What's wrong with America's Heath Care System?

[Jessiemmc]

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Any thoughts??

 

[bigbassinbob]

A lot of stuff. We're obviously headed for a big change in the near future, and I'm sure it will have something to do with insurance companies.

 

[Fed Meat]

1) insurance plans that reward doctors for witholding care (this has its pros, too)

2) heavy emphasis on tertiary and secondary care as opposed to primary care (though this alos has its benefits, as well)

3) extremely high medical malpractice premiums

4) unequal access to healthcare

5) dwindling numbers of companies paying for private healthcare plans for employees. --> smaller companies being unable to secure lower, discounted premiums that larger companies can (I really like Bush's plan to allow small companies to merge their interests together to purchase discounted healthcare plans)

I quit using parentheses because most of these are double-edged swords.

 

[Mumpu]

US spends a larger fraction of GNP on healthcare than any other country in the world and still has 40% of population uninsured or underinsured. Pharmaceutical and insurance industries are largely unregulated and have a tremendous political influence. Frivolous litigation and juries awarding insane sums of money is making it impossible for some specialists to practice in states without tort reform. And so on...

 

[PreMedAdAG]

this is very helpful.. please post more and post resources if you have them

 

[MadameLULU]

Any thoughts??

The fact that we spend the most $$ and dont even have the best healthcare outcomes in the world. When I mean healthcare outcomes, I am referring to the standard indicators that public health and others use to guage the health of a nation. Thats pretty sad. We are ranked #35 or so in infant mortality rates.

 

[marr]

I do hope that HMO would turn more of their profit back toward the patients instead of satisfying their investor's pocket. Just look up in major business journal on these HMO and see how much a profit margin they have. It's insane that they would raise insurance rate eventhough they are making a healthy profit.

 

[PookieGirl]

Many primary care doctors don't talk to their patients about obesity.

 

[medic170]

The fact that we spend the most $$ and dont even have the best healthcare outcomes in the world. When I mean healthcare outcomes, I am referring to the standard indicators that public health and others use to guage the health of a nation. Thats pretty sad. We are ranked #35 or so in infant mortality rates.

Ranked by whom? Overall, we do indeed have the best healthcare and outcomes in the world!!!

 

[mshheaddoc]

Ranked by whom? Overall, we do indeed have the best healthcare and outcomes in the world!!!

How can you say that? Ranked overall by clinical data that shows overall life expectancy lower to other industrialized countries? You really think we have the best healthcare? With millions of people a year who get none? 😕

 

[TiggidyTooth]

First, 45 million Americans, about 15% are uninsured, not 40%. Let me add that since 2003, that number has risen by 1.4%.

Whether it's 40% or 15%, it's a huge problem, especially considering that the United States spends around 14% (can't remember the exact percentage) of its GDP on health care, and we're talking government expenditure ONLY. HMOs, PPOs, etc., private health expenditure is not even included in that figure. When you compare this to countries like Japan and Sweden, countries with pretty successful universal healthcare programs, on average these nations, and others like them, spend a total of 8% of their GDP on health care, and everyone is insured in these nations.

So what's the result of all of these uninsured individuals? First, they'
re lack of insurance is one cause of the United States' high governmental expenditure on health care, as these individuals have no where to go except for free clinics and state-run ERs. Thus, the government foots a much higher bill than they need to and the uninsured are left with piss-poor healthcare and no continuity of care Furthermore, the high percentage of uninsured puts a lot of strain on limited state medical resources and leads to the ER being used as a primary care facility instead of well, a place for emergencies. In my opinion, the U.S. needs to stop sitting on its thumbs and finally face reality and start pushing for some serious healthcare reform.

I also just wanted to point out in rebuttal to a previous post that over fifty percent of HMOs were taking losses until 1998. Today, I'm not sure what percentage, but a substantial number of HMOs take losses. HMOs have been quite unsuccessful when you compare their profits as an industry to most any other industry over a ten year period, the majority are not fattening up as a previous poster said. In general, HMOs have been a pretty large failure.

