saw sicko yesterday

[hoyden]

---

Members do not see this ad.

No, this is not what the liberals are about this is what human nature is about. It happens every where and all the time!
The elite group of leaders exists in every situation and regardless of the ideology.

Yes, but only socialist/liberal one wants everybody else to pay for the privileges of their eliteness and never ever even attempt to invade the elite.

 

[cubs3canes]

This is NOT true, and nearly every study proves it. We have a very mediocre health system. If you have insurance you MAY get "awesome" care, or you may be denied care for a myriad of reasons. If you do not have insurance you will probably get substandard care or maybe no care at all. This is what the data shows.

How are those studies run? Upper class in France (#1) vs. upper class in US (#37)...France is 36 countries better, I doubt it!!!

However, I do conceide that all of the studies show we are not number 1. I was being optomistic. I just love the US.

Cubs

 

[deleted59964]

Which may be one reason why their access to healthcare is not as good as the US of A.

HA HA HA HA HA
access to healthcare by who? sounds to me like a lot of americans cant afford to access healthcare. trust me - you dont want to compare access to healthcare on a population basis.

you can be an unemployed IV drug user with IE and get a 6 week inpatient stay with consultations from all the hotshots, before getting your valve replacement free of charge here.

yes you may wait a while for your completely elective total hip joint replacement - or you can go private if you dont want to wait. i wouldnt trade systems with you.

 

[m3unsure]

you can be an unemployed IV drug user with IE and get a 6 week inpatient stay with consultations from all the hotshots, before getting your valve replacement free of charge here.

This is why I don't like socialized medicine. It just takes away personal responsibility of one's own health and puts it in someone else's hand. How many irresponsible Americans would clog the system while people who deserve to be helped wouldn't get it quickly? I shouldn't judge a patient but I should be able to prioritize funding for a kid vs. IV druggie. And far as I'm aware, Australia is not rampant with such a case and so few of these would not be a problem versus the gained benefits.

 

[Planktonmd]

Many people are still too proud to see reality, and prefer to ignore it.
The U.S. is a great country and we all love it, but we must be realistic, the health care system is inferior to most industrialized countries because it's based on profit, and as long as there are people trying to get rich from Illness and access to treatment there will always be injustice.
The government programs that are supposed to compensate for the profit based mentality, and protect the poor, are simply being used to temporarily maintain a diseased system, so more money can be made by certain players, like Pharmaceutical companies and managed care organizations.

 

[gaspasser2004]

One of the points Moore made in his film was that America has decided to socialize many services already. For instance, Moore states that we "tolerate" our law enforcement and fire protection being socialized. This obviously seems like a no-brainer - most Americans gladly pay taxes to have these services available when they need them. Americans also don't seem to complain about the family whose house burned down "overutilizing" fire protection services that we all pay taxes for.

There are no right or wrong answers here. As a society, we have collectively decided that healthcare will be delivered as it is today. If you are wealthy enough to have private insurance, you get great care. If you are poor enough to qualify for government assistance, you get adequate care. If you are somewhere in the middle, you get no care until your disease process runs its course to the point where you get really expensive care and go bankrupt.

Also, we as a society have allowed people to become rich off healthcare. I don't think people have an issue with a neurosurgeon making $750K a year, an anesthesiologist making $400K a year or an internist making $200k a year. I do think people have a problem with CEO's of insurance and drug companies making millions often at the expense of their customers. But again, there are no right or wrong answers here. If there weren't millions/billions of dollars to be made making drugs, no one would risk the millions/billions to bring new drugs to market. Some even argue that insurance companies make things better by doing more preventative screening and counseling.

These are all larger issues that must be decided by society as a whole. If we decide that we want to keep the current system, then fine. If we decide that we want to change the current system, then that's fine too. We all have our own ideas of what the "ideal" healthcare system should be and we should all advocate on behalf of our ideas. However, we live in a democratic society and the people get the government (and healthcare) they deserve. Look at the last two presidential elections for proof of this.

 

[moeron]

I am a little surprised that no one has mentioned American's lifestyle issues as a cause for our lower rankings in most health indicators. Wouldn't the huge amounts of obese drinkers and smokers in this country skew the numbers down? Our culture is set up where bigger is better and the prevalence of fast food here is absurd. It is not really fair to compare our health system to France's health system where that population eats in moderation and shops at fresh markets, compared to America where we shove down two quarter pounders with cheese, an extra large order of french fries, and a gallon of coke and shop at Wal-mart.
You can tell which industries I have a major beef with (haha), and it aint the medical industry, although I am not arguing that a little more oversight for insurance companies (setting their profit margins at 15%, and mandating that the other 85% must be spent on giving care etc) would be bad, I am saying that our lifestyles make our healthcare what it is, not the for profit system.

For those of you arguing for a single payer system, have you ever been to the DMV? I once sat for literally 8 hours to take a 4 minute paper exam, and I was treated like I should be grateful for the chance to wait 8 hours. Competition is good in every industry, and if my doctor's office is not competing for its customers, it will become the DMV and our health system will really be sicko.

 

[jbcarlso]

a

 

[jbcarlso]

When the government takes money from people and gives it entirely for "free" to another set of people, it's called socialism. This is wrong.

I'm surprised no one has pointed this out before, but the US is hardly free of socialism as you define it. Ever heard of public education? 🙄

Medicare and medicaid would also fall under your definition. Are you suggesting that babies/children of the poor/seniors be denied - flat out denied - heathcare? I don't want to live in a country that is that cruel, do you?

Do you really think it's fair that Family Docs are barely making 100k/yr with 7 years of graduate education; that they're limited to 10-15m visits per patient? What happens when they start refusing medicare/medicaid patients because reimbursements continue to decline? If you think the ED is overrun now, I'd hate to see it then.

For those of you arguing for a single payer system, have you ever been to the DMV? I once sat for literally 8 hours to take a 4 minute paper exam, and I was treated like I should be grateful for the chance to wait 8 hours. Competition is good in every industry, and if my doctor's office is not competing for its customers, it will become the DMV and our health system will really be sicko.

I'm sorry but the numbers just don't bear this out. Go do some reading at the WHO. Regardless of their wait times, people in developed nations with universal coverage live longer than we do. People really aren't dropping dead in the UK waiting for CABG, tumor resections, etc anymore than they are in the States from what I've been able to find. They may wait longer - or they may not - but the wait is not affecting outcomes.

Follow me here, and this is important, Competition for profits among insurance companies means DENYING CARE TO PATIENTS! How do you think they make their money?

Aren't we supposed to be the greatest country on Earth? Isn't it reasonable to think that the answer to several lifestyle issues might be more access to healthcare (by removing prohibitive costs) rather than less? Why shouldn't we be the example to the world, covering all our citizens because we have the capability and because it's the right thing to do?

