Universal health care?

[HMSBeagle]

With all this talk about Universal health care, it seems to me that doctors will get the shaft. No wonder many in med school want to be a dermatologist or a plastic surgeon. But, rant aside, my question is how do you think specialists will do under a UHC proposal? Or is this all political talk and never come to fruition once people find out the outrageous taxes needed to fund such system?

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[Chizwheel]

Think of the dumbest person that you know. Now multiply that dumbness by 100. Have an idea of how dumb that person would be? Well the average person out on the street is even dumber than that when it comes to understanding what UHC entails. Essentially, most politicians will promise whatever the public wants to hear, and because the public is so dumb, they wont question what implications those promises may have for themselves or health care in general. As a result, when whomever becomes president, what was promised and what will happen will be dramatically different. Essentially what I am trying to say is we're almost going to have to wait and see what happens...

If UHC does happen to the extreme, then I'm quitting and moving to Scotland where I'll tend sheep on the hillside.

 

[Bushido416]

hah my dream is to go back to scotland was one of the best places I visited in europe. I think i'll do the same thing minus the sheep. I think I'll clone my own sheep or something there they got a lot less strict rules about that kind of stuff.

 

[Ashers]

Think of the dumbest person that you know. Now multiply that dumbness by 100. Have an idea of how dumb that person would be? Well the average person out on the street is even dumber than that when it comes to understanding what UHC entails. Essentially, most politicians will promise whatever the public wants to hear, and because the public is so dumb, they wont question what implications those promises may have for themselves or health care in general. As a result, when whomever becomes president, what was promised and what will happen will be dramatically different. Essentially what I am trying to say is we're almost going to have to wait and see what happens...

If UHC does happen to the extreme, then I'm quitting and moving to Scotland where I'll tend sheep on the hillside.

In Scotland you'll have to deal with the NHS as a patient, but I'll admit, moving to Scotland or anywhere in the UK sounds quite tempting.

 

[Chizwheel]

No if I move to Scotland, I won't be practicing medicine. I'll just raise livestock.

 

[lildave2586]

UHC is the worst thing that could happen to this country.

If someone tells you we should try UHC becuase of it's success in Canada, England, ect., ask them what the population of those countries. There is no way it would work in a country with our population. We don't have enough doctors.

If someone tells you we should try UHC because we are currnetly rationing healthcare based on those who can pay for it, tell them they are right and we can't give away healthcare for free and expect students to continue to go into the field.

If this country wants to lower the cost of healtcare and give more people access to it, we need to do the following things:
1.) Tell people to lose weight and stop smoking
2.) Get rid of the paper trail. We can put a man on the moon but we can't come up with a data system to store health information because of some people's precious "privacy."
3.) Train more doctors, nurses, and skilled healthcare practicioners
4.) Promote health careers in underserved areas.
5.) Malpractice reform now. Let's stop paying lawyers for healthcare.

None of this will ever happen because a politician can't win votes promoting these ideas. Politicians win votes by telling people they are going to give them things for free (democrats do anyway).

 

[bawer234]

With all this talk about Universal health care, it seems to me that doctors will get the shaft. No wonder many in med school want to be a dermatologist or a plastic surgeon. But, rant aside, my question is how do you think specialists will do under a UHC proposal? Or is this all political talk and never come to fruition once people find out the outrageous taxes needed to fund such system?

What I think your classmates are afraid of is the prospect of a single payer system. Universal Health Care does not necessarily entail socialized medicine but many people use the terms interchangably.

The US will not reform health care into a socialized health care system...just won't happen. It would require far too many structural changes and the insurance companies would spend every last dollar available to make sure it died a horrible and painful death.

Universal Health Care is a great thing...finding a way to create it with out making our current situation any worse is the trick. Most likely the UHC reforms will take place at the state levels and with slow and gradual changes.

 

[HMSBeagle]

UHC is the worst thing that could happen to this country.

If someone tells you we should try UHC becuase of it's success in Canada, England, ect., ask them what the population of those countries. There is no way it would work in a country with our population. We don't have enough doctors.

If someone tells you we should try UHC because we are currnetly rationing healthcare based on those who can pay for it, tell them they are right and we can't give away healthcare for free and expect students to continue to go into the field.

