What are your thoughts on US healthcare?

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What you state as fact is, in fact, opinion- and one on which we differ. I do like when the argument moves beyond policy to individual beliefs about the role of government. You (coming from what appears to be a more libertarian bent) and me (coming from a more socialist bent) could argue policy all day, and it would be a silly, useless endeavor. I'd prefer to join you for a Lagavulin and a rare porterhouse and discus our favorite finish to use on handcrafted furniture.

Osmo Polyx, personally.

This has been one of favorite threads to lurk on.

I appreciate this thread.
 
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Hi all,

A disclaimer because I'd like to be as transparent as possible; I am neither a Doctor nor a Doctoral student. I'm just a mom trying to info gather for my daughter who is suffering from, "which college do I pick to start my path-itis." I found the link to this website on a YouTube post and this just happened to be the first forum that popped up. Lucky you guys. 😉

What I do have, however, is a particular first-hand knowledge base that I thought some here might be interested in.

I'll try and keep this brief and if you'd like to ask me any questions afterwards I am more than happy to try and answer them.

I'm a born and bred New England girl who just happened to meet and marry a lovely Australian man. When I met my husband he was a CPA who was originally born in the UK and immigrated to Australia when he was a teen. I moved to Australia just after I turned 30 and returned to the US 6 years ago. I spent almost 15 years living under Universal Health Care.

I've had 2 babies under the US system and one under UHC. I've had US pediatricians for the first 2 before we moved and UHC pediatricians for all 3 while we lived in Aus. One of my first 2 babes was diagnosed with an ASD, along with partial blindness in one eye under UHC. We've also had multiple therapies for said child under both systems. Of course there are the medications, allergic reactions, stitches, broken bones, dentistry, etc that come with the whole kid territory.

Personally I have had the usual "upkeep servicing" under both systems, a lump checked there and a different one here, of course the babies under both, seen a few psychologists for therapy (ASD is a tough task master). I'm probably missing things but I think you get the gist that I've had enough experiences to make a fair assessment.

There is simply no question that Universal Health Care wins. Every time. Hands down. *Mic Drop*

But, seriously, please be wary of folks complaining about "wait times" who have never lived or have lived only a short time under the UHC umbrella. I have waited far, far longer to see a therapist for my ASD kiddo here than I ever did in Aus under UHC. (3 weeks was the longest for a first time appointment with a well known Aus Clinical Psychologist who specialized in ASD. Here it was 5 weeks IF they were taking new patients and IF they accepted my Insurance). I didn't have to wait to have the lump checked in Aus but I most certainly had to wait here to have the new one checked. I've waiting longer in US emergency rooms than in Aus.

People going to see doctors unnecessarily was just not something you ever heard anyone complaining about in Aus. There is a 24 hour phone service manned by nurses that you can call if you are unsure if you need to take a trip to the hospital or if it can wait to see your GP the next day. We have two unrelated friends who are GPs and it simply isn't an issue for them. But the system for getting diagnosed with a disability in Aus is a lot more strenuous than it is here. It would be harder to "work the system" there by far. The US system is easier to scam because its all separated by the insurance companies. Over there, since UHC is one system your info follows you, here I know its prohibited by privacy laws within the private health care system.

And then there are reasons that have nothing to do the Private Health Care system. For instance, in Aus my husband worked for himself in an IT Business related field. When he decided to go out on his own the last thing he needed to worry about was if we could go bankrupt due to health care related issues if any of us were to get sick. Here it was the biggest concern when after a few years in the US he decided to follow the same path. There are so many consequences to that difference.

I know I said I would try to keep it short, I failed, but Universal Health Care is one of my two great passions.

Other topics I would have loved to have touched on;


- How the tax system works in Aus in regards to UHC (or Why the heck did you need to know my husband was a CPA?)

- Mayor Pete said at the 2/25 debate that even Countries with UHC also have PHC even though it has very little in common with the US system besides the name, but he's going to say it no matter how misleading it is.

- Medicare/Medicaid why should I pay for others? (or, Me, me, me! But, enough about me. What about you? What do you think of me?)

