virginia) and work in the state of Pennsylvania.

I'm paying about $45 a paycheck (26 times a year) for me and my wife. That includes a copay scale of $10 for office visits with PCPs (or "GPs") and specialists in network. ED visits are $0 and I can visit any ED or urgent care facility I want. Prescriptions are through my hospital's private "benefit." Basically, we fill it for employees in house...everything is $10 generic, $25 brand or cost, whichever is cheaper. Everything is covered except for erectile dysfunction and smoking cessation drugs. Everything from Xyzal to Xopenex to Xenical.

Also, if I bumped it up to $120/paycheck, I'd get the coverage where I can go to any out-of-network provider for a standard copay.

Honestly, I love my medical coverage. They don't challenge claims...if its submitted...they pay. I'm rather pleased with that...other insurances seem to reject everything people submit to them. There are no issues with prescription drug insurance as the hospital handles it in-house. The thing that sucks is that I HAVE TO get it filled at work....which is 40 minutes away from my home. The network of physicians covers nobody in WV. So I have to cross the Mason-Dixon line for care. Thankfully, I live about 4 miles from the border.

Hope it helps...

 

[charfdorn]

Well, this is me Mr. UK man:

I live in the state of West Virginia (not to be confused with regular-ass Virginia) and work in the state of Pennsylvania.

I'm paying about $45 a paycheck (26 times a year) for me and my wife. That includes a copay scale of $10 for office visits with PCPs (or "GPs") and specialists in network. ED visits are $0 and I can visit any ED or urgent care facility I want. Prescriptions are through my hospital's private "benefit." Basically, we fill it for employees in house...everything is $10 generic, $25 brand or cost, whichever is cheaper. Everything is covered except for erectile dysfunction and smoking cessation drugs. Everything from Xyzal to Xopenex to Xenical.

Also, if I bumped it up to $120/paycheck, I'd get the coverage where I can go to any out-of-network provider for a standard copay.

Honestly, I love my medical coverage. They don't challenge claims...if its submitted...they pay. I'm rather pleased with that...other insurances seem to reject everything people submit to them. There are no issues with prescription drug insurance as the hospital handles it in-house. The thing that sucks is that I HAVE TO get it filled at work....which is 40 minutes away from my home. The network of physicians covers nobody in WV. So I have to cross the Mason-Dixon line for care. Thankfully, I live about 4 miles from the border.

Hope it helps...

Those are some damned good benefits. It still ignores the issue of how much your employer pays for this coverage, which is probably hard to say given that you work for the people doing the doctoring. I believe "Mr. UK" pays the entire premium. You can't get decent private insurance for that much over here.

 

[Farmercyst]

Is that through your employer? Because I bet they're paying at least that much, too.

Nope, that's straight out of pocket. USC "pays" for mine with an insurance fee of ~$1300/yr. When, I used the "student" plan for my wife's coverage it was $800/month. It didn't really matter what the benefits were at that point because I couldn't afford it. The Kaiser plan for my wife and kids has a $1500/person/year deductible with a $3000/family cap. Her preventative care has no copay (so all her prenatal visits have been "free", but she does have to pay for labs (UA, OGTT, etc) I expect the $3000 will easily be met with the kid due 5/16+/-, so I'm hoping not to have to pay for anything else the rest of the year. We'll see how much fine print I pay for.

 

[genesis09]

I have a high deductible plan from Blue Cross/Blue Shield of IL, and my premium is about $300 every 2 months.

 

[solzont]

Pro's:

If I'm ill - anywhere, anytime - I'm entitled to medical care.
I would get continuing care for longstanding medical conditions, such as diabetes, without worrying about money.
My GP (general practioner - not sure what this is in the US. Family doctor maybe?) is strongly encouraged to practice primary preventative medicine. Lots of people on statins, aspirin and anti-hypertensives over this side of the pond!
If I don't have to have insurance that is provided by my work, I am freer to move around if I get grief at work.
National breast, cervical and (new) bowel cancer screening programs.
Free vaccinations (not travel ones).

Con's:

New expensive medicines mean that prescribing decisions have to be cost effective. ie, you can only have lenalidomide (one month = £4500) if you have failed on thalidomide. You get daily filgrastim injections for 10 days (cost ~£200) instead of one injection of pegfilgrastim (cost ~£750).

