The US has the best health care in the world?

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In summary: What if it's busy? I don't want to talk to a machine", she said. I then took my business card and wrote down the number on a piece of paper and gave it to her. "Here, just in case". In summary, this claim is often made by those who oppose Obama's efforts to reform the medical system. Those who make this claim do not understand how the medical system works in the United States. The system is more about business than health. Health care has become more expensive, difficult, and frustrating for those who use it.
  • #386
cristo said:
Substantially means nothing, unless you are using a comparison. The UK spends a lot less on healthcare per capita than the US, for example (and has a higher life expectancy...)
The comparison in this context was to your statement about not having to https://www.physicsforums.com/showpost.php?p=2308009&postcount=356" as you well know.
 
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  • #387
cristo said:
Not true:
Yes, generally, regarding Medicaid it is true. Clearly the eligibility criterion are more complex than my one sentence statement, it includes other things including the size of ones assets, such as a fat bank account or a flashy boat in the backyard. I might have said simply 'poor', but that has such a wide definition that its not useful. Generally speaking:
cms.hhs.gov said:
Medicaid is health insurance that helps many people who can't afford medical care pay for some or all of their medical bills.
And in fact Medicaid covers "http://www.cdc.gov/pcd/issues/2009/Jul/08_0153.htm" "

cms.hhs.gov said:
In general, you should apply for Medicaid if your income is limited and you match one of the descriptions of the Eligibility Groups. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)
cms.hhs.gov said:
Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds
An able bodied adult male with no dependants will have a hard time qualifying.

Clearly neither Medicaid nor Medicare cover everyone that lack insurance, though given that the US is closing in on spending a trillion dollars annually on the two programs collectively one might think they would. So given the 58 million people on the Medicaid roles alone along with funding, it is simply nonsense to claim only the 'wealthy' have access to medical help in the US.

There remains roughly 3-4% of US citizens that don't qualify for help as destitute but still can't manage to afford access. I'd like to see action taken to get it to them, though not via what's on the table now.
 
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  • #388
mheslep said:
There remains roughly 3-4% of US citizens that don't qualify for help as destitute but still can't manage to afford access. I'd like to see action taken to get it to them, though not via what's on the table now.
How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees. One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe.

Reps Bachman and Kline have both come out saying that public insurance would be cheaper. So as true neo-cons, they are against cutting waste and inefficiency, and want to let insurance companies decide who lives or dies.

http://minnesotaindependent.com/39874/bachmann-kline-oppose-public-option-because-its-cheaper
 
  • #389
turbo-1 said:
How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees. One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe...
I'm only ~familiar w/ HR3200, as much as I can understand it without running down all the redirections, and with various statements from this or that Senator. There's some good in there, but mainly I think its a mistake. There are other plans I do like, mostly, and have posted about them here.
 
  • #390
turbo-1 said:
How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees. One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe.

Reps Bachman and Kline have both come out saying that public insurance would be cheaper. So as true neo-cons, they are against cutting waste and inefficiency, and want to let insurance companies decide who lives or dies.

http://minnesotaindependent.com/39874/bachmann-kline-oppose-public-option-because-its-cheaper

I agree that we need to allow Congress to do their job. However, their first priority should be to address the problems with the existing Government run systems. Instead, the President has pushed for his $600 billion+ "down payment" to restructure health care. Bigger doesn't always mean better - adding to the problem will undoubtedly make it worse.

One place to start in the Government programs might be to encourage doctors to volunteer at free clinics (reward them with tax credits - not cash). This would certainly cut down on treatment at emergency rooms for colds, flu and other non-emergency treatments. This will require new free clinics - which some of the stimulus money could build-out.

Next, one of the biggest problems with private health insurance is denial of coverage for pre-existing conditions. I'm sure the insurance industry could teach the Government how to design and manage one super-sized risk pool to address this issue. The Government is the only entity that could establish such a pool.

Last, if someone sneaks into this country to work - that is take a job away from a citizen - they should use their earnings to pay for their own health insurance. If they snuck into this country to live off welfare and enjoy free health care - they should be deported. We can't be expected to provide health care for people who are here illegally.

