Is Universal Health Care nothing but socialized medicine ?

[redapple123]

http://news.aol.com/political-machine/2008/07/02/kennedy-preparing-universal-health-care/

---

Members don't see this ad.

 

[DrIng]

At the risk of sucumbing to provocation.... what is so terrible about the idea of socialised medicine? Why is it that a person who works for a company which aims to make money out of healthcare telling you what you can and can't do for a patient is worse than a governement employee (who is at least in theory supposed to be providing a public service) telling a doctor what they can and can't do? Sorry for the rant... Thought teh following links mgiht be a of interest.

http://www.understandfrance.org/Diaries/Editorial2.html#ancre2132695

http://www.washingtonmonthly.com/archives/individual/2005_04/006078.php

Have a great day everyone.

 

[pingouin]

moving to Topics in Healthcare

 

[Miami_med]

At the risk of sucumbing to provocation.... what is so terrible about the idea of socialised medicine? Why is it that a person who works for a company which aims to make money out of healthcare telling you what you can and can't do for a patient is worse than a governement employee (who is at least in theory supposed to be providing a public service) telling a doctor what they can and can't do? Sorry for the rant... Thought teh following links mgiht be a of interest.

http://www.understandfrance.org/Diaries/Editorial2.html#ancre2132695

http://www.washingtonmonthly.com/archives/individual/2005_04/006078.php

Have a great day everyone.

Atleast you theoretically have choices in a market. If you've ever dealt with Medicare/Medicaid, you'd probably not think more highly of the goernment employee, and you can't just go to a competing company.

Free market economics works by forcing people to compete for finite resources. It's sort of like economic darwinism. Of course, healthcare doesn't resemble a free market, but the solution isn't to cement the ******ed system in stone with a single government payer.

 

[Dirt]

Free market economics works by forcing people to compete for finite resources. It's sort of like economic darwinism.

Yeah and that is sort of like social darwinism.

 

[Dr.Millisevert]

If you've ever dealt with Medicare/Medicaid, you'd probably not think more highly of the goernment employee, and you can't just go to a competing company.

Just to play devil's advocate..

What about public librarys... or the public services provided by firemen/women. That seems to work out well for everyone. Just because one goverment run program is crap doesn't mean they all are... or if the US gov was to set up a nationwide public health system that it would be just like medicaid. It would entirely depend on the type of providers the gov wanted to provide the public with (will we get to see a family physician annually or does everyone just get free checkups by DNPs at your local walmart medical emergency clinic?). How much input would the public have.. how much would the public want to invest in such a venture? What sort of people would the public vote in to run such a system. Would it be someone like John Edwards? Sorry.. I don't want a career medical malpractice attorney designing my nations healthcare system.

However.. I think it "could" work if you put the right people in charge, was well designed, and if the public had enough input.

Also, It doesn't have to be an all or nothing deal. All public or all private. You can have a public system and also have private hospitals.

 

[oldpro]

What about the right to "Life, liberty and the pursuit of Happiness" ?

Do we not deny "Life" if we do nothing and let people die?

Suffering is not "Happiness" either.

When I practice I will have a policy of turning no one away. Just my personal policy.

 

[San_Juan_Sun]

What about the right to "Life, liberty and the pursuit of Happiness" ?

Do we not deny "Life" if we do nothing and let people die?

Suffering is not "Happiness" either.

These are concepts from the Declaration of Independence, and although they do express some of the Constitutional ideals, they are not codified rights.

 

[167649]

What about the right to "Life, liberty and the pursuit of Happiness" ?

Do we not deny "Life" if we do nothing and let people die?

Suffering is not "Happiness" either.

When I practice I will have a policy of turning no one away. Just my personal policy.

The phrase "Life, liberty and the pursuit of happiness" mean freedom from the government. The phrase is originally derived from the writings of John Locke who expressed a similar concept of "life, liberty, and estate," and that nobody can harm or interfere with those of another. In the decleration, Jefferson was referring to government interfering with the lives (and inalianable rights) of the people.

And with "happiness" the phrase clearly says: (Man) is endowed with certain inalianable rights...the pursuit of happiness. Meaning man himself has the right to pursue happiness, it does not mean that government has the right to pursue it for him.

 

[167649]

Just to play devil's advocate..

What about public librarys... or the public services provided by firemen/women. That seems to work out well for everyone. Just because one goverment run program is crap doesn't mean they all are... or if the US gov was to set up a nationwide public health system that it would be just like medicaid. It would entirely depend on the type of providers the gov wanted to provide the public with (will we get to see a family physician annually or does everyone just get free checkups by DNPs at your local walmart medical emergency clinic?). How much input would the public have.. how much would the public want to invest in such a venture? What sort of people would the public vote in to run such a system. Would it be someone like John Edwards? Sorry.. I don't want a career medical malpractice attorney designing my nations healthcare system.

However.. I think it "could" work if you put the right people in charge, was well designed, and if the public had enough input.

Also, It doesn't have to be an all or nothing deal. All public or all private. You can have a public system and also have private hospitals.

The examples you brought up are different than most proposals for socialized medicine in that they are almost always civic services that fall under the juristiction of local government (counties or cities). We do not have a nationalized fire department that is run by the federal government. Librarians are not federal employees. (With a few exceptions, like the library of congress, which does not equate to a nationalized library system).

I have nothing against social programs and services that are administered by state and local governments.

 

[cpants]

To answer the OP, Universal Health Care is not necessarily socialized medicine. It just means health care accessible to everyone.

In a socialized system, providers would work directly for the government, and care would be paid for by tax dollars. Socialism is only one strategy for providing UHC. Many advocate other approaches involving a mixed public/private system, mandatory health insurance, or other strategies.