If this country wants to lower the cost of healtcare and give more people access to it, we need to do the following things:
1.) Tell people to lose weight and stop smoking
2.) Get rid of the paper trail. We can put a man on the moon but we can't come up with a data system to store health information because of some people's precious "privacy."
3.) Train more doctors, nurses, and skilled healthcare practicioners
4.) Promote health careers in underserved areas.
5.) Malpractice reform now. Let's stop paying lawyers for healthcare.

None of this will ever happen because a politician can't win votes promoting these ideas. Politicians win votes by telling people they are going to give them things for free (democrats do anyway).

Yeah i agree. But do you think UHC will ever happen here?

 

[bawer234]

Yeah i agree. But do you think UHC will ever happen here?

Eventually, but like i said not the UHC that you are refering too. I think that every man, woman and child will be covered by some kind of system but not one that is run by the federal government. The system will probably involve insurers and be subsidized by the state/fed gov.

 

[meister]

I get the feeling that almost all of the people who rail against "socialized medicine!" or universal healthcare haven't really got a ****ing clue what they're talking about. No to universal coverage because we don't have enough doctors? That is the stupidest thing I've ever heard. Let's deny medical insurance because there's no one to treat them! Honestly, please tell me you typed that without actually thinking about it for longer than two seconds.

Anyone who's had to deal with insurance companies and uninsured patients should realize that our current system is utterly broken. There are 30-40 million people currently without insurance, and all the people who say that UHC is a bad idea don't realize that we already ****ing pay for all of their medical care when they go to the emergency room or fall off a cliff or whatever. They just get it for free and we all foot the bill by getting higher premiums. SO WE ALREADY PAY FOR THEM.

Not only do we have tens of millions of people without insurance, we have probably twice as many who are UNDERinsured. What happens when these people can't pay or max out their benefits? Yup you guessed it, the taxpayers pay for their care! See a pattern yet?

God this is frusterating.

 

[bawer234]

I get the feeling that almost all of the people who rail against "socialized medicine!" or universal healthcare haven't really got a ****ing clue what they're talking about.

You are right, most don't have a clue about the issue.

No to universal coverage because we don't have enough doctors? That is the stupidest thing I've ever heard. Let's deny medical insurance because there's no one to treat them! Honestly, please tell me you typed that without actually thinking about it for longer than two seconds.

Anyone who's had to deal with insurance companies and uninsured patients should realize that our current system is utterly broken. There are 30-40 million people currently without insurance, and all the people who say that UHC is a bad idea don't realize that we already ****ing pay for all of their medical care when they go to the emergency room or fall off a cliff or whatever. They just get it for free and we all foot the bill by getting higher premiums. SO WE ALREADY PAY FOR THEM.

I disagree with you that our system is utterly broken. We actually have the best health care in the world. The access to it is what needs fixing. The care you refer to is emergency care which is differs from chronic care or preventive care. This can add up fast, especially when people have no kind of incentive to use this priviledge with responsibility (one of the major problems of socialized medicine).

Not only do we have tens of millions of people without insurance, we have probably twice as many who are UNDERinsured. What happens when these people can't pay or max out their benefits? Yup you guessed it, the taxpayers pay for their care! See a pattern yet?

God this is frusterating.

This is where the statistics actually get interesting. The "30-40 million" uninsured is actually a misrepresentation of the actual population. Most people will quote that there are currently 46 million uninsured americans today. However, approximately 20% of those are not US citizens (illegal aliens who, although they deserve care, may not be contributing to the care of others through taxes, as well as other temporary visitors). This leaves about 36.8 million "uninsured" americans among us. The percentage of this population who are chronically uninsured for a period under 4 months is approximately 45%...the % uninsured for a period for over 24 months....(drumroll)....16% (Gratzer, The Cure). Most of the "uninsured" in our country are uninsured because they either fall into the catagory of choosing not to have health insurance or because they are in between jobs which provide their care. I will not down play the tragedy that some people face due to the current system but many "facts" that are being thrown around are horribly misleading.

Its actually pretty amazing how good a job our broken system does when you sit down and do your research. BTW I am in no way against UHC reform, I just believe a lot of individuals jump to the conclusion that our country's system is pathetically broken when it is in fact functioning...however poor it may be in some cases.