The bottom line is this - health care should not be a political matter. This is not a Democrat vs Republican issue and we shouldn't allow it to be a left vs right issue.

Everything the Government touches cost too much and is mired in red tape. The less involved the Government is in the details, the better. If they want to fund a risk pool to cover un-insurable people, clean up their own programs, reward doctors for helping under-insured people, and tell illegal immigrants to go home (instead of trying to get their votes), the industry can fix itself - they now understand they don't have a choice.
 
  • #391
I have never been to a medical centre in the US, or know enough about the US healthcare system to make a fair comment. Like many Americans making comments about the NHS or other social healthcare you don't know our/there system either to give an un-biased opinion. Each have there problems and many people can pick faults in both.

However I rest assured that at any time any place, me or any member of my family can make an appointment, or if an emergency, make a simple call and we will be given an appointment or rescued and taken care of to a very good standard.

I or my family don't have to worry about forms, insurances, level of cover, money.

I don't mind putting money into the pot for everyone to get healthcare if they need it, it should be a given right like the air we breath. I have paid into the system all my life and do not begrudge someone who may not have paid as much as me into the system. As are the current world circumstance, if I ever lost my job and could not get another for awhile, and could not pay insurance for healthcare it would not worry me, I rest assured the NHS is there for me and my family regardless.

If the issue is paying for people who do not pay there share towards healthcare or the system. Then why is this issue not raised when billions are given in aid to foreign nations for grain and vaccinations etc in Africa, Asia etc these people don't pay into your system, yet you pay for all of it through your taxes. then you question helping a fellow citizen when they need it. your government spends hundreds of Billions on defence to safeguard it's population etc yet 1000's die or have ill health because the lack of health insurance. Because of what seems a capitalist healthcare system. If half the healthcare system was non profit yet the doctors are getting paid well and the drug company's are still making profit everyone is getting treated, I struggle to see the issue

There are certain things that should not have been or be privatised or for profit.
Health, Water, Power (to the home) all are necessities and should be available to all at a cost which covers running costs and a percentage for future required investments, not excess amounts to pay shareholders.

Sorry if it turned into a small rant, no one likes there country being picked on or highlighted to having flaws. ours is far from perfect like yours but we will defend it when highlighted for the wrong reasons :).
 
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  • #392
WhoWee said:
I agree that we need to allow Congress to do their job. However, their first priority should be to address the problems with the existing Government run systems. Instead, the President has pushed for his $600 billion+ "down payment" to restructure health care. Bigger doesn't always mean better - adding to the problem will undoubtedly make it worse.

Next, one of the biggest problems with private health insurance is denial of coverage for pre-existing conditions. I'm sure the insurance industry could teach the Government how to design and manage one super-sized risk pool to address this issue. The Government is the only entity that could establish such a pool
Denial of coverage and refusal to pay for covered services are the insurance companies' biggest money-makers. A not-for-profit government-run system would be much better at bringing down costs. Neo-cons know this and have made it an arguing point.
 
  • #393
Why after opening with a reasonable comment like this
3thanol said:
I have never been to a medical centre in the US, or know enough about the US healthcare system to make a fair comment. Like many Americans making comments about the NHS or other social healthcare you don't know our/there system either to give an un-biased opinion. Each have there problems and many people can pick faults in both...
do you then follow up with this comment?
...yet 100,000's die because of what seems a capitalist healthcare system.
 
  • #394
turbo-1 said:
Denial of coverage and refusal to pay for covered services are the insurance companies' biggest money-makers. A not-for-profit government-run system would be much better at bringing down costs. Neo-cons know this and have made it an arguing point.

Turbo,

I honestly don't believe the Government can run anything at a lower cost - it's just not their specialty. If they can fix medicare, medicaid, and social security (without blending it into a bigger program), I'll eat my words.

The reason insurance companies deny pre-existing conditions is because the pre-existing conditions (diabetes, high blood pressure, high cholesterol, cancer) all lead to other very expensive conditions.