 

[oldpro]

The phrase "Life, liberty and the pursuit of happiness" mean freedom from the government. The phrase is originally derived from the writings of John Locke who expressed a similar concept of "life, liberty, and estate," and that nobody can harm or interfere with those of another. In the decleration, Jefferson was referring to government interfering with the lives (and inalianable rights) of the people.

And with "happiness" the phrase clearly says: (Man) is endowed with certain inalianable rights...the pursuit of happiness. Meaning man himself has the right to pursue happiness, it does not mean that government has the right to pursue it for him.

I'm aware of this interpretation, but interpretations change with the times too, I think it could mean an obligation of a people to take care of it's citizens. A "Right to Life" could include the right to reasonable care to continue that life, to continue to persu that life unless by law that right has changed in some way ( In example a conviction of Murder and sentence deemed as death )

Our taxes are already collected and used for health care now, just not for all citizens only some, so the door has been opened in this case, its just coming time to make this equal and to redesign the system to do a better job.

I think its time to cover all citizens not just a select. Congress has been abusing the collection of taxes for decades.

We need a military for defense of our country and safety of our citizens.
The military helps also in these ways
Employs contractors
Employs service men
Is also used in times of emergency
Trains and provides skills for some to go to private sector

A government Healthcare system can
Provide a healthier citizenship and rehab citizens to be productive
employ contractors
Reorganize the tremendous cost of Medicaid/medicare/workmans comp healthcare/ even VA

I think throw it all out and have one system (Excluding active Duty armed forces of course)

I know you may not agree with me, but the current system is really broke and we need a new system (10% medicare cut?)

 

[oldpro]

To answer the OP, Universal Health Care is not necessarily socialized medicine. It just means health care accessible to everyone.

In a socialized system, providers would work directly for the government, and care would be paid for by tax dollars. Socialism is only one strategy for providing UHC. Many advocate other approaches involving a mixed public/private system, mandatory health insurance, or other strategies.

I think a Mandatory basic Universal plan with premiums on a tier system based on Income and allowed supplemental insurance, and Physicians allowed to private practice with choices of accepting supplimental insurance and or Cash for procedures not coved under the basic, such as breast jobs, nose jobs ETC.

 

[southerndoc]

Current examples of socialized systems by our government: US Postal Service, Amtrak (heavily subsidized), Social Security, Medicare, Police (local), Fire (local), and the list goes on and on.

Socialized systems are not that bad. It's when the entire economy becomes socialized that it's a problem. That's highly unlikely to happen.

 

[Miami_med]

Just to play devil's advocate..

What about public librarys... or the public services provided by firemen/women. That seems to work out well for everyone. Just because one goverment run program is crap doesn't mean they all are... or if the US gov was to set up a nationwide public health system that it would be just like medicaid. It would entirely depend on the type of providers the gov wanted to provide the public with (will we get to see a family physician annually or does everyone just get free checkups by DNPs at your local walmart medical emergency clinic?). How much input would the public have.. how much would the public want to invest in such a venture? What sort of people would the public vote in to run such a system. Would it be someone like John Edwards? Sorry.. I don't want a career medical malpractice attorney designing my nations healthcare system.

However.. I think it "could" work if you put the right people in charge, was well designed, and if the public had enough input.

Also, It doesn't have to be an all or nothing deal. All public or all private. You can have a public system and also have private hospitals.

Well, all of the examples of "efficient" government function are local. Fire departments are rarely any larger than countywide. Public libraries are either city or countywide. I've expressed willingness to allow local communities to make determinations about county hospital funding. However, I am still waiting for one example of a federal entitlement program that works remotely well. I have seen no examples.

 

[Miami_med]

What about the right to "Life, liberty and the pursuit of Happiness" ?

Do we not deny "Life" if we do nothing and let people die?

Suffering is not "Happiness" either.

When I practice I will have a policy of turning no one away. Just my personal policy.

This gets into a LONG conversation about positive and negative rights. This statement makes no sense unless viewed in the initial context of John Locke, who was a proponent of negative rights. This basically means that people have the right to be left alone. The government cannot take your life, liberty, or property (or your pursuit of happiness to quote Jefferson). If life was a positive right (as in you had the right to be kept alive by other people), that would interfere with the liberty of the people forced to keep you alive, and the whole statement would contradict itself.

With true liberty, you are well able to have whatever policy you want about turning people away. You would be more than able to take all comers if that was what you wanted to do.

 

[oldpro]

This gets into a LONG conversation about positive and negative rights. This statement makes no sense unless viewed in the initial context of John Locke, who was a proponent of negative rights. This basically means that people have the right to be left alone. The government cannot take your life, liberty, or property (or your pursuit of happiness to quote Jefferson). If life was a positive right (as in you had the right to be kept alive by other people), that would interfere with the liberty of the people forced to keep you alive, and the whole statement would contradict itself.

With true liberty, you are well able to have whatever policy you want about turning people away. You would be more than able to take all comers if that was what you wanted to do.

True but the fact is no one any where, any country of the world including the USA have pure liberty, we do not even have a Democracy in this country, we currently have and have had a form of Socialism ( try to stop paying taxes LOL), Just read the crap by the Democrats, its clear.

To take the step to Universal Health care is not a big step, in fact as I said we already have it

poor you get medicaid ( state)
Disabled or over 65 Medicare ( federal)
Vet VA (federal)

These are funded through our taxes, I say throw them out and have one system, it would cost less then having three systems.

 

[Dirt]

I think a Mandatory basic Universal plan with premiums on a tier system based on Income and allowed supplemental insurance, and Physicians allowed to private practice with choices of accepting supplimental insurance and or Cash for procedures not coved under the basic, such as breast jobs, nose jobs ETC.