 

[moeron]

I would argue that teaching people to be dependent for all of their needs on a government is also cruelty.

I agree that basic healthcare should be available to all people regardless of race/income/sex etc. Do I believe we should be obligated to pay 60-70% taxes in order to accomplish this, no I don't, and I think the majority of Americans agree with me. Why can't we make it mandatory to own a very simplified version of health insurance that covers x numbers of visits per year in much the same way that auto insurance is handled?

If you would like to work in a government run health system, there are plenty of available options to choose from, but we as Americans don't support it. The system is broken, I agree, we should focus on fixing it, not on shoving an unwanted system down American's throats. Moore and his propaganda don't resonate with most Americans, the ideals of free choice, competition, and hard work do.

Personally, I believe we as physicians should completely focus on prevention in all aspects of medical care and social change. I really think that all of this lobbying and money would be better spent on changing the way ciggarettes and food are advertised in this country. If we could get a better handle on prevention, the skyrocketing costs of healthcare would pretty much take care of themselves. (this is my opinion, I can't say that I have any data to back it up, that is another argument entirely)

Quick reply to your above post. The reason people in those countries live longer is not because they deliver better healthcare, it is because the live healthier lives. Good healthcare does not equal good health (just ask the 400 lb chain smoking attorney who has had 3 mi's, his healthcare was the best in the world, but his health stinks). You are not comparing apples to apples at all.

 

[jbcarlso]

I would argue that teaching people to be dependent for all of their needs on a government is also cruelty.

Please quote the line where I even inferred that we should teach people to be dependent on the government for "all of their needs."

I agree that basic healthcare should be available to all people regardless of race/income/sex etc. Do I believe we should be obligated to pay 60-70% taxes in order to accomplish this, no I don't, and I think the majority of Americans agree with me. Why can't we make it mandatory to own a very simplified version of health insurance that covers x numbers of visits per year in much the same way that auto insurance is handled?

There are private health insurance policies out there. I've even used one for a brief time. Do you seriously think someone who is barely above the poverty line (ineligible for medicaid) has an extra $150/month for health insurance?

I've proposed universal coverage as a solution to the problem we both agree exists. There are a variety of ways of paying for it - most of which are WAY off topic on a board like this - but increasing taxes is not necessary for universal coverage if other domestic and foreign policies are reevaluated. I know what you're thinking. I'd be happy to PM a list of books from former CIA folks and senior government officials if you'd care to move beyond what cable TV and talk radio tell you.

If you would like to work in a government run health system, there are plenty of available options to choose from, but we as Americans don't support it. The system is broken, I agree, we should focus on fixing it, not on shoving an unwanted system down American's throats. Moore and his propaganda don't resonate with most Americans, the ideals of free choice, competition, and hard work do.

Remember, insurance companies profit by DENYING CARE. This isn't a competition to see who can make the most widgets the cheapest; for the insurance companies it's a competition to see HOW MANY CLAIMS THEY CAN DENY - and by extension, how many pts go untreated or incur massive financial debt.

Our current system is not the result of the free market. Managed care was imposed on us by Federal Law! The HMO Act of 1973 requires almost every employer to provide health insurance for its employees.

Personally, I believe we as physicians should completely focus on prevention in all aspects of medical care and social change. I really think that all of this lobbying and money would be better spent on changing the way ciggarettes and food are advertised in this country. If we could get a better handle on prevention, the skyrocketing costs of healthcare would pretty much take care of themselves. (this is my opinion, I can't say that I have any data to back it up, that is another argument entirely)

No data, noted. Note that I do have data to support my position. Like I said, check the WHO: We don't live as long as other developed nations with universal coverage; our infant mortality is higher, etc.

Quick reply to your above post. The reason people in those countries live longer is not because they deliver better healthcare, it is because the live healthier lives. Good healthcare does not equal good health (just ask the 400 lb chain smoking attorney who has had 3 mi's, his healthcare was the best in the world, but his health stinks). You are not comparing apples to apples at all.

I'm not disagreeing; I'm proposing that a big part of the solution to our lifestyle issues in this country is more access to healthcare by removing barriers that prevent the working poor from obtaining regular medical care. Universal coverage is one way to reduce those cost barriers. Likely there are others; I'd love to hear some specific ideas.

 

[starsop93]

Quick reply to your above post. The reason people in those countries live longer is not because they deliver better healthcare, it is because the live healthier lives. Good healthcare does not equal good health (just ask the 400 lb chain smoking attorney who has had 3 mi's, his healthcare was the best in the world, but his health stinks). You are not comparing apples to apples at all.

By your logic, we should not try to provide health care to those who have preventable diseases. If you are an obese smoker - NO HEALTHCARE FOR YOU!

I understand what you are saying, but don't you think that most of the preventable diseases in the US would be treated better with free (yes I know it ain't "free") universal preventive medicine for everyone? I understand you are against "socialism" (never mind the police and fire department) but is not our job to provide the best healthcare to the most people? I don't think anyone can advocate that's what our system does best.

 

[jbcarlso]

By your logic, we should not try to provide health care to those who have preventable diseases. If you are an obese smoker - NO HEALTHCARE FOR YOU!

I understand what you are saying, but don't you think that most of the preventable diseases in the US would be treated better with free (yes I know it ain't "free") universal preventive medicine for everyone? I understand you are against "socialism" (never mind the police and fire department) but is not our job to provide the best healthcare to the most people? I don't think anyone can advocate that's what our system does best.

👍

 

[Coastie]

I'm surprised no one has pointed this out before, but the US is hardly free of socialism as you define it. Ever heard of public education? 🙄

Yes, I've heard of it. Point? We're talking about healthcare here, not public education.

Medicare and medicaid would also fall under your definition. Are you suggesting that babies/children of the poor/seniors be denied - flat out denied - heathcare? I don't want to live in a country that is that cruel, do you?

Oh yes, as a capitalist, I'm just itching to see everyone denied who doesn't pay cash.

Give me a break. Liberals, such as yourself, have such a hard time seeing that this isn't a zero sum game, that capitalists are actually providing BETTER care for patients and that, in fact, there are alternatives to the current system which don't include an increase in government.

Of course, we can't stop the system overnight, so there would have to be a proper weaning, but seriously, you think the government and it's massive bureaucracy provides better for the people than the free market and the people themselves? The free market always wins in that fight.

Do you really think it's fair that Family Docs are barely making 100k/yr with 7 years of graduate education; that they're limited to 10-15m visits per patient? What happens when they start refusing medicare/medicaid patients because reimbursements continue to decline? If you think the ED is overrun now, I'd hate to see it then.

What is this I hear about Family Docs salaries? First off, regarding "fair". There is no "fair" in medical salaries. Why? The government regulates them through massive bureaucracy and inane billing rules, mostly tied to medicare.

