Who should pay the healthcare costs of the uninsured?

[CaptainQuasar]

Yes but as suggested up thread they don't actually eat the cost. You do, via $10 hospital tissue boxes.

I don't know about that. This is a separate entity from a hospital, remember, and there are lots of competing companies in any given area. It sure sounded like they were just SOL and could easily get into financial trouble and be overwhelmed by their competitors and go under if they got too many of those sorts of calls for too many months in a row.

Yeah, it causes more expenses, but the expense is the 911 dispatch system calling up a competing company's ambulance because the usual guys are shucking an uninsured or otherwise non-paying client.

⚛​

 

[gravenewworld]

The US does not have a free market health care system in any sense that's its normally seen. At least 50% of all health care spending is by the government already, and in the rest of it the buyer is not the recipient. In a market the recipient must freely negotiate w/ the provider

Exactly, that is what the US health care system has evolved into. You have a very few huge conglomerates controlling the vast majority of health care for the population. Even the government itself finds that this is leading to more and more higher costs and less choice for patients. Do you see it going away anytime soon if nothing is changed? I don't think so. Where is the efficiency in the system we have now? NO COUNTRY IN THE WORLD with the best of health care has a free market health care system. Why?

 

[mheslep]

Exactly, that is what the US health care system has evolved into. You have a very few huge conglomerates controlling the vast majority of health care for the population. Even the government itself finds that this is leading to more and more higher costs and less choice for patients. Do you see it going away anytime soon if nothing is changed? I don't think so. Where is the efficiency in the system we have now? NO COUNTRY IN THE WORLD with the best of health care has a free market health care system. Why?

Here and abroad I believe its in large part because health care is so perfectly suited to the pandering of politicians: "elect me and I will get you more covered procedures, its your right!". This goes on and on until health care is 100% run by government at which point government can only control costs by limiting supply (queues).

Yet there are plenty of examples of small free markets in play in the US and elsewhere. http://healthcare-economist.com/2006/04/25/markets-at-work-lasik/" , as its not covered by insurers, is a famous one. It now has the highest patient satisfaction of any surgery. 1998 price was $2200, now its $1350. But remain vigilant. Soon some politco will start yelling its your right to see as well as the next man in this society, we all must have it; Lasik will get mandated onto insurance plans. Then one day, our Original Poster will return to our forum and query: "...John Smith is uninsured, has terrible vision, gets a $100K lasik eye job ... who pays?"

 

[gravenewworld]

Here and abroad I believe its in large part because health care is so perfectly suited to the pandering of politicians: "elect me and I will get you more covered procedures, its your right!". This goes on and on until health care is 100% run by government at which point government can only control costs by limiting supply (queues).
There are plenty of examples of small free markets in play in the US and elsewhere. http://healthcare-economist.com/2006/04/25/markets-at-work-lasik/" , as its not covered by insurers, is a famous one. It now has the highest patient satisfaction of any surgery. 1998 price was $2200, now its $1350. But remain vigilant. Soon some politco will start yelling its your right to see as well as the next man in this society, we all must have it; Lasik will get mandated onto insurance plans. Then one day, our Original Poster will return to our forum and query: "...John Smith is uninsured, has terrible vision, gets a $100K lasik eye job ... who pays?"

LOL exactly. The first and hardest step for millions of Americans is getting insurance in the first place. On top of that, having insurance here in the US doesn't guarantee affordable health care for an individual at all.

 

[gravenewworld]

Here and abroad I believe its in large part because health care is so perfectly suited to the pandering of politicians: "elect me and I will get you more covered procedures, its your right!". This goes on and on until health care is 100% run by government at which point government can only control costs by limiting supply (queues).

Really? See pg 3 of the OECD report.

http://www.oecd.org/dataoecd/5/27/26781192.pdf

So how is it that places like Japan spend less % of their GDP on health care, have universal coverage, and have waiting times just as long as we do in the US for health care?

