Universal Healthcare in the US

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Vaniver
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Re: Universal Healthcare in the US

Postby Vaniver » Wed Jul 02, 2008 7:46 pm UTC

I like the part where they predict that 97% of US income will be devoted to healthcare by 2100. *facepalm*
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Re: Universal Healthcare in the US

Postby Calorus » Wed Jul 02, 2008 7:54 pm UTC

Vaniver wrote:I like the part where they predict that 97% of US income will be devoted to healthcare by 2100. *facepalm*


Stupid, indeed - but for the fact that, as it says '"If it continues like this"

Unfortunately the most illustrative trend isn't shown - it's a graph printed in the paper which shows developed nation trends, and then has US trends overlayed, increasing at double the rate of the rest of us - equally enlightening was the 2000 WHO report which places US Healthcare 37th for quality (tied with, of all people, Cuba) and most expensive.

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Re: Universal Healthcare in the US

Postby Vaniver » Wed Jul 02, 2008 7:56 pm UTC

Calorus wrote:Stupid, indeed - but for the fact that, as it says '"If it continues like this"
I mean, it's so obvious that continuing like that is impossible. Is that just there so they can demonstrate to people who don't know how exponentials work how exponentials work?
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Re: Universal Healthcare in the US

Postby Calorus » Wed Jul 02, 2008 7:59 pm UTC

Vaniver wrote:
Calorus wrote:Stupid, indeed - but for the fact that, as it says '"If it continues like this"
I mean, it's so obvious that continuing like that is impossible. Is that just there so they can demonstrate to people who don't know how exponentials work how exponentials work?


Don't get me started - when the FT, widely considered the best Daily Journal in the world, can't grasp simple Maths you wonder what the f'ing point is.

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Re: Universal Healthcare in the US

Postby Gunfingers » Wed Jul 02, 2008 8:05 pm UTC

Calorus wrote:Was reading the Financial Times today and an article drew my attention back here - thought I'd share it with you.

http://www.ft.com/cms/s/0/b00ff30e-47d1-11dd-93ca-000077b07658.html
http://www.ft.com/cms/s/0/6e75f9d8-485e-11dd-a851-000077b07658.html?nclick_check=1


So...the answer is killing old people? 'Cuz i think i could get behind that.

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Re: Universal Healthcare in the US

Postby Calorus » Wed Jul 02, 2008 8:07 pm UTC

Gunfingers wrote:
Calorus wrote:Was reading the Financial Times today and an article drew my attention back here - thought I'd share it with you.

http://www.ft.com/cms/s/0/b00ff30e-47d1-11dd-93ca-000077b07658.html
http://www.ft.com/cms/s/0/6e75f9d8-485e-11dd-a851-000077b07658.html?nclick_check=1


So...the answer is killing old people? 'Cuz i think i could get behind that.


I think it's a start, but part of the point is that at the current rate few will be able to afford the health insurance policies to survive, anyway...

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Re: Universal Healthcare in the US

Postby Kendo_Bunny » Mon Jul 07, 2008 4:47 pm UTC

Actually, I get excellent coverage from TRICare- because I'm a Colonel's daughter, and I have TRICare Prime. It's a little tough finding a doctor who accepts it, but once I do, I get good treatment (though my primary care physician doesn't always listen to me). I'm figuring that getting the government involved in health care will worsen that particular problem: AbNo was enlisted, he got crappy treatment. I'm an officer's daughter, I get terrific treatment. Even if everyone is paying generally the same rates, the middle class will probably be getting the crappiest treatment, while those who are "important" will still be getting better treatment. Dad doesn't pay that much for our health insurance (even though the government has cheated him out of his Social Security, so he does have less disposable income than he should), but gets the best because of his position.

Then again, the only thing I trust the government to do right is to screw things up.

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Re: Universal Healthcare in the US

Postby Kid A » Mon Jul 07, 2008 9:31 pm UTC

I think that the United States should eventually have universal healthcare, but the Government should not start footing the bill until the costs come back under control. It would be prohibitively expensive to operate otherwise. The argument that implementing universal healthcare would reduce the quality of healthcare is only partially true. Although the US does have the best health care for people who can afford it, Many cannot, and therefore quality equals availability. Another way to bring costs down would be to provide funding for health education, that way people can learn how to choose healthy lifestyles as well as ways to prevent illness.

I suppose we can start with a system that subsidies for health insurance, and then move up from there, that would be a low cost start, as well as maintaining competition in pharmaceuticals until a way to maintain that under a government operated system can be found

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Re: Universal Healthcare in the US

Postby Akula » Tue Jul 08, 2008 1:26 am UTC

Calorus wrote:
Vaniver wrote:I like the part where they predict that 97% of US income will be devoted to healthcare by 2100. *facepalm*


Stupid, indeed - but for the fact that, as it says '"If it continues like this"

Unfortunately the most illustrative trend isn't shown - it's a graph printed in the paper which shows developed nation trends, and then has US trends overlayed, increasing at double the rate of the rest of us - equally enlightening was the 2000 WHO report which places US Healthcare 37th for quality (tied with, of all people, Cuba) and most expensive.