Family docs taking medicare is a HUGE problem, because with the little they are reimbursed, they have to increase volume just to pay the bills, and by doing so, drastically reduce the QUALITY of each visit. In the end, this hurts patients. That's your beautiful government doing it, and doing it more and more each year.

There are solutions to this. Take cash. Reduce overhead. Reduce government bureaucracy. Get the government out of what should be a PRIVATE economic function, and we will all be the better.

You do this, and increase access to urgent care centers which are rapid, cheap, and efficient, and you'll see a quick pressure release off the ED's, not to mention an overall decrease in costs overall.

I'm sorry but the numbers just don't bear this out. Go do some reading at the WHO. Regardless of their wait times, people in developed nations with universal coverage live longer than we do. People really aren't dropping dead in the UK waiting for CABG, tumor resections, etc anymore than they are in the States from what I've been able to find. They may wait longer - or they may not - but the wait is not affecting outcomes.

Yes, the WHO forgets to factor things in such as abortion rates in other countries, how the US spends money on people who would never get it in other countries, and, oh yeah, the fact that it is WRONG for the government to continue to grow and feed on PRIVATE industries.

Liberals and Conservatives differ on this point: Liberals see the government as the solution, Conservatives see the government as a problem. You guys want to see it grow, we want to see it shrink: ALOT.

In the end, we both want what is best for the patient. Capitalism and patient care go together to provide what is best for the system, and it's best for liberals to take note that "money", "capitalism", "less government" are not dirty phrases when associated with healthcare.

Follow me here, and this is important, Competition for profits among insurance companies means DENYING CARE TO PATIENTS! How do you think they make their money?

Reduce regulations, allow people to take more control of their healthcare through HSA's, and tell the crappy insurance companies to piss off through free market solutions.

How? Enough people get weaned off the govt and insurance tits, doctors will have greater flexibility when deciding what to accept or not. Oh, and setting prices based on MEDICARE is what insurance companies do, just another problem with government involvement.

Aren't we supposed to be the greatest country on Earth? Isn't it reasonable to think that the answer to several lifestyle issues might be more access to healthcare (by removing prohibitive costs) rather than less? Why shouldn't we be the example to the world, covering all our citizens because we have the capability and because it's the right thing to do?

We do live in the greatest country on Earth. Greatest country in the history of Earth. In Capitalism, government bureaucracy lends more to prohibitive costs than anything else, and by increasing government, we'll see a massive rise in costs. They are simply less efficient than the free market.

We are an example to the world: We have the best care, the best country, and the most GIVING country of ANY country in the entire world.

The right thing to do is to increase access , quality, and delivery of healthcare. The wrong way to do it is by increasing the government involvement and size within our healthcare system.

 

[GassiusClay]

Teachers get screwed for their VITAL services to society. I don't understand how society can give a business grad (job I did out of high school better than someone with a finance BS) 40K while there are teachers getting 30K? How does this country expect to maintain quality of education when we treat the main provider like cr@p? I wonder what will happen in medicine. People already stiff teachers when they strike saying that's not right. How about you raise your kids to stop being jagoffs in the classroom? UHC is another example of hey I don't want to be responsible for something and let's make someone else deal it. That's why Ron Paul should be president and return to small governement and people taking care of themselves.

 

[deleted59964]

We are an example to the world: We have the best care, the best country, and the most GIVING country of ANY country in the entire world.

yeah OK then🙄

 

[jbcarlso]

That's why Ron Paul should be president and return to small governement and people taking care of themselves.

👍👍👍

Coastie thank you for such a detailed response. However let's avoid partisan politics as much as possible please. I love how quickly some people make assumptions - and how often those assumptions are wrong - as a few of yours were about me. I'd prefer to deal with each issue seperately and on its merits. "Us vs them" politics are a HUGE part of this country's problem. People get caught up in "winning" rather than stepping back to really examine what might be best for the country. As Ron Paul says, "We've really got two choices in this country: big government Democrats or big government Republicans." He's absolutely correct, and that's a shame.

I have a tendency to look at healthcare as a basic human service - not a right, very important distinction - such as roads, clean water, clean food, safe drugs, a police and fire department, military etc. I think the difference between myself and those who are so vehemently opposed to universal coverage is that folks like me are willing to lump healthcare in with these basic services that we think the government should provide. We think that universal healthcare is part of the way we as a society should take care of each other - just like public sanitation, education, and so on. Others disagree, and that's fine.

Personally I would like to see a massive reduction in the size and spending of government on just about every other front - the absolute opposite of what has happened with 6 years of a Republican executive and a Republican congress. I'm not trying to be partisan; this is a fact. Republicans are supposed to be fiscal conservatives advocating less government, right? We've added a trillion dollars to our national budget since 2000 and that doesn't include the vast majority of the war budget which is passed through so-called "supplementals." Our total national deficit - foreign and domestic, current and future - tops 53 trillion dollars. Again, not trying to be partisan; these are facts: National Budgets National Deficit. I want what's best for the country, not what's best for any political party, and I think massive increases in spending and debt serve the country very poorly. Coastie, I think we may agree here? Still think I'm a liberal?

I would entertain a return to cash pay as long as HMOs were completely eliminated and some kind of safety net was in place - I will never live in a country where people die in the streets because they cannot afford to goto a doctor; That idea is horrifying to me, and I hope it would be to all of you as well. In a cash system I think folks would still need some sort of insurance vs catastrophic events, however. How would we implement that? HSAs for routine stuff with insurance only for catastrophic events could work. But what about the safety net? Again, a country that lets people die in the streets because they cannot afford to goto the doctor is for me completely unacceptable.

Do you think it would be possible to preserve only medicaid as the safety net for all citizens regardless of age and then simply eliminate managed care for those above the poverty line? Folks could use HSAs to provide for their non-catastrophic healthcare needs and then carry much less expensive insurance in anticipation of catastrophic events - but who would provide the insurance? Private companies I suppose? What about exempting people dealing with catastrophic illness from any and all taxes during the course of their treatment as a further way to empower them to use every available resource for their care? Of course, if we carry insurance for only "catastrophic illness" that begs that question: What is a catastrophic illness? Who will answer it? Doctors (hopefully)? Legislators (how to we prevent this)? The safety net could be easily funded while at the same time reducing the federal budget and taxes if we would reevaluate our foreign policy - a discussion for another time and place mentioned only to point out that the safety net could in fact parallel a reduction in taxes and overall spending.

This is a debate that will likely solve nothing and convert no one. However, we're all physicians or at least med students. Let's debate ideas on their merits alone. Descending into "us vs them" partisan politics will bore me back into lurking; there's plenty of such foolishness on cable tv and talk radio. Again, anyone who will not accept a safety net for the poor is only going to waste time trying to convince me - and hopefully most of the rest of you - that people should be allowed to die in the streets because they can't afford care. If we can accept at least this basic premise I think we can move forward with a productive discussion.