 

[mheslep]

Really? See pg 3 of the OECD report.

http://www.oecd.org/dataoecd/5/27/26781192.pdf

So how is it that places like Japan spend less % of their GDP on health care, have universal coverage, and have waiting times just as long as we do in the US for health care?

Lumping all those countries together and saying they all have 'universal coverage' is grossly imprecise. I'm only familiar with a 2 or 3 other countries shown there and of the ones I know only England (the topic of the report) has real 'universal' care: doctors, hospitals, everything run and paid for by the government. As you can see the waiting time is >six months. Other countries are moving away from failing universal plans and opening up free market health care. Government care is just another 3rd party payer system, it doesn't work either. There is no way around supply and demand.

 

[mheslep]

LOL exactly. The first and hardest step for millions of Americans is getting insurance in the first place. On top of that, having insurance here in the US doesn't guarantee affordable health care for an individual at all.

Really? See pg 3 of the OECD report.

http://www.oecd.org/dataoecd/5/27/26781192.pdf

So how is it that places like Japan spend less % of their GDP on health care, have universal coverage, and have waiting times just as long as we do in the US for health care?

You seem to agree w/ the premise of the Lasik example I posted but in the next post I gather that rather you believe that only an insurance system would inflate Lasik costs, but that if it were provided under a universal government program this would not be the case. http://www.hoover.org/publications/digest/3459466.html" . The real cost of producing any handout will always increase rapidly as the demand increases without check. It matters not who the 3rd party payer may be. If the 3rd party (insurer/government) stops paying the increase, the supplier will inevitably start limiting the quality of the service or good.

 

[gravenewworld]

Lumping all those countries together and saying they all have 'universal coverage' is grossly imprecise. I'm only familiar with a 2 or 3 other countries shown there and of the ones I know only England (the topic of the report) has real 'universal' care: doctors, hospitals, everything run and paid for by the government. As you can see the waiting time is >six months. Other countries are moving away from failing universal plans and opening up free market health care. Government care is just another 3rd party payer system, it doesn't work either. There is no way around supply and demand.

Where did I lump them together? I pointed out Japan as an example. The US only has about 1/3-1/2 the number of hospital beds as Japan (per capita wise of course) and has only half the number of MRI machines (per capita wise as well). These are some of the reasons why Japanese are able to receive prompt treatment AND maintain universal coverage. Hospitals in Japan keep patients for a much longer time than they due in the US, where patients are kicked out of the door as fast as possible. Japan is a much more efficiently run system of health care than the US.

Background info on Japanese health care
http://www.nyu.edu/projects/rodwin/lessons.html

Japan's health care system is characterized by universal coverage, free choice of health care providers by patients, a multi-payer, employment-based system of financing, and a predominant role for private hospitals and fee-for-service practice.

Virtually all residents of Japan are covered without regard to any medical problems they may have (so-called predisposing conditions) or to their actuarial risk of succumbing to illness. Premiums are based on income and ability to pay. Although there is strong government regulation of health care financing and the operation of health insurance, control of the delivery of care is left largely to medical professionals and there appears to be no public concern about health care rationing.

Like the Australian, Canadian and many European health care systems, Japan's national health insurance program is compulsory. But Japan surpasses all 24 member countries of the Organization for Economic Cooperation and Development (OECD) in life expectancy at birth and also has the lowest infant mortality rate (Appendix 1, Table 1).1 It achieves these successes at a cost of only 6.6 percent of gross domestic product, $1,267 per capita - half that of the United States (Table 1) .

Japanese-style national health insurance raises a fascinating question: how has Japan reduced financial barriers of access to medical care and achieved a No. 1 ranking on health status at a cost that is among the lowest of wealthy industrialized nations?2 In addressing this question, we begin with a comparative analysis of health care resources and the use of medical care in Japan, the United States and other OECD countries. Next, we review the financing and organization of medical care in Japan, evaluate some strengths and weaknesses of the health care system, and explore possible lessons for health care reform in the United States.