I hope my surmon was helpful

AJ

 

[medic170]

How can you say that? Ranked overall by clinical data that shows overall life expectancy lower to other industrialized countries? You really think we have the best healthcare? With millions of people a year who get none? 😕

Again, ranked by whom? Liberal pollsters?

 

[mshheaddoc]

Funny just talked about this last night in my healthcare mgmt class .... our top ones


- uninsured and underinsured (actually #1 by health economists)
- reactive rather than preventive care
- cost of healthcare
- influence of private insurance/pharmaceutical companies
- lack of education of patients

 

[elee20]

Any thoughts??

George Bush is what's wrong.

 

[mshheaddoc]

Again, ranked by whom? Liberal pollsters?

uh no. ranked against data collected by the OCED - organization for economic co-operation and development (from what I have in my possession currently) but look at any world health organization statistical analysis.

 

[bewitched1081]

well of course you can never say this in an interview, but i think we all need to turn the looking glass toward ourselves, our future selves. as future physicians, will we put our own interests above our patients?

 

[mshheaddoc]

George Bush is what's wrong.

great response! 👍






😎

 

[mshheaddoc]

well of course you can never say this in an interview, but i think we all need to turn the looking glass toward ourselves, our future selves. as future physicians, will we put our own interests above our patients?

bet you we will end up doing that. That is the sad part.

 

[UseUrHeadFred]

I do hope that HMO would turn more of their profit back toward the patients instead of satisfying their investor's pocket. Just look up in major business journal on these HMO and see how much a profit margin they have. It's insane that they would raise insurance rate eventhough they are making a healthy profit.

For-profit HMOs are not social organizations. They are corporations just like any other. Their objective is to maximize profit. This is done by receiving more in premiums than is spent on healthcare.

HMOs business plans somehow expect to make money by charging premiums. People buy plans because they think their premiums will cost less than the care they receive. This is a total conflict of interest.

Insurance only works when it's set up more like homeowners insurance - it's there if your house burns down, not if you break a window.

I want a free market solution. Neither party supports that.

 

[medic170]

George Bush is what's wrong.

You are whats wrong

 

[dnelsen]

this is very helpful.. please post more and post resources if you have them

www.pnhp.org

physicians for a national health program


This is a very good site that seems to endorse the single payer system (government would replace insurance companies, but doctors are still private)

 

[mshheaddoc]

I hope my surmon was helpful

isn't it sermon?

 

[medic170]

www.pnhp.org

physicians for a national health program


This is a very good site that seems to endorse the single payer system (government would replace insurance companies, but doctors are still private)

Socialize everything, that way nobody will have to worry about personal responsibility

 

[dnelsen]

Socialize everything, that way nobody will have to worry about personal responsibility

The single payer system they propose isn't socialized medicine you turd-burglar......read the site.

 

[elee20]

You are whats wrong

Whatever!

 

[medic170]

The single payer system they propose isn't socialized medicine you turd-burglar......read the site.

That is really mature. Sticks and stones.......

 

[mshheaddoc]

this is perfect example why Pre-Allo is so mature.

 

[fun8stuff]

You are whats wrong

hahaha..... I agree 😉 Too many people try and take the easy way out and point the finger at one person/one thing....

 

[dnelsen]

That is really mature. Sticks and stones.......

😀




Some thoughts/observations on medicine from my short exposure to the field:

-ANYONE can receive treatment (at least in minnesota, and I think nationally) regardless of whether or not they have insurance. Granted, they will receive a huge bill, but most don't bother paying it. It is illegal to deny treatment to people who show up at the county hospital.
-Regarding the point above, many uninsured people end up coming to the ER for colds, the flu, and other minor ailments that would normally be taken care of by a primary care physician. This is a huge waste of money and time!
-Minnesota doesn't allow for-profit HMOs to do business in the state. Although, even the not-for-profit HMOs have been accused (and rightfully so) of wasting money (expensive golf outings, ridiculous executive salaries, etc.)

It seems the problem isn't access to healthcare, because as I mentioned above, you can receive it regardless of your ability to pay. However, the unbearable high cost of medical treatment for those without insurance is often a deterring factor in their receipt of medical care. The doctors are then forced to charge more to cover the X percent that they know can't/won't pay and as a result our insurance goes up... and on and on it goes...

