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They Weren't Kidding About Those Wait Times

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
More good stuff from Captain Capitalism!

http://captaincapitalism.blogspot.com/2008/06/they-werent-kidding-about-those-weight.html

Friday, June 20, 2008

They Weren't Kidding About Those Wait Times


So when Obama gets elected on the backs of ignorant youth who think it cool to wear a Che Guevera t-shirt (and I don't care if I spelled his name wrong), he no doubt will start embarking on nationalized health care.

And one of those common mantra arguments you hear from the right is "do you know how long the wait times are for these countries with universal health care???" And although hypocritical, I'm more inclined to believe these arguments without confirming them as over the years of my life, the "right wing" arguments tend to prove true and leftist arguments tend to prove false. It's why I will take a capitalist or libertarian at their word and confirm what they claim at my leisure, and will listen to a socialist with an eyebrow raised, believing nothing they say until I can confirm it.

Regardless, thanks to a friendly Canadian, he pointed me in the direction of the Fraser Institute where they conducted a study on wait times in Canada. And it seems not only were they not joking about wait times being horribly long in Canada and other countries, but they're getting worse. Here are just two charts from the report (but the report is just full of charty goodness);






Now only if the OECD or some outfit had "wait times" as a measure we could compare different countries against.
 

nixon

Boned
GOLD Site Supporter
Great post ! Those that believe that a "free "health care service Is a panacea should read Your post .
 

Melensdad

Jerk in a Hawaiian Shirt & SNOWCAT Moderator
Staff member
GOLD Site Supporter
"free" is just a lie.

We all know that it means higher taxes, so it is just paid for via a forced payroll deduction. Unfortunately there a many uninformed people who simply don't realize they will pay every week, via those payroll deductions, for their 'free' health care.

We need more information like these graphs brought to light so we can slap the idiots upside the head with facts.
 

mak2

Active member
I love this topic.

Related Readings
Graphs: U.S. Health Stats Compared to Other Countries
Health Care Systems -- The Four Basic Models
United Kingdom
An interview with an expert on the UK's system +Percentage of Gross Domestic Product (GDP) spent on health care: 8.3

Average family premium: None; funded by taxation.

Co-payments: None for most services; some co-pays for dental care, eyeglasses and 5 percent of prescriptions. Young people and the elderly are exempt from all drug co-pays.

What is it? The British system is "socialized medicine" because the government both provides and pays for health care. Britons pay taxes for health care, and the government-run National Health Service (NHS) distributes those funds to health care providers. Hospital doctors are paid salaries. General practitioners (GPs), who run private practices, are paid based on the number of patients they see. A small number of specialists work outside the NHS and see private-pay patients.

How does it work? Because the system is funded through taxes, administrative costs are low; there are no bills to collect or claims to review. Patients have a "medical home" in their GP, who also serves as a gatekeeper to the rest of the system; patients must see their GP before going to a specialist. GPs, who are paid extra for keeping their patients healthy, are instrumental in preventive care, an area in which Britain is a world leader.

What are the concerns? The stereotype of socialized medicine -- long waits and limited choice -- still has some truth. In response, the British government has instituted reforms to help make care more competitive and give patients more choice. Hospitals now compete for NHS funds distributed by local Primary Care Trusts, and starting in April 2008 patients are able to choose where they want to be treated for many procedures.

Japan

An interview with an expert on Japan's system +Percentage of GDP spent on health care: 8

Average family premium: $280 per month, with employers paying more than half.

Co-payments: 30 percent of the cost of a procedure, but the total amount paid in a month is capped according to income.

What is it? Japan uses a "social insurance" system in which all citizens are required to have health insurance, either through their work or purchased from a nonprofit, community-based plan. Those who can't afford the premiums receive public assistance. Most health insurance is private; doctors and almost all hospitals are in the private sector.

How does it work? Japan boasts some of the best health statistics in the world, no doubt due in part to the Japanese diet and lifestyle. Unlike the U.K., there are no gatekeepers; the Japanese can go to any specialist when and as often as they like. Every two years the Ministry of Health negotiates with physicians to set the price for every procedure. This helps keeps costs down.

What are the concerns? In fact, Japan has been so successful at keeping costs down that Japan now spends too little on health care; half of the hospitals in Japan are operating in the red. Having no gatekeepers means there's no check on how often the Japanese use health care, and patients may lack a medical home.

Germany

An interview with an expert on Germany's system +Percentage of GDP spent on health care: 10.7

Average family premium: $750 per month; premiums are pegged to patients' income.

Co-payments: 10 euros ($15) every three months; some patients, like pregnant women, are exempt.

What is it? Germany, like Japan, uses a social insurance model. In fact, Germany is the birthplace of social insurance, which dates back to Chancellor Otto von Bismarck. But unlike the Japanese, who get insurance from work or are assigned to a community fund, Germans are free to buy their insurance from one of more than 200 private, nonprofit "sickness funds." As in Japan, the poor receive public assistance to pay their premiums.

How does it work? Sickness funds are nonprofit and cannot deny coverage based on preexisting conditions; they compete with each other for members, and fund managers are paid based on the size of their enrollments. Like Japan, Germany is a single-payment system, but instead of the government negotiating the prices, the sickness funds bargain with doctors as a group. Germans can go straight to a specialist without first seeing a gatekeeper doctor, but they may pay a higher co-pay if they do.