Isn't this essentially what is being proposed by the dems?

 

[167649]

Current examples of socialized systems by our government: US Postal Service, Amtrak (heavily subsidized), Social Security, Medicare, Police (local), Fire (local), and the list goes on and on.

I don't think any of these examples are comparable to the (federal) socialized medicine proposals.

As several of us have already pointed out, Police and Fire are civic services administered at the county or city level (sometimes the state). Social programs at a federal level have completely different economical, political, legal/constitutional, and practical ramifications that those implemented by the state or below. Amtrak is not a true socialized program, it is a corporation whose most desireable stock is owned by the government (Although some railroad companies also own common stock). Although it is subsidized, so is the rest of the transportation industry (Look at airlines being bailed out left and right).

So that leaves SS, the USPS, and M-Care, as the only three examples that could even compare. But I don't think they are good examples:

In my opinion, the USPS' neccesity is waning in the age of emails. It's service was abysmal until private companies, like UPS and Federal Express, came in and started giving it competition. Perhaps it was different in the age of stagecoach and railroad post stations, but today I'm not convinced a federalized postal service is even necessary, and that the private sector couldn't do a better job.

I won't touch SS and MCare in huge detail, but I'll only say that we all know how great their budget outlook is right now.

So anyways, I don't agree that these are examples of socialized systems, or at least they are not good ones, that we can compare to national, socialized medicine. The latter three are good ones to argue against it.

Socialized systems are not that bad. It's when the entire economy becomes socialized that it's a problem. That's highly unlikely to happen.

I'm not too sure what your position is on this, but healthcare is 1/5 of our economy. So true that it's not the whole thing, but socializing healthcare (at a federal level) is a big, big step closer to a socliazed economy. Just a thought...

 

[southerndoc]

I'm not too sure what your position is on this, but healthcare is 1/5 of our economy. So true that it's not the whole thing, but socializing healthcare (at a federal level) is a big, big step closer to a socliazed economy. Just a thought...

Fire and brimstone, doom and gloom, and the list goes on and on.

Seriously, moving to a socialized health system isn't going to put us on track for everyone having equal wages anymore than social security did when it was developed a long time ago.

 

[leviathan]

Instead of paying thousands of dollars into your private insurance, you pay thousands of dollars into your income tax instead for the same services. Yes, you do get some minor setbacks in things like elective surgeries (long wait times), but at the gain of every American citizen having health coverage. In addition, private insurance companies are out there to do anything possible to find ways to reject your claims and save money. It's scary to think that you could get sick one day and your insurance company will find some loophole to reject your coverage, or treat you for your problem and then suddenly have a change in policy and refuse to insure you afterwards.

I like the fact that when I get sick, I don't have to worry whether my insurance provider will cover it, or which physician/hospital I'm allowed to go to, or whether there will be deductibles, or whether I will have to fill out paperwork to get reimbursed, etc. etc. I just go to the hospital/clinic, see a physician, and go home.

And universal healthcare is NOT socialized medicine. There is a single universal insurance provider who covers everything, but each individual physician still works his own business for profit and decides how s/he wants to practice medicine, which patients s/he wants to see, and so forth. That's why a friend of mine is ticked because her long-time family physician will no longer take care of her, and only does cosmetic medicine now with Botox and the like.

 

[futuredo32]

Current examples of socialized systems by our government: US Postal Service, Amtrak (heavily subsidized), Social Security, Medicare, Police (local), Fire (local), and the list goes on and on.

Socialized systems are not that bad. It's when the entire economy becomes socialized that it's a problem. That's highly unlikely to happen.

Current examples also include Medicaid and Romneycare. Both are "that bad." If Romneycare were applied to the country as a whole, we'd have a huge waiting list. People getting Romneycare have access to waiting days before being seen by a doctor. We all know that sometimes waiting days doesn't matter and other times waiting days means that a bacterial URI becomes pneumonia. To top it all off, doctors accepting Romneycare are losing money by seeing those patients. http://www.nytimes.com/2008/04/05/u...sphere_related_content&partner=rssnyt&emc=rss

 

[oldpro]

The biggest problem is many are arguing using example against Universal Health care by comparing Canada and the UK,

The US has two failing systems currently

Medicare and Medicaid. I do not care if one is federal and one is state, the fact is we pay for them right now and also theres the VA system.

Vets have both right? Medicare and VA or at times Medicaid and VA?

If we through it all out and reorganize under Universal you have a leaner system

You have all the people who pay for insurance now at work paying ( I believe a lot less) into Universal health care.

Reorganized and able to keep up with all the new seniors and no duplication of services.

 

[Miami_med]

The biggest problem is many are arguing using example against Universal Health care by comparing Canada and the UK,

The US has two failing systems currently

Medicare and Medicaid. I do not care if one is federal and one is state, the fact is we pay for them right now and also theres the VA system.

Vets have both right? Medicare and VA or at times Medicaid and VA?

If we through it all out and reorganize under Universal you have a leaner system

You have all the people who pay for insurance now at work paying ( I believe a lot less) into Universal health care.

Reorganized and able to keep up with all the new seniors and no duplication of services.

It sounds great to say that it would be:

1. reorganized
2. better
3. involve no duplication

There is no evidence that any of these things will actually happen. Every government insurance program in the US is an absolute disaster. Even the Mass healthcare plan is a disaster. Also, people may not want to stop paying their insurance to get the government healthplan. Some people prefer the insurance. Some people who pay cash right now will be forced into the government health plan at unnecessary cost to them in order to subsidize groups that the government has already proven it can't effectively treat while they're being subsidized.

Also, there is plenty of study duplication with Medicare/Medicaid patients now. In fact, the system currently pays more to duplicate studies. A doctor who orders the study makes the hospital money, while failing to order it puts him at risk for some plaintiff attorney accusing him of not having an up to date study a couple of years down the road.