Slightly restricted access to newer radiotherapy techniques/equipment.

Waiting lists.

Private companies getting the hospital cleaning contracts and trying to do it on the cheap.

There isn't a lot of money about at the moment to upgrade facilities - this is changing.

Most importantly, these one-source medical systems would not offer the level of care they do without the pioneering research and development of drugs in the United States. It's so much easier to be a follower than a leader where up front R&D dollars are concerned. The top five American hospitals together conduct more clinical trials than any entire European country. I don't contend that there isn't a lot of fat to be trimmed in the U.S., like the outrageous rates specialists charge, but there is so much more to this onion than the obvious outer layers.

 

[Pharmavixen]

For $750 per year I get basic coverage, and I have extended coverage through my employer that pays for Rx drugs, some lab tests that aren't covered by the public plan, semi-private rooms, orthotics, shiatsu massage, dental.

The expense of the American system is often justified as being a necessary stimulus for innovation, but it seems there are a whole lot of non-medical people, ie, executives at HMOs, making dog-choking sums of money who don't contribute anything to the advancement of medical knowledge.

And free-market medical research seems to contribute disproportionately to the "me-too" drug list rather than to the alleviation of human suffering. Does the world need another PPI? Do you think we'll get one?

 

[Handy388]

like the outrageous rates specialists charge, but there is so much more to this onion than the obvious outer layers.

4 years of college, 4 years of med school, 7 years of neuro residency making 40kish per year and a 2-3 years fellowship later, neurosurgeons make average of 500k per year, when they are in their late 30s/early 40s.

PharmD make 100k+ when they are mid/late 20s.

the opportunity cost of being a specialist is huge. Their pay is anything but outrageous.

 

[shelle]

It certainly seems like getting newer drugs out on the market may be a little more difficult to do in that sort of environment. If there are cheaper medications out there, what is the incentive in a company wasting billions of dollars in drug research design? Companies loose incentive to search for the new statin or penicillin. Think about this with antibiotics, antineoplastics, and biologics. What happens then? I do see that drugs that have marginal benefits over existing medications on the market exist here, but companies need to take chances.

Getting newer drugs out on the market is already a huge issue because the new drugs are nothing but incrementally modified versions of already existing drugs and do nothing but cause the public to resent our industry more for the high cost that comes with it.

I'm saying this to point out the system is flawed as it is in this aspect- and definitely nothing to protect and try to keep it as is. Companies absolutely need to "take chances" -become more innovative- but it doesn't have to be considered "a chance" because lets face it, its and business and morals or not-they need to make money to survive. So, we have to make it so that its not viewed as "taking a chance" to be innovative, it has to be viewed as the norm, as the competitive way.

So the solution doesn't lie in whether we have free healthcare or not- it lies in rearranging the patent structure to be appropriate for the type of money and time it takes to develop a quality drug to provide REAL incentive and it lies in restructuring the marketing techniques in the industry- more emphasis needs to be put on a quality drug and the patient's subsequent approval of the drug, not how much the company is willing to take out of their research budget and put into marketing. If a drug is good- awareness should come about for it to reward the company for a job well done- this will take the pressure of marketing and incremental modification of decent drugs just to stay afloat etc. off of the companies and put pressure on them to do a good job in the R&D sector.

So don't worry about Pharma with free healthcare or not, because if things don't change similar to as stated above- it won't be a quality system regardless.

Sorry for concentrating on only one portion of this argument- but its the only portion I feel completely comfortable discussing, I hope to learn more about the other portions through this post! Thank you original poster for putting this out there!

 

[Praziquantel86]

And free-market medical research seems to contribute disproportionately to the "me-too" drug list rather than to the alleviation of human suffering. Does the world need another PPI? Do you think we'll get one?

It may cause the "me-too" list to expand, but that allows companies to take risks on very risky ventures. If Pfizer weren't able to pull in a few hundred million a year on Lipitor, I don't think they would be so willing to put in the time and effort into developing some of the more "niche" products that they have.

And we just got another PPI, actually. Dexlansoprazole...far superior to regular lansoprazole.