What are the concerns? The single-payment system leaves some German doctors feeling underpaid. A family doctor in Germany makes about two-thirds as much as he or she would in America. (Then again, German doctors pay much less for malpractice insurance, and many attend medical school for free.) Germany also lets the richest 10 percent opt out of the sickness funds in favor of U.S.-style for-profit insurance. These patients are generally seen more quickly by doctors, because the for-profit insurers pay doctors more than the sickness funds.

Taiwan

An interview with an expert on Taiwan's system +Percentage GDP spent on health care: 6.3

Average family premium: $650 per year for a family for four.

Co-payments: 20 percent of the cost of drugs, up to $6.50; up to $7 for outpatient care; $1.80 for dental and traditional Chinese medicine. There are exemptions for major diseases, childbirth, preventive services, and for the poor, veterans, and children.

What is it? Taiwan adopted a "National Health Insurance" model in 1995 after studying other countries' systems. Like Japan and Germany, all citizens must have insurance, but there is only one, government-run insurer. Working people pay premiums split with their employers; others pay flat rates with government help; and some groups, like the poor and veterans, are fully subsidized. The resulting system is similar to Canada's -- and the U.S. Medicare program.

How does it work? Taiwan's new health system extended insurance to the 40 percent of the population that lacked it while actually decreasing the growth of health care spending. The Taiwanese can see any doctor without a referral. Every citizen has a smart card, which is used to store his or her medical history and bill the national insurer. The system also helps public health officials monitor standards and effect policy changes nationwide. Thanks to this use of technology and the country's single insurer, Taiwan's health care system has the lowest administrative costs in the world.

What are the concerns? Like Japan, Taiwan's system is not taking in enough money to cover the medical care it provides. The problem is compounded by politics, because it is up to Taiwan's parliament to approve an increase in insurance premiums, which it has only done once since the program was enacted.

Switzerland

An interview with an expert on Switzerland's system +Percentage of GDP spent on health care: 11.6

Average monthly family premium: $750, paid entirely by consumers; there are government subsidies for low-income citizens.

Co-payments: 10 percent of the cost of services, up to $420 per year.

What is it? The Swiss system is social insurance like in Japan and Germany, voted in by a national referendum in 1994. Switzerland didn't have far to go to achieve universal coverage; 95 percent of the population already had voluntary insurance when the law was passed. All citizens are required to have coverage; those not covered were automatically assigned to a company. The government provides assistance to those who can't afford the premiums.

How does it work? The Swiss example shows that universal coverage is possible, even in a highly capitalist nation with powerful insurance and pharmaceutical industries. Insurance companies are not allowed to make a profit on basic care and are prohibited from cherry-picking only young and healthy applicants. They can make money on supplemental insurance, however. As in Germany, the insurers negotiate with providers to set standard prices for services, but drug prices are set by the government.

What are the concerns? The Swiss system is the second most expensive in the world -- but it's still far cheaper than U.S. health care. Drug prices are still slightly higher than in other European nations, and even then the discounts may be subsidized by the more expensive U.S. market, where some Swiss drug companies make one-third of their profits. In general, the Swiss do not have gatekeeper doctors, although some insurance plans require them or give a discount to consumers who use them.

home + introduction + watch online + five countries + interviews + analysis + join the discussion + q & a with t.r. reid
live chat with correspondent t.r. reid + teacher's guide + readings & links + site map + dvd + transcript + press reaction
credits + privacy policy + journalistic guidelines + FRONTLINE series home + wgbh + pbs

posted april 15, 2008

FRONTLINE is a registered trademark of wgbh educational foundation.
background photograph © image100/corbis
web site copyright 1995-2008 WGBH educational foundation
 

mak2

Active member
Also, if you really look into the variables that are measured, the and the ones US excels in, all are profit centers. I just cannot understand how so many people are fans of the US health care system. It is the worse of all worlds. And please do not tell me you have private pay today. Everyone in American can get health care, just in the least efficient way possible with the insurance companies, doctors, drug companies, and hospitals making mega bucks in the process.


Also please take a look at this.
http://www.cihi.ca/cihiweb/en/downloads/aib_provincial_wait_times_e.pdf
 
Last edited:

mak2

Active member
Why not just train everyone in medicine so they can treat themselves.


actually, prevention is a very important part of UHC, but there is no profit in it so it is not stressed here in the US. Eat those quarter pounders, the US has the shortest wait times for open hearts (arguable point). But the profit is in the open heart surgery.
 

daedong

New member
There maybe someone listening!

http://search.japantimes.co.jp/cgi-bin/eo20070529cc.html

Tuesday, May 29, 2007

World's 'best' health care fatally flawed


By CESAR CHELALA
NEW YORK — One of the most contentious issues of the U.S. presidential campaign will be how to fix what many agree is a malfunctioning health-care system. Adding fuel to the fire is a recent study detailing the shortcomings of the U.S. health-care system compared with those of Australia, Canada, Germany, New Zealand and Britain.
The study, entitled "Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care," released by the Commonwealth Fund in New York, finds that not only is the U.S. health-care system the most expensive in the world (double that of the next most costly, Canada) but that it comes in dead last in most measures of performance.