They duplicate fewer studies at the VA partly because they have good records (which doesn't imply a need for universal healthcare) and partly because getting a repeat study take forever because government run hospitals are short on imaging equipment.

 

[futuredo32]

The biggest problem is many are arguing using example against Universal Health care by comparing Canada and the UK,

The US has two failing systems currently

Medicare and Medicaid. I do not care if one is federal and one is state, the fact is we pay for them right now and also theres the VA system.

Vets have both right? Medicare and VA or at times Medicaid and VA?

If we through it all out and reorganize under Universal you have a leaner system

You have all the people who pay for insurance now at work paying ( I believe a lot less) into Universal health care.

Reorganized and able to keep up with all the new seniors and no duplication of services.

I'm having a difficult time following your logic. One can look at the UK or Canada and see the problems that they are having with socialized medicine for both patients and physicians. Or one can look at forms of "socialized medicine" that we have in the US- Medicaid, VA care, Romneycare, and Medicare. All of the types of government sponsored care in the US (not so much Medicare at this moment, but probable in the future) are problematic
for physicians and patients.
So, using all of the examples of problems with socialized medicine , both in our country and in other countries, you think that somehow, changing multiple forms of socialized medicine into one form is going to fix everything? The US can't do it on several small scales, but it will be able to do it on one large scale? Other countries with socialized medicine can't provide quality healthcare for a reasonable price, but somehow the US will?

 

[southerndoc]

I'm having a difficult time following your logic. One can look at the UK or Canada and see the problems that they are having with socialized medicine for both patients and physicians. Or one can look at forms of "socialized medicine" that we have in the US- Medicaid, VA care, Romneycare, and Medicare. All of the types of government sponsored care in the US (not so much Medicare at this moment, but probable in the future) are problematic
for physicians and patients.
So, using all of the examples of problems with socialized medicine , both in our country and in other countries, you think that somehow, changing multiple forms of socialized medicine into one form is going to fix everything? The US can't do it on several small scales, but it will be able to do it on one large scale? Other countries with socialized medicine can't provide quality healthcare for a reasonable price, but somehow the US will?

ALL forms of insurance in America is problematic: Medicare, Medicaid, HMO's, everything.

I've had my share of problems with my HMO. I've experienced it as a patient and as a physician.

 

[futuredo32]

ALL forms of insurance in America is problematic: Medicare, Medicaid, HMO's, everything.

I've had my share of problems with my HMO. I've experienced it as a patient and as a physician.

I don't know that I'd say that ALL forms of insurance are problematic, Blue Cross/Blue Shield seems awesome.
But, IMO, Medicaid, VA medicine in our country and socialized medicine in other countries are far more problematic compared to most private forms of insurance in the US.


Reading posts on SDN about this topic in this and other threads, some people seem to think that universal healthcare will improve access to healthcare. Based on Romneycare, which has lead to more people being insured( but not all people) it has not improved access to healthcare if one looks at the long waiting times to just see a primary care provider. Is waiting months for an appointment really access? Is waiting months for an appointment really an improvement for anyone?

 

[psy]

I schedule doctor appts for my mom with her PCP. Often, we must wait weeks to months before she can be seen and my mom does have insurance. The system right now is pretty bad. I can't imagine how horrible it would be with universal healthcare...

 

[futuredo32]

I schedule doctor appts for my mom with her PCP. Often, we must wait weeks to months before she can be seen and my mom does have insurance. The system right now is pretty bad. I can't imagine how horrible it would be with universal healthcare...

Weeks to months with insurance? Just out of curiousity, what type of insurance? I often schedule same-day appointments for my Grandmother with her PCP for issues that aren't even urgent. For urgent issues, she always gets an appointment the same day.

 

[leviathan]

Other countries with socialized medicine can't provide quality healthcare for a reasonable price, but somehow the US will?

Canada's health care costs are a fraction of the US. Get your facts straight.

I schedule doctor appts for my mom with her PCP. Often, we must wait weeks to months before she can be seen and my mom does have insurance. The system right now is pretty bad. I can't imagine how horrible it would be with universal healthcare...

I can see a PCP within 30 minutes any day of the week. I don't even need to book appointments, although I could if I want to go in and not have to wait that 30 minute delay. And you are INSURED and get this quality of care? That sounds more like private insurance sucks @$#@#.

Edit: I also live in a suburban town that has trouble recruiting family physicians. Some of the clinics are willing to pay locums up to $150/hour to come here and still cannot fill shifts, yet I still don't need to wait in an "underserved" area.

 

[futuredo32]

Canada's health care costs are a fraction of the US. Get your facts straight.

My statement addressed both cost and quality. Being that many in Canada cross the border to the US for medical care each year, it's safe to say the quality in the US is superior to that in Canada, if for no other reason than the long waits in Canada.
Are their costs a fraction of the costs in the US? Let's look at those facts.
The economic cost of waiting for health care in Canada was nearly $15 billion in 2007, according to new data released Tuesday by the Canadian Medical Association.
http://www.nationalpost.com/news/story.html?id=239713
By the way, Canadian physicians make much less than American docs. http://www.payscale.com/research/ca/People_with_Jobs_as_Physicians_/_Doctors/Salary
Also, how useful is it to compare healthcare costs in the US to those of Canada without looking at the difference in obesity between the US and Canada? Being overweight leads to disease which leads to higher healthcare costs.

http://win.niddk.nih.gov/statistics/index.htm

I can see a PCP within 30 minutes any day of the week. I don't even need to book appointments, although I could if I want to go in and not have to wait that 30 minute delay. And you are INSURED and get this quality of care? That sounds more like private insurance sucks @$#@#.