Insurance companies don't insure people who build in flood plains or in wild fire or earthquake areas unless they build the risk into their pricing. Dangerous drivers pay more for car insurance. Insurance companies don't place bad bets. AIG is an example of what happens when they do something risky.

A Government led risk-pool to assist with the associated costs of assuming the risk of pre-existing conditions could solve the problem. By sharing the risk, insurance companies won't risk their ability to pay other claims (and earn profits).

When a region is declared a disaster area due to a natural disaster, the Government steps into help, it's the same basic model. The insurance companies pay their claims and the Government helps the under-insured and un-insured.
 
  • #395
WhoWee said:
Turbo,

I honestly don't believe the Government can run anything at a lower cost - it's just not their specialty. If they can fix medicare, medicaid, and social security (without blending it into a bigger program), I'll eat my words.

The reason insurance companies deny pre-existing conditions is because the pre-existing conditions (diabetes, high blood pressure, high cholesterol, cancer) all lead to other very expensive conditions.

Insurance companies don't insure people who build in flood plains or in wild fire or earthquake areas unless they build the risk into their pricing. Dangerous drivers pay more for car insurance. Insurance companies don't place bad bets. AIG is an example of what happens when they do something risky.

A Government led risk-pool to assist with the associated costs of assuming the risk of pre-existing conditions could solve the problem. By sharing the risk, insurance companies won't risk their ability to pay other claims (and earn profits).

When a region is declared a disaster area due to a natural disaster, the Government steps into help, it's the same basic model. The insurance companies pay their claims and the Government helps the under-insured and un-insured.

That makes too much sense to be something the Government would do. I like it, though.
 
  • #396
mheslep said:
Yes, generally, regarding Medicaid it is true.

Again are you reading different things to me? You say:

And in the US if one has no or very little income (<~20k/yr), then they are eligible for government based health care via the Medicaid program as I posted before, and before, and before.

Yet, I quoted from the source:

Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups.

The poverty line in the US is something like a wage of $10,000. Now, pray tell, if the medicaid guidelines state that being in poverty is not sufficient to receive aid, how is every person with a wage of $20,000 eligible to receive such aid?

Your figures just don't add up, yet you try say that I'm wrong. Prove it, or stop making such claims. That's now (at least) two cases of misinformation you've made in this thread, and this discussion is getting pretty tiresome.
 
  • #397
turbo-1 said:
How do you know what's on the table? Have you read any of the mark-ups coming out of the various committees? Do you have a crystal ball to see what could emerge as a reconciled bill merging the House's language with the Senate's? Nobody has a clear view of where all this will end up yet, which is why the neo-cons are stirring people up to shout "We don't want it." when they haven't a clue what has come out of committees.
Nothing passed by any committee as of yet changes the bulk of the objectionable parts of the proposal. Any attempt by Republicans to amend it so that it doesn't outlaw all insurance plans that aren't part of the new system will fail according to my crystal ball.
One thing for sure - if we don't contain costs and rein in the cost of health-care, the US is headed for economic catastrophe.
Unsubstantiated bunk.
Reps Bachman and Kline have both come out saying that public insurance would be cheaper.
As has been pointed out to you before, what they actually are saying is that public insurance will be "cheaper" to a consumer because they will pay for 30-40% of the public insurance by taxation whether they choose it or not, then pay the other 60-70% directly for the (subsidized) public insurance. If they choose private insurance, they will pay the premium (100%) plus the 30-40% on top, making the public plan the cheaper choice artificially.
So as true neo-cons, they are against cutting waste and inefficiency, and want to let insurance companies decide who lives or dies.
This is an outright hateful lie, and you know it. Forum rules can be found here: https://www.physicsforums.com/showthread.php?t=113181
 
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  • #398
It's not an outright hateful lie. I only wish it were not true. Right now, if you own a small business and offer health insurance to your employees and one of your employees comes down with a catastrophic illness the insurance company will either jack up your rates or refuse to renew your policy. If you have been paying for private coverage for years and you come down with a catastrophic illness, it's likely that your insurance company will drop you on some pretext to avoid paying for your care. This is the status quo, and this is the system that the GOP wants to perpetuate. We can speculate about their motivations, but the end result is the same.