Although U.S. political leaders are fond of stating that we have the best health-care system in the world, they fail to add an important caveat: It is the best for those who can afford it. For the rest of the population, disadvantages far outweigh the merits.
This new study not only confirms the findings of previous Commonwealth Fund studies but also that of a World Health Organization analysis in 2000: that the overall performance of the U.S. health-care system ranks 37th among all countries included in the analysis.
Presidential candidates will be asked to justify the costs (15 percent of GDP and estimated to reach 19.6 percent by 2016) of such a disadvantageous system that also fails to insure a sizable portion of the population. The most notable way in which the United States differs from other developed countries is in the absence of universal coverage. But it is also last in terms of access, patient safety, efficiency and equity.
The other five countries considered spend considerably less on health care — per capita and as a percentage of GDP. The U.S. spends more than $ 6,000 per person annually on health care, almost double that of Australia, Canada and Germany, all of which achieve better results on health status indicators. This suggests that the U.S. health-care system can and must do much more with its substantial investment in health.
Americans' average life expectancy of 78 ranks 45th in the world — behind Greece, Bosnia and Jordan. Also, according to the CIA's World Fact Book, the U.S. infant mortality rate — deaths of newborns (under age 1) per 1,000 live births — is 6.50, higher than most developed nations. Even Cuba's IMR is 6.33.
The U.S. lags behind all industrialized nations in health insurance coverage. The most recent data available from the U.S. Census Bureau indicate that 46.6 million Americans (about 15.9 percent of the population) had no health insurance coverage during 2005, an increase of 1.3 million over the previous year. It is no wonder that medical bills, overwhelmingly, are the most common reason for personal bankruptcy in the U.S.
According to the Children's Health Fund, 9 million children are completely uninsured in the U.S., while another 23.7 million — nearly 30 percent of the nation's children — lack regular access to health care.
Compared with the other countries studied, the U.S. lags behind in the adoption of information technology and other national policies that promote quality improvement. Real-time information systems in countries such as New Zealand, Germany and Britain enhance physicians' ability to monitor chronic conditions and the use of medication, including that prescribed by other physicians. In other countries, experienced nurses monitor chronic conditions, thus easing the physicians' burden.
The U.S. also shows poor performance with regard to national health expenditures and administrative costs. Americans with below-average income are more reluctant to visit a physician when sick, get a recommended test, fill a prescription, undergo necessary treatment, or receive a proper followup.
These rankings are based on national mortality data and the perceptions and experiences of physicians and patients; they do not include information from medical records or other administrative data. Yet they paint a disturbing picture of the most expensive health-care system in the world.
Only structural reform can solve the U.S. health-care system's deep problems. All people must be adequately insured and everyone must have access to good care. At the same time, the U.S. must incorporate the advantages of modern health information technology to develop an integrated medical record and information system. Lessons from other countries should be applied in the U.S.
In a recent article in the Journal of the American Medical Association, Dr. Ezekiel J. Emanuel, of the Department of Clinical Bioethics at the National Institutes of Health, stated, "The U.S. health-care system is considered a dysfunctional mess." Is this an understatement?
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
Mak - it's interesting that someone that works in healthcare would be so oblivious to the downside of socialized healthcare - you would get paid less and be expected to work more and in worse conditions.

We discussed that Frontline commie love piece here:

http://www.forumsforums.com/3_9/showthread.php?t=15776&highlight=frontline+healthcare

The other systems appear great but they have only been in place a short time. They are all essentially going bankrupt basically because you can't give away something for free without the general population abusing it.

If you watch that episode you will see that Japan's hospitals are all going bankrupt, Germany's doctors are all under-paid and no new Doctor's are being trained, and the facilities in many of these countries would never be deemed "acceptable" by even those poor unfortunate Americans that already get free healthcare (those on welfare, any kids under the age of 19, veterans, disabled, seniors).

No system is perfect, but givining away something for free is a utopian concept that invariably leads to the destruction of high quality healthcare.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
The U.S. lags behind all industrialized nations in health insurance coverage. The most recent data available from the U.S. Census Bureau indicate that 46.6 million Americans (about 15.9 percent of the population) had no health insurance coverage during 2005, an increase of 1.3 million over the previous year. It is no wonder that medical bills, overwhelmingly, are the most common reason for personal bankruptcy in the U.S.
According to the Children's Health Fund, 9 million children are completely uninsured in the U.S., while another 23.7 million — nearly 30 percent of the nation's children — lack regular access to health care.
Compared with the other countries studied, the U.S. lags behind in the adoption of information technology and other national policies that promote quality improvement. Real-time information systems in countries such as New Zealand, Germany and Britain enhance physicians' ability to monitor chronic conditions and the use of medication, including that prescribed by other physicians. In other countries, experienced nurses monitor chronic conditions, thus easing the physicians' burden.
The U.S. also shows poor performance with regard to national health expenditures and administrative costs. Americans with below-average income are more reluctant to visit a physician when sick, get a recommended test, fill a prescription, undergo necessary treatment, or receive a proper followup.
These rankings are based on national mortality data and the perceptions and experiences of physicians and patients; they do not include information from medical records or other administrative data. Yet they paint a disturbing picture of the most expensive health-care system in the world.
Only structural reform can solve the U.S. health-care system's deep problems. All people must be adequately insured and everyone must have access to good care. At the same time, the U.S. must incorporate the advantages of modern health information technology to develop an integrated medical record and information system. Lessons from other countries should be applied in the U.S.
In a recent article in the Journal of the American Medical Association, Dr. Ezekiel J. Emanuel, of the Department of Clinical Bioethics at the National Institutes of Health, stated, "The U.S. health-care system is considered a dysfunctional mess." Is this an understatement?