THERE WILL BE NO PERFECT SYSTEM FOR HEALTH CARE. I find it extremely ethically wrong that yes here in the US we may not have to wait long for health care, but one of the main reasons why is simply because we deny 45 million of our citizens health coverage. That is not efficiency, that is simply lunacy. Also, when private insurance companies enter the market, it kills universal systems of health. I believe it is in the UK, where if you have private insurance you get to be placed ahead of people that have UH on waiting lists. This in turn motivates more and more people to buy private insurance which in the end (if enough people buy into private insurance) will increase costs and leave a big chunk of people who get 2nd rate health care service.

You seem to agree w/ the premise of the Lasik example I posted but in the next post I gather that rather you believe that only an insurance system would inflate Lasik costs, but that if it were provided under a universal government program this would not be the case. I ask you to reconsider. The real cost of producing any handout will always increase rapidly as the demand increases without check. It matters not who the 3rd party payer may be. If the 3rd party (insurer/government) stops paying the increase, the supplier will inevitably start limiting the quality of the service or good.

For some reason you seem to assume that supply always will remains stagnant. This is how Japan is able to control their health care costs and waiting times-by having much better supplies (per capita wise) of medical technology and hospital beds available.

 

[mheslep]

Where did I lump them together? I pointed out Japan as an example.

The post said "places like Japan". Ok to advance the discussion, please define with a little detail what you mean when you say 'Universal Coverage' so we can have some common ground. Who pays, for what services , limitations to the services, allowance for alternative coverage, etc.

 

[gravenewworld]

The post said "places like Japan". Ok to advance the discussion, please define with a little detail what you mean when you say 'Universal Coverage' so we can have some common ground. Who pays, for what services , limitations to the services, allowance for alternative coverage, etc.

I will respond to this later after I get home from work.

So many places are now switching to a more free market based approach to health care?

Chew on this-

http://content.nejm.org/cgi/content/full/358/6/549

"Market-Based Failure — A Second Opinion on U.S. Health Care Costs"

The
dominance of for-profit insurance
and pharmaceutical companies,
a new wave of investorowned
specialty hospitals, and
profit-maximizing behavior even
by nonprofit players raise costs
and distort resource allocation.
Profits, billing, marketing, and the
gratuitous costs of private bureaucracies
siphon off $400 billion to
$500 billion of the $2.1 trillion
spent, but the more serious and
less appreciated syndrome is the
set of perverse incentives produced
by commercial dominance
of the system.

 

[mheslep]

I will respond to this later after I get home from work.

So many places are now switching to a more free market based approach to health care?

Chew on this-

http://content.nejm.org/cgi/content/full/358/6/549

"Market-Based Failure — A Second Opinion on U.S. Health Care Costs"

We're not getting anywhere as this post is a non-sequitur. Up thread I posted, and you agreed twice ala 'LOL, exactly': 1) the US health system fails, 2) the US health system is not a free market, its a 3rd party payer system. Then you reply w/ this aha! post that 1) says the US health system fails and 2) says nothing about my assertion that other countries may be allowing more private alternatives in addition to their government run systems (they are, e.g. Ireland, Canada, Netherlands).

BTW: Here's an interesting debate between Kuttner and the author of the piece I provided, Friedman.

 

[JasonRox]

Good post turbo-1. (The first one.)

 

[Oerg]

Isn't Bush supposed to pay them?

 

[TVP45]

I'm not saying the way the insurance industry runs things is great, I just don't have any reason to think government red tape would improve upon it, not the way our government is run.

Moonbear,
I pretty much agree with you about what the government would do, but I'm not so sure private insurance companies are a bit better. It must have taken 15 minutes the other day for my urologist to sort out which insurer would pay for which catheter (making that one of the most expensive hoses in the world). And the two biggies in this area are now looking at "value-based reimbursement", a very nice phrase for rationing.
Do have any inside insight on the right path to follow?