I think that Psy's Moms problem with timely care is not the norm in the US.

 

[oldpro]

I schedule doctor appts for my mom with her PCP. Often, we must wait weeks to months before she can be seen and my mom does have insurance. The system right now is pretty bad. I can't imagine how horrible it would be with universal healthcare...

It would be better.

I have lived in countries with Socialized medicine and I never had such problems

In the US I have elected HMO care and gone to the HMO clinics and everything was fine and went like a breeze

I think you are equating the broken system we have with something yet to be done int his country, like many you are saying the system will not work without knowing what it is, I think its pretty closed minded not even give it a try, we have a current system that is not working, anything IMHO will be better.

Reimbursement is a joke at the moment about 0.25 cents on the real dollar.

We need an inflation adjustment for reimbursement.

Why would your PCP bend over backwards for your insurance who pays them 35 dollars for a 65 dollar visit? ( sometimes they do not even get paid at all) I have seen many pay in cash now to get in sooner and some Docs honoring that.( I do not think this is right)

Having insurance does not mean much anymore. It means you might get paid enough to cover cost in some cases.

 

[oldpro]

Canada's health care costs are a fraction of the US. Get your facts straight.


I can see a PCP within 30 minutes any day of the week. I don't even need to book appointments, although I could if I want to go in and not have to wait that 30 minute delay. And you are INSURED and get this quality of care? That sounds more like private insurance sucks @$#@#.

Edit: I also live in a suburban town that has trouble recruiting family physicians. Some of the clinics are willing to pay locums up to $150/hour to come here and still cannot fill shifts, yet I still don't need to wait in an "underserved" area.

Yes Yes this is 100% the truth about 80% of the time in Ca and the UK, yet the political Hacks for the US insurance companies do everything to post lies about the reality of how a national system can work! I lived with it for a year myself and my family, we never had to wait and everything worked fine!

 

[oldpro]

I don't know that I'd say that ALL forms of insurance are problematic, Blue Cross/Blue Shield seems awesome.
But, IMO, Medicaid, VA medicine in our country and socialized medicine in other countries are far more problematic compared to most private forms of insurance in the US.

You are not understanding the biller side of this at all, they are all problematic. You are stalled to get payments, sometimes denied for BS reasons, other times paid at 0.25 cents on the Dollar of the Billing, months later asked to pay back what was paid to you due to a new review and some claims adjuster believes ( this may not be a person with any medical training) that the claim should not have been paid, all along you the consumer have no idea.

I worked in home health before and one year the Visiting Nurses I worked for had to pay back around 200,000 dollars for care that Medicare claims should not have been paid for. When I asked about it, I was told that this happens from time to time, some audit is done and 6 to 9 months down the road all of sudden this pops up, the care may have been necessary and the people have th insurance but some adjuster found some loop holes and now they are demanding the money back, if not then forget ever getting paid by Medicare again. Blue Cross and Blue shield, as others, Operate this kind of terrorist way too.

 

[futuredo32]

It would be better.

I have lived in countries with Socialized medicine and I never had such problems

In the US I have elected HMO care and gone to the HMO clinics and everything was fine and went like a breeze

I think you are equating the broken system we have with something yet to be done int his country, like many you are saying the system will not work without knowing what it is, I think its pretty closed minded not even give it a try, we have a current system that is not working, anything IMHO will be better.

Reimbursement is a joke at the moment about 0.25 cents on the real dollar.

We need an inflation adjustment for reimbursement.

Why would your PCP bend over backwards for your insurance who pays them 35 dollars for a 65 dollar visit? ( sometimes they do not even get paid at all) I have seen many pay in cash now to get in sooner and some Docs honoring that.( I do not think this is right)

Having insurance does not mean much anymore. It means you might get paid enough to cover cost in some cases.

Oldpro, you were really fortunate to have such short waiting times while living in Canada and other countries with socialized medicine. The link to the article I posted above tells a very different story.

Other than Medicaid, VA insurance, and perhaps Medicare with the new cuts, doctors are earning money by seeing patients with insurance, not losing it.

 

[oldpro]

My statement addressed both cost and quality. Being that many in Canada cross the border to the US for medical care each year, it's safe to say the quality in the US is superior to that in Canada, if for no other reason than the long waits in Canada.
Are their costs a fraction of the costs in the US? Let's look at those facts.
The economic cost of waiting for health care in Canada was nearly $15 billion in 2007, according to new data released Tuesday by the Canadian Medical Association.
http://www.nationalpost.com/news/story.html?id=239713
By the way, Canadian physicians make much less than American docs. http://www.payscale.com/research/ca/People_with_Jobs_as_Physicians_/_Doctors/Salary
Also, how useful is it to compare healthcare costs in the US to those of Canada without looking at the difference in obesity between the US and Canada? Being overweight leads to disease which leads to higher healthcare costs.

http://win.niddk.nih.gov/statistics/index.htm


I think that Psy's Moms problem with timely care is not the norm in the US.

He was saying that Canadian costs are lower due to the national system

It costs less to administer

It costs less to operate

I think this is clear.

In the US the Insurance companies are used to creating a claims system that makes it hard for the billers to collect.

Have you not seen the movie "The Rain Maker?" based on a real story?

If I have 40% of uncollected fees, then I need to cover my cost and income with the other 60%, right? Then this alone drives up the cost of care. Does it not?

I just finished Orthopedic surgery, and this Doc told me that it is as High as 50% of non payers now........ 50%! I think that drives up the cost.

 

[futuredo32]

You are not understanding the biller side of this at all, they are all problematic. You are stalled to get payments, sometimes denied for BS reasons, other times paid at 0.25 cents on the Dollar of the Billing, months later asked to pay back what was paid to you due to a new review and some claims adjuster believes ( this may not be a person with any medical training) that the claim should not have been paid, all along you the consumer have no idea.