Have you actually read the WHO report in it's entirety? I have. The 37th ranking is a crock of shit.

They rank countries on several categories, quality, speed, accessibility, etc. The US ranks at or near the top in all of them.

Then there's this nifty category dedicated to "fairness" which the US ranks near the bottom in. Further reading indicates that the WHO's subjective opinion is that socialist systems are more "fair." In other words, it doesn't matter if we provide better care, faster, to more people if we're not doing it in a manner that they agree with politically. Actual results be damned, it's not fair! :cry:
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Re: Universal Healthcare in the US

Postby 22/7 » Tue Jul 08, 2008 2:56 pm UTC

Akula wrote:
Calorus wrote:
Vaniver wrote:I like the part where they predict that 97% of US income will be devoted to healthcare by 2100. *facepalm*


Stupid, indeed - but for the fact that, as it says '"If it continues like this"

Unfortunately the most illustrative trend isn't shown - it's a graph printed in the paper which shows developed nation trends, and then has US trends overlayed, increasing at double the rate of the rest of us - equally enlightening was the 2000 WHO report which places US Healthcare 37th for quality (tied with, of all people, Cuba) and most expensive.



Have you actually read the WHO report in it's entirety? I have. The 37th ranking is a crock of shit.

They rank countries on several categories, quality, speed, accessibility, etc. The US ranks at or near the top in all of them.

Then there's this nifty category dedicated to "fairness" which the US ranks near the bottom in. Further reading indicates that the WHO's subjective opinion is that socialist systems are more "fair." In other words, it doesn't matter if we provide better care, faster, to more people if we're not doing it in a manner that they agree with politically. Actual results be damned, it's not fair! :cry:

That's quite interesting, do you have a link to that document? I'd be very interested in perusing it.
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Re: Universal Healthcare in the US

Postby Gunfingers » Tue Jul 08, 2008 3:25 pm UTC

I think this is it.

It's not quite as he described. We're number one in responsiveness, but also numbers 3-38 for some reason. Number 15 in "Overall achievement", whatever that means, 24 in Disability-Adjusted Life Expectancy (no surprise there, given how well we take care of ourselves), and 72 in Performance on level of health, which i also don't understand but is obviously bad. For fairness we're both 54 AND 55. Sure, why not.

Edit: I think this is related somehow, too, but it's almost 100 pages long so i haven't really read it.

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Re: Universal Healthcare in the US

Postby 22/7 » Wed Jul 09, 2008 4:20 pm UTC

Gracias.
Totally not a hypothetical...

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Re: Universal Healthcare in the US

Postby bbctol » Fri Jul 25, 2008 1:58 am UTC

Oh god. At debate camp right now, and the topic is "Resolved: That the United States gov't should adopt a nationalized healthcare system." Anybody want 30-odd pages of summarized sources for both sides, or four page opening speeches?

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Re: Universal Healthcare in the US

Postby Kachi » Fri Jul 25, 2008 6:21 am UTC

Here's an interesting anecdote, which I think is indicative of just how inefficient current healthcare is in the U.S..

Suppose you have a sleeping disorder (like, let's say, me). In most states, the protocol will be that for your insurance to cover any form of treatment, you will first have to be referred by your medical doctor. With their approval, your insurance will then cover a polysomnograph or sleep study. The cheapest of these that I've found (in my area, with a low cost of living), if you were to pay out-of-pocket, is $800 per night, which may take one or two nights (the most expensive was $3000). The most common diagnosis (~99%, I'm told) is sleep apnea. Sleep apnea is the only diagnosis that offers a treatment option and if you are diagnosed with sleep apnea, your insurance will only cover a CPAP machine, a device that delivers pressurized air through a hose to your nostrils and/or mouth. From what I've seen these run on average of $200-800. They do require a "prescription" setting though there are only a few possible settings.

Now, to recap, your insurance is having to pay for the doctor's visit and the polysomnograph, both of which together cost more than the CPAP machine in service charges alone, and then for the machine itself. Alternatively, you could buy a CPAP machine yourself for a few hundred dollars, figure out via trial and error if it helps you at all and what setting you need. If you didn't need it, you could just sell the machine to someone else or possibly return it to the company. There's no real risk to using a CPAP even if you don't need one.

Is it any wonder that insurance costs are so high when they insist on paying so much additional money for a simple diagnosis when they could simply skip to the cheaper, (and only) completely refundable treatment option?