 

[moeron]

By your logic, we should not try to provide health care to those who have preventable diseases. If you are an obese smoker - NO HEALTHCARE FOR YOU!

I understand what you are saying, but don't you think that most of the preventable diseases in the US would be treated better with free (yes I know it ain't "free") universal preventive medicine for everyone? I understand you are against "socialism" (never mind the police and fire department) but is not our job to provide the best healthcare to the most people? I don't think anyone can advocate that's what our system does best.

You missed the point of what I was saying. JB is telling me he has data from WHO that backs up his point of view, I am telling him his data is worthless because he is comparing European/Canadian Society to American society. Completely different populations with the rise of fast food, working 60 hour weeks, and never walking anywhere in the US. Yes there health stats may be lower, but correlation and causation are not the same thing.

And actually no I don't think Universal Healthcare will provide these services better than a free market system. A free market system would recognize that prevention saves money for the industry and is therefore more efficient over the long run. Therefore, they would focus on prevention. As I said earlier, it is our responsibility as doctors to look out for the wellfare of our patients, and it is therefore our responsibility to give preventative care and to advocate for practices/legislation that increases preventative care.

As far as denying claims, in my view, the key to fixing that problem is to make it VERY expensive for insurance companies to deny claims without cause. Levy huge fines for any proven fraud and have these trials set up with people in the medical field (using these same medical courts to try malpractice cases so doctors can actually be tried by a jury of their peers but that is a whole new can of worms).

As far as the comment about teachers being worth more than business majors, that is the way it should be. If there were not enough people to be teachers at $30,000, than their pay would increase to attract qualified canidates until whatever the market values a teacher at would be paid. The fact is there are tons of people out there willing to be a teacher for $30,000 and have 3 months off, so that is why they are paid what they are, not because the evil business people have rigged it to be that way. Businesses evidently can't find business majors to work for $30,000, they are in enough demand to be paid $40,000. This is 8th grade economics.

The free market (i.e. the people choosing what they want) is always preferred to government providing (i.e. other people choosing what you want). Government is here to protect the free market and make sure it is not corrupted and taken advantage of; not to destroy it.

Finally, as far as education, fire department, police, 911, roads, etc... I would argue that they would be more efficient and useful if they were private. About the only thing that does not fall into this category is Defense. If fire departments had to compete against other fire departments for there customers, they would no doubt improve their performance so that they would get the call when the time came. People respond to incentives, if they have no incentive to improve they won't, if you give them an incentive (i.e. more pay, and not losing there job) they will work harder, and perform better. When the government removes incentives/competition the consumer is the one who gets screwed (see my DMV example earlier).

 

[moeron]

I posted the above before seeing jb's last post.

JB, I could sign up for your HSA/cash system with insurance being regulated to only catastrophic cases with a small government based safety net for those in need. Meet me on capital hill in 30 years and we can draft resolution 106: the non-partisan healthcare reform bill. Then we could sit back and watch as we both get trampled on by all of the partisan bickering that would ensue 🙂

 

[proclivity]

Finally, as far as education, fire department, police, 911, roads, etc... I would argue that they would be more efficient and useful if they were private. About the only thing that does not fall into this category is Defense. If fire departments had to compete against other fire departments for there customers, they would no doubt improve their performance so that they would get the call when the time came. People respond to incentives, if they have no incentive to improve they won't, if you give them an incentive (i.e. more pay, and not losing there job) they will work harder, and perform better. When the government removes incentives/competition the consumer is the one who gets screwed (see my DMV example earlier).

I agree wholeheartedly that except for the military, the private sector does everything faster, more efficiently (regarding money, production etc), and almost always with a better result.

Case in point #1: US post office vs all private sector shipping companies. There is no way that it actually costs $0.41 cents to ship a piece of mail. Coincidentally the price has more than doubled in the past 15 years. I remember when it cost 17 cents to send mail. Some idiot screwed up the pension fund and the same idiot probably didn't find it necessary to hedge against increasing oil prices by purchasing options.

Case in point #2: NASA and the private company that put a ship in space and brought it back down not too long ago. Don't get me wrong, a lot of inventions have come from NASA during the process but it doesn't seem to justify the cost especially since we still haven't been to mars. Come on....let's perfect that ion drive.

 

[starsop93]

And actually no I don't think Universal Healthcare will provide these services better than a free market system. A free market system would recognize that prevention saves money for the industry and is therefore more efficient over the long run. Therefore, they would focus on prevention. As I said earlier, it is our responsibility as doctors to look out for the wellfare of our patients, and it is therefore our responsibility to give preventative care and to advocate for practices/legislation that increases preventative care.

Isn't this our system already??? It's not working. Why do you think it will magically start working in the future? Corporations no longer look out for the long-term interests for their companies and their workers. Back when they did the free market DID work. Now it is only about how much money they can make before the next shareholders meeting. Most completely disregard the long-term future of the company, only wanting to see the stock continuing to shoot up so they can cash out quick; and they are REWARDED for this! The free market system will NOT improve our health care with the current ideology of what "free market" means.

As far as denying claims, in my view, the key to fixing that problem is to make it VERY expensive for insurance companies to deny claims without cause. Levy huge fines for any proven fraud and have these trials set up with people in the medical field (using these same medical courts to try malpractice cases so doctors can actually be tried by a jury of their peers but that is a whole new can of worms).

Will this not create an even greater bureaucracy than we have now? The free market freaks always tout their system as superior because it streamlines systems and provides services with less overhead. In fact, the exact opposite has happened with health care (and with many other services too). All socialized medical systems run with dramatically less overhead and bureaucracy than for-profit systems. They are much more efficient. In reality, socialism provides services much more efficiently with large, countrywide programs than the free market can.

The free market (i.e. the people choosing what they want) is always preferred to government providing (i.e. other people choosing what you want). Government is here to protect the free market and make sure it is not corrupted and taken advantage of; not to destroy it.

I think our failed health care system has proven you wrong. I think the incredible success of social security has proven you wrong. I don't disagree that the free market is best for the economy in the short term, but the quality of life, as measured by many different metrics, if consistenly rated higher in highly socialized countries than in the US. Therefore, your statement can't "always" be correct.

Finally, as far as education, fire department, police, 911, roads, etc... I would argue that they would be more efficient and useful if they were private. About the only thing that does not fall into this category is Defense. If fire departments had to compete against other fire departments for there customers, they would no doubt improve their performance so that they would get the call when the time came.

Are you kidding??? This is ridiculous!! Can you imagine the massively increased overhead that having multiple fire departments in your neighborhood competeing for... what?? How much profit do you think there is in stopping fires???

People respond to incentives, if they have no incentive to improve they won't, if you give them an incentive (i.e. more pay, and not losing there job) they will work harder, and perform better. When the government removes incentives/competition the consumer is the one who gets screwed (see my DMV example earlier).