I worked in home health before and one year the Visiting Nurses I worked for had to pay back around 200,000 dollars for care that Medicare claims should not have been paid for. When I asked about it, I was told that this happens from time to time, some audit is done and 6 to 9 months down the road all of sudden this pops up, the care may have been necessary and the people have th insurance but some adjuster found some loop holes and now they are demanding the money back, if not then forget ever getting paid by Medicare again. Blue Cross and Blue shield, as others, Operate this kind of terrorist way too.

Again, I think that there are problems with insurance, but I think that the problems with insurance are far less than the problems that we would face with socialized medicine. Though we have problems, comparing it to a "terrorist way" is not a good analogy.

 

[oldpro]

It sounds great to say that it would be:

1. reorganized
2. better
3. involve no duplication

There is no evidence that any of these things will actually happen. Every government insurance program in the US is an absolute disaster. Even the Mass healthcare plan is a disaster. Also, people may not want to stop paying their insurance to get the government healthplan. Some people prefer the insurance. Some people who pay cash right now will be forced into the government health plan at unnecessary cost to them in order to subsidize groups that the government has already proven it can't effectively treat while they're being subsidized.

Also, there is plenty of study duplication with Medicare/Medicaid patients now. In fact, the system currently pays more to duplicate studies. A doctor who orders the study makes the hospital money, while failing to order it puts him at risk for some plaintiff attorney accusing him of not having an up to date study a couple of years down the road.

They duplicate fewer studies at the VA partly because they have good records (which doesn't imply a need for universal healthcare) and partly because getting a repeat study take forever because government run hospitals are short on imaging equipment.

The gov insurance plan will be mandatory, it will replace the Medicare tax.
no more VA
No More Medicaid

Yes people could have supplemental insurance as I stated

 

[futuredo32]

He was saying that Canadian costs are lower due to the national system

It costs less to administer

It costs less to operate

I think this is clear.

In the US the Insurance companies are used to creating a claims system that makes it hard for the billers to collect.

Have you not seen the movie "The Rain Maker?" based on a real story?

Nope, I haven't seen that movie. I tend to base my opinions on fact and not movies that are "based on a real story."
The cost of healthcare in Canada compared to that of the US may seem less. When one takes into account the cost of waiting to actually get seen and treated in Canada, the numbers change. How much does it cost to lose months of wages because your back pain is preventing you from working? How much does it cost for rehab after becoming dependent on pain pills used to alleviate the pain until treatment for the pain occurred?

 

[psy]

If we were to implement a universal health care system, do we have the infrastructure to make it work? Do we have enough docs to handle the surge of new patients? With the expansion in medical school classes started recently how long would it be till we can make this system viable?

 

[oldpro]

Again, I think that there are problems with insurance, but I think that the problems with insurance are far less than the problems that we would face with socialized medicine. Though we have problems, comparing it to a "terrorist way" is not a good analogy.

I think it is a terrorist when the insurance company pays you for ORIF of an ankle, then 6 months later wants all the money back because of some review that they think the ORIF was unnecessary?

Care has been rendered and the patient is long gone, if yo do not pay back none of the current and future claims will be paid.

Terrorist act? extortion in the least.

 

[oldpro]

If we were to implement a universal health care system, do we have the infrastructure to make it work? Do we have enough docs to handle the surge of new patients? With the expansion in medical school classes started recently how long would it be till we can make this system viable?

I'm confused? We have what we have now and new ones on the way?

What do you propose? How would the payer source make this different?

 

[psy]

My main concern with a universal health care system is that we aren't ready for it yet. We lack the monetary support and health care provider. For the lack of money problem maybe the first thing we need to do is stop going to war. That sure costs this country a good amount of money. We can't even take care of our own people how can we care for others? The second option would probably be increased taxes to fund the universal health care system and increase reimbursement, but no politician will risk his career by raising taxes.

 

[MOHS_01]

It is absolutely absurd to believe that any increase in regulation or government intervention will result in any beneficial rewards for providers in any qualitative or quantitative measure. Beyond compensation concerns, by far and away the number one complaint of practicing providers centers upon the regulatory, administrative, and bureaucratic burdens that hinder the delivery of care. Further institutional involvement will only accelerate and worsen both these and the compensation concerns.

Until political or leaders of private industry openly and honestly address the fundamental underlying problem at play (insatiable demand and finite resources), we will continue to travel down perilous paths with an insolvent dead end destination.

Rationing, in some form or fashion, inevitably plays a role in all things -- healthcare is no different.

 

[leviathan]

My statement addressed both cost and quality. Being that many in Canada cross the border to the US for medical care each year, it's safe to say the quality in the US is superior to that in Canada, if for no other reason than the long waits in Canada.
Are their costs a fraction of the costs in the US? Let's look at those facts.
The economic cost of waiting for health care in Canada was nearly $15 billion in 2007, according to new data released Tuesday by the Canadian Medical Association.
http://www.nationalpost.com/news/story.html?id=239713

Look at any statistic that shows PER CAPITA spending..the US is sky high compared to Canada.

By the way, Canadian physicians make much less than American docs. http://www.payscale.com/research/ca/People_with_Jobs_as_Physicians_/_Doctors/Salary

Ha ha ha..nice, $100,000 for an internist or an emerg physician? Wow, I guess my friend better sell her $1M condo in the West End because the Canuckistan commies will soon find out she's been making triple that, and want their money back! I don't know where you are getting those statistics, but they are so far from the truth it is ridiculous. The only thing remotely close to accurate is the wage there for family physicians ($116k), but even that is grossly low unless you are accounting for all of the part-timers. As per my prevoius post, they're paying $150/hour (that's $300k/year assuming a 40 hour work week) for family docs to cover clinics in my area. Realistically, none of those physicians are going to work 40 hours/week for 52 weeks straight, so it's a bit less..but you get my drift.