They didn't do their research. There are federal and state programs that provide free healthcare coverage to any child under the age of 19. The only reason someone may not be getting these is because they haven't looked or asked.

The rest of that article is all about the costs of healthcare but does not address the quality of healthcare issue. The fact is that the quality of healthcare under socialized medicine is much lower.

As I have pointed out before, I have lived under both systems so I'm speaking from experience. Be careful what you ask for - you just might get it.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
actually, prevention is a very important part of UHC, but there is no profit in it so it is not stressed here in the US. Eat those quarter pounders, the US has the shortest wait times for open hearts (arguable point). But the profit is in the open heart surgery.

Sorry Mak, but the obesity rates in Australia are higher than in the US. I don't remember getting much "prevention" education in Canada - at least not any more or less than I see in the US.

You have a utopian view that appears unable to see the reality.
 

mtntopper

Back On Track
SUPER Site Supporter
Everyone in American can get health care, just in the least efficient way possible with the insurance companies, doctors, drug companies, and hospitals making mega bucks in the process.

I agree on this and will add that there are many people in this country that do not have insurance, or even the ability to get insurance as the insurance companies do not want and will not take on the people with potential health problems. They want to be large profit centers only by taking the healthy. Something has to be done for the ones at risk, those unable to pay for basic health care and others at risk of not getting the necessary preventive health care to be less burden on the tax payers who support the system now.

It appears that Japan and a couple others may have a decent working system of taking care of their citizens. Canada is used often as a model but the Canadian system is not working and other models are available that are more suited to a free enterprise economy. Let us look at the best and try to make ours even better. It is just a matter of time before both political parties must and will decide some type of socialized health and medical program must be done for the ones not covered by the existing health system of our country.

Rep points to Mak2 for taking a different approach and stand on this issue that is against the grain of many on FFF.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
I agree on this and will add that there are many people in this country that do not have insurance, or even the ability to get insurance as the insurance companies do not want and will not take on the people with potential health problems. They want to be large profit centers only by taking the healthy. Something has to be done for the ones at risk, those unable to pay for basic health care and others at risk of not getting the necessary preventive health care to be less burden on the tax payers who support the system now.

It appears that Japan and a couple others may have a decent working system of taking care of their citizens. Canada is used often as a model but the Canadian system is not working and other models are available that are more suited to a free enterprise economy. Let us look at the best and try to make ours even better. It is just a matter of time before both political parties must and will decide some type of socialized health and medical program must be done for the ones not covered by the existing health system of our country.

Rep points to Mak2 for taking a different approach and stand on this issue that is against the grain of many on FFF.

You guys need to watch that Frontline Episode but with some truly skeptical glasses on. After the doofus reporter salivates all over Japan they do quickly gloss over the fact that Japan's hospitals are all going bankrupt. The government off-loaded the burden of the expenses onto the hospitals by capping their fees. No new hospitals are getting built and the exisitng ones are just going to get older and older until they close.
 

mak2

Active member
Mak - it's interesting that someone that works in healthcare would be so oblivious to the downside of socialized healthcare - you would get paid less and be expected to work more and in worse conditions.

We discussed that Frontline commie love piece here:

http://www.forumsforums.com/3_9/showthread.php?t=15776&highlight=frontline+healthcare

The other systems appear great but they have only been in place a short time. They are all essentially going bankrupt basically because you can't give away something for free without the general population abusing it.

If you watch that episode you will see that Japan's hospitals are all going bankrupt, Germany's doctors are all under-paid and no new Doctor's are being trained, and the facilities in many of these countries would never be deemed "acceptable" by even those poor unfortunate Americans that already get free healthcare (those on welfare, any kids under the age of 19, veterans, disabled, seniors).

No system is perfect, but givining away something for free is a utopian concept that invariably leads to the destruction of high quality healthcare.

"Oblivious", I find most people who cannot field an argument immediately start with the personal attacks. Again I am not dissappointed.

There are downsides to UHL, of course. But lets review a few of the problems with the greatest healthcare system in the world.

I know I am oblivious to the many facts you understnad but I have worked big city ER's. Our ER's are jammed on a daily basis with people who do not need to be there or would not have been there had there been a clinic they could get into before their cold developed into pnuemonia. But clinics are not high profit areas. ERs are. Oh you say these people dont pay anyway, and you are right. you know who does? YOu do. Thats right, instead of charging 5 bucks for the liter of normal saline the hospital chages $20 to the next smucks insurace policy. The insurance companies occassionally squack to make it sound like they are trying to keep cost down, but in the end they just raise out premiums and tack on a little more to their profits, so they can build more giant buildings and issue more executive bonuses.

The free thing you guys refer to is a strawman used to make someone who disagrees with you sound stupid so I wont even address that.