Obviously we disagree on a lot of points! From my perspective, I don't want to live in a society where there is no society. I believe that my quality of life (even though I could afford to pay for EVERYTHING I need out of pocket) is dramatically improved by the socialized programs that keep my neighbors out of destitute poverty. I like getting paid for doing work, and that would happen a lot more often with my patient population if everyone had some kind of insurance. Despite the callousness of the free market system advocates, we still provide care to people, not just because we'll get sued if we don't, but because it is the right thing to do. And that's not going to change. What is going to change is the number of people who will be able to pay for those services; and it's not going to go up...

 

[jbcarlso]

I posted the above before seeing jb's last post.

JB, I could sign up for your HSA/cash system with insurance being regulated to only catastrophic cases with a small government based safety net for those in need. Meet me on capital hill in 30 years and we can draft resolution 106: the non-partisan healthcare reform bill. Then we could sit back and watch as we both get trampled on by all of the partisan bickering that would ensue 🙂

This isn't really "my" system; it pulls several ideas from Ron Paul, MD (black sheep of the Republican party, former Libertarian, 2008 presidential candidate) 😉

You can read his full position on private healthcare reform here: http://www.lewrockwell.com/paul/paul339.html

If we don't like universal coverage, my solution above would be the basis for a free-market alternative.

 

[jbcarlso]

You missed the point of what I was saying. JB is telling me he has data from WHO that backs up his point of view, I am telling him his data is worthless because he is comparing European/Canadian Society to American society. Completely different populations with the rise of fast food, working 60 hour weeks, and never walking anywhere in the US. Yes there health stats may be lower, but correlation and causation are not the same thing.

I cite the WHO data to show that universal coverage does work for other developed nations, and therefore, that it should not be discounted out of hand. Yes there are differences between the States and the UK, etc. However, universal coverage is working for every other developed "Western" nation. As such, it does not seem to me incredible that it could work here as well.

Finally, as far as education, fire department, police, 911, roads, etc... I would argue that they would be more efficient and useful if they were private. About the only thing that does not fall into this category is Defense. If fire departments had to compete against other fire departments for there customers, they would no doubt improve their performance so that they would get the call when the time came.

If my house is on fire I want the CLOSEST fire dept. assuming they're not drunk or incompetent. I think you may be overreaching a bit here. 😉

 

[jbcarlso]

Case in point #1: US post office vs all private sector shipping companies. There is no way that it actually costs $0.41 cents to ship a piece of mail. Coincidentally the price has more than doubled in the past 15 years. I remember when it cost 17 cents to send mail. Some idiot screwed up the pension fund and the same idiot probably didn't find it necessary to hedge against increasing oil prices by purchasing options.

A bit off topic but I'll bite. Did you know that the USPS is actually a for-profit entity? it's usps.COM not .GOV. Second, what has the price of fuel done over the past 15 years? More than doubled? Hmm... 😉

Case in point #2: NASA and the private company that put a ship in space and brought it back down not too long ago. Don't get me wrong, a lot of inventions have come from NASA during the process but it doesn't seem to justify the cost especially since we still haven't been to mars. Come on....let's perfect that ion drive.

I'm all for basic research and exploration, but of all the things to spend money on right now, is going to Mars really the best use of our scarce resources?

I would rather spend money on developing alternative energy technology to rid ourselves of our dependence on foreign oil. 👍 I'm tempted to segue into a discussion of foreign policy (specifically in the Middle East) but I'll stop myself. There are several extremely enlightening books on the subject, and I'll not try to condense them into a few paragraphs here.

We now return you to your regularly scheduled thread re: healthcare reform.

 

[moeron]

Isn't this our system already??? It's not working. Why do you think it will magically start working in the future? Corporations no longer look out for the long-term interests for their companies and their workers. Back when they did the free market DID work. Now it is only about how much money they can make before the next shareholders meeting. Most completely disregard the long-term future of the company, only wanting to see the stock continuing to shoot up so they can cash out quick; and they are REWARDED for this! The free market system will NOT improve our health care with the current ideology of what "free market" means.



Will this not create an even greater bureaucracy than we have now? The free market freaks always tout their system as superior because it streamlines systems and provides services with less overhead. In fact, the exact opposite has happened with health care (and with many other services too). All socialized medical systems run with dramatically less overhead and bureaucracy than for-profit systems. They are much more efficient. In reality, socialism provides services much more efficiently with large, countrywide programs than the free market can.



I think our failed health care system has proven you wrong. I think the incredible success of social security has proven you wrong. I don't disagree that the free market is best for the economy in the short term, but the quality of life, as measured by many different metrics, if consistenly rated higher in highly socialized countries than in the US. Therefore, your statement can't "always" be correct.



Are you kidding??? This is ridiculous!! Can you imagine the massively increased overhead that having multiple fire departments in your neighborhood competeing for... what?? How much profit do you think there is in stopping fires???



Obviously we disagree on a lot of points! From my perspective, I don't want to live in a society where there is no society. I believe that my quality of life (even though I could afford to pay for EVERYTHING I need out of pocket) is dramatically improved by the socialized programs that keep my neighbors out of destitute poverty. I like getting paid for doing work, and that would happen a lot more often with my patient population if everyone had some kind of insurance. Despite the callousness of the free market system advocates, we still provide care to people, not just because we'll get sued if we don't, but because it is the right thing to do. And that's not going to change. What is going to change is the number of people who will be able to pay for those services; and it's not going to go up...

sn't this our system already??? It's not working. Why do you think it will magically start working in the future? Corporations no longer look out for the long-term interests for their companies and their workers. Back when they did the free market DID work. Now it is only about how much money they can make before the next shareholders meeting. Most completely disregard the long-term future of the company, only wanting to see the stock continuing to shoot up so they can cash out quick; and they are REWARDED for this! The free market system will NOT improve our health care with the current ideology of what "free market" means.

My discussion from the beginning has centered on fixing our broken system, so no I do not think this system is working as well as it could. I also don't think that it is magically going to start working, hence the reason we are all throwing around ideas in a forum such as this.

All socialized medical systems run with dramatically less overhead and bureaucracy than for-profit systems. They are much more efficient. In reality, socialism provides services much more efficiently with large, countrywide programs than the free market can.

That is a very bold statement. I would love to see your data that backs this up, remembering that the population needs to be similar. Maybesome before Canada went to universal and after data so we can actually compare a before and after?

I think the incredible success of social security has proven you wrong.

Again, a bold statement indeed. I guess the insolvency of social security is being ignored here, as well as the fact that my money is taken from me and invested how someone else feels is best and then given back with a nice pat on my head by my fatherly government. You and the government sure no how to spend my money better than I do, thank you for your never ending knowledge and goodwill.