Also, how useful is it to compare healthcare costs in the US to those of Canada without looking at the difference in obesity between the US and Canada? Being overweight leads to disease which leads to higher healthcare costs.

http://win.niddk.nih.gov/statistics/index.htm

Maybe the US wouldn't have an epidemic of obesity if it invested more money into preventative medicine. But that's an entire different issue which would derail this thread.

I think that Psy's Moms problem with timely care is not the norm in the US.

But the fact that it's even happening is ABSURD. How much is she paying every month for her insurance premiums? I bet she has to pay a deductible as well when she sees her doc, and at any moment her insurance company is just looking for a way to drop her out of their coverage plan as she is getting older. Oh and by the way, looks like she isn't covered for that elective hip surgery, because she'd have to pay 3x the costs for premium coverage that includes non-essential services.

And what about my grandfather, who had an MI while on vacation in May. He had the best travel insurance plan, but the US hospital refused to do PCI until they had $40,000 in cold cash in their pockets from our bank accounts. Unfortunately that delay for my family to round up all of that money meant that window of reperfusion was long gone...and now I'll never know if he'd still be alive if he had the MI in Canada and had immediate access to a cath lab. I think we're still waiting to get reimbursed for part of the costs of his hospital stay down there, as well.

Every time I read about the horrors of universal healthcare, people seem to use a large amount of misleading or absolutely incorrect information to defend against it. Our system sucks, but I'd still take it any day over the US system.

 

[MOHS_01]

He was saying that Canadian costs are lower due to the national system

It costs less to administer

It costs less to operate

I think this is clear.

In the US the Insurance companies are used to creating a claims system that makes it hard for the billers to collect.

Have you not seen the movie "The Rain Maker?" based on a real story?

If I have 40% of uncollected fees, then I need to cover my cost and income with the other 60%, right? Then this alone drives up the cost of care. Does it not?

I just finished Orthopedic surgery, and this Doc told me that it is as High as 50% of non payers now........ 50%! I think that drives up the cost.

It is true that Medicare has a lower administrative cost than private plans. This, arguably, does constitute "a waste" which can be converted to dollars spent in providing care. This would constitute a hot topic and a source of great debate, with compelling arguments on both sides.

To base any argument upon "fees" is problematic and less than intellectually honest, however (and I believe strongly that our services are devalued). It is common knowledge that our "fees" are greatly inflated. This occurs for a variety of reasons, but about the only truly legitimate reason that I am aware of is the fact that a small percentage of insurance companies continue to pay based upon a "percentage of charges up to a usual and customary fee". This necessitates providers to charge sometimes >250% of MC in order to collect a reasonable, market appropriate reimbursement level.

Private insurance plans, with their higher payments, have subsidized gov't funded plans for years. Who will subsidize your universal system?

The percentage of bad debt goes up year in and year out, and this has accelerated rapidly with the rise of high deductible plans. The burden of escalating costs have been shifted largely to the patient and provider as a result of this.

 

[futuredo32]

Look at any statistic that shows PER CAPITA spending..the US is sky high compared to Canada.


Ha ha ha..nice, $100,000 for an internist or an emerg physician? Wow, I guess my friend better sell her $1M condo in the West End because the Canuckistan commies will soon find out she's been making triple that, and want their money back! I don't know where you are getting those statistics, but they are so far from the truth it is ridiculous. The only thing remotely close to accurate is the wage there for family physicians ($116k), but even that is grossly low unless you are accounting for all of the part-timers. As per my prevoius post, they're paying $150/hour (that's $300k/year assuming a 40 hour work week) for family docs to cover clinics in my area. Realistically, none of those physicians are going to work 40 hours/week for 52 weeks straight, so it's a bit less..but you get my drift.


Maybe the US wouldn't have an epidemic of obesity if it invested more money into preventative medicine. But that's an entire different issue which would derail this thread.


But the fact that it's even happening is ABSURD. How much is she paying every month for her insurance premiums? I bet she has to pay a deductible as well when she sees her doc, and at any moment her insurance company is just looking for a way to drop her out of their coverage plan as she is getting older. Oh and by the way, looks like she isn't covered for that elective hip surgery, because she'd have to pay 3x the costs for premium coverage that includes non-essential services.

And what about my grandfather, who had an MI while on vacation in May. He had the best travel insurance plan, but the US hospital refused to do PCI until they had $40,000 in cold cash in their pockets from our bank accounts. Unfortunately that delay for my family to round up all of that money meant that window of reperfusion was long gone...and now I'll never know if he'd still be alive if he had the MI in Canada and had immediate access to a cath lab. I think we're still waiting to get reimbursed for part of the costs of his hospital stay down there, as well.

Every time I read about the horrors of universal healthcare, people seem to use a large amount of misleading or absolutely incorrect information to defend against it. Our system sucks, but I'd still take it any day over the US system.

I am honestly very sorry to hear about your Grandfather. I have never ever ever seen a single patient refused care in the US for an MI (or anything else urgently life threatening). I'm based at a community hospital and we get a lot of patients without insurance and they are treated for everything from MIs to possible PEs to URIs. I have never seen a patient in the hospital denied care for lack of ability or willingness to pay. I have heard of Americans travelling to other countries and being asked for cash before they were treated, so perhaps the factor with your Grandfather was the same as in other countries- he wasn't a citizen. Again, I am very sorry for your loss. However, being that your Grandfather was not a citizen of the US, I think that his care or lack of care, is beyond the scope of the discussion about healthcare in the US for US citizens.