In regard to "death panels" cited by Palin, Gingrich, and Grassley, guess who voted to fund end-of-life counseling in 2003? The blatant lying and fear-mongering on the right are disheartening. They seem determined to undermine reform by whatever means available.

http://swampland.blogs.time.com/2009/08/13/oh-those-death-panels/
 
  • #399
http://jama.ama-assn.org/cgi/content/full/298/6/638?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=1900&resourcetype=HWFIG


Despite the ability of vaccines to prevent illness and death, our current system of vaccine financing has resulted in a gap for underinsured children. Current trends in health insurance products, including enrollment in high-deductible health plans that may or may not provide immunizations or other preventive benefits before a high deductible has been met, are likely to increase the magnitude of this gap and must be carefully monitored. Furthermore, the impact of the gap in vaccine financing for underinsured children on vaccination rates deserves further study once data on coverage rates for new vaccines become available. Evidence from past studies supports the premise that the availability of financing affects immunization rates.11, 21 Meanwhile, strategies are needed to address the current needs of underinsured children and should include efforts to enhance immunization benefits through requirements or incentives for insurers and employers. Until such enhancements in private insurance coverage for immunization are implemented, however, support of the public sector safety net is critical to ensure the protection of this vulnerable group of children in the United States.



Sounds like the best system of health care in the world to me.
 
  • #400
turbo-1 said:
It's not an outright hateful lie. I only wish it were not true. Right now, if you own a small business and offer health insurance to your employees and one of your employees comes down with a catastrophic illness the insurance company will either jack up your rates or refuse to renew your policy. If you have been paying for private coverage for years and you come down with a catastrophic illness, it's likely that your insurance company will drop you on some pretext to avoid paying for your care. This is the status quo, and this is the system that the GOP wants to perpetuate. We can speculate about their motivations, but the end result is the same.

http://swampland.blogs.time.com/2009/08/13/oh-those-death-panels/

This is a result of small group risk pools. One sick person can raise the rates of everyone in the pool.

Without restating my earlier posts, this is a major problem in covering high risk individuals. To look at the problem another way, when the Government looked at the mortgage industry they identified certain "toxic assets". Plans were developed to isolate these assets and deal with them as a group. The same type of approach could be used for health insurance. Basically, move people out of low risk pools into Government subsidized pools as they develop more serious conditions. Government doesn't need to run health care, just guarantee the catastrophic and ensure availability of Prevention/Wellness.

If you think of health care as tiered - similar to the way prescriptions are categorized you would have the following (based on the way health insurance policies are organized):

Tier 1 - Preventative Care/Wellness This includes all of the annual physicals and routine exams, diet and exercise evaluation and routine testing.

Tier 2 - Emergency/Outpatient Care/Rehab

Tier 3 - Hospital/In-patient Care/Surgery

Tier 4 - Long Term Care/Disease Management

Tier 5 - Critical Illness/Intensive Care

The cost/risk increases through each Tier. Currently (as Turbo pointed out) if only 1 person in a small group becomes seriously ill, everyone's rates in that group can be affected.

At the same time, the current Government plans do not address the prioritization of illness. As an example, if a person on welfare catches a cold (and can't afford to pay for an $85 doctor's visit) they often go to the (Tier 2) emergency room for diagnosis and medicine - it's their best option- but far more costly to the system than seeking Tier 1 Wellness care.

This is part of the "waste" component in the Government program - it's like going to the car dealer to buy tires or a battery for your used car - it will cost more than if you went to a tire or battery store - the dealer has more overhead and a higher hourly rate.

Many of the problems with our current system can be fixed by applying common sense.
 