 

[Mythos219]

I think it boils down to who has the guts to push a UHC plan through. No matter how well its structured to provide access it will initially be worse than what we have now. The instant access to medical care people enjoy now will be gone. This is what the general public fails to realize.

Personally I don't think any politician or party is bold enough to take that kind of step regardless of what they promise during campaign time. I do think incremental regulation (ie. expanding the scope of practice to allied health professionals, more cost control mechanisms, etc.) will continue finally culminating in a de facto UHC system at some point.

 

[cpants]

Universal Healthcare does not mean Socialized healthcare a la Canada or Europe. It just means that everyone can get medical care. The best way to do this would be to cut out the staggering bureaucracy that is suffocating our system.

People should pay cash for basic preventative care and minor illnesses. They should buy a cheap insurance policy for catastrophic and chronic illnesses. Doctors and charitable organizations should pick up the slack for people who can't afford to buy care or insurance. If we actually got some market forces working in this business, doctor's salaries and patient access would go up while costs go down.

 

[Ashers]

Here's an article my dad sent me from a local newspaper (that he got through the Hawaii Medical Association)

Canada’s medical care is bad for your health
Politicians and reporters often mention the Canadian health system as a model the United States should accept to improve medical care. I am no expert on this, but in Washington, D.C., at the National Orthopedic Leadership Conference, I listened with interest as Dr. Brian Day of Vancouver spoke on the state of Canadian health care. Day has been an Orthopedic surgeon for 30 years and is now president of the Canadian Medical Association. From his point of view, one word describes Canadian health care today -- rationing.
Among the facts he presented were: 36 percent of Canadians with acute illness have to wait six or more days to see a doctor. He personally has a 250-patient waiting list -- patients waiting for bone and joint surgery. Despite this, his operating room time was cut, as a cost savings measure, from 22 hours per week to five hours per week. There is a chronic shortage of facilities. Canada has only been able to afford one-tenth as many MRI, CT and ultrasound scanners compared to Japan on a per capita basis. The future is even more grim. Money for research has dried up. New technology is denied. Half of newly trained medical graduates leave. They are now 30 percent short of physicians. Canada was fourth in the world in per capita physicians; now it is 24th. A total of 700,000 patients have been on waiting lists. More than 8,000 have died while waiting.

The cost of waiting is estimated at $15 billion per year -- medical complications plus lost time at work and sometime irretrievably lost health. This waiting is so pervasive that on the bottom of the pre-printed form telling one patient the date and time of a scheduled test is written -- "If the person named on this computer generated letter is deceased, please accept our sincere apologies."

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[Mythos219]

Universal Healthcare does not mean Socialized healthcare a la Canada or Europe. It just means that everyone can get medical care. The best way to do this would be to cut out the staggering bureaucracy that is suffocating our system.

People should pay cash for basic preventative care and minor illnesses. They should buy a cheap insurance policy for catastrophic and chronic illnesses. Doctors and charitable organizations should pick up the slack for people who can't afford to buy care or insurance. If we actually got some market forces working in this business, doctor's salaries and patient access would go up while costs go down.

The problem is people would never buy health insurance until they were facing a chronic/catastrophic illness. If you think costs are expensive now they will be exponentially higher if the risk isn't spread out. No insurance company will survive if they only insure people with chronic/catastrophic illnesses so they won't do it unless the gov. forces them to. In which case they will simply jack up the premiums into the stratosphere, companies will cite that healthcare costs for US workers are too high, and further outsourcing will happen.

 

[cpants]

The problem is people would never buy health insurance until they were facing a chronic/catastrophic illness. If you think costs are expensive now they will be exponentially higher if the risk isn't spread out. No insurance company will survive if they only insure people with chronic/catastrophic illnesses so they won't do it unless the gov. forces them to. In which case they will simply jack up the premiums into the stratosphere, companies will cite that healthcare costs for US workers are too high, and further outsourcing will happen.