 

[Hernandez]

last month my National Insurance contribution was £233.12, taken straight out of my wages.

So when you calculate currency differences between the dollar and the pound, you're paying twice as much as I am and it'll take you just over 4 months to get in to see a specialist.

I think I'll make myself an appointment with a uber-specialist thursday just because I can.

as far as the OPs question, it highly depends on the insurance. i could get sick at an out-of-state hospital and get 95% of my care paid for if I wasn't stable enough to transfer, or I could get all but a few hundred dollars paid for major surgery at a in-service hospital.

 

[shelle]

It may cause the "me-too" list to expand, but that allows companies to take risks on very risky ventures. If Pfizer weren't able to pull in a few hundred million a year on Lipitor, I don't think they would be so willing to put in the time and effort into developing some of the more "niche" products that they have.

Yes and no- They are making their money off of incremental modifications and yes sometimes that leads to green-lighting innovative projects, but right now with all the merging, down grading and the rest of the mess in the industry (just the economy as a whole really) its not giving them any room to green light- all they have time and money to do are those incremental modifications, which rarely are very beneficial. Maybe that PPI was good and sometimes a new dosage form really helps some patients- but as a whole this system of "do a lot of little jobs so you can make money to do one really cool big one" is failing. Again, if the patent structure is restructured to be suitable to the product and if more emphasis is put on rewarding a company for quality products not quality advertising, and letting the quality advertise itself-- then we will be a lot better off.

 

[Pharmavixen]

It may cause the "me-too" list to expand, but that allows companies to take risks on very risky ventures. If Pfizer weren't able to pull in a few hundred million a year on Lipitor, I don't think they would be so willing to put in the time and effort into developing some of the more "niche" products that they have.

But even if you have single-payer health care, the drug companies still sell their drugs.

And we just got another PPI, actually. Dexlansoprazole...far superior to regular lansoprazole.

We don't have that one here yet, though probably it's on its way. I'd be curious to know how it affects CYP450 2C19.

 

[StaviZFingerZ]

We don't have that one here yet, though probably it's on its way. I'd be curious to know how it affects CYP450 2C19.

It don't matter. Once Prasugrel hits the market, PPI vs. Clopidogrel DI is history.

 

[Quiksilver]

Getting newer drugs out on the market is already a huge issue because the new drugs are nothing but incrementally modified versions of already existing drugs and do nothing but cause the public to resent our industry more for the high cost that comes with it.

I'm saying this to point out the system is flawed as it is in this aspect- and definitely nothing to protect and try to keep it as is. Companies absolutely need to "take chances" -become more innovative- but it doesn't have to be considered "a chance" because lets face it, its and business and morals or not-they need to make money to survive. So, we have to make it so that its not viewed as "taking a chance" to be innovative, it has to be viewed as the norm, as the competitive way.

So the solution doesn't lie in whether we have free healthcare or not- it lies in rearranging the patent structure to be appropriate for the type of money and time it takes to develop a quality drug to provide REAL incentive and it lies in restructuring the marketing techniques in the industry- more emphasis needs to be put on a quality drug and the patient's subsequent approval of the drug, not how much the company is willing to take out of their research budget and put into marketing. If a drug is good- awareness should come about for it to reward the company for a job well done- this will take the pressure of marketing and incremental modification of decent drugs just to stay afloat etc. off of the companies and put pressure on them to do a good job in the R&D sector.

So don't worry about Pharma with free healthcare or not, because if things don't change similar to as stated above- it won't be a quality system regardless.

Sorry for concentrating on only one portion of this argument- but its the only portion I feel completely comfortable discussing, I hope to learn more about the other portions through this post! Thank you original poster for putting this out there!

I chose big pharma argument to speak of innovations because this is what we are comfortable knowing. Its easier to quantify but heres a thought, and this is where innovation is more a problem; specialists. The american system of medicine has so many specialists compared to other countries because lets face it, you sell a unique product ie: a less invasive surgery, you are going to set it rich. You are able to produce a machine that cuts surgery time in half, your golden. Not to mention that but who wants to be GP these days? the money isn't there, you deal with the swine flu on a daily basis and you answer to insurance companies. Who wants to be a GP?
Everyone wants to specialize because they make money. That is the breeding grounds for the advancement of medicine. You take that incentive away, you loose their innovation.You loose what no other country has.