Right now you really do have universal healthcare in the US. Just the most ineffieient system possible. Not only do those of us who have insurnance premiums taken out of our checks monthly so it hurts less when the big bill comes (sound like taxes?) pay for our own, we pay for every one else too. Plus all the profit that go to drug comanies, hospitals, doctors and insurance companies. I live in Indy, some of the richest peole in town work for anthem, huge building, lots of exec's running around. Oh yea, and Lilys.

Thanks for the enlightment PBinWA. I do work in healthcare and the reason I think like I do about it is becasue I see it every day. Try to think about something besides that party line once in a while.:smile:
 

Cityboy

Banned
Here are some of our problems with our healthcare system as I see it:

1. An entitlement mentality of insurance policy holders. Americans tend to figure if they are insured, they can just go to the doctor anytime for anything, including justifying sick days at work for non-illnesses. People figure they are insured and go to the doctor for every sniffle.

2. An entitlement mentality by the uninsured, and those who understand the American welfare system. It is common knowledge that it is illegal to turn anyone away from an emergency room. So, people without insurance, and in many cases, no intention of paying for the services they recieve, head to the local emergency room for treatment. This creates major staffing and safety issues in large, metropolitan hospitals because of the increased triage workload. The fact is we already have free healthcare here and it is being taken advantage of daily.

3. Overcharging insurance policy holders by doctors and health care facilities. Fact: Uninsured individuals get 40% and better discounts when paying cash. I know this because I have done it. We are paying up to 60% more for our healthcare because of the costs involved with the insurance campany and government bureaucracy.

4. The government. Our laws prevent freedom of choice when consumers purchase insurance policies. Insurance companies are required to provide maternity and mental health coverage for all policies, for example. Consumers are not allowed to taylor and purchase their own coverage; they have to buy what is legally mandated, which drives the cost up for everyone.

The most economical health insurance model for most families would be to hold a major medical policy for catostrophic illness and injury, and to pay cash for routine doctor visits. This would force doctors to compete for the cash, which would drive costs down. It would also eliminate much of the insurance company and government bureaucracy, which would reduce costs by as much as 60%. However, this healthcare model is not in the best interest of government politicians, so they make laws preventing it from happening.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
Thanks for the enlightment PBinWA. I do work in healthcare and the reason I think like I do about it is becasue I see it every day. Try to think about something besides that party line once in a while.:smile:

No party line here - just experience. Everyone I know that has lived and worked on both sides of the coin will pick the US system over Canada's any day.

The grass is not greener on the other side. I lived there for 30 years.

Sure the US system's financial end is not great but the problems with the US system are largely the result of the legal system as much as it is corporate greed.

There are ways to improve any system but don't ever expect me to support the utopian view that "free" is going to solve the problems.

Someone has to pay the price and it needs to be the consumer and it needs to be visible. Hiding the costs behind higher taxes and layers of bureaucracy will only allow the quality of the care to deteriorate.

Doctors need to get paid and paid well. They go through one of the hardest educational programs and commitments from a life perspective. They deserve to be paid well - very well.

Drug companies deserve to make money and to be able to sell their product at a fair market value. Otherwise, you will reduce their incentive to create new products.

Why not create a system where if the government wants to supply services then it can operate like a business. Let the government open hospitals and fund them with special bond measures based on locations. Then let those hospitals operate as non-profits. See how long they operate successfully without additional tax-payer funding.

Everything takes money to produce, if people are given something for free then they will keep taking for ever. That Frontline episode shows that in Japan - people go to the doctor way too often over there.

Like I stated before, how would you like it if I decided you were paid too much and that you should take a 20-50% pay cut and still work just as hard because that is all I "want" to pay you? How long would you stick around in your job?
 

mak2

Active member
You guys need to watch that Frontline Episode but with some truly skeptical glasses on. After the doofus reporter salivates all over Japan they do quickly gloss over the fact that Japan's hospitals are all going bankrupt. The government off-loaded the burden of the expenses onto the hospitals by capping their fees. No new hospitals are getting built and the exisitng ones are just going to get older and older until they close.

I usually dont discuss anecdotal (sp) evidence and perfer to look at the studies but if you guys dont mind just the one exception and I wont do it again. A friend of mine is married to a Japanese national. He makes enough to send his wife to any doctor he wants and he has great insurance. Her family is silly rich. She got pregnant and went home just for the healthcare. He says she thinks she gets better care there, she had her first one here and was not at all happy. My buddy says it did not cost a dime. Must not be too bad or she would not have insisted on going home. Her family did not pay a dime out of pocket for her care (except taxes).
 

mak2

Active member
Sorry Mak, but the obesity rates in Australia are higher than in the US. I don't remember getting much "prevention" education in Canada - at least not any more or less than I see in the US.

You have a utopian view that appears unable to see the reality.

OK I am sorry how does fat aussies make the US health care system the best in the world? :mrgreen: Just kidding, I see your point and I read a study on that very thing but I think it was in Canada. The study tried to say were it not for healthcare education it would be worse. The study seemed really weak.

Utopian is another strawman, no health care system is free or perfect, just not as bad as what we have now.
 

mak2

Active member
No party line here - just experience. Everyone I know that has lived and worked on both sides of the coin will pick the US system over Canada's any day.

The grass is not greener on the other side. I lived there for 30 years.

Sure the US system's financial end is not great but the problems with the US system are largely the result of the legal system as much as it is corporate greed.

There are ways to improve any system but don't ever expect me to support the utopian view that "free" is going to solve the problems.