 

[Danger]

I don't actually have time to read this thread and its attendent attachments, so I'm just going to weigh in.
While I'm quite happy with our admittedly Socialist society up here, maybe the Yanks have it right: let them freeze and starve to death on the streets. Darwinism at its worst.

 

[baywax]

I can tell you, as a Canadian, that government collected taxes when used to paid for universal health care works great... if you only have about 30 million people in the country. Once you start going over that limit of population you start to see a shortage of skilled medical practitioners in ratio to the number of non-medical practitioners. And equipment, transport, hospital and transitional accommodations begin to eat the budget really quickly. Complications like increased cancer rates over increased cancer survival rates also take their toll on the health budget (the makers of the linear accelerators and pharmaceuticals love it). With immigration you'd think a lot of doctors would be adding to the medical ranks but when you have public funded medicare, you have publicly fashioned regulations and requirements. These rules demand exact specifications be met by every in-coming MD. So that, when they get here, they have to go back to school. Then when they finish that, they have to practice in a "rural community" for a number of years. Rules and regulations then add to the wait times and the quality of care of patients.

I know Americans really want everyone to make it on their own. That's one reason there is no universal anything in the States... except the IRS and a law about education! What I have always proposed for any country is self-help. If everyone was really well educated in the matters of their health, everyone would be able to take care of their own health. This way the hospitals would only see acute cases like broken limbs or unavoidable conditions like this. The minor stuff would never see the florescent light of the hospital corridor. After a few generations we might actually see hospitals converted into condos or torn down.

 

[turbo]

Good post turbo-1. (The first one.)

Thanks, Jason. People who have never worked in the medical field have no idea how much friction and waste insurance companies cause in the delivery and cost of medical treatment. Doctors spend a LOT of time and money deciding which insurance plans to participate with, and their staff have to learn the ins and out of each plan, including which procedure codes are acceptable and covered under each plan and which are not. People who fear a single-payer system of universal health coverage have no idea how much fragmented private insurance coverage costs.

 

[mheslep]

I can tell you, as a Canadian, that government collected taxes when used to paid for universal health care works great...

Baxwax: perhaps you can help with filling in the story on the http://en.wikipedia.org/wiki/Medicare_(Canada)#The_Parallel_Private_Debate" AFAIK there's a huge private system in place in parallel to the government system that, though not banned by the CHA, the provinces can and do ban private care but its practiced massively w/ a wink and nod regardless? More importantly this would be real free market care, not 3rd payer insured, that is one walks in pays the good doc. directly.

 

[TVP45]

My personal feelings about health care are based on my religious beliefs, but there is an objective, hard-nosed reason for moving away from employer-provided insurance (not that too many employers still do). That insurance cost can inflate direct and indirect overhead by significant amounts. For companies trying to compete in free-trade areas, that makes it extremely difficult since those costs must be included in the selling price. I won't advocate for either national health insurance or for individual insurance, but I will strongly argue employer-provided health insurance does not give a level playing field and, in some states, leads to discrimination against older workers, women, and those with chronic illness (or perhaps bad genes soon) in the job market.

 

[baywax]

Baxwax: perhaps you can help with filling in the story on the http://en.wikipedia.org/wiki/Medicare_(Canada)#The_Parallel_Private_Debate" AFAIK there's a huge private system in place in parallel to the government system, though not banned by the CHA the provinces can and do ban private care but its done massively w/ a wink and nod regardless? More importantly this would be real free market care, not 3rd payer insured where one walks in pays the good doc. directly.

Its gotten weird in response to what was all over the media as a "failing health care system"... (wonder who paid for those media hypes...??). Since then we have private clinics setting up that bill the government for patients with the HC card. Others may or may not be using their private insurer. But, why bother when the govt. costs 117 dollars a month for 4 kids and two adults being covered?