  • #401
Another factor that is often glossed over in the discussions about health-care reform is that the costs associated with treating the uninsured are passed on to those with insurance. For-profit hospitals and medical practices do not simply "eat" those costs - they pass them on in the form of higher charges. When I worked for a large ophthalmic practice, we had two retinal surgeons, one of whom had to be on call at all times. If they got a call about someone who had suffered a retinal detachment in an accident, they wouldn't ask if the victim had insurance. They would get to the operating theaters STAT and do their best to re-attach the retina(s) in an effort to preserve the victim's sight. If the victim was uninsured and unable to pay for that $$$$$ surgery, the medical practice and the hospital passed those costs on to insured people in the form of higher charges for services.

If we had a public health insurance option, this situation could be resolved, resulting in more reasonable charges for procedures. Also, as WhoWee pointed out, giving the currently uninsured/underinsured access to preventative health care should help resolve potential health problems before they become more serious and require more expensive interventions. There are some potentially huge improvements in efficiency and cost-containment that could be brought about by a well-crafted reform bill. It's a shame that most of the GOP in Congress can't bring themselves to participate, because simple nay-saying and obstruction will not result in the best possible bill.
 
  • #402
turbo-1 said:
For-profit hospitals and medical practices do not simply "eat" those costs - they pass them on in the form of higher charges. ... If we had a public health insurance option, this situation could be resolved, resulting in more reasonable charges for procedures.
Those costs do not magically go away -- they are just going to be passed on in the form of "taxes" rather than in the form of "higher charges".
 
  • #403
turbo-1 said:
If we had a public health insurance option, this situation could be resolved, resulting in more reasonable charges for procedures. Also, as WhoWee pointed out, giving the currently uninsured/underinsured access to preventative health care should help resolve potential health problems before they become more serious and require more expensive interventions. There are some potentially huge improvements in efficiency and cost-containment that could be brought about by a well-crafted reform bill. It's a shame that most of the GOP in Congress can't bring themselves to participate, because simple nay-saying and obstruction will not result in the best possible bill.

Control of health care should not be a political prize. The system we have needs refinement and support.

We need to diagnose the problems with medicare, medicaid and social security - and fix those problems - not roll them into a much bigger program where they will never be cured.

The President made a comparison of UPS and FedEx to the US Postal service. If UPS and FedEx lost $7,000,000,000 per year (as the Post Office is projecting) would they continue to exist?

Insurance companies and health care networks operate at a profit. Their operations are efficient. A great deal of the waste in health care is already under Government control, a result of Government regulation, or can be addressed by Tort Reform.

Does anyone realize how much HIPPA regulations have cost the industry - and consumers?

When politicians talk about IT improvements, are they unaware of HIPPA requirements? Are they unaware of the millions of dollars already (mandated and) invested by the industry?

Our President and many others in Government are lawyers. Lawyers are taught how to analyze problems in a methodical manner. First gather all of the information, study and prioritize that information, (using all of the information available) make strategic plans and measure their possible outcomes, re-examine and tweak, take action on the best strategy.

This basic problem solving model needs to be used in dealing with health care reform. This is not something that can be done in haste or rammed through with political grandstanding. This is life and death and a large part of our economy.

Our elected officials need to start acting like adults and do their jobs. I expect our elected politicians to read the Bills and understand what they are voting on - if they can't - we need to find better qualified people to make the decisions.
 
  • #404
WhoWee said:
Insurance companies and health care networks operate at a profit. Their operations are efficient.

Operating at a profit does not mean that they are efficient for society as a whole.
A lot of of republicans have attacked the NHS here in the UK over the past few days claiming it is inefficient etc.
Now, if the NHS is that inefficient, why is it that the total cost of health care in the UK is HALF of what it is in the US (in terms of GDP)?
 
  • #405
Emotions say tort reform would save a lot of money, but the facts (or lack thereof) so far say otherwise:

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf


Evidence from the states indicates that premiums for malpractice
insurance are lower when tort liability is restricted
than they would be otherwise. But even large savings
in premiums can have only a small direct impact on
health care spending—private or governmental—because
malpractice costs account for less than 2 percent of that
spending.3 Advocates or opponents cite other possible effects
of limiting tort liability, such as reducing the extent
to which physicians practice “defensive medicine” by conducting
excessive procedures; preventing widespread
problems of access to health care; or conversely, increasing
medical injuries. However, evidence for those other
effects is weak or inconclusive.
 