 

[TiggidyTooth]

isn't it sermon?

Oh it is, how enlightening... 🙄

 

[mshheaddoc]

Oh it is, how enlightening... 🙄

joking ... since noone is being serious on this thread other than us ... 👍 🙁

 

[BGGA]

😀




Some thoughts/observations on medicine from my short exposure to the field:

-ANYONE can receive treatment (at least in minnesota, and I think nationally) regardless of whether or not they have insurance. Granted, they will receive a huge bill, but most don't bother paying it. It is illegal to deny treatment to people who show up at the county hospital.
-Regarding the point above, many uninsured people end up coming to the ER for colds, the flu, and other minor ailments that would normally be taken care of by a primary care physician. This is a huge waste of money and time!
-Minnesota doesn't allow for-profit HMOs to do business in the state. Although, even the not-for-profit HMOs have been accused (and rightfully so) of wasting money (expensive golf outings, ridiculous executive salaries, etc.)

It seems the problem isn't access to healthcare, because as I mentioned above, you can receive it regardless of your ability to pay. However, the unbearable high cost of medical treatment for those without insurance is often a deterring factor in their receipt of medical care. The doctors are then forced to charge more to cover the X percent that they know can't/won't pay and as a result our insurance goes up... and on and on it goes...

In this age of managed care, where the shrinking surpluses generated from insured patients can no longer absorb the losses that physicians acquire from treating the uninsured, what are the doctors choices?

 

[ajnak182]

😀




Some thoughts/observations on medicine from my short exposure to the field:

-ANYONE can receive treatment (at least in minnesota, and I think nationally) regardless of whether or not they have insurance. Granted, they will receive a huge bill, but most don't bother paying it. It is illegal to deny treatment to people who show up at the county hospital.
-Regarding the point above, many uninsured people end up coming to the ER for colds, the flu, and other minor ailments that would normally be taken care of by a primary care physician. This is a huge waste of money and time!
-Minnesota doesn't allow for-profit HMOs to do business in the state. Although, even the not-for-profit HMOs have been accused (and rightfully so) of wasting money (expensive golf outings, ridiculous executive salaries, etc.)

It seems the problem isn't access to healthcare, because as I mentioned above, you can receive it regardless of your ability to pay. However, the unbearable high cost of medical treatment for those without insurance is often a deterring factor in their receipt of medical care. The doctors are then forced to charge more to cover the X percent that they know can't/won't pay and as a result our insurance goes up... and on and on it goes...

Nelson, while I agree with most of what you've said, I'm in opposition to your belief that access to care is not a prime issue. True, county hospitals cannot deny care. However, the lack of access to primary care for the uninsured results in the flooding of county hospitals, which become less able to handle real emergencies and often have no option but to make their patients wait for incredibly long periods of time for things easily treated by a nurse practitioner or primary care doc. Furthermore, medical bills are responsible for approximately 1/3 of homelessness. While they can't deny you care, they can send your bill to a debt collection agency. Since those bills are normally so large, $700-$1000 for a fracture (based on personal experience) for example, a person living paycheck to paycheck trying to now pay off that bill is in for some seriously tough times once the debt collector comes knocking. It's scenarios like these that really make me a supporter of universal healthcare where government acts only as a representative for insurance holders (the U.S. population) but has very limited control over the operation of whatever entity manages the healthcare program (kind of like the Federal Treasury, maybe?) and healthcare providers remain private. Basically, what PNHP seems to advocate.

AJ

 

[NubianPrincess]

We coulda had this discussion BEFORE I wrote my secondary last night 🙁

I am just kidding 😉

 

[dnelsen]

Nelson, while I agree with most of what you've said, I'm in opposition to your belief that access to care is not a prime issue. True, county hospitals cannot deny care. However, the lack of access to primary care for the uninsured results in the flooding of county hospitals, which become less able to handle real emergencies and often have no option but to make their patients wait for incredibly long periods of time for things easily treated by a nurse practitioner or primary care doc. Furthermore, medical bills are responsible for approximately 1/3 of homelessness. While they can't deny you care, they can send your bill to a debt collection agency. Since those bills are normally so large, $700-$1000 for a fracture (based on personal experience) for example, a person living paycheck to paycheck trying to now pay off that bill is in for some seriously tough times once the debt collector comes knocking. It's scenarios like these that really make me a supporter of universal healthcare where government acts only as a representative for insurance holders (the U.S. population) but has very limited control over the operation of whatever entity manages the healthcare program (kind of like the Federal Treasury, maybe?) and healthcare providers remain private. Basically, what PNHP seems to advocate.

