If healthcare were to become socialized, would this still be possible?

[rachmoninov3]

Some of the greatest things about healthcare in the U.S. is those miracle cures that people from around the world come here for. Our research, our surgeons, our "miracles".
Yet these are only the things that people with time, $$$$, insurrance, and motivation are able to obtain. When was the last time a kid on the reservation had a full neurological work-up in order to cure epilepsy? Or the Vet being sent to the Mayo Clinic for a full diagnostic work-up of stomache pain?
We have the best medical care in the world, if you can afford it. Will such luxeries still be available under universal healthcare?


I don't know the answer, and would be interested in hearing the discussion.

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[badasshairday]

Yes, those luxories will probably still be there. The system will become two tiered. The upper tier will be very small.

 

[montessori2md]

1) Medicine is already socialized. It's called medicare/medicaid, which is roughly 30% of all US citizens. Add in all government employees, whose health care is basically paid for with tax dollars, and military/VA, it's probably more like 45%+ of US health care being paid for by tax dollars. And that's not even counting the tax-free status of health care expenses for businesses and people w/ HSP or high health care costs.

2) There is already a tiered system. See this report:

http://www.mckinsey.com/mgi/reports/pdfs/healthcare/MGI_US_HC_synthesis.pdf

A tiny fraction of the public (I think it was 5%) uses 25% of health care dollars.

I think, in a weird sort of way, that this is a good thing. If your kid is born with his fingers fused together, and 18 surgeries later, etc, he can use his hands, the information gained from that experience may be able to help others -say people who get their hand mangled in a machine, or burned.


3) Let's just say that the world was turned upside down and every US citizen was required to have medicare -what would happen is what happens now -everyone who could afford it would buy extra insurance to get better coverage than medicare, b/c medicare sucks.

The basic problem with that is it's hard to say if MDs would benefit from that secondary insurance at all -I'm thinking no, for most primary care- and then you're looking at a huge income drop for most primary care docs, b/c medicare reimbursement sucks.

The mckinley report has a whole bunch of great stuff in it, BTW.

 

[Dr.Millisevert]

1) Medicine is already socialized. It's called medicare/medicaid, which is roughly 30% of all US citizens. Add in all government employees, whose health care is basically paid for with tax dollars, and military/VA, it's probably more like 45%+ of US health care being paid for by tax dollars. And that's not even counting the tax-free status of health care expenses for businesses and people w/ HSP or high health care costs.

You're also not factoring in all of the illegal immigrants who get free immediate top notch treatment at all of our nation's emergency departments who don't have a social security #, don't pay taxes, and who can't be traced.

It is illegal to turn people away from the emergency room. Therefore millions of people a year get free health care thanks to the US government.

This is yet another form of free universal health care provided to "people who live in the United States".

 

[masterofmonkeys]

You're also not factoring in all of the illegal immigrants who get free immediate top notch treatment at all of our nation's emergency departments who don't have a social security #, don't pay taxes, and who can't be traced.

It is illegal to turn people away from the emergency room. Therefore millions of people a year get free health care thanks to the US government.

This is yet another form of free universal health care provided to "people who live in the United States".

This is true. The EMTALA dialysis insurance plan is famous around here.

 

[Geri_Gal]

Some of the greatest things about healthcare in the U.S. is those miracle cures that people from around the world come here for. Our research, our surgeons, our "miracles".
Yet these are only the things that people with time, $$$$, insurrance, and motivation are able to obtain. When was the last time a kid on the reservation had a full neurological work-up in order to cure epilepsy? Or the Vet being sent to the Mayo Clinic for a full diagnostic work-up of stomache pain?
We have the best medical care in the world, if you can afford it. Will such luxeries still be available under universal healthcare?


I don't know the answer, and would be interested in hearing the discussion.

I would imagine so. We already have a tiered system of care: people at the "top" will not change their utilization of health care services. The Mayo Clinic is a model of private sector health care, and after spending a month on elective there, I'd wager that a lot of their $$ originates from wealthy donors and international elite that pay for concierge level services. (Interesting fact: several TV stations at Mayo's adjoining hotel catered to the many patients from Jordan or UAE. I never thought I'd watch Al Jazheera (sp?) in a town on the Midwestern US prairie.)

Universal healthcare will benefit the people in the "middle" and will stress our nation's primary care providers. I predict that this will lead to a large influx of APRNs or PAs to fill the primary care doc role. OR (can only hope) will lead to financial incentives to increase the # of MDs going into primary care (loan forgiveness would be a HUGE help). But, the cynic in me thinks our current market will favor the mid-levels as they are less expensive to train and keep.

 

[MOHS_01]

Some of the greatest things about healthcare in the U.S. is those miracle cures that people from around the world come here for. Our research, our surgeons, our "miracles".
Yet these are only the things that people with time, $$$$, insurrance, and motivation are able to obtain. When was the last time a kid on the reservation had a full neurological work-up in order to cure epilepsy? Or the Vet being sent to the Mayo Clinic for a full diagnostic work-up of stomache pain?
We have the best medical care in the world, if you can afford it. Will such luxeries still be available under universal healthcare?


I don't know the answer, and would be interested in hearing the discussion.

I really don't see how. The size of the pie is not likely to expand, which means that we will be dealing with a situation of ever shrinking slices per party as more and more parties join at the table. While we will still likely subsidize the remainder of the world as far as medical research goes. Individual consumption, however, will be largely rationed, curtailed, or at the very least delayed save the development of a two tier system.

Unfortunately, it is my opinion to believe otherwise is utopian and naive.

 

[MOHS_01]

I would imagine so. We already have a tiered system of care: people at the "top" will not change their utilization of health care services. The Mayo Clinic is a model of private sector health care, and after spending a month on elective there, I'd wager that a lot of their $$ originates from wealthy donors and international elite that pay for concierge level services. (Interesting fact: several TV stations at Mayo's adjoining hotel catered to the many patients from Jordan or UAE. I never thought I'd watch Al Jazheera (sp?) in a town on the Midwestern US prairie.)

Universal healthcare will benefit the people in the "middle" and will stress our nation's primary care providers. I predict that this will lead to a large influx of APRNs or PAs to fill the primary care doc role. OR (can only hope) will lead to financial incentives to increase the # of MDs going into primary care (loan forgiveness would be a HUGE help). But, the cynic in me thinks our current market will favor the mid-levels as they are less expensive to train and keep.

Probably spot on -- two tiered system.... I would be dusting off and brushing up the CV's ladies and gentlemen... and buckle the seatbelts and refrain from moving around the cabin as significant turbulence is expected.