But if you think about it... Canucks pay dearly through the nose along with the monthly fee. At the end of the year we're seeing 26 percent govt tax (provincial and federale) on an income under 40 grand. Over 40 grand and you're paing 33 percent and over 50 grand you're paying close to 50 percent of your income.
... you should see the thousands of Americans who've moved here FREAK at that tax bill!

But, on the other hand... as you see in Sweden or Switzerland or any of those "social" countries.., taxes are high but services are great... to the degree that they are "manned" by competent employees.

I think you need well educated people to get away with appealing to their altruistic nature and taxing the snot out of them. If they are able to realize the benefits arising out of their tax dollar... via imagination and understanding where the money goes... then the system will work. If you have a large number of not-so-educated people who are in positions of wealth and power... these people will make a noise and shout down the tax system that supports the average and less average family.

There are some strange hybrids raising their gantry heads these days. Private clinics that open to the public sometimes if they don't have hard cash paying customers. Then there's Govt. facilities opening to private paying patients on "off periods"... it gets very messy when the Govt in power favours Arnold Schwarzinegger's style of "kill them if they're not moving".

 

[Danger]

I'm not at odds with you, Baywax, but we seem to have different opinions and experiences with the health system. Since I'm at work, I'm somewhat inebriated at the moment, so I'll hold further comments until sobriety rears its ugly head.

 

[Evo]

Thanks, Jason. People who have never worked in the medical field have no idea how much friction and waste insurance companies cause in the delivery and cost of medical treatment. Doctors spend a LOT of time and money deciding which insurance plans to participate with, and their staff have to learn the ins and out of each plan, including which procedure codes are acceptable and covered under each plan and which are not. People who fear a single-payer system of universal health coverage have no idea how much fragmented private insurance coverage costs.

It's all computerized now. When my doctor needs to prescribe something, what my plan pays for pops up and he asks me which option I want.

Nothing is as great as anyone thinks. My Italian fiance's father was diagnosed with lung cancer. Socialized medicine. They diagnosed him from a single x-ray and scheduled him for chemotherapy. Ooops, x-rays can't determine the difference between the two types of lung cancer and he was given the wrong treatment. He was almost killed because he was also given a near lethal dose of chemo by mistake. When I urged my fiance to raise a rucus, his father was put on a 6 month waiting list to get an MRI, which was at the other end of the country.

My fiance's family finally had to make the decision to fly his father out of the country to get immediate and accurate care, all at their own expense. So much for socialised medicine that they have to pay through the nose for in taxes.

 

[turbo]

It's all computerized now. When my doctor needs to prescribe something, what my plan pays for pops up and he asks me which option I want.

When you need specialized diagnostics and specific treatments/procedures, your insurance program may refuse to pay for your treatment for any number of reasons. They may say that you weren't pre-approved to receive the treatment, or that a lesser treatment should have been offered, or that the diagnosis and/or procedure coding did not meet their guidelines. When I was the network administrator for a VERY large (for Maine) Ophthalmic practice that was growing aggressively, they needed to borrow against their receivables to purchase or lease new treatment facilities, hire new staff, buy new equipment, etc. The major impediment to their growth was the banks' reluctance to lend money against receivables that were being stalled repeatedly by the insurance companies' refusal to pay for covered services, based on technicalities.

As you might imagine, equipment and operating facilities to do eye surgeries are quite expensive, especially specialized gear like surgical retinal lasers, that have huge power supplies, monster capacitor banks, etc, residing in a housing twice as big as your CEO's desk. The cold, hard fact is that billing specialists and coding specialists are critical for the health of any large medical-service enterprise, because only they can learn the rules that allow then to cut through the insurance companies' red tape and get the practice paid for necessary, qualified procedures in a timely fashion. These vagaries of the various insurance companies' quirks and coding requirements are not "computerized", nor are they transparent to the medical community - they are ever-changing hurdles that have to be learned by the billing and coding specialists to try to get their medical practices paid for services rendered. My cousin is a coding specialist in a one-doctor pediatric ophthalmic practice. I know her boss, worked with him for a few years, and he is a hell of a guy, but if she ever quit him, he'd have to shut down or join a group practice. She is the engine of his business.