  • #406
Hurkyl said:
Those costs do not magically go away -- they are just going to be passed on in the form of "taxes" rather than in the form of "higher charges".
My point is that we already pay these costs in the current system, in the form of higher fees for service. Hospitals and medical practices pad their fees because they know that they are going to have to treat the uninsured and need to keep their profits up. With the recent job-losses, many more people are losing insurance coverage, and that will place additional pressure on ERs, etc.

My wife had to change doctors after her employer switched carriers and ended up with a plan that he couldn't afford to participate with. With a single doctor and a single staffer, the coding requirements, paperwork, etc would have sunk his practice. He is an Osteopathic country-doctor in a rural area, and he only charges $60 for an office visit. That still can be a lot of money for an out-of work uninsured person to come up with, but it's far cheaper than letting the uninsured get sicker until they show up at the ER. Give people access to preventive care and the their medical needs will be addressed before they need to resort to an ER.

There really needs to be a public option that will cover all people. I have a disability (pre-existing condition) that would prevent me from ever getting private insurance if my wife should lose her job. How many people in this country are at risk this way? Getting denied insurance coverage puts you just one serious illness away from bankruptcy, and that's unconscionable.
 
  • #407
gravenewworld said:
Emotions say tort reform would save a lot of money, but the facts (or lack thereof) so far say otherwise:

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf

The cost isn't just from lawsuits.

The hidden costs often include ordering extra tests to cover the doctor and hospital. Medicine has come a long way from ancient times. Doctors have a difficult job and are often forced to make fast decisions. Their priority should be in saving the patients, not shielding themselves from litigation.

I believe that doctors should be held accountable, but there needs to be reasonable limits and expectations.
 
  • #408
WhoWee said:
The cost isn't just from lawsuits.

The hidden costs often include ordering extra tests to cover the doctor and hospital. Medicine has come a long way from ancient times. Doctors have a difficult job and are often forced to make fast decisions. Their priority should be in saving the patients, not shielding themselves from litigation.

I believe that doctors should be held accountable, but there needs to be reasonable limits and expectations.

Maybe I need to REPOST with bolded words. Try reading the PDF this time before posting please.

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf

Evidence from the states indicates that premiums for malpractice
insurance are lower when tort liability is restricted
than they would be otherwise. But even large savings
in premiums can have only a small direct impact on
health care spending—private or governmental—because
malpractice costs account for less than 2 percent of that
spending.3 Advocates or opponents cite other possible effects
of limiting tort liability, such as reducing the extent
to which physicians practice “defensive medicine” by conducting
excessive procedures; preventing widespread
problems of access to health care; or conversely, increasing
medical injuries. However, evidence for those other
effects is weak or inconclusive.


States that have enacted forms tort reform still haven't seen their health costs go down significantly. Why?
 
  • #409
gravenewworld said:
Maybe I need to REPOST with bolded words. Try reading the PDF this time before posting please.

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf




States that have enacted forms tort reform still haven't seen their health costs go down significantly. Why?

I read your post and I deal with this issue daily.

Maybe you need to post the specifics of their reforms in bold. Perhaps their reforms were not adequate or focused?

Perhaps the trial lawyers helped draft the reforms?
 
  • #410
WhoWee said:
I read your post and I deal with this issue daily.

Maybe you need to post the specifics of their reforms in bold. Perhaps their reforms were not adequate or focused?

Perhaps the trial lawyers helped draft the reforms?