All we know about Psy's mom is that she has insurance and she waited weeks for care. Does she live in an underserved area that physicians choose not to work in? Does she have Medicaid or a plan that doesn't reimburse well? We don't have enough information to draw any conclusions. We do know that waiting times in the US for most people with insurance are practically nonexistent. Though I sympathesize with Psy's mom, it's far more productive to look at statistics instead of anecdotal stories.

Blaming obesity on lack of prevention? The whole attitude held by many Americans is absolutely different from that of countries with socialized medicine. I have worked with many PCPs who try again and again to promote healthy eating and exercise to their patients only to have all of their efforts ignored. We saw an 8 year old girl with a BMI of 32.2 this week. Her Mom absolutely refuses to change anything. The mother, who has insurance and a PCP who is very emphatic about preventative care, feels that it's normal for her to be fat considering thats the other siblings and both parents are obese as well.

But, the reason that I mentioned obesity is that it is a huge factor in the cost of health care in the US. One can not compare spending of healthcare dollars in the US to that of any other country without taking into account other factors like obesity. If doctor A and doctor B both saw 1000 patients each year and doctor A was reimbursed 40% more than doctor B, would you be willing to draw conclusions just based on this information alone? What if Dr.A had a high proportion of obese patients who smoked while Dr.B had a healthy patient population? If you truly want to compare healthcare costs for the US vs any other country, you have to look at more than just the dollar amount. Would you blindly accept that drug x had a lower mortality rate than drug y without looking closely at the participants in the study, without examining the parameters of the study? I hope not!

What information in any of these articles or the one I posted earlier is misleading?

Smith, who has been living in constant pain for three weeks, said he has been told he'll have to wait five months for an MRI and another two years for surgery..............
Smith said living with that kind of pain is not an option, and plans to go to Halifax and pay for the MRI out of his own pocket. The scan will cost about $860, plus travel and accommodation expenses, he said....
However, Dr. Bill Scantlebury, the head of the P.E.I. Medical Society, said it's impossible to find trained staff in such a short time period.......
"I don't see it getting better in the near future," he said. "All the factors that come into it, all the beds, and nursing and [operating room] time and the amount of other surgeons competing for the same time."
http://www.cbc.ca/health/story/2008/03/18/pei-knee.html?ref=rss

Legislation in Finland sets out a "three days, three weeks, three months" time frame for patients to be examined and treated at primary health care centres and hospitals. Patients must be assessed within three days of their first contact about a health problem. Further assessment by a specialist, if required, must be arranged within three weeks, and if thespecialist recommends treatment, this care should be provided within three months and no later than six months. If a local facility is unable to meet these time frames, treatment must be provided through another service at no extra cost to the patient. http://www.healthcouncilcanada.ca/do... ENGLISH.pdf

If you have reliable links with information that contradicts any of those that I've posted, I'd really like to read them and discuss them. But, there's really no point to discuss anecdotal evidence. N=1 isn't really all that significant to this discussion.

 

[Miami_med]

It would be better.

I have lived in countries with Socialized medicine and I never had such problems

In the US I have elected HMO care and gone to the HMO clinics and everything was fine and went like a breeze

I think you are equating the broken system we have with something yet to be done int his country, like many you are saying the system will not work without knowing what it is, I think its pretty closed minded not even give it a try, we have a current system that is not working, anything IMHO will be better.

Reimbursement is a joke at the moment about 0.25 cents on the real dollar.

We need an inflation adjustment for reimbursement.

Why would your PCP bend over backwards for your insurance who pays them 35 dollars for a 65 dollar visit? ( sometimes they do not even get paid at all) I have seen many pay in cash now to get in sooner and some Docs honoring that.( I do not think this is right)

Having insurance does not mean much anymore. It means you might get paid enough to cover cost in some cases.

Not wanting to try it here isn't being closed minded. Once it's implemented here, it will never go away. Ever. Even if it doesn't work. Also, I am opposed to being forced to fund something that I don't agree with using my tax dollars. As far as anything being better, that is simply not true.

The real issue is with third party payers funding every simple thing and the misuse of medical insurance for simple problems. Here's an idea. People buy insurance for catastrophes. This insurance is predicated on personal funding of maintenance (ie physicals, screening). We do not cement the ridiculous third party payer system that everyone feels entitled to into law in any permutation.

 

[nsx]

Canada's health care costs are a fraction of the US. Get your facts straight.

One problem that comes to mind when comparing the success of universal health care in other countries is that you cannot extrapolate results from a relatively smaller population to a larger, more diverse country like the US. It is not even so much a population issue but differences in what is being treated, i.e. more homeless, more drug-addicted, fatter Law2doc made an excellent post mentioning this a while ago.

 

[oldpro]

Not wanting to try it here isn't being closed minded. Once it's implemented here, it will never go away. Ever. Even if it doesn't work. Also, I am opposed to being forced to fund something that I don't agree with using my tax dollars. As far as anything being better, that is simply not true.

The real issue is with third party payers funding every simple thing and the misuse of medical insurance for simple problems. Here's an idea. People buy insurance for catastrophes. This insurance is predicated on personal funding of maintenance (ie physicals, screening). We do not cement the ridiculous third party payer system that everyone feels entitled to into law in any permutation.

1st, you have little say about you tax dollars now how is that going to change?

The comment on closed minded is a plan in the works to be possibly implemented has not even been totaly put together, so how do you know it will not work?

The current Gov health care plans are failing in a big way we have to replace them.

I agree with not paying for "Every little thing" the other countries do not either, in the UK they have supplemental that people pay for that covers more things, thats what I propose.

I believe it can work to our benifit as well.