You have the best healthcare available but the worse way to obtain it in this country. Unfortunately nothing is free and you have to earn everything you make and I think thats fair. I work hard to earn my share and so do you.

 

[prevacid]

I chose big pharma argument to speak of innovations because this is what we are comfortable knowing. Its easier to quantify but heres a thought, and this is where innovation is more a problem; specialists. The american system of medicine has so many specialists compared to other countries because lets face it, you sell a unique product ie: a less invasive surgery, you are going to set it rich. You are able to produce a machine that cuts surgery time in half, your golden. Not to mention that but who wants to be GP these days? the money isn't there, you deal with the swine flu on a daily basis and you answer to insurance companies. Who wants to be a GP?
Everyone wants to specialize because they make money. That is the breeding grounds for the advancement of medicine. You take that incentive away, you loose their innovation.You loose what no other country has.

You have the best healthcare available but the worse way to obtain it in this country. Unfortunately nothing is free and you have to earn everything you make and I think thats fair. I work hard to earn my share and so do you.

specialists are not the main problem, people just focus on them as a punching bag, as medicare just cut reimbursement to them AND made more dumb rules for paperwork required when a specialist is consulted in the hospital....i agree there are some specialists who are hacks who should be regulated more (ie those ENT docs who do nothing but allergy shots, dont even go to the office, and has the nurse adminster them)

but other than that, those specialists deserve their pay: 4 yrs med school, at least 4 yrs residency + fellow ship, surgery is 5 yrs + fellowship years if desired, their pay is justified, cuz if they dont get paid well, less people will go into it, and that means the quality of service available decreases

most of my friends are mds, the ones who are specialist all bill fairly, and give HUGE discount to those who are paying cash (ie they'll take 30 dollars for first visit, which is just sweet)

there are bigger problems in the system than specialists, aka medicare and medicaid, fat a** americans, etc

and fyi, there is muchos money to be made in FP (granted not as much as in specialties, but im talking $200K), you just have to be able to do gyne stuff, I/D, be a DO so you can do manipulations, and be in big practice to split costs

 

[Quiksilver]

specialists are not the main problem, people just focus on them as a punching bag, as medicare just cut reimbursement to them AND made more dumb rules for paperwork required when a specialist is consulted in the hospital....i agree there are some specialists who are hacks who should be regulated more (ie those ENT docs who do nothing but allergy shots, dont even go to the office, and has the nurse adminster them)

but other than that, those specialists deserve their pay: 4 yrs med school, at least 4 yrs residency + fellow ship, surgery is 5 yrs + fellowship years if desired, their pay is justified, cuz if they dont get paid well, less people will go into it, and that means the quality of service available decreases

most of my friends are mds, the ones who are specialist all bill fairly, and give HUGE discount to those who are paying cash (ie they'll take 30 dollars for first visit, which is just sweet)

there are bigger problems in the system than specialists, aka medicare and medicaid, fat a** americans, etc

and fyi, there is muchos money to be made in FP (granted not as much as in specialties, but im talking $200K), you just have to be able to do gyne stuff, I/D, be a DO so you can do manipulations, and be in big practice to split costs

I actually have no problem with specialists, i bring it up because thats what we would loose if we went socialized healthcare. I know the cuts that we take from reimbursements from the socialized systems hurts pharmacy, but it hurts MDs even more. They take bigger hits then we do. I don't know about you but if I developed a cancer or an immunological disease, I would want a specialist.

News flash to all those who want universal healthcare, our reimbursement rates for filling a prescription have been cut year after year after year by these government programs. Do you think that your pay check would continue to be as high if we went completely socialized medicine? I think NYS medicaid has been cutting reimbursement rates for the last at least 10 years. Even better then that, do you think that they are going to reimburse alot for the holy grail of pharmacy; the MTM?

 

[Praziquantel86]

and fyi, there is muchos money to be made in FP (granted not as much as in specialties, but im talking $200K), you just have to be able to do gyne stuff, I/D, be a DO so you can do manipulations, and be in big practice to split costs

Seriously? No FP in his/her right mind would do anything more than the most basic gyne stuff...there's way too much liability and not nearly enough time. I don't know what you mean about doing ID, the majority of the things that ID docs do are so bizarre and/or rapidly fatal that an FP would never have the experience to take care of it.