Effects on Defensive Medicine

Proponents of limiting malpractice liability have argued
that much greater savings in health care costs would be
possible through reductions in the practice of defensive
medicine. However, some so-called defensive medicine
may be motivated less by liability concerns than by the
income it generates for physicians or by the positive (albeit
small) benefits to patients. On the basis of existingstudies and its own research, CBO believes that savingsfrom reducing defensive medicine would be very small.
A comprehensive study using 1984 data from the state of
New York did not find a strong relationship between the
threat of litigation and medical costs, even though physicians
reported that their practices had been affected by
the threat of lawsuits.14 More recently, some researchers
observed reductions in health care spending correlated
with changes in tort law, but their studies were based on a
narrow part of the population and considered spending
for only a few ailments. One study analyzed the impact of
tort limits on Medicare hospital spending for patients
who had been hospitalized for acute myocardial infarction
or ischemic heart disease; it observed a significant
decline in spending in states that had enacted certain tort
restrictions.15 Other research examined the effect of tort
limits on the proportion of births by cesarean section. It
also found savings in states with tort limits, though of a
much smaller magnitude.16
However, when CBO applied the methods used in the
study of Medicare patients hospitalized for two types of
heart disease to a broader set of ailments, it found no evidence
that restrictions on tort liability reduce medical
spending. Moreover, using a different set of data, CBO
found no statistically significant difference in per capita
health care spending between states with and without
limits on malpractice torts. Still, the question of whether
such limits reduce spending remains open, and CBO
continues to explore it using other research methods.



This CBO report here probably will answer a lot of questions you have, it's kind of long but worth the read:

http://www.cbo.gov/ftpdocs/55xx/doc5549/Report.pdf



The evidence that tort reform would have a significant impact on defensive medicine has been weak so far. Who says doctors aren't ordering more tests simply to line their own pockets?
 
  • #411
Here's something else to consider, how many of the service providers in the study operate in states outside of the one's with reforms? How many of those hospital networks have system-wide policies in place to protect the organization as a whole?

Insurance companies and health service providers deal must conform to the rules of each individual state - this also adds cost.
 
  • #412
gravenewworld said:
This CBO report here probably will answer a lot of questions you have, it's kind of long but worth the read:

http://www.cbo.gov/ftpdocs/55xx/doc5549/Report.pdf



The evidence that tort reform would have a significant impact on defensive medicine has been weak so far. Who says doctors aren't ordering more tests simply to line their own pockets?

Don't forget, doctors can order tests until their pens break, the insurance companies (or patients) have to pay for those tests.

The tests have to be a good business decision or the insurance companies will not go along.

Isolated incidents where patients ultimately pay for unnecessary tests based upon emotions is unfortunate and unacceptable.
 
  • #413
gravenewworld said:
The evidence that tort reform would have a significant impact on defensive medicine has been weak so far. Who says doctors aren't ordering more tests simply to line their own pockets?
Doctors who own diagnostic equipment or who own a share of a local hospital can certainly drive up costs in the quest for profit. You might be surprised to learn, though, that some of the "unnecessary" diagnostic testing is done to satisfy the insurance companies. If a doctor performs a procedure on a patient without jumping through all the insurance companies' hoops, the claim will be denied. Each insurance company has its own requirements, and if the doctor has not provided the specific diagnostic evidence they require, they will not pay for the treatment. Insurance companies drive up the administrative costs in medical practices and hospitals and actually foster more spending on diagnostic testing than one might expect.
 
  • #414
turbo-1 said:
Doctors who own diagnostic equipment or who own a share of a local hospital can certainly drive up costs in the quest for profit. You might be surprised to learn, though, that some of the "unnecessary" diagnostic testing is done to satisfy the insurance companies. If a doctor performs a procedure on a patient without jumping through all the insurance companies' hoops, the claim will be denied. Each insurance company has its own requirements, and if the doctor has not provided the specific diagnostic evidence they require, they will not pay for the treatment. Insurance companies drive up the administrative costs in medical practices and hospitals and actually foster more spending on diagnostic testing than one might expect.

Turbo brought up another very interesting point - who owns the MRI's and other equipment? Is it wrong for doctor's to invest in equipment they understand - and can guarantee clients will use?

Going back to my earlier post, it might be wise for the Government to not only invest in clinics - staffed by doctors who receive tax credits for services rendered - but to invest in the diagnostic and research labs - and leave the management and operations to the professionals.

I'm 100% in favor of Government investment in hard assets and underwriting high risk insurance pools - just not anything that involves administration or control.
 