AJ

I really don't think we disagree at all, as I said, the access to healthcare is there in the strictest sense of the word "access". However, many people don't seek out healthcare due to the oppressive costs (see my original post).

And I hear you on the homelessness point. I volunteer in a homeless shelter and many/most of the people there have chronic health issues and many of those issues are psychiatric. A nurse practitioner visits the shelter every Thursday and many of the homeless people do take advantage of this service.

 

[dnelsen]

In this age of managed care, where the shrinking surpluses generated from insured patients can no longer absorb the losses that physicians acquire from treating the uninsured, what are the doctors choices?

I don't fault the doctors at all. It is a vicious cycle, where the uninsured drive up the cost care, which drives up the cost of health insurance, making health insurance more expensive, which in turn creates more uninsured....and on and on...

 

[LNpisces]

i am REALLY behind on all of these issues. does anyone have any reliable links or suggestions on magazines/books?

 

[mamaMD]

George Bush is what's wrong.

Ohh so we didn't have any problems at all before GWB took office? LOL This is one issue where it's not that simple to just point fingers. The thing is, this has been a problem for a long time and it's getting worse and no one has been able to fix it (Clinton, Bush, etc) partly because people like Bush, Kerry, Clinton, whoever, are so damn rich they have no clue.

I think there are so many freaking problems, I would have no clue where to even start. Bush stays in office its going to still go downhill, Kerry takes office its still going to go downhill.

 

[DocMizzle]

Ohh so we didn't have any problems at all before GWB took office? LOL This is one issue where it's not that simple to just point fingers. The thing is, this has been a problem for a long time and it's getting worse and no one has been able to fix it (Clinton, Bush, etc) partly because people like Bush, Kerry, Clinton, whoever, are so damn rich they have no clue.

I think there are so many freaking problems, I would have no clue where to even start. Bush stays in office its going to still go downhill, Kerry takes office its still going to go downhill.

I completely agree. I don't think either condidate is capable and/or will be willing to push through a major healthcare reform in the next four years. There is so much more going on right now (the war, homeland security, a slow economic recovery), and neither candidate seems to be making it a huge issue or offering any significant stance on the matter. I know it's pessimistic, but I foresee things as just getting worse the next four years. Maybe in the 2008 election it will be a top priority...

 

[Cerbernator]

Why does everyone think socializing is somehow going to make medicine better? Its not like medicine will no longer cost someone money. It's not like the government has a great track record with huge social programs. I see something along the lines of a huge money sucking government run HMO if we get a "national" healthcare program.

 

[medic170]

Why does everyone think socializing is somehow going to make medicine better? Its not like medicine will no longer cost someone money. It's not like the government has a great track record with huge social programs. I see something along the lines of a huge money sucking government run HMO if we get a "national" healthcare program.

Well said as usual cerb!

 

[constructor]

if you look at some of the world's most successful healthcare systems (sweden, norway, canada, france), it is apparent that having a government single-payer system operate within the framework of private medical practice is working very well in reality. i don't know if it will work as well in the united states because we already have so many entrenched customs that make the reform much more difficult than in the other countries, but i certainly think it would be the best option in the long run because it cuts down on a lot of the administrative complexities and costs that you have when there are so many intermediary players in a system like ours.

 

[Jessiemmc]

Thanks for all the great replys everyone! Very Helpful!!!

 

[medic170]

if you look at some of the world's most successful healthcare systems (sweden, norway, canada, france), it is apparent that having a government single-payer system operate within the framework of private medical practice is working very well in reality. i don't know if it will work as well in the united states because we already have so many entrenched customs that make the reform much more difficult than in the other countries, but i certainly think it would be the best option in the long run because it cuts down on a lot of the administrative complexities and costs that you have when there are so many intermediary players in a system like ours.