Obviously we disagree on a lot of points! From my perspective, I don't want to live in a society where there is no society. I believe that my quality of life (even though I could afford to pay for EVERYTHING I need out of pocket) is dramatically improved by the socialized programs that keep my neighbors out of destitute poverty. I like getting paid for doing work, and that would happen a lot more often with my patient population if everyone had some kind of insurance. Despite the callousness of the free market system advocates, we still provide care to people, not just because we'll get sued if we don't, but because it is the right thing to do. And that's not going to change. What is going to change is the number of people who will be able to pay for those services; and it's not going to go up...

Yes we do. If you would like to live in a socialized society by all means go and live there. France or Canada would love to have you. I just find it hard to believe that you are telling me that socialism works, when pretty much all historical context is on my side especially as I sit in the most prosporous country in the history of the world that is built on the free market system. I just don't understand...

On another note, thanks for all of the good discussion and book recommendations. I needed to stop lurking, and I get more good reading recs from this site than pretty much anywhere else.

 

[moeron]

still figuring out the quoting system... sorry about that.

 

[Coastie]

That is exactly the kind of system we need. Except insurance would be relegated by the market, not regulated by the government.

I posted the above before seeing jb's last post.

JB, I could sign up for your HSA/cash system with insurance being regulated to only catastrophic cases with a small government based safety net for those in need. Meet me on capital hill in 30 years and we can draft resolution 106: the non-partisan healthcare reform bill. Then we could sit back and watch as we both get trampled on by all of the partisan bickering that would ensue 🙂

 

[jbcarlso]

Yes we do. If you would like to live in a socialized society by all means go and live there. France or Canada would love to have you. I just find it hard to believe that you are telling me that socialism works, when pretty much all historical context is on my side especially as I sit in the most prosporous country in the history of the world that is built on the free market system. I just don't understand...

On another note, thanks for all of the good discussion and book recommendations. I needed to stop lurking, and I get more good reading recs from this site than pretty much anywhere else.

Social security is a HUGE part of that 53 trillion dollar future public deficit I mentioned several posts past. I would hardly says it's "working." How we're going to phase it out, however, is a question for which I must say I have no solution.

Socialism (at least in healthcare) is working for other countries. In fact, it is working for every developed "Western" nation but ours, most (all?) of which have elected governments - get this whole socialism = Stalin thing out of your heads. We are very much the exception to this rule. Even if we can't compare WHO data on lifespan etc, we can say that folks in those countries are getting at least adequate care, if not good to excellent care. People aren't dieing waiting on CABGs, cancer treatments, etc. It's a common misconception in the States and it's false.

Unfortunately the US is bleeding money faster than ever before. We have an ever increasing trade deficit, an ever increasing national deficit, an economy that is turning away from manufacturing and toward service (a trend that started in the 70s I believe, and has only accelerated since); troops based all over the world; we're printing new money with reckless abandon; it's kind of scary.

So I can stop alluding to foreign and domestic policy that is completely off topic (and because there is at least some interest), I'll go ahead and list some books for those who are interested. Then I can stop talking about it and assume people will read a bit if they're interested:

Imperial Hubris: Why the West is Losing the War on Terror by Michael Scheuer - former head of the CIA's Bin Landen unit, resigned in 2004 after 20 years with the CIA working on national security issues in Afghanistan and Southeast Asia

Blowback: the Costs and Consequences of American Empire by Chalmers Johnson - President of the Japan Policy Research Institute, Prof. Emeritus at the University of California

Dying to Win: The Strategic Logic of Suicide Terrorism by Robert A. Pape - Prof. of Political Science at the University of Chicago, Director of the Chicago Project on Suicide Terrorism.

The 9/11 Commission Report This one is surprisingly large, but surprisingly inexpensive even in hardback.

The Creature from Jeckyl Island This one I don't have in front of me, but it is a history of the creation of the Federal Reserve bank (which is neither federal nor a reserve in the sense of holding gold or cash), various money systems (think gold-standard vs. smoke-and-mirrors paper money). It's an extremely interesting read and will make you want to run out and by some gold. 👍

Phew. I'll nab that book by David Grazer as well. I'm just about done with the five I've listed above and need more non-medical reading material.

Ok that list is WAY off topic, but it's there because at least one person has expressed an interest in book-swapping. Those books really are a breath of fresh air in the face of what politicians, cable tv and talk radio spew at us all day long, and each is written by an expert in the particular field. If you only picked up one, pick up Imperial Hubris. You just can't beat the experience of a 20-year veteran of the CIA. The book originally had to be published anonymously due to CIA regulations.

Back to healthcare?

 

[jbcarlso]

That is exactly the kind of system we need. Except insurance would be relegated by the market, not regulated by the government.

Ron Paul, baby. Ron Paul

 

[moeron]

just a few that have influenced me

Prescription for a Healthy Nation: A New Approach to Improving Our Lives by Fixing Our Everyday World
by M.D.", Tom "Farley (Author), M.D.", Deborah A. "Cohen (Author)

Public health docs doing what they do best, but even with my semi-conservative nature I couldn't help but nod my head and agree through 90% of it.

Freakonomics: A Rogue Economist Explores the Hidden Side of Everything.
by Steven D. Livett and Stephen J. Dubner

Not really healthcare-centric but an awesome read nonetheless

The Corporation: The Pathological Pursuit of Profit and Power
by Joel Bakan
Will make you hate big business, I still walked away with my free market (mostly) in tact, but it sure makes an argument for greater oversight.

Well thats it for now, I am surprised out how liberal my book choices are... I think I will pick up The Cure: How Capitalism Can Save American Healthcare for my vacation in a couple of weeks.

 

[Coastie]

Not just him. Most, if not all conservatives.

I could never vote for him on other issues. Many other issues. Won't say anymore!

Ron Paul, baby. Ron Paul

 

[proclivity]

A bit off topic but I'll bite. Did you know that the USPS is actually a for-profit entity? it's usps.COM not .GOV. Second, what has the price of fuel done over the past 15 years? More than doubled? Hmm... 😉

I realize it is a for profit entity but if so, it should be run like a true company and not like a government agency. A true company would have nipped the funding problem in the bud a longtime ago as well as hedge the commodity prices (fuel etc) by giving Goldman Sachs a call just like all other true companies. Southwest Airlines is currently paying $40 per barrel of jet fuel....because the appropriately hedged. They are getting a 50% discount.

I'm all for basic research and exploration, but of all the things to spend money on right now, is going to Mars really the best use of our scarce resources?

I would rather spend money on developing alternative energy technology to rid ourselves of our dependence on foreign oil. 👍 I'm tempted to segue into a discussion of foreign policy (specifically in the Middle East) but I'll stop myself. There are several extremely enlightening books on the subject, and I'll not try to condense them into a few paragraphs here.

We now return you to your regularly scheduled thread re: health care reform.