Someone has to pay the price and it needs to be the consumer and it needs to be visible. Hiding the costs behind higher taxes and layers of bureaucracy will only allow the quality of the care to deteriorate.

Doctors need to get paid and paid well. They go through one of the hardest educational programs and commitments from a life perspective. They deserve to be paid well - very well.

Drug companies deserve to make money and to be able to sell their product at a fair market value. Otherwise, you will reduce their incentive to create new products.

Why not create a system where if the government wants to supply services then it can operate like a business. Let the government open hospitals and fund them with special bond measures based on locations. Then let those hospitals operate as non-profits. See how long they operate successfully without additional tax-payer funding.

Everything takes money to produce, if people are given something for free then they will keep taking for ever. That Frontline episode shows that in Japan - people go to the doctor way too often over there.

Like I stated before, how would you like it if I decided you were paid too much and that you should take a 20-50% pay cut and still work just as hard because that is all I "want" to pay you? How long would you stick around in your job?

Wow I did not realize everyone you know picks US healthcare everytime. The grass here is not that green, really. the Lawyers also hate UHC, that is another good argument for it. I wish you would quit saying utopian and free, I swear those are talking points from Rush Limbaugh or something. No one, that thinks, thinks it will be free or utopian, jsut not as terrible as it is right now. What is it you dont understand about we are paying now? just we aer making a few corporations and industries rich, which money could spent on healthcare. I read a lot of studies the last few years from Great Britian from the doctors point of view and the big thing they complaind about was medicine being ran by evidence based practice. To make that simpler it means there has to be science behind procedures, not jsut tradition and profit. That is a good thing by the way. Nurses in the civilian sector here are paid the minimum the market will bear, that is why there has been a shortage now nad for the last several years, I know seveal Canadian nurses who came down here for the bucks and went home becasue there really wasnt that much difference. I dunno, i jsut know what I have seen, I work in it everyday. If you ever read studies look at who wrote them. Most are funded directly or indeirectly by some part of the industry. Most of the guys i know that do research are honest good guys but if you know where the grants come from it has to taint the structure of the study.

Are you calling our system private pay? Just wondering?
 

Cityboy

Banned
Hey Mak & PB....how about a comment to my post? No liberal or conservative talking points here, just the facts as I have experienced them. I KNOW we can do a better job here than we are currently doing, and it is far simpler than the politicians on both sides would lead us to believe.

Here are some of our problems with our healthcare system as I see it:

1. An entitlement mentality of insurance policy holders. Americans tend to figure if they are insured, they can just go to the doctor anytime for anything, including justifying sick days at work for non-illnesses. People figure they are insured and go to the doctor for every sniffle.

2. An entitlement mentality by the uninsured, and those who understand the American welfare system. It is common knowledge that it is illegal to turn anyone away from an emergency room. So, people without insurance, and in many cases, no intention of paying for the services they recieve, head to the local emergency room for treatment. This creates major staffing and safety issues in large, metropolitan hospitals because of the increased triage workload. The fact is we already have free healthcare here and it is being taken advantage of daily.

3. Overcharging insurance policy holders by doctors and health care facilities. Fact: Uninsured individuals get 40% and better discounts when paying cash. I know this because I have done it. We are paying up to 60% more for our healthcare because of the costs involved with the insurance campany and government bureaucracy.

4. The government. Our laws prevent freedom of choice when consumers purchase insurance policies. Insurance companies are required to provide maternity and mental health coverage for all policies, for example. Consumers are not allowed to taylor and purchase their own coverage; they have to buy what is legally mandated, which drives the cost up for everyone.

The most economical health insurance model for most families would be to hold a major medical policy for catostrophic illness and injury, and to pay cash for routine doctor visits. This would force doctors to compete for the cash, which would drive costs down. It would also eliminate much of the insurance company and government bureaucracy, which would reduce costs by as much as 60%. However, this healthcare model is not in the best interest of government politicians, so they make laws preventing it from happening.
 

mak2

Active member
i type so slow I miss stuff. I will reply soon as i get back from dropping my son off at little leauge.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
I usually dont discuss anecdotal (sp) evidence and perfer to look at the studies but if you guys dont mind just the one exception and I wont do it again. A friend of mine is married to a Japanese national. He makes enough to send his wife to any doctor he wants and he has great insurance. Her family is silly rich. She got pregnant and went home just for the healthcare. He says she thinks she gets better care there, she had her first one here and was not at all happy. My buddy says it did not cost a dime. Must not be too bad or she would not have insisted on going home. Her family did not pay a dime out of pocket for her care (except taxes).

That's a great example. As I stated in the other thread, these socialized healthcare systems don't always show their true long term implications. Japan only introduced their system in the 80's or 90's. They are only now starting to see the implications of the government caps on what the hospitals can charge.

The Frontline episode showed this female General Practicioner in Germany, her pay has been stagnant for 10 or so years. Fewer and fewer new doctors are coming out of the educational system because the pay is not proportionate to the effort it takes to become a doctor and the effort it takes once you become a doctor. Who wants to be on call every fourth night for only $120K a year when they could pick another profession that pays more and has better hours?