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Re: Universal Healthcare in the US

Postby Cooley » Fri Jul 25, 2008 7:36 am UTC

thread is tl;dr for me right now, don't have the time to savor it in its entirety, so...

Why can't we just pay for things like checkups, colds, the flu, etc... out of our own pockets? As I understand it shouldn't be that much money. And then we can have some kind of health insurance plan for the big stuff that we pay for ourselves. And if we can't pay for it ourselves (because we're too poor), then the state gov't does some kind of state sponsored health insurance if you can demonstrate need for it. It seems fair to me, making preventative medicine cheap/simple, while big stuff like heart surgery is in the domain of insurance.

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Re: Universal Healthcare in the US

Postby TheStranger » Fri Jul 25, 2008 10:35 am UTC

Kachi wrote:Is it any wonder that insurance costs are so high when they insist on paying so much additional money for a simple diagnosis when they could simply skip to the cheaper, (and only) completely refundable treatment option?


Having the insurance company set treatment policies without even consulting a doctor does not sound like a good idea to me. The 'test-diagnose-treat' process is very important to medicine, and it is much more efficient to go through it and be sure rather then start wandering through treatments before a test has been performed.

Cooley wrote:Why can't we just pay for things like checkups, colds, the flu, etc... out of our own pockets? As I understand it shouldn't be that much money. And then we can have some kind of health insurance plan for the big stuff that we pay for ourselves. And if we can't pay for it ourselves (because we're too poor), then the state gov't does some kind of state sponsored health insurance if you can demonstrate need for it. It seems fair to me, making preventative medicine cheap/simple, while big stuff like heart surgery is in the domain of insurance.


I think that's how it works largely. Things that are somewhat inexpensive can be / are bought out of pocket (because its easier / faster to do so rather then going through an insurance company). The problem is that even the less expensive things (tests and medications) can prove to be costly.
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Re: Universal Healthcare in the US

Postby ZeroSum » Fri Jul 25, 2008 12:43 pm UTC

Malice wrote:When I die, I don't want to leave my family crippled by hundreds of thousands of dollars of debt for ultimately useless medical bills.
Luckily our financial system doesn't pass debts to other family members upon death. If your estate is unable to pay your bills then it goes into default and the debts are dissolved. All it means is that you won't have much to give away when you die.

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Re: Universal Healthcare in the US

Postby Varsil » Fri Jul 25, 2008 8:45 pm UTC

Cooley wrote:thread is tl;dr for me right now, don't have the time to savor it in its entirety, so...

Why can't we just pay for things like checkups, colds, the flu, etc... out of our own pockets? As I understand it shouldn't be that much money. And then we can have some kind of health insurance plan for the big stuff that we pay for ourselves. And if we can't pay for it ourselves (because we're too poor), then the state gov't does some kind of state sponsored health insurance if you can demonstrate need for it. It seems fair to me, making preventative medicine cheap/simple, while big stuff like heart surgery is in the domain of insurance.


This seems like a great way to ramp up total costs. Someone with a minor infection doesn't come in to see a doctor until it's a Big Problem, because they can't afford to see a doctor about it when it's a minor infection. When it turns into something like blood poisoning or organ failure, then they're both more motivated, and now it's paid for. Ideally, though, you want to treat that when it's small, cheap, and easy.

Personally, I'm rather in favour of universal health care because often, other people not getting proper care might be putting me at risk. For instance, if a homeless guy has a persistent cough, I'd like him to be able to go in and see a doctor. It's far better than that homeless guy turning out to have TB and just being out on the street corner as an infection vector without getting any treatment until he shows up in an emergency ward because he's dying.

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Re: Universal Healthcare in the US

Postby BlackSails » Fri Jul 25, 2008 8:51 pm UTC

Varsil wrote:This seems like a great way to ramp up total costs. Someone with a minor infection doesn't come in to see a doctor until it's a Big Problem, because they can't afford to see a doctor about it when it's a minor infection. When it turns into something like blood poisoning or organ failure, then they're both more motivated, and now it's paid for. Ideally, though, you want to treat that when it's small, cheap, and easy.


Most people do not need very much medical care. For the great majority of infections, antibiotics are either the wrong drug (ie, viral syndrome) or are not really needed.

Yes, there will be people who develop sepsis, but the vast majority of these people will either be old, or otherwise immunocompromised.

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Re: Universal Healthcare in the US

Postby AbNo » Sat Jul 26, 2008 9:47 pm UTC

So, have any of the "Oh me yarm! We need Government to take care of us!" types ever stopped to ask WHY the cost of health care has gone up so high?

The sentence "We're from the government, we're here to help." has certain connotations on it for a reason.