I wasn't referring to going to mars in the future, rather we should have already been there with the money that was spent. I apologize for the confusion and apologies all around for hijacking. Just an intesting topic is all.

 

[jbcarlso]

Not just him. Most, if not all conservatives.

I could never vote for him on other issues. Many other issues. Won't say anymore!

Ya I don't agree with him on everything, but he is rather refreshing in some ways. It's kind of moot because I'd be absolutely shocked if he got the nomination. It sure would make for some great debates though if he did. 🙂

 

[starsop93]

Ron Paul, baby. Ron Paul

It is refreshing to hear someone speak the TRUTH with actual FACTS in a forum featuring Republicans... Nevertheless they are far too stupid to nominate him.

 

[GSresident]

I saw sicko yesterday as well. Just a few points:
1) I had a daughter born deaf a couple years ago. We went through an astounding battle to get her a single cochlear implant let alone two. It turns out that the University I was a resident at had selectively bargained cochlear implants out of all available insurance plans. We eventually got it paid for by having my wife switch to a different insurance plan at her workplace (teacher in a public school). By the time we paid for childcare and the new insurance we went in the hole $200 every month with her working. Even then it took 6 months of every day phone calls to the insurance agency, to our member of congress etc. to get her a cochlear implant. Needless to say I was a little bitter sewing in the second liver transplant for a 50 year old alcoholic with hep C who drank his way through his natural liver plus a transplanted one. One time the transplant surgeons where I was a resident were 15 minutes away from taking another patient back for his second liver transplant - of course he was currently drunk and + for methamphetamine and cocaine. I won't tell you why he didn't get the transplant but suffice it to say that there were numerous anonymous threats to call the media should it go foreward.

2) As Moore correctly points out, insurance companies make money by denying patient care. In a bizarre twist of fate my wife became friends with Lisa Pinot after we moved for my fellowship. It simply cannot go on like it is. I am absolutely opposed to a Soviet style socialized medicine system like Moore seems to advocate, but the current system, as is, must end.

3) If, in the free market, insurance companies have the incentive to keep you healthy by providing preventative care then why aren't they doing so? That is a rhetorical question. It is very simple the average American will switch jobs something like 5-7 times in his/her lifetime. Most likely that means switching insurance companies 5-7 times as well. Let me give you a little lesson in economics. Aetna doesn't want to pay $50K for a roux-en-y gastric bypass even though in the long run it will save them money. Chances are, the patient won't be covered by Aetna in the long run, and short term profits rule.

4) Moore shows an FP in england living in a 1 million dollar house. The physician states that he has ~160K salary per year. With the tax rate like it is in England, he would not be able to afford a million dollar house on that income. I'm sorry but something does not compute. I think its called family money. I would love to have access to family money but there isn't any. I'm a 'bootstraps' surgeon with 200K in medschool debt. I would barely be able to afford a 2 bedroom apartment, a used car and my loans on the FP's salary + taxes. In a socialized system the doctors will take a hit period.

5) Never, ever, ever, ever hold the US public school system up as an example of socialism working. Never, period.

Well thats enough for now. I have to go do a complicated flap on an indigent patient, who supposedly doesn't get health care in the US system.

 

[Tenesma]

healthcare is affordable once people change their priorities

cost to insure the average family of 4 per month with super low deductible: $1000/month (on average)


cost of cable/satellite /month: 50
cost of cigarettes/month: 160
cost of entertainment (movies/DVDs/rentals)/month: 40
cost of etc... you get my point - if people wanted insurance they could afford it.... the people who can't afford it (ie: most seniors on fixed incomes) should get some type of support

and in my opinion most uninsured kids break my heart - but why should we take responsibility for them when their parents don't?

it would always amaze me as a medical student in the ER the number of patients who would come in with tons of jewelry around their neck, brand-spanking new Air Jordans with a dental abscess because they "can't afford" dental insurance.... give me a break... this welfare system has led to people not taking responsibility for themselves...

 

[GSresident]

Tenesma:

and in my opinion most uninsured kids break my heart - but why should we take responsibility for them when their parents don't?

Even with insurance people are getting the f'ing shaft. That was the whole point of Moore's movie. My kid was insured, doubly. I don't think there is anyone in the world who wouldn't say that a general surgery resident working ungodly hours and taking care of everyone and their dogs is doing everything possible to "take responsibility" for his kid.

If you haven't run into this yet in your own life then count your freaking blessings. The bad thing about our health care system isn't the people working in it. The problem with our system is the way that resources are allocated to pay for it. I am a capitalist, period. What we have now is not capitalism.

You see, I am a little naive. I think that if you go to work every day and do your job you should be basically alright in life. Sure you'll have ups and downs but I think it is entirely reasonable to expect that if you abide by the rules and pay your freaking monthly premiums for health insurance (right now ~$500 a month out of pocket before I even get paid) you should be able to expect that your m'fing insurance company will come through when it is time to come through. Yeah, I know, the whole concept of getting what you pay for is a little dated.

it would always amaze me as a medical student in the ER the number of patients who would come in with tons of jewelry around their neck, brand-spanking new Air Jordans with a dental abscess because they "can't afford" dental insurance.... give me a break... this welfare system has led to people not taking responsibility for themselves...

People like that continue to amaze me on a daily basis. What is really scary though is that those people will probably get the health care that they need. It is people who actually go to work and have health insurance that are currently getting bent over the proverbial saw-horse. The insurance company is all up in them guts every month to get the $1000 premium but goes to every length possible to deny your claims when something actually goes wrong.

Like I said, the doctors and nurses in the US are great, it is the way they get paid that sucks. Maybe it is the whole concept of 'insurance' that is flawed.

 

[DOAnestMan]

I have always found the argument of health care as a "right" somewhat of an enigma. Certainly food is more of an essential to life than health care, yet know one suggests that their employer or the government should keep their fridge stocked. Why is it that we feel entitled to have someone else pay for all their healthcare costs.
The problem with further government encroachment or expansion of current entitlement programs is that is does nothing to address the real issue: people are too far removed from the true cost of their healthcare. People have little incentive to make better decisions regarding their healthcare when they know they can receive treatment free of cost at any ER. The truth is, a large majority of the alleged 46 million uninsured are uninsured by choice because they value things like cable, cell phones, cigarettes, electronics, etc more than they value their health. In essence, most gamble that they will be/stay healthy and know that in the event of an emergency, they will have full access to the greatest health care system in the world.
Additionally, people who idealize socialized medicine such as that found in Europe and Canada need to know that they are far from utopia. People in those countries are routinely denied newer treatments and one need only look at death rates from things like cancer to see that treatment their is far from cutting edge. Long waits and lack of access to more cutting-edge treatments combined with a lack of patient autonomy do not point to path the US should follow and 80% of Canadians rate their current system as "in crisis".