The only reason many of these systems are able to exist for 10-30 years is because a good portion of the Doctor's are "trapped" in their professions. Not many people who go through 10 years of hard education and training want to re-train when they are in their 40's so they suck it up and try to make the best of what they have. Your average Doctor enters the work force in their early 30's so it takes around 30 years for the real long term implications of these attacks on their profession to be seen.

I can honestly say that I would never become a doctor if I had to work any other place than the US - what's the incentive? I can make more as a lawyer or engineer and have better working conditions and probably less educational expense.

Many of these socialized systems have only been in place for 10-30 years. Canada's system was implemented in the 70's and we are seeing the consequences of the system now. There is a doctor shortage in Canada. Many of the new doctors are from over-seas and are only using Canada as a stepping stone to getting into the US. Canadian Doctors coming out of Canadian Universities are coming the US as fast as they can. This isn't greed - this is reality. Don't point fingers at doctors unless you want the same treatment in your profession.

The Frontline episode looked at Taiwan's system and touched on the fact that before the system was only 5 years old they realized that the cost of the system was too high and that they needed to change it. Of course, they haven't changed it yet because they can't figure out how to take away the "free" stuff from the citizens without paying the political price.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
Here are some of our problems with our healthcare system as I see it:

1. An entitlement mentality of insurance policy holders. Americans tend to figure if they are insured, they can just go to the doctor anytime for anything, including justifying sick days at work for non-illnesses. People figure they are insured and go to the doctor for every sniffle.

2. An entitlement mentality by the uninsured, and those who understand the American welfare system. It is common knowledge that it is illegal to turn anyone away from an emergency room. So, people without insurance, and in many cases, no intention of paying for the services they recieve, head to the local emergency room for treatment. This creates major staffing and safety issues in large, metropolitan hospitals because of the increased triage workload. The fact is we already have free healthcare here and it is being taken advantage of daily.

3. Overcharging insurance policy holders by doctors and health care facilities. Fact: Uninsured individuals get 40% and better discounts when paying cash. I know this because I have done it. We are paying up to 60% more for our healthcare because of the costs involved with the insurance campany and government bureaucracy.

4. The government. Our laws prevent freedom of choice when consumers purchase insurance policies. Insurance companies are required to provide maternity and mental health coverage for all policies, for example. Consumers are not allowed to taylor and purchase their own coverage; they have to buy what is legally mandated, which drives the cost up for everyone.

The most economical health insurance model for most families would be to hold a major medical policy for catostrophic illness and injury, and to pay cash for routine doctor visits. This would force doctors to compete for the cash, which would drive costs down. It would also eliminate much of the insurance company and government bureaucracy, which would reduce costs by as much as 60%. However, this healthcare model is not in the best interest of government politicians, so they make laws preventing it from happening.

Sorry I missed this before but these are all some great points. As well, you suggest good improvements.

:thumb:

There's no arguing that the system could be better. But to advocate universal healthcare or free healthcare without seriously looking at the implications is a very dangerous path.

The main problem with all these systems comes from a breakdown in society. It really does have to do with people expecting stuff for free.

How many of our members would tolerate:

- a $40-50 dollar fee to visit a Doctor even if you have insurance for EVERYONE or they can go to a clinic and wait in a long long line and still pay $20.

- caps on malpractice settlement payments where no criminal negligence is found (as in you don't get millions if a nurse accidentally gives the wrong medicine to your child and they die).

- reverse penalties for people that bring lawsuits against Doctor's and lose (i.e. John Ritter's wife).

- 4 patients to a room in hospitals - no private rooms unless you pay a lot extra out of your pocket.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
Wow I did not realize everyone you know picks US healthcare everytime. The grass here is not that green, really. the Lawyers also hate UHC, that is another good argument for it. I wish you would quit saying utopian and free, I swear those are talking points from Rush Limbaugh or something. No one, that thinks, thinks it will be free or utopian, jsut not as terrible as it is right now. What is it you dont understand about we are paying now? just we aer making a few corporations and industries rich, which money could spent on healthcare. I read a lot of studies the last few years from Great Britian from the doctors point of view and the big thing they complaind about was medicine being ran by evidence based practice. To make that simpler it means there has to be science behind procedures, not jsut tradition and profit. That is a good thing by the way. Nurses in the civilian sector here are paid the minimum the market will bear, that is why there has been a shortage now nad for the last several years, I know seveal Canadian nurses who came down here for the bucks and went home becasue there really wasnt that much difference. I dunno, i jsut know what I have seen, I work in it everyday. If you ever read studies look at who wrote them. Most are funded directly or indeirectly by some part of the industry. Most of the guys i know that do research are honest good guys but if you know where the grants come from it has to taint the structure of the study.

Are you calling our system private pay? Just wondering?

If I compare the quality of healthcare I received in Canada to the quality of healthcare I received in the US then I think I am doing way better in the US.

In Canada, if you make over $52K a year you are in the 35-40% tax bracket, make over $120K and you are near 50%. Do you think that additional taxes is all going into healthcare? No, it has been squandered away - and certainly not on any military expenses either. The liberal government that ruled Canada for 15 years prior to the current Conservative governement kept raising taxes under the guise of improving healthcare but not actually improving healthcare.

