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Health Care

Discussion in 'Pre-Medical - MD' started by xoomn, Feb 19, 2002.

  1. xoomn

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    Can anyone please answer the following questions in detail. I am trying to prepare for my interview and want to be ready for these sorts of quetions. if you were to change the health care system, how would you do it? What is wrong with out health care system and propose a solution to the problem? :rolleyes:
     
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  3. WMN

    WMN Member

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    I would support a single payer system similar to Canada and some European countries. That way, we would not have the shame of 40 million Americans uninsured which includes 10 million children. What does anyone else think about that?
     
  4. Diogenes

    Diogenes Succat

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    WMN,

    please explain/define single payer system...

    thanks
     
  5. johnM

    johnM Senior Member

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    is a "single payer" the government?
     
  6. AmateurChef

    AmateurChef Health policy consultant

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    Wow...so many things to change...where to begin...

    1. Reform medicare. Align Medicare with appropriately managed market forces to facilitate value-based purchasing. Expose medicare to competitive pricing through use of defined contributions and increased transparency of benefit packages, etc., with annual open enrollment...this will reduce risk selection as seen with the California Public Employees Retirement System reforms in the mid-1990s., blah, blah, blah. Began transitioning Medicare away from FFS, although this could take decades. Look to the Federal Employees Health Benefits Program as an example. Some suggest eliminating supplemental insurance and integrating Medigap programs into Medicare. etc, etc., etc.

    2. Public health infrastructure

    Start with the basics tenets of public health such as immunization programs and health surveilance. Both federal programs were slashed during the Reagan/Bush years and never recovered. Increase standards for hospital infection control to reduce nosocomial infections and MDR. (In 1995, there were 1.7 million nosocomial infections, leading to 100k deaths and $4.5 billion in expenses) Multidrug resistance will continue to grow without strong campaigns against it.

    3. And, yes, as written previously, switch to a national health care system. However, since the US has viewed health care as a market commodity for the last century, this will be a very challenging transition.

    (sigh)

    Since I've had zero interviews, this information has proven to be pretty useless for me. Hopefully some of you have better luck with it!
     
  7. nebula7

    nebula7 Senior Member

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    From what I understand, the "single payer" is the government, and everyone in Canada is insured under this system. I have heard some complaints from people who have had to deal with it (eg long wait lines, etc), and I've also heard some positive things from people who have had first hand experience, such as, it is pretty efficient. and like WMN said, such a system gets rid of the problem of having close to 40 million people with NO coverage. I'd take standing in a line over being uninsured anyday.
     
  8. mpp

    mpp SDN Moderator
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by AmateurChef:
    <strong>Reform medicare. Align Medicare with appropriately managed market forces to facilitate value-based purchasing. Expose medicare to competitive pricing through use of defined contributions and increased transparency of benefit packages, etc., with annual open enrollment...this will reduce risk selection as seen with the California Public Employees Retirement System reforms in the mid-1990s., blah, blah, blah. Began transitioning Medicare away from FFS, although this could take decades. Look to the Federal Employees Health Benefits Program as an example. Some suggest eliminating supplemental insurance and integrating Medigap programs into Medicare. etc, etc., etc.
    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Could you explain this further. I do not understand any of what you have written here.
     
  9. Doctora Foxy

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    The problem with health care is that so many people are not covered and are ineligible to receive health care at a lowered cost. Only the very poor are covered, and middle/upper classes can afford coverage such as HMOs, but people that don't fit into those categories are stuck with nothing. Doctors raise their bills since people are covered by health plans anyway, so those without insurance are stuck paying inflated health care costs.

    The solution is that the government should allot more dinero to pay for everyone to go to the doctor.

    Although it would be very difficult to attain volunteer doctors, I think it should be encouraged for doctors to volunteer time at free clinics to help those in need. Once a month is not asking that much, and I've seen how much volunteer doctors can do and what a difference they make for uninsured patients. <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />
     
  10. AmateurChef

    AmateurChef Health policy consultant

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    mpp -- Hopefully this makes more sense. Sorry about the previous post...I'm just kinda frustrated that I haven't received any interviews. I will certainly apply next year, and that will be fine...it's just hard to stay optimistic when nothing is working!

    1. Align Medicare with appropriately managed market forces to facilitate value-based purchasing. In other words, make Medicare accountable to a health care marketplace. Compared to private health insurance, Medicare is ridiculously wasteful and inefficient.

    Make Medicare beneficiaries understand what benefits they receive, and provide them with incentives to choose efficient plans. Medicare, in return, will be forced to operate more efficiently. One way to help consumers (Medicare beneficiaries) to compare plans is to define standard benefit plans (CalPERS used this technique when it switched to a managed-competition approach). Defining enrollment (e.g. annual open enrollment) will help prevent adverse selection. Distributing information about comparative plan quality will encourage consumers to analyze their use of health care services and pick the most efficient plan for themselves, thereby encouraging health care providers to provide competitive rates/benefits/plans.

    2. Began transitioning Medicare away from FFS, although this could take decades.

    87 percent of Medicare beneficiaries use a fee-for-service arrangement. Transitioning to managed care will be difficult for a variety of reasons: elderly beneficiaries who have strong attachments to doctors they've had for decades, the lack of availability of managed care plans in rural areas, managed care is not known for its ability to care for the elderly and chronically ill, etc.

    3. Look to the Federal Employees Health Benefits Program as an example.

    Unlike Medicare, FEHBP relies primarily on the private market for most functions, including decisions on benefit package design. It uses open enrollment and has a variety of plans &#8211; fee for service, preferred-provider options, HMOs &#8211; and is able to evolve much more rapidly (or at all!) compared to Medicare. It would be a good model for reform.

    4. Some suggest eliminating supplemental insurance and integrating Medigap programs into Medicare.

    Medicare's only true cost-control mechanism is cost-sharing with beneficiaries. Private supplementary insurance (Medigap) has eliminated this control by paying deductibles and coinsurance. Beneficiaries with supplemental insurance consume much more care (roughly 28% more), and Medicare pays the difference &#8211; about $1000 per beneficiary. Since only 13% of Medicare recipients have neither Medigap or Medicaid, the total costs burden imposed on Medicare as a result is about 20 percent of the total Medicare budget, or about $30 billion. Prohibiting/discouraging supplemental insurance or integrating it into Medicare would result in a tremendous savings.

    Hope it helps!

    :)
     
  11. mpp

    mpp SDN Moderator
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    Thanks for clarifying but I'm still don't know enough about this stuff to fully understand everything you wrote.

    I think I agree with you in that I think one of the major problems with health care today is the high (and rising) costs.

    Sorry to hear about the bad-luck run regarding interviews this year. Keep your chin up and knock 'em dead next year if necessary...Cheers
     
  12. WMN

    WMN Member

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    Yep, single payer would be the government and the states could run their own programs. It would appear, that one of the major problems with the system as it is right now, is the administrative burden of things like utilization review. Some figures state that 12% of the cost of health care is administative versus 2% in countries like UK (my home country). Patients still have the opportunity to choose their provider and stick with them even if/when they change jobs. That would mean continuity of care which is sadly lacking in the USA. There are many great aspects of health care in this country but I feel guilty having the privilege of access to health care when my son's friend's parents, who are hard working people, cannot afford to pay for health insurance. It just isn't right and I would love to see things change sometime soon. Maybe some of us will be a catalyst for change some day.
     

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