  • #415
I should add that not only do the diagnostic tests have to match the insurance companies' requirements, but that the tests, diagnoses, and treatments have to be coded to match the insurance companies' coding requirements before they will reimburse the doctor/clinic/hospital.

I suggest that anyone interested in reducing the administrative cost burdens on health-care providers Google on "medical coding specialists" to see what those people do. Coding specialists can make or break your facility, and the plethora of coding standards imposed by the various private insurers is quite daunting. My cousin is a coding specialist for a small pediatric ophthalmic practice that takes lots of Medicaid applicants. The saving grace in that client-base is that the coding requirements are rather stable and monolithic, so she can do the job all by herself, even though she has to spend most of her time wading through the ever-changing coding requirements of the private insurers.
 
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  • #416
This is an example of hidden costs

"For affected organizations, HIPAA compliance can be a costly, Herculean task. In fact, many
of these efforts have been compared with Y2K preparations in terms of their impact and costs.
Surveys project upgrade costs to vary from $10,000 for a small private practice to $14 million
for a larger organization (Nunn, McGuire, 2005). The average cost of $3.1 million from
surveyed firms is considerably more expensive than the projected average estimate of
$450,000 that was done prior to implementation."

http://lorrie.cranor.org/courses/fa05/mpimenterichaa.pdf

There is a big gap between an estimate of $450,000 and an actual cost of $3,100,000.

We are all paying for these Government mandated regulations.
 
  • #417
Now consider the irony of the IRS enforcing health insurance mandates.
 
  • #419
Count Iblis said:

Mostly I've been watching this thread with fascination mingled with horror.

What I find most interesting in this link here is not the article itself, nor the story it tells in support, but some of the comments following after the story, from americans... which tends to echo some of what I am reading here in this thread.

See, for example, one rather extreme example: http://news.independentminds.livejournal.com/3753821.html?thread=22834525#t22834525. This comment represents what is sometimes taken as a convenient caricature of the USAmerican by some of us in other countries.

The commenter does not actually say anything much about health care or the story in the the article, but merely asserts that "A majority of Americans DO NOT want universal health care as you have in England."

And why not? Because its "socialized". It would be a "handout" to the "poor and illegal migrants". It is "government is trying to force Progressive and Liberal ideas down our throats". In this person's comment, "liberal" and "progressive" are negative terms. (Which is weird in itself.) All the things that are "liberal" and "progressive", such as diversity, inclusiveness, social justice and a lot more (there's a list given) are, for this commenter, just ways of saying "redistribution of wealth".

The whole comment is just surreal.

But here's the thing. The commenter is wrong. The government has recently changed in the USA towards these more liberal ideas because it was voted that way by a very clear majority of citizens. Far from representing a majority of Americans, this comment seems to be the shill cry of an extreme point on a side of conservative political thought that is a minority. Most USAmericans don't deserve this kind of comment as their caricature.

Cheers -- sylas
 
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  • #420
sylas said:
See, for example, one rather extreme example: http://news.independentminds.livejournal.com/3753821.html?thread=22834525#t22834525 . This comment represents what is sometimes taken as a convenient caricature of the USAmerican by some of us in other countries.

That guy's clearly an idiot, though. Someone who says something like

We Americans have empathy with our friends in England, and think that it is wrong of your government to CENSURE englander's FREE SPEECH. SPEECH CODES ARE SIMPLY WRONG. WE MUST ALLOW ALL TYPES OF SPEECH, EVEN WHEN THEY ARE LABELED AS "HATE SPEECH", in order to hear ALL ideas period.

and

The main source of TRUTH in our media right now is FOX NEWS CHANNEL period.

doesn't deserve to be taken seriously! The former comment is presumably pointed towards the BNP party, who recently won a few seats in the European parliament. Well, whilst I would agree that they are permitted to stand for elections, and to campaign, such campaigns which are based upon racism and bigotry should not be permitted. Perhaps this guy thinks racist rallies should be allowed, but in which case he cannot empathise with me, as a British citizen. The latter comment is clearly nonsense, as anyone with two brain cells will be able to see.
 
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