 

[mheslep]

Its gotten weird in response to what was all over the media as a "failing health care system"... (wonder who paid for those media hypes...??). Since then we have private clinics setting up that bill the government for patients with the HC card. Others may or may not be using their private insurer. But, why bother when the govt. costs 117 dollars a month for 4 kids and two adults being covered?

So you don't have to wait http://www.fraserinstitute.org/commerce.web/newsrelease.aspx?nID=4967" to get surgery?

 

[gravenewworld]

The post said "places like Japan". Ok to advance the discussion, please define with a little detail what you mean when you say 'Universal Coverage' so we can have some common ground. Who pays, for what services , limitations to the services, allowance for alternative coverage, etc.

Universal coverage- just what is sounds like, everyone has health coverage. Could be a combo of private+government, however, almost all cases of universal coverage are due to the majority of government run universal health care. Private involvement is usually only supplemental.

Universal health care- health care available to everyone via mandatory health insurance and publicly paid for health care. Implemented through legislation and taxation.

We could go on about UC vs. UH, but the differences are moot, the major point being that either system provides health care access to EVERYONE.

If you read the NYU link that I posted, it answers pretty much all of the questions you just asked.


Countries similar to Japan: Greece, Luxembourg,


The WHO's European Observatory on Health Care answers all your questions for many countries (even countries outside of Europe)
http://www.euro.who.int/observatory/ctryinfo/ctryinfo

 

[gravenewworld]

We're not getting anywhere as this post is a non-sequitur. Up thread I posted, and you agreed twice ala 'LOL, exactly': 1) the US health system fails, 2) the US health system is not a free market, its a 3rd party payer system. Then you reply w/ this aha! post that 1) says the US health system fails and 2) says nothing about my assertion that other countries may be allowing more private alternatives in addition to their government run systems (they are, e.g. Ireland, Canada, Netherlands).

BTW: Here's an interesting debate between Kuttner and the author of the piece I provided, Friedman.

Non sequitur? You are the one who posted this:

Other countries are moving away from failing universal plans and opening up free market health care. Government care is just another 3rd party payer system, it doesn't work either. There is no way around supply and demand

And I simply linked to a NEJM article that pointed out the failures of some of the free market aspects of the US health care system. Examples of the same free market failures in the US are already seen in the free market approaches in places like the UK--they result from profits being the #1 motive.

Maybe I haven't made myself clear, the US certainly isn't a free market health care system, but that is only because it has evolved into an oligopolist run market due to the free market approach. The oligopolist system that we have is due to the inherent nature of the market. Huge barriers to entry in providing health care will always limit free market activity. We have let private insurance companies run around freely controlling our health care and all it has produced are a handful of conglomerates that control the vast majority of health care, driven up health care costs, and limited choices.

So you don't have to wait 4 months to get surgery?

OK. So what? Consider someone here in the US that needs the same surgery, but who is uninsured. HOW LONG WILL THEY HAVE TO WAIT FOR THE SAME SURGERY? 1 year, 2 years, indefinitely before they can save up enough cash to pay for the surgery?

 

[gravenewworld]

It's all computerized now. When my doctor needs to prescribe something, what my plan pays for pops up and he asks me which option I want.

Nothing is as great as anyone thinks. My Italian fiance's father was diagnosed with lung cancer. Socialized medicine. They diagnosed him from a single x-ray and scheduled him for chemotherapy. Ooops, x-rays can't determine the difference between the two types of lung cancer and he was given the wrong treatment. He was almost killed because he was also given a near lethal dose of chemo by mistake. When I urged my fiance to raise a rucus, his father was put on a 6 month waiting list to get an MRI, which was at the other end of the country.