Perhaps instead of throwing tax dollars (your dollars) at a problem, we should find the root cause of increasing health care, and fix it.

But if not, I suppose we can just give it some more vitamin M (or in this case, vitamin Fed), tell it to stop bleeding, and pretend the problem is fixed.

I mean, come on, I KNOW there are enough people that do maintenance and repair on this forum (or even garage engineering) to look at the problem this way.

Instead of treating the symptoms, maybe we should try treating the root cause of the problem. After all, you wouldn't give morphine to a guy with a broken wrist, then not put a cast on his wrist, would you? Why should this be treated any different.
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Re: Universal Healthcare in the US

Postby Gunfingers » Sat Jul 26, 2008 10:06 pm UTC

AbNo wrote:Perhaps instead of throwing tax dollars (your dollars) at a problem, we should find the root cause of increasing health care, and fix it.

Of course, cure cancer! It's so simple! Why didn't we think of it before?

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Re: Universal Healthcare in the US

Postby Cooley » Sat Jul 26, 2008 11:57 pm UTC

There's a lot of regulation and malpractice insurance doctors have to deal with. We could at least get rid of the regulation and leave the option to sue for malpractice. That in itself should motivate doctors to be careful, so we don't really need the regulation.

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Re: Universal Healthcare in the US

Postby iop » Sun Jul 27, 2008 12:04 am UTC

AbNo wrote:Perhaps instead of throwing tax dollars (your dollars) at a problem, we should find the root cause of increasing health care, and fix it.

Sure. We should make sure that the expensive procedures (cancer therapy, transplants, care for the elderly, to name a few) only goes to the truly deserving, instead of keeping them accessible to everyone. Of course, only government-run health care could do this. Otherwise, there would always be those that find enough money to get treatment, even though they shouldn't.

Of course, that is not going to happen either way (I hope), so health care costs will keep rising. The only thing universal healthcare could really fix is that access to health-care is no longer tied to having a job with sufficient benefits.

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Re: Universal Healthcare in the US

Postby Cooley » Sun Jul 27, 2008 1:03 am UTC

iop wrote:Of course, that is not going to happen either way (I hope), so health care costs will keep rising. The only thing universal healthcare could really fix is that access to health-care is no longer tied to having a job with sufficient benefits.


Entirely privatized healthcare would take care of this as well. Cash could pay for it just as well as government mandated insurance (read, coverage for everything), and then it would be a matter of saving money and buying health insurance. And there is nothing wrong with gov't health insurance for the poor, can't have them spreading the plague, can we?

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Re: Universal Healthcare in the US

Postby AbNo » Sun Jul 27, 2008 8:14 am UTC

iop wrote:
AbNo wrote:Perhaps instead of throwing tax dollars (your dollars) at a problem, we should find the root cause of increasing costs in health care, and fix it.

Sure. We should make sure that the expensive procedures (cancer therapy, transplants, care for the elderly, to name a few) only goes to the truly deserving, instead of keeping them accessible to everyone. Of course, only government-run health care could do this. Otherwise, there would always be those that find enough money to get treatment, even though they shouldn't.

Of course, that is not going to happen either way (I hope), so health care costs will keep rising. The only thing universal healthcare could really fix is that access to health-care is no longer tied to having a job with sufficient benefits.


... Did you even READ my post?

Seriously, this class warfare BS has no place in this discussion. You and that other guy are trying to derail a valid, sound argument with garbage and misdirection.

according to your above quoted post, finding the causes of artificially inflated health care prices, and attempting to fix the ROOT CAUSE OF THE PROBLEM is making health care something only an elite, rich few can afford. Pretty curious considering I've made less than $14k a year for the last eight years.

I'd like to know how either of you came to that conclusion based on my above statement, highlighted in red bold.

THEN, I'd like to know why removing the artificial cause of inflated prices, enabling them to fall to a more affordable level is a bad idea that puts health care into a financial area attainable by a select elite few.

Bonus points if you tell me why it's in my interest to keep health care costs out of my own reach.

Now, if you prefer, you can just make another tugs-the-heart-strings post that exploits cancer patients and the elderly to distract from the fact you don't have anything better to say than "Your idea is stupid!".

I say that based on the post that I have quoted in the top of this post. That's all I have to work with in regards to considering your ability to think and reason, so it's what I have to base my assumptions on when it comes to your abilities.

How about you take this thread in Serious Business seriously, and offer a productive argument or idea, instead of just posting an extended version of, as I paraphrased it before, "Your idea is stupid!". :roll:
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Re: Universal Healthcare in the US

Postby 22/7 » Sun Jul 27, 2008 5:29 pm UTC

Cooley wrote:There's a lot of regulation and malpractice insurance doctors have to deal with. We could at least get rid of the regulation and leave the option to sue for malpractice. That in itself should motivate doctors to be careful, so we don't really need the regulation.