And if you think that being a DO makes an FP more qualified, you're insane. I've known and have seen many DOs, never once have they mentioned manipulation. Yes, they learn it in school, but none of them use it. Look at the DO forums if you don't believe me, the majority of them think it's a crock. A.T. Still has been gone a long time, and so are all of his techniques.

 

[prevacid]

Seriously? No FP in his/her right mind would do anything more than the most basic gyne stuff...there's way too much liability and not nearly enough time. I don't know what you mean about doing ID, the majority of the things that ID docs do are so bizarre and/or rapidly fatal that an FP would never have the experience to take care of it.

And if you think that being a DO makes an FP more qualified, you're insane. I've known and have seen many DOs, never once have they mentioned manipulation. Yes, they learn it in school, but none of them use it. Look at the DO forums if you don't believe me, the majority of them think it's a crock. A.T. Still has been gone a long time, and so are all of his techniques.

thats wat i meant, basic gyne stuff aka paps

you get paid for doing those manipulations, so its advantageous to be a DO since they get ample training in that, i never said it makes the more qualified, it allows them to do the OMT stuff which they can bill for

I/D = incision and drainage....guy busts his elbow up...instead of referring him to orthapod, you I/D it, give him keflex and then go from there, you get reimbursed for doing the I/D

 

[Aznfarmerboi]

I actually have no problem with specialists, i bring it up because thats what we would loose if we went socialized healthcare. I know the cuts that we take from reimbursements from the socialized systems hurts pharmacy, but it hurts MDs even more. They take bigger hits then we do. I don't know about you but if I developed a cancer or an immunological disease, I would want a specialist.

News flash to all those who want universal healthcare, our reimbursement rates for filling a prescription have been cut year after year after year by these government programs. Do you think that your pay check would continue to be as high if we went completely socialized medicine? I think NYS medicaid has been cutting reimbursement rates for the last at least 10 years. Even better then that, do you think that they are going to reimburse alot for the holy grail of pharmacy; the MTM?

What is your point? Even if NYS has been cutting medicaid for the last 10 years, it still pays a LOT higher than what PBM does. If a pharmacy converts all of its script to medicaid, they will be rolling in $$$.

A lot of the things are subjective here. However, a single healthcare payer system is the best way to go. For the average middleclass to uppermiddle class americans (us), we lose out in the sense that we got to pay a lot for our health insurance but dont get any benefits versus medicaid/medicare.

Also . . . that stuff about a single healthcare payor system killing innovations is bull****. If anything, it will force the drug companies to stop coming up with new bs drugs (like solodyn. . .) that costs us hundreds of millions every year. Over in Britian, drug companies have to prove that the drug is worth it in order for them to pay for it. If the drug is worth it, the drug companies would have no problems making a lot of money from it.

 

[Praziquantel86]

thats wat i meant, basic gyne stuff aka paps

you get paid for doing those manipulations, so its advantageous to be a DO since they get ample training in that, i never said it makes the more qualified, it allows them to do the OMT stuff which they can bill for

I/D = incision and drainage....guy busts his elbow up...instead of referring him to orthapod, you I/D it, give him keflex and then go from there, you get reimbursed for doing the I/D

I don't think that many FPs will do paps. There's a huge amount of risk if they miss something. Not to mention the patient being uncomfortable with it. DOs may know how to manipulate, but most don't. That also goes back to patient comfort.

Thanks for the clarification on I/D, that makes sense.

 

[prevacid]

I don't think that many FPs will do paps. There's a huge amount of risk if they miss something. Not to mention the patient being uncomfortable with it. DOs may know how to manipulate, but most don't. That also goes back to patient comfort.

Thanks for the clarification on I/D, that makes sense.

how do you miss something on a pap? stick the speculum in, get the sample, send it for testing....

there are DOs who do numerous manipulations, but that was my point, if you do all those things, you can hit 200K in FP

 

[PharmDstudent]

how do you miss something on a pap? stick the speculum in, get the sample, send it for testing....

You can't test it for everything known to (wo)man. 😉