Based on my real life experience as a consumer under both systems, I am getting a better quality product by making corporations and industries rich than I am by making the government rich.
 

mak2

Active member
1. People do have a tendency to use insurance if they have it. That is the idea behind the 80/20 so the person had to pay something to keep the visits down some. I think this might occur a lot but doctors do not complain because they do get paid. The most problematic thing I can think of in this area is people’s tendency to think medicine can cure anything so they don’t bother with behavioral modification for better health, they just buy cholesterol meds.
2. The emergency room could be cleared out immediately if there was a clinic available instead. Even the uninsured, as a rule, don’t want to sit in ER all night. People are either forced into emergency medicine by not getting care that could have prevented the acute problem or know they have no choice so come in earlier. One of my classes for my masters looked at what one change in a hospital does to other department. The clinic thing was the aspect discussed in the class. Open a clinic and refer pts to it by the ER triage nurse might avert over 50% of pts some nights. I think this is not done because there is more cash to be netted in the ER some one pays for these people, again it is us, with insurance. There will always be those people with the entitlement mentality. Until you are ready to tell them if they don’t pay they go outside and die we are going to be paying for them. I just don’t like everyone making so much money off of it.
3. One of the handy excuses used in the industry for overcharging insurance companies is the people who don’t pay for the same services. Most doctors are not bad guys, the %40 discount is justified by a reduction in administration charges, but in reality I think it is because doctors don’t want to intentionally overcharge the pt, but overcharging the insurance company is a way of life. Just like business owners cheating the IRS without the penalties. Either way I think 40% administration fees are a bit inefficient for the best health care system in the world.
4. Yes, there are some things that are required for an insurance company to cover. I think the insurance companies just give the reluctance to pay exorbitant medical expenses lip service, in the end they charge more premiums, make more profits, and pay for more stuff. Again it is all about the profit, not about the pt.
5. I agree with the major medical concept, but even then, until we as a society can tell granny she aint getting her heart pills till she pays, we might as well just get used to paying for it.
No matter what PB thinks, this system is designed for profit.
 

mak2

Active member
If I compare the quality of healthcare I received in Canada to the quality of healthcare I received in the US then I think I am doing way better in the US.

In Canada, if you make over $52K a year you are in the 35-40% tax bracket, make over $120K and you are near 50%. Do you think that additional taxes is all going into healthcare? No, it has been squandered away - and certainly not on any military expenses either. The liberal government that ruled Canada for 15 years prior to the current Conservative governement kept raising taxes under the guise of improving healthcare but not actually improving healthcare.

Based on my real life experience as a consumer under both systems, I am getting a better quality product by making corporations and industries rich than I am by making the government rich.

You can pick variables in each system and find things that are better in each. I dont remember all the variables but when you compare such things as infant mortality, life expectancy, well child care (like immunizations), and many many other things I think are more indicitave of an effective health care system than how fast one gets an MRI or Open heart surgery. I worked at a major hospital in the OR. One very popular surgery in the middle of the night was removing the gall bladder with the scope when the patient had abdominal pain. I asked the Doc how many were really bad when he got the reports back from path. He (honest) told me not very many, but by the time the soreness went away from the surgery the abd pain was gone too. All teh pts had insurance. In this same OR I seen anesthesia get up and walk out of the room becasue the pt did not have insuracne. It pt had not been given meds yet, but a different doc had to do the procedure.
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
You can pick variables in each system and find things that are better in each. I dont remember all the variables but when you compare such things as infant mortality, life expectancy, well child care (like immunizations), and many many other things I think are more indicitave of an effective health care system than how fast one gets an MRI or Open heart surgery. I worked at a major hospital in the OR. One very popular surgery in the middle of the night was removing the gall bladder with the scope when the patient had abdominal pain. I asked the Doc how many were really bad when he got the reports back from path. He (honest) told me not very many, but by the time the soreness went away from the surgery the abd pain was gone too. All teh pts had insurance. In this same OR I seen anesthesia get up and walk out of the room becasue the pt did not have insuracne. It pt had not been given meds yet, but a different doc had to do the procedure.

Yup - ask a surgeon for an opinion and he's gonna try and cut you open! ;)
 

XeVfTEUtaAqJHTqq

Master of Distraction
Staff member
SUPER Site Supporter
No matter what PB thinks, this system is designed for profit.

It should be designed for profit! If you take the profit out of the equation then there is no motivation! Good will towards your fellow man has not proven to be the greatest motivator (especially when it involves probing the anus of some 400lb obese person with poor hygiene).
 

mak2

Active member
It should be designed for profit! If you take the profit out of the equation then there is no motivation! Good will towards your fellow man has not proven to be the greatest motivator (especially when it involves probing the anus of some 400lb obese person with poor hygiene).

You know, I can see docs making some bucks, but, do you really think the industry should be designed for profit? In med school they used to teach doctors to be efficient, which when translated means spend 5 min in the room with you each visit or at your bedside. Is that really what you want? I work at the VA and understand the lack of motivation, sometimes it is difficult to get someone to do something your pt needs that doctors would be lined up for if the pt had insurance in the private sector. But as a rule, almost all the doctors and all the nurses and other professionals do the best they can all the time. When there is a problem where I work it is becasue someone screwed up or is too lazy. It is not the greed like it almost always is in the profit centers.

PB I do see this stuff all the time. I think most doctors are good guys, but it is natuarl to err on the side of making more money. Making good money and basing practice on evidence instead of profit will someday be better for each and every one of us.
 
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