Or you'll get the scenario that already exists in some areas (where you can't get medical attention unless you pay out the ass for it and sign a waiver saying you won't sue), except everywhere. Good call. Let's go ahead and think about this fact for a moment. In some places, malpractice insurance is high enough that doctors can't afford to be doctors. That's right, those filthy rich greedy bastards who charge you way too much for their decades and hundreds of thousands of dollars of expertise can't actually make money while they're charging you way too much money because their malpractice insurance is anywhere between 90% and 150% of what they're going to make that year. Yeah, that's a great idea. Let's deregulate how much money ambulance chasers can make for taking advantage of someone else's misfortune.
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Re: Universal Healthcare in the US

Postby iop » Sun Jul 27, 2008 7:21 pm UTC

AbNo wrote:
iop wrote:
AbNo wrote:Perhaps instead of throwing tax dollars (your dollars) at a problem, we should find the root cause of increasing costs in health care, and fix it.

Sure. We should make sure that the expensive procedures (cancer therapy, transplants, care for the elderly, to name a few) only goes to the truly deserving, instead of keeping them accessible to everyone. Of course, only government-run health care could do this. Otherwise, there would always be those that find enough money to get treatment, even though they shouldn't.

Of course, that is not going to happen either way (I hope), so health care costs will keep rising. The only thing universal healthcare could really fix is that access to health-care is no longer tied to having a job with sufficient benefits.


... Did you even READ my post?


Yes. Did you ever read mine?

The major cause of rising health costs is that all the new, fancy tests and treatments that can be done today cost money, and that hospitals will nowadays x-ray you every time you stub your toe, because it is possible that there could be a fracture, instead of saying, "well, it's probably nothing, so let's not check". Also, higher life expectancy often comes with more need for treatment. Those hip replacements are not cheap, you know. And all this is driving health insurance costs through the roof.

The only solution I see to that is to drastically curb access to health care. I hope that solution never gets implemented (because how would you really figure out who is truly "deserving"?). However, if it is to be implemented, it can only be through government-run health care, because otherwise, there would always be those who just try and pay more to have all the test run, anyway.

I am not in favor of rising health care costs, but I have moral qualms about the alternative. In fact, I'd say your idea is impossible to implement in a reasonable fashion.

There. Is it clearer now?

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Re: Universal Healthcare in the US

Postby Cooley » Sun Jul 27, 2008 11:44 pm UTC

@22/7: Er, I'm not sure if you were being sarcastic or not. I'm naturally bad at telling sarcasm from... whatever, but the internet might also be at work here?

@iop: the patient and the doctor should be able to figure out if they want x-rays done or not. Whether or not health insurance covers that is really up to the health insurance company and the person buying insurance when they hammer out the terms of the insurance policy. It's the mandatory stuff that the gov't regulates that only helps a few people, and most people don't need that inflates health care costs. That and malpractice insurance.

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Re: Universal Healthcare in the US

Postby iop » Mon Jul 28, 2008 1:22 am UTC

Cooley wrote:@iop: the patient and the doctor should be able to figure out if they want x-rays done or not. Whether or not health insurance covers that is really up to the health insurance company and the person buying insurance when they hammer out the terms of the insurance policy. It's the mandatory stuff that the gov't regulates that only helps a few people, and most people don't need that inflates health care costs. That and malpractice insurance.

But see, it is neither in the interest of the patient nor the doctor that the patient doesn't get x-rayed. It is obvious for the doctor that every single procedure will net them money, but would you not take the x-ray if you came into the hospital if it really hurts, and the doctor says "Most likely there is nothing broken, but we can only say for sure if we x-ray."? And would you say "I'm going to die in maybe 5 years, anyway, so I will spend the rest of my life in a wheelchair rather than have my hips replaced?" Or would you refuse an expensive cancer treatment if you have only 10% chance of success?
Ok, maybe you would. I wouldn't.

Finally, when you take out an insurance, you expect that the large expenses (accident, cancer treatment etc) are covered - otherwise, why take out that insurance in the first place? But since fixing an accident costs more today, and since there are more options for cancer treatment today than 10 years ago, insurance costs have gone up.

Sure, malpractice insurance may also contribute, but it is the hospital bills, not the doctor's charges, that have gotten really expensive. Of course, no one wants to cut back on treatment options, so they blame everything on malpractice insurance etc.

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Re: Universal Healthcare in the US

Postby BlackSails » Mon Jul 28, 2008 2:41 am UTC

iop wrote:Sure, malpractice insurance may also contribute, but it is the hospital bills, not the doctor's charges, that have gotten really expensive. Of course, no one wants to cut back on treatment options, so they blame everything on malpractice insurance etc.