Waiting 9 months for surgery, or 4 weeks to see a PCP is "successful" A lot of patients from those countries end up coming to the U.S. for surgeries because they are stuck on a waitlist in their socialized system.

 

[constructor]

Waiting 9 months for surgery, or 4 weeks to see a PCP is "successful" A lot of patients from those countries end up coming to the U.S. for surgeries because they are stuck on a waitlist in their socialized system.

you are completely wrong... you might want to actually read up on how things work in those countries before you respond so you at least sound like you have something semi-intelligent to say. the people who come here for surgeries from other countries are generally very wealthy and want to try an experimental procedure or some procedure that is in the preliminary stages. this means they only come here during exceptional circumstances (they have tried many treatment options and haven't experienced success, for example), not simply because they want to have something done soon. the other countries i mentioned are actually very good with both the waiting time and the access, two things that only work as a tradeoff in our system unfortunately...

 

[Fed Meat]

The fact that we spend the most $$ and dont even have the best healthcare outcomes in the world. When I mean healthcare outcomes, I am referring to the standard indicators that public health and others use to guage the health of a nation. Thats pretty sad. We are ranked #35 or so in infant mortality rates.

This is really untrue. If you look at 5-year cancer survival rates, the US is hands down the most effective healthcare system in the world (US 5-year colon cancer survival rate is 60%. In the UK, it's 36% in 1999). True, we don't have nurses showing up at the house of new borns and making sure they have all their injections and starting a long-term relationship.

I'm not convinced that infant mortality has much to do with the quality of healthcare being offered, at least in this country. It probably has more to do with societal views on healthcare and accessibility.

 

[medic170]

you are completely wrong... you might want to actually read up on how things work in those countries before you respond so you at least sound like you have something semi-intelligent to say. the people who come here for surgeries from other countries are generally very wealthy and want to try an experimental procedure or some procedure that is in the preliminary stages. this means they only come here during exceptional circumstances (they have tried many treatment options and haven't experienced success, for example), not simply because they want to have something done soon. the other countries i mentioned are actually very good with both the waiting time and the access, two things that only work as a tradeoff in our system unfortunately...

Ok then, so they come here when "they have tried many treatment options and haven't experienced success," I guess if there system is better, why don't they have those innovative treatments avaliable to them there? Looks like our system is better after all since we have all the innovative treatments avaliable. Furthermore, going on what you have said, how does there system eliminate disparities when, as you stated, even in those countries, the wealthy get better health care (since they come here for innovative treatments)?


BTW, please don't insult me by calling me unitelligent just because I have a different opinion than you do. That just makes you look bad and discredits your own opinion, regardless of whether it is right or wrong. Good debaters with a valid point don't have to resort to personal insults because their position speaks so well!! 😉

 

[constructor]

This is really untrue. If you look at 5-year cancer survival rates, the US is hands down the most effective healthcare system in the world (US 5-year colon cancer survival rate is 60%. In the UK, it's 36% in 1999). True, we don't have nurses showing up at the house of new borns and making sure they have all their injections and starting a long-term relationship.

I'm not convinced that infant mortality has much to do with the quality of healthcare being offered, at least in this country. It probably has more to do with societal views on healthcare and accessibility.

i believe the survival rates are adjusted for how much we spend for each case, so you can't directly compare to the UK for example without accounting for how much they spend... i've never seen it stated anywhere that we're doing well with this statistic.

 

[constructor]

Ok then, so they come here when "they have tried many treatment options and haven't experienced success," I guess if there system is better, why don't they have those innovative treatments avaliable to them there? Looks like our system is better after all since we have all the innovative treatments avaliable. Furthermore, going on what you have said, how does there system eliminate disparities when, as you stated, even in those countries, the wealthy get better health care (since they come here for innovative treatments)?

we definitely have better innovation here because of the tons of money we throw into research, but that doesn't mean there's any reason to expect better outcomes... hype plays a big role in what people here and abroad perceive as better care.

 

[constructor]

i'm not calling you unintelligent... i said you need to read up for background if you don't know what someone's talking about instead of saying something just because you love to hear yourself talk.