My fiance's family finally had to make the decision to fly his father out of the country to get immediate and accurate care, all at their own expense. So much for socialised medicine that they have to pay through the nose for in taxes.

So how does an uninsured person in the US get treatment for lung cancer without having to sell their house? Don't even get me started on medical mistakes. The US has some of the highest medical error rates in the world. So much for the "great" health care system we have here in the US that we pay for the most in per capita terms right? http://www.commonwealthfund.org/newsroom/newsroom_show.htm?doc_id=313141
Also,it is not all computerized now. I forget where I read it (either in Nature, Science, NEJM, or JAMA), but something only like 10% of all medical records are actually in computers.

 

[baywax]

I'm not at odds with you, Baywax, but we seem to have different opinions and experiences with the health system. Since I'm at work, I'm somewhat inebriated at the moment, so I'll hold further comments until sobriety rears its ugly head.

Yeah but Danger... you're in Alberta... Canada's Texas of the north... as far as I know you have some pretty different experiences going on with public Health Care and private health care in your province. (And you got the best part of the Rockies...aghhhhh!)

 

[baywax]

So much for socialised medicine that they have to pay through the nose for in taxes.

(In Italy.)

 

[baywax]

So you don't have to wait http://www.fraserinstitute.org/commerce.web/newsrelease.aspx?nID=4967" to get surgery?

After assessment by what you hope is a qualified and competent specialist there is a wait period designed for you...

If the tumour cells are dividing exponentially at a rate of double per hour... you are shuffled to the front of the line as best can be done... at least this is how I have seen it managed.

Priority and severity of condition play a major part in determining the wait. If a patient is upset and anxious about their condition, they may be exasperating it and making it worse. These types usually go to John Hopkins (the beer making hospital) or some other instant $500,000 dollar clinic in one of your United States. Then... get this... they come back and stick the tax payer with the bill for their impatience... or for the advice of a doctor on the take.

Anyway... Canucks are a bit ahead of other countries with MRI facilities, Surgeons, specialists etc... but you do see the talent slipping south to bigger $$$. On the other hand, I don't know if its been the cooler climate or what or if its the small population (when compared) but we tend to stay away from those doctors and their contraptions. We are continually bombarded with health education... and some of it welcome and some of it in poor taste and of commercial interest. The education of our people is the way to take the burden off of the care givers.

Education really costs much less, now and over time, than most doctors, linear accelerators, drugs, tongue irradiators, mammagrams, x-rays, MRIs, CT scans and the rest of all the gak.

Happy Valentines.

 

[ShawnD]

But if you think about it... Canucks pay dearly through the nose along with the monthly fee. At the end of the year we're seeing 26 percent govt tax (provincial and federale) on an income under 40 grand. Over 40 grand and you're paing 33 percent and over 50 grand you're paying close to 50 percent of your income.
... you should see the thousands of Americans who've moved here FREAK at that tax bill!

Which province is that? In Alberta the highest tax rate for anybody is 40%. As you go east it gets higher and higher and higher until you get to newfoundland where there's 15% sale tax and infinite percent income tax.

edit: I have to favour public health simply because my mother has had more surgeries than anyone can afford. Under the US system she would have died when I was around 3 years old; she had a significant portion of her intestines removed and a bag was put in place of it. It was just last year that he spent about 2 weeks in hospital and had another surgery for that same problem. Total cost out of pocket: $0

 

[gravenewworld]

More example of the profit motivated tactics that insurance companies are concerned with first:

http://www.delawarewoman.com/apps/pbcs.dll/article?AID=/20080208/NEWS/802080354/1104/opinion

(from the News Journal, my home state's main news paper)

Aetna pulls full sedation coverage for colonoscopies
Opponents say move will discourage some from getting screened for cancer


Aetna Inc., eager to cut costs, is restricting coverage of a doctor-preferred anesthetic used during colonoscopies.

Doctors fear the move will discourage patients from getting the vital cancer screening because the anesthetic, propofol, makes the patient more comfortable. The change in coverage comes as many baby boomers turn 50, the age doctors recommend people begin getting the test.