I completely disagree. The American people are a lot smarter than you give them credit for. People buy homeowner's insurance, traveler's insurance, postal insurance. They understand that the worst can happen to them, and they are willing to invest some money in insuring against that possibility. A policy that truly covered catastrophic illness, with say a 10,000 dollar deductible, would not be very expensive at all. Insurance and healthcare costs should be paid for by people, not companies.

 

[Mythos219]

I completely disagree. The American people are a lot smarter than you give them credit for. People buy homeowner's insurance, traveler's insurance, postal insurance. They understand that the worst can happen to them, and they are willing to invest some money in insuring against that possibility. A policy that truly covered catastrophic illness, with say a 10,000 dollar deductible, would not be very expensive at all. Insurance and healthcare costs should be paid for by people, not companies.

If you think the average american is going to pay a $10K deductible when they have the option not to you are out of your mind. Its why health insurance can't be for catastrophe only b/c no one will buy it until they get injured. Why do you think States have mandatory auto insurance laws? B/c no one would buy it otherwise since they will be thinking "I won't get into an accident." Even with auto insurance laws and financially feasible premiums will below your proposed $10K deductible, thousands of people still don't buy car insurance. The reality is people don't care about their health until they get sick.

There's a huge difference b/w a $5 surcharge for insuring a letter and a $10K deductible. In short your proposal will never work b/c a) people won't buy insurance till they are catastrophically injured and b) no insurance company will insure a group of people whose aggregate healthcare costs far exceed the average premium which would happen unless the risk is spread out as it is currently.

Maybe a private healthcare trust account separate from insurance might be the solution. Each person puts away X dollars every month in an interest bearing account as they see fit for their future healthcare costs.

 

[Sifilis]

There are 30-40 million people currently without insurance,

People toss this statistic around a lot, but that doesn't mean that there are 40 million people who CAN'T get insurance. A portion of those people simply choose to spend their money on something else, like hi-def tv's and cell phones.

In a system of universal care, whether it's run by the government or just subsidized by the taxpayers, there's absolutely no incentive for people to limit the amount of services they use when someone else is footing the bill. That gets really expensive. Even in Canada, there are shortages (you have to wait forever to get things like CT scans and elective surgeries) because there's no limit to demand. Also, the Canadians pay obscenely high tax rates.

As for people using emergency departments and skipping out on the bill, you can thank EMTALA for that...

 

[peanutbutterman]

If you think the average american is going to pay a $10K deductible when they have the option not to you are out of your mind. Its why health insurance can't be for catastrophe only b/c no one will buy it until they get injured. Why do you think States have mandatory auto insurance laws? B/c no one would buy it otherwise since they will be thinking "I won't get into an accident." Even with auto insurance laws and financially feasible premiums will below your proposed $10K deductible, thousands of people still don't buy car insurance. The reality is people don't care about their health until they get sick.

There's a huge difference b/w a $5 surcharge for insuring a letter and a $10K deductible. In short your proposal will never work b/c a) people won't buy insurance till they are catastrophically injured and b) no insurance company will insure a group of people whose aggregate healthcare costs far exceed the average premium which would happen unless the risk is spread out as it is currently.

Maybe a private healthcare trust account separate from insurance might be the solution. Each person puts away X dollars every month in an interest bearing account as they see fit for their future healthcare costs.

Are you kidding me? The easy way to get around this is to make everyone get insurance...then they wouldn't be able to wait until a catastrophe already happened before they bought insurance. Also, what insurance company will let you sign up for their plan after a catastrophe has happened?

Another thing...a lot of young poor people that are healthy (like me and a lot of my friends) have catastrophic insurance because it has cheap premiums. Yes...people don't like high deductibles...but when you play the odds, and you're healthy, you probably won't have to pay 10,000 dollars for your deductible.

And your comment about insurance premiums going through the roof because everybody is on catastrophic insurance...it doesn't make sense. The only way this would happen is if the only people that are on catastrophic insurance are the chronically ill and those that need to go above and beyond their deductible. Like I already said, there are A LOT of healthy, young people that won't ever go above their deductible...not even close...and it is just better to be paying low monthly premiums. When there are a lot of healthy people that are paying the same premiums as everybody else...this spreads the risk out.

I agree that catastrophic insurance isn't a good fit or a good fix for everybody. But there are a lot of people that it could work for.