 

[GSresident]

Dear DOAnestMan:
I agree 100% with what you said about healthcare not being a right. I don't think of any right as being entitled to goods and services. Most 'rights' that I know are rights to action, which is totally different from having the right to have someone do something for you.

The movie SiCKO had nothing to do with the uninsured and he even says so in the opening 5 minutes of the film. The movie is about the people who have insurance and are paying the premiums and are still getting denied "cutting edge" or even "basic" treatment as you mention in your post.

Each insured individual enters a contract with a health insurance company to cover the costs of health care. We tend to get a little pissed when we have medical problems and we have paid the premiums, thus living up to our part of the contract, only to have the insurance companies dick out of their end based on technicalities. If you haven't run into this problem personally yet just give it a little time. I can tell you from personal experience that going through something like that has a tremendous power to make you take a careful look at the system and question some of your assumptions.

 

[Disse]

Quote:
Originally Posted by moeron
Finally, as far as education, fire department, police, 911, roads, etc... I would argue that they would be more efficient and useful if they were private. About the only thing that does not fall into this category is Defense. If fire departments had to compete against other fire departments for there customers, they would no doubt improve their performance so that they would get the call when the time came.

Are you kidding??? This is ridiculous!! Can you imagine the massively increased overhead that having multiple fire departments in your neighborhood competeing for... what?? How much profit do you think there is in stopping fires???

This was actually the case in the not too distant past. Look up the history prior to the development of fire departments....very interesting... very scary.



Some excellent responses on this topic. Personally I hope all the true conservatives realize that, apparently, there are very few true "conservatives" in congress despite supposedly having control of all branches for six years. As a financial conservative/social liberal (hey...if I don't want government interfering in my financial life why the hell would I want them dictating my social life as well!?!?!) there does not seem to be any political party representing my interests. I'm more of a moderate over all and the many of the libertarians scare me.

An important point that does gets forgotten in the extremes was reemphasized by GSresident:

The movie SiCKO had nothing to do with the uninsured and he even says so in the opening 5 minutes of the film. The movie is about the people who have insurance and are paying the premiums and are still getting denied "cutting edge" or even "basic" treatment as you mention in your post.

The current healthcare system already works for those with good benefits and those with no benefits. Unfortunately, the hard working, trying to be productive, working class and, increasingly, middle-class are getting squeezed out of existence (does this terrify anyone else?).

These folks aren't the alcoholic multi-liver transplant recipient or the bling bling, talk on the cell phone while you're trying to take a history but can't seem to work/find a job/"can you write a script for motrin because I have no money?" crowd.

The people in trouble work hard and are trying to do things "right." There are an awful lot of good people trying as hard as they can with the resources they have to get the care they need. Unfortunately, the current system is failing them. Similar to most of the homeless who are usually not seen by society (i.e. not the mentally ill guy pestering you on the street that most associate with the homeless), these folks are almost invisible.

I am not some bleeding heart but I do try to retain some perspective and there are most definitely a lot of very deserving people out there not getting the care they need--try to remember them.

This does not necessarily mean universal health care or rampant taxes. A good hard look should be taken at end-of-life care, lifestyle choices and "need." I don't think its feasible but a simple co-pay for non-emergent, emergency room care would probably save millions of dollars in health care costs (why do you think HMO's use them) but the lawyers won't let you do that. *sigh*

 

[VanillaBeans]

It would be wonderful if all americans were insured...
It would be great if we could revolutionize the lifestyle of the average american to create a healthier/smarter population...(sidenote: this may need require, in part, an overhaul of our "socialist" educational system--which I agree is hugely flawed....but, I am sure glad it is there at all--imagine the alternative)

However, those are not the arguements at hand--I think that it is essentially the health insurance system that is being scrutinized by Moore and not the healthcare system (very different debates--although both sides are flawed and need serious consideration. To begin the debate on how to fix either, the goals of each need to be decided on and made distinct from one another (before they can again be considered as hugely interrelated--something that may have been alluded to earlier concerning things like end-of-life care...etc))...

As far as the insurance side of the business is concerned (put simply):
Purpose: to provide a way for the american population to afford necessary medical treatment (and of course to turn a profit)

Problem: the tremendous failure of the insurance companies to serve their primary purpose for several segments of society (making money is currently their more primary concern...something which they deserve an A+ at)

Fixing the Problem(just thinking through the issue): how do you create the want for insurance companies to perform better for the population at large (or at least the segment that they insure)? They sure seem to like money...can the government provide monetary incentives for creating healthier patients (not merely recruiting the healthy)? As proposed in an earlier post, could the profit margin of these companies be limited in a way to inprove the system for the paying customer? Or, can the patient be given the power to incite a free-market tailored to better service? (Or, could the idea of insurance be revolutionized in such a drastic way from the current system that health insurance, as it is understood today, becomes completely obsolete?-As suggested in an earlier post) Lastly, could a non-profit insurance company, founded on some sort of morality and charity, provide sufficient coverage with minimal premiums and deductables?

(Also, the prospect of encouraging greater enrollment in health insurance needs to be considered as the next major issue...provide better service to more people=more money for them and less of the problems created by the uninsured? C'mon...your not telling me that someone isn't clever enough to make this happen)

Although Moore does the diservice of providing a "Socialist vs. Current US HMO's", there are clearly many answers to the problem that can be considered, outside of this narrow view. Despite this, I think that Moore has given the nation a gift in presenting a controversial subject matter in a such a way that it begs an intense scrutiny of the facts and the system...(you at least have to thank him for creating the foundation for this great thread) In the very least the average american walking out of Sicko feels a true sense of failure in the current system which could lead towards change (fingers crossed).

I think that the comments concerning healthcare issues (outside of insurance...but of course not far removed, deserve a spotlight of their own...another thread)

Thoughts: can you tax or penalize the unhealthy and at risk populations in the short term to provide better longterm health prospects? Or provide incentives to be healthy? or something...anything to change this fattening society--reality tv shows can only do so much😳....apparently early death and the discomfort/$ of future health problems is not enough to dissuade this population . Can the health insurance business actually become a system where free-trade produces a better product for the consumer? Can the process of guarding the population from the monetary burden of healthcare be acquired in a more efficient form? (GEEZ I HOPE SO!)

Also, in response to an earlier post concerning teacher wages, the supply and demand theory of wages (vs. business grads)...doesn't really seem to hold: http://www.nea.org/teachershortage/index.html

thanks for the previous intellectually stimulating posts!

(sorry if this is confusing...I have been awake for 24 hours now)

 

[deleted87051]

Well thats enough for now. I have to go do a complicated flap on an indigent patient, who supposedly doesn't get health care in the US system.

Indigent patients always get care as long as they can get to a hospital. The problem is that if you are not currently indigent and get an unlucky diagnosis, you can end up indigent at the whim of an insurance company.

The take home message of the movie for me is that countries with government run universal healthcare programs do not share our current healthcare "crisis".