"It would make it very difficult to get an adequate exam," said Dr. Joseph Hacker, a gastroenterologist at Gastroenterology Associates in Stanton.

The use of propofol "allows me to get a better examination if patients are laying still, basically asleep and not fighting me," he said.

Aetna has about 95,000 subscribers in the state. Along with Blue Cross Blue Shield of Delaware, it is one of two insurers that provide health coverage to about 110,000 state workers and retirees in Delaware.

Aetna has notified physicians in its coverage networks nationwide that, as of April 1, the insurer will no longer pay for an anesthesiologist to administer propofol to sedate patients and monitor their level of consciousness during routine colonoscopies. Aetna figures the move will shave $300 to $1,000 off the cost of the procedure

...

But Delaware physicians such as Dr. Michael Katz, an anesthesiologist with Outpatient Anesthesia Specialists in Wilmington, say Aetna's decision is more about saving money than patient care.

"The insurance company is playing doctor," Katz said. "It's really a business decision for them. It's a cost-cutting move."

BTW colorectal cancer is the 2nd leading cause of cancer deaths.


Seriously, what is stopping insurance companies from simply taking your money and then denying you coverage? That is what you get when you get a privatized system of health care aimed at maximizing profits first.



Like I said before, just because you have health insurance in the US doesn't mean sh*t. Insurance doesn't guarantee affordable health care at all for an American.

 

[Astronuc]

My father had colo-rectal cancer, and with surgery and subsequent chemotherapy and radiation, the bill was well over $100K. Compare that to $300-$1000 per check up - every 5 to 10 years, and there's a bargain.

 

[Astronuc]

It's all computerized now. When my doctor needs to prescribe something, what my plan pays for pops up and he asks me which option I want.

Nothing is as great as anyone thinks. My Italian fiance's father was diagnosed with lung cancer. Socialized medicine. They diagnosed him from a single x-ray and scheduled him for chemotherapy. Ooops, x-rays can't determine the difference between the two types of lung cancer and he was given the wrong treatment. He was almost killed because he was also given a near lethal dose of chemo by mistake. When I urged my fiance to raise a rucus, his father was put on a 6 month waiting list to get an MRI, which was at the other end of the country.

My fiance's family finally had to make the decision to fly his father out of the country to get immediate and accurate care, all at their own expense. So much for socialised medicine that they have to pay through the nose for in taxes.

Just wait till one is older. My mother-in-law often has to wait weeks or months for medical care. She gets put in a queue.

If one does not have insurance, or the insurance doesn't cover a procedure, one may not get treatment. That applies to nearly 50 million Americans at the moment.

Those with limited medical insurance, Medicaid or Medicare, may not get adequate treatment. In some cases, less effective (less expensive) medicine is used, with adverse consequences (sometimes/often?).

Retired folks NEED supplemental insurance, and that is no guarantee of better or even adequate care.

 

[mheslep]

Just wait till one is older. My mother-in-law often has to wait weeks or months for medical care. She gets put in a queue.

65 and older and everyone is covered by Medicare. Is that what she's on / causes the queue?

If one does not have insurance, or the insurance doesn't cover a procedure, one may not get treatment. That applies to nearly 50 million Americans at the moment.

I think the 50 million number is indefensible, or at least not helpful to choosing a better system. Lots of holes: part of that number is ~10million in illegals. Do other countries w/ universal systems cover illegals?

Those with limited medical insurance, Medicaid or Medicare, may not get adequate treatment. In some cases, less effective (less expensive) medicine is used, with adverse consequences (sometimes/often?).

Retired folks NEED supplemental insurance, and that is no guarantee of better or even adequate care.

Suggestions/alternatives? If you are proposing government care, we have examples of that in the form of Medicaid/Medicare already. If one finds shortcomings in those two systems its plausible to suggest a universal government plan would contain more or the same.