The legal environment is what causes the vast waste that is defensive medicine.

Lets say a 20 year old marathoner presents to the ED with chest pain. He has no family history of heart disease, and his last EKG with his primary care physician was perfectly clean.
Does he need an EKG and a $500 blood test? No, he is an extremely low risk category for a heart attack. But because missing a heart attack in a 20 year old will cost the doctor his job, his home and ability to ever work as a doctor again, he will order the tests.

If the same marathoner comes in complaining of knee pain, the first response should be "go home, ice it, and if it doesnt get better, follow up in the orthopedics clinic or with your PCP." What actually happens is he gets a several thousand dollar MRI.

There is a point of diminishing returns in everything, but espically medicine. Lets say that for every 100,000 teenagers that present with chest pain, 1 has a real heart attack. At ~$100 for a troponin assay, thats 10 million dollars to diagnose that one heart attack.

In other words, a doctor has two choices. He can order a test that costs him nothing (in fact, he will make a couple dollars from it) or he can take a small risk of losing his entire career.

Until that threat is removed, the choice is obvious.

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Re: Universal Healthcare in the US

Postby AbNo » Mon Jul 28, 2008 4:49 am UTC

iop wrote:There. Is it clearer now?


Yes! Excellently so, in fact. Wasn't trying to be a jerk, but I figured it I prodded you just right, I could get a good response. Thank you for working with me on this, you came through BEAUTIFULLY! :D

iop wrote:The major cause of rising health costs is that all the new, fancy tests and treatments that can be done today cost money, and that hospitals will nowadays x-ray you every time you stub your toe, because it is possible that there could be a fracture, instead of saying, "well, it's probably nothing, so let's not check". Also, higher life expectancy often comes with more need for treatment.


Aye, and part of the reason that things like this are done, in addition to the costs you mentioned is the potential cost of NOT doing every possible test, missing something, and getting sued by someone screaming "Oh me yarm!!1 lrn2dctr, I'm gonna sue you!"

Of course, when you have lawyers fishing for cases, and coaching people on what to say, we all end up paying more in the end, when we all have to foot those malpractice premiums.

http://www.dgcaseylaw.com/PracticeAreas ... agnose.asp
http://www.hardball-law.com/PracticeAre ... actice.asp
http://www.gordonlawoffices.net/Practic ... actice.asp

In fact, hospitals and private practices are having a hard time keeping fully staffed as the number of doctors declines.
http://www.post-gazette.com/pg/06097/680272-114.stm
http://health.usnews.com/usnews/health/ ... ecline.htm

Hell, there's been a shortage of nurses, particularly RNs, for years.
http://www.aacn.nche.edu/media/FactShee ... ortage.htm

One of the harder hit areas would appear to be OB-GYN, the cause of which is being directly blamed on malpractice insurance costs. OB-GYN is considered a "high risk" medical field for malpractice suits.

http://findarticles.com/p/articles/mi_m ... i_75505253

"To err is human", even doctors make mistakes. Malpractice suits should be reserved for gross negligence or incompetence, like the cases of these snake-oil prescription specialists....

http://abcnews.go.com/Health/Cosmetic/s ... 296&page=1
http://www.tmz.com/2007/11/13/dr-adams- ... edentials/

iop wrote:Those hip replacements are not cheap, you know. And all this is driving health insurance costs through the roof.


Actually, I'm looking at knee replacement(s), myself. Maybe they can rebuild my knees, better than they were before. Better, stronger, faster. (yes, I went there)
http://www.costhelper.com/cost/health/k ... ement.html

iop wrote:The only solution I see to that is to drastically curb access to health care. I hope that solution never gets implemented...


Why is this the only solution you can think of?

What makes other proposed solutions invalid in your mind? Be specific, we might be able to improve on them, or find new solutions.

Don't be afraid to speak your mind, back up your assertions!

It makes SB much more interesting. :D

iop wrote:However, if it is to be implemented, it can only be through government-run health care, because otherwise, there would always be those who just try and pay more to have all the tests run, anyway.


Based on my own personal experiences with government-run health care, as well as a general observation of government efficiency, the proposal to Socialize hospitals and medical facilities terrifies me greatly. I've already gone into detail a page or two back, and even used the snazzy {code} feature, so it is easy to find.

Apparently, the Canadians all aren't too crazy on Socialized medicine, either.

http://www.city-journal.org/html/17_3_c ... hcare.html
http://www.pubmedcentral.nih.gov/articl ... id=1174723

[political rant] I couldn't find many stories on the Cuban citizenry's opinion of their healthcare, it's doubtful any dissenters had much to say on the quality of the work their mortician performed.[/PR]

iop wrote:I am not in favor of rising health care costs, but I have moral qualms about the alternative. In fact, I'd say your idea is impossible to implement in a reasonable fashion.