- I've been told if we change to UHC I may loose my preferred doctor, is that true? (or Scare Mongering 101; Learning to ask, "Does that make sense?")

- Universal Health Care a/k/a Never Having To Call An Insurance Company To Verify Coverage Ever, Ever, Ever Again. Ever.


So many other topics yet so afraid I've wasted your time if you've read this far. Happy to answer any questions you may have and apologies if I've over stepped any boundaries here. Again, UHC is one of my great passions. Everyone has the right to live with the peace of mind I was able to for almost 15 years under UHC.


Thanks so much for your time!



"How do you feel about frilly toothpicks?" "I'm for 'em!" "Well, this club is formed."

- The Great Mitch Hedberg
 
One thing I'm wondering is how it will impact access and engagement in mental health treatment. As a VA provider, we definitely face issues with people being overtreated and not being able to "deny people care." I wonder if that would extend to the general population with universal coverage. I assume not because the only thing that would change would be the payer, but...

There has been increased utilization review with medicare in recent years that has been concerning. A lot of colleagues have been getting threatening letters about patterns of practice due to having a high contingent of medicare patients, so I don't think that will be an issue.

Concerns I have:

1. Effect on VA positions - Will good VA jobs be cut and replaced with worse positions in the community due to medicare for all? Psychology has a stronger foothold at the VA and less so in the many private areas where masters level providers continue to encroach.

2. With significant payment cuts since 2001 and another 8% happening in 2021, this may mean a significant decrease in salaries. Will it continue to decrease? This is especially concerning when you cannot refuse medicare and take other options.

3. With MIPS and EHR requirements kicking in 2021, will this mean increased paperwork and required reporting for most psychologists as there are no other insurances. Along with that, a decrease in the ability to maintain an independent practice and the need to be employed for a large corporation. This is already common in geriatrics and the companies have poor benefits and ridiculous productivity requirements. 18 patients/day anyone?

4. Coming back to independent practice - reduced need for cash based services and problems due to medicare having silly rules about being required to accept their payments in all settings if you have a day job.

5. Medicare audits - Will this mean that if you fail an audit you will essentially be blackballed from clinical practice?
 
We all die. You don’t get to pretend that govt seizing an industry changes that. Everyone dies. Full stop.

Even part of the proposed cost savings of going full govt takeover is to start backing off on end of life “full care” and push more hospice/palliative

The libertarian crowd just accepts that reality earlier. When deciding if my treatment that might extend life by a year is worth $200k, I need to have the $200k to make a real value judgement. I shouldn’t be making that call with other people’s money. That situation doesn’t change with a maintenance treatment at $20k/yr or $500

Are you a social Darwinist clinical psychologist? That’d be a rare and mysterious breed in the modern era. Indeed, I’ve never met one out in the wild before.

Even if you don’t self-style that way you really know how to talk the classist apartheid talk. Honestly, I’m almost as bemused as I am disappointed by the comments you’ve made (that I’ve gotten through to this point, anyway) in this thread. I want to see more as much as I want to never see any again. You just may have broken my fragile mind tonight, sb247... With that, I’m going to bed
 
Are you a social Darwinist clinical psychologist? That’d be a rare and mysterious breed in the modern era. Indeed, I’ve never met one out in the wild before.

Even if you don’t self-style that way you really know how to talk the classist apartheid talk. Honestly, I’m almost as bemused as I am disappointed by the comments you’ve made (that I’ve gotten through to this point, anyway) in this thread. I want to see more as much as I want to never see any again. You just may have broken my fragile mind tonight, sb247... With that, I’m going to bed
I’ve been pretty dang consistent for years here about how the govt should not treat anyone any different regardless of race or class. You haven’t read enough of my posts if you are going to start dropping incorrect implications like that.
 
I’ve been pretty dang consistent for years here about how the govt should not treat anyone any different regardless of race or class. You haven’t read enough of my posts if you are going to start dropping incorrect implications like that.
. Yep, that pretty much confirms it...
 
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