1> Who is in favor of rising health care costs? You hold him, and I'll raise HIS health care costs. :wink:

2> Why is there only one alternative in your mind? Why do you automagically discount anything but what you see as the one true alternative?

3> What makes my idea impossible to implement? There may be errors or omissions in my plan I do not see, and a good dialog (yaa for two-way!) can not only fix problems in existing ideas, but bring about new ones. :)

Note: My IRL presence was just requested elsewhere, so I may have left some points unanswered/poorly worded. I will review this when I return at X o'clock later today (EST).
Darwin was right, but nanny-staters keep trying to undermine him

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Re: Universal Healthcare in the US

Postby Kachi » Mon Jul 28, 2008 8:57 am UTC

Having the insurance company set treatment policies without even consulting a doctor does not sound like a good idea to me. The 'test-diagnose-treat' process is very important to medicine, and it is much more efficient to go through it and be sure rather then start wandering through treatments before a test has been performed.


So you think that spending ~$1000 on a diagnosis for a $200 treatment which is completely safe, returnable, and the only treatment option available is a good idea because... what? We can't make exceptions?

Don't even have to forego the doctor visit. For some conditions, it's far more effective to bypass testing and prescribe the most likely treatment, as long as there are no serious consequences. Testing isn't always even remotely necessary.

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Re: Universal Healthcare in the US

Postby 22/7 » Mon Jul 28, 2008 3:58 pm UTC

Cooley wrote:@22/7: Er, I'm not sure if you were being sarcastic or not. I'm naturally bad at telling sarcasm from... whatever, but the internet might also be at work here?
Yes, I was being pretty sarcastic. Deregulating how much you can sue a doctor for will do 3 things, and 3 things only. The first thing it will do is drive up the cost of care such that only the fabulously wealthy will be able to afford care (we're talking about paying on the order of hundreds of thousands of dollars per family for the doctor to agree to be your doctor, and then the patient having to foot any medical expenses (not the doctor's time, but things like x-rays and drugs) on top of that retainer fee). Two, it will drive most doctors out of business, as that $200,000-$300,000/year that your average family practitioner makes won't be able to cover the $500,000/year or more that malpractice insurance would be. Also, remember that the more specific the doctor's expertise, the more money they'll make, and the more damage they're likely to get sued for, and so the more they'll have to pay in malpractice insurance. So the brain surgeons probably won't be in the clear either. Third thing it'll do is make a bunch of ambulance chasers very, very wealthy.
Totally not a hypothetical...

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Re: Universal Healthcare in the US

Postby iop » Mon Jul 28, 2008 4:39 pm UTC

AbNo wrote:
iop wrote:There. Is it clearer now?

Yes! Excellently so, in fact. Wasn't trying to be a jerk, but I figured it I prodded you just right, I could get a good response. Thank you for working with me on this, you came through BEAUTIFULLY! :D

Thank you, oh great teacher. Please tell me, where do you think the rising health care costs come from?

In my opinion, it is the high availability of (costly) interventions.

This can lead to more malpractice suits, because there is more that can be done (however, the suits can only be successful when there is a consensus that all has to be done that can be done). But malpractice suits cannot be the cause, because health care costs are rising even in countries without a strong tradition of suing.

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Re: Universal Healthcare in the US

Postby TheStranger » Mon Jul 28, 2008 9:50 pm UTC

Kachi wrote:So you think that spending ~$1000 on a diagnosis for a $200 treatment which is completely safe, returnable, and the only treatment option available is a good idea because... what? We can't make exceptions?

Don't even have to forego the doctor visit. For some conditions, it's far more effective to bypass testing and prescribe the most likely treatment, as long as there are no serious consequences. Testing isn't always even remotely necessary.


Sure, as long as you are willing to pass on any lawsuits that may come up (say if the insomnia is caused by something else).

Part of the rising cost is due to the cost of malpractice insurance, but another part is that there are more tests that can be performed today to diagnose a problem (compare the diagnostic tools available today to those 25, 50, or 100 years ago). With all these new tools comes their associated cost (the tool itself, the tech who runs it, training the doctor in it's use).

Though I've not seen the numbers myself I have heard from doctors I know that most health care costs come from the last 20 days of your life (I was once told that it was 60%).
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Re: Universal Healthcare in the US

Postby BlackSails » Tue Jul 29, 2008 12:50 am UTC

TheStranger wrote:Though I've not seen the numbers myself I have heard from doctors I know that most health care costs come from the last 20 days of your life (I was once told that it was 60%).


The figure I heard is that 90% of the money you will ever spend on health care will be in the last year of your life, going between chemotherapy, ICU visits and dialysis.

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Re: Universal Healthcare in the US

Postby Bubbles McCoy » Tue Jul 29, 2008 5:17 am UTC

iop wrote:The major cause of rising health costs is that all the new, fancy tests and treatments that can be done today cost money, and that hospitals will nowadays x-ray you every time you stub your toe, because it is possible that there could be a fracture, instead of saying, "well, it's probably nothing, so let's not check". Also, higher life expectancy often comes with more need for treatment. Those hip replacements are not cheap, you know. And all this is driving health insurance costs through the roof.

The only solution I see to that is to drastically curb access to health care. I hope that solution never gets implemented (because how would you really figure out who is truly "deserving"?). However, if it is to be implemented, it can only be through government-run health care, because otherwise, there would always be those who just try and pay more to have all the test run, anyway.

I am not in favor of rising health care costs, but I have moral qualms about the alternative. In fact, I'd say your idea is impossible to implement in a reasonable fashion.


Why would you have to actively promote the curbing of heathcare access? Isn't the general point of capitalism that the ones who deserve access will be able to afford it?

For the most part, the market already seems to be heading in the direction you describe. Health insurance is becoming less and less popular, and rightly so - health insurance seems to have reached a point where so much is covered that all insurance does is evenly redistribute the money people pay into it, so the bureaucracy of the insurance company adds needless cost to most people's insurance. Ignoring govermental expansion of healthcare this could largely be seen as ideal so long as you are not exceptionally poor or unlucky when it comes to health, but on the whole such people are in the minority and it's definitely not in the interest of the overwhelming majority to spend their money on the medically unfortunante.

If someone lacks any form of coverage, then the testing senario is largely resolved - the doctor can recommend a test to resolve any potential heart attacks, but the patient will have to pay every dollar for the test. The doctor will gain a few bucks by administering the test, but it would be up to the patient to decide whether that 1:100,000 chance of them dying of a heart attack is worth several hundred dollars from their pocket. With insurance, the test might only directly cost them 1/10 of the actual cost of the test. By eliminating insurance, the customer must weigh the exact costs to the entire system instead of just a fraction, and as such both usage and demand for medical facilities will decline along with net cost.

As to the 60% figure (or the 90% for that matter), I can't help but find this incredibly unlikely. If that was really true, politicians (namely Republicans) would have brought it up before in an effort to discredit Democratic efforts to paint healthcare in a crisis. Such a figure would be too important to the debate for no one to have found as of yet, and in my experience with doctors/ med students they are not a group that possess what I'd call an expert grasp of mathematics. Granted, this last point is largely hearsay, but so are your figures.

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Re: Universal Healthcare in the US

Postby Cooley » Tue Jul 29, 2008 5:28 am UTC

22/7, you have a point there. I didn't think of that.

I looked up medical malpractice:
Wikipedia wrote:Medical malpractice is an act or omission by a health care provider which deviates from accepted standards of practice in the medical community and which causes injury to the patient. Simply put, medical malpractice is professional negligence (by a healthcare provider) that causes an injury.

So, who sets these accepted standards? If they are unreasonable, they should be changed, and if not, they should be followed.

And I've got some wild idea roaming my brains about doctors regulating doctors in malpractice suits, but hmmm....

Edit: Ok, I feel like an idiot. All this arguing and this was on the first page of google the whole time.

http://www.aarpmagazine.org/health/health_care_costs.html

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Re: Universal Healthcare in the US

Postby Adalwolf » Tue Jul 29, 2008 6:48 am UTC

Universal healthcare.

Sounds all nice, but why should I pay for Joe Schmo 1000 miles away? And why should he pay for me?

Simple: We shouldn't.

Other people's health is their own responsibility, not mine or the governments. Each individual is responsible for themselves. Kids are their parent's responsibility, not the governments.

Now, does the health care in the US need something changed? Yes. What? I have no idea, I don't work in that field.
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Re: Universal Healthcare in the US

Postby e946 » Tue Jul 29, 2008 7:14 am UTC

Adalwolf wrote:Universal healthcare.

Sounds all nice, but why should I pay for Joe Schmo 1000 miles away? And why should he pay for me?

Simple: We shouldn't.

Other people's health is their own responsibility, not mine or the governments. Each individual is responsible for themselves. Kids are their parent's responsibility, not the governments.


So you would support, for example, refusing to fund dental visits for young teens (who thus have at least some of their adult teeth) whose parents cannot afford it? How about refusing to treat a child with a treatable, reoverable form of cancer because, again, their parents just can't aford it? If you do that, yes you're making the kid the parent's reponsibility but you're also punishing the child for something they have absolutely no control over.

The answer to "why should I pay for some guy on the other side of the country's checkup", the answer is that the country as a whole benefits when everyone is healthy, and that absolutely cannot happen under the current system.


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