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Most US doctors now support a national health plan

  1. Mar 31, 2008 #1
    No surprise to me, but in case there was still any doubt that the current for-profit situation in the US isn't working.....

    http://www.pnhp.org/news/2008/march/most_doctors_support.php
     
  2. jcsd
  3. Apr 1, 2008 #2
    I can imagine it must be tough to think "Great, we now know what's wrong with Mr. Smith. Just a matter of a relatively-safe operation... oh... no insurance... :frown:"
     
  4. Apr 1, 2008 #3
    Not a surprise, I've met American physicians on line who were deeply disillusioned with the current system. Which is why I don't spend a lot of time taking people who think it is a terrible idea seriously. Kind of heard all the arguments from the people in the know already. It makes more sense, private and nationalised health is better, it is both on paper and in the real world. Since the US is ranked 38th or if you want to manipulate the figures to favour your country then 17th, I'd say the 16 national/privatised systems above you say it all really.

    It's really only a matter of convincing stubborn capitalists, that nationalised HS isn't really socialism honest. So that they'll swallow a medicine that is good for the system. :wink:
     
    Last edited: Apr 1, 2008
  5. Apr 1, 2008 #4

    turbo

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    I managed the network of a very large (by Maine standards) ophthalmic practice, and I can attest to the strangle-hold that the insurance companies have on private medical practices. Each insurance company has its own fee schedules, and if a doctor wants to be able to accept patients covered by an insurance plan, they have to agree to accept whatever payment the insurance company allows for each procedure. In addition, each insurance company has their own coding requirements, and if the coding experts in the billing office don't adhere to those coding requirements exactly, the insurance company will either refuse to pay or will only pay a portion of the claim. Then the billing department has to figure out why the insurance company bounced the claim, re-code, and resubmit. The more claims the insurance companies can deny, reduce, or delay, the more money they have on hand to invest - and this comes at the expense of both doctors and patients.

    A single-payer health care system would all but eliminate this friction by providing a single standard system for coding medical procedures. If the coding specialists in medical billing offices had only one set of standards to adhere to, their jobs would be greatly simplified, and doctors would be paid in a timely fashion instead of being stalled by the insurance companies.

    One more advantage this would offer: Much of Maine borders Canada, and somehow Canadian lumber companies find it profitable to buy logs in Maine, truck them into Canada, saw them into lumber, and truck the lumber back to Maine for sale. One of the advantages that the Canadian companies have over our companies is that they don't have to pay for and administrate their own health-care plans for their employees. This is especially important for smaller companies that don't have a lot of clout in the insurance market.
     
  6. Apr 1, 2008 #5

    ShawnD

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    Couldn't the US company just not pay health benefits? Since small companies don't have bargaining power with insurance, a lot of them don't offer insurance. I work for a small company in Canada and I don't get any benefits. A lot of Americans are in the same position as me, and they rely on insurance outside of their work.
     
  7. Apr 1, 2008 #6

    mgb_phys

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    The problem in America is that insurance outside work is incredibly expensive - if small companies don't have much bargaining power, how much does an individual have. Especially since individuals with no insurance are bundled in with all the un-insurable. In Canda even without benefits you are basically just paying the extra bit of tax ( $50/month for me in BC) yourself instead of through the payroll.

    It is interesting that British doctors were the main campaigners against the NHS in the 40s, then in Canda they went on strike in the 50s to prevent an NHS there - now it seems American doctors have learnt from history.
     
  8. Apr 1, 2008 #7

    lisab

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    Not only is it expensive to buy individual insurance, but insurance companies can refuse to sell it to you if you have an "pre-existing condition." These are things like diabetes, heart disease, or a previous bout with cancer.

    So, if you are trying to buy individual insurance and you're healthy, it'll simply cost you big bucks. But if you're already sick, good luck finding a company that will even sell it to you.
     
  9. Apr 1, 2008 #8

    ShawnD

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    But why does the logging company care about your health care? Other companies like McDonalds or Walmart give literally no benefits unless you're a supervisor, so why would the expectation be any different for the logging company? Methinks there's more to this than just health care, like a stronger union on the Maine side or maybe lower taxes in whichever province turbo is talking about.
     
  10. Apr 1, 2008 #9
    Because a logging company needs people who know how to drive trucks, forklifts, etc., people who have an actual skill and are harder to find. They want to keep these people.

    If an angry McDonald's employee wants insurance, he can just be ignored until he quits or does something stupid and gets fired, and lo a new person will come to fill his shoes, because that is so-called "unskilled labor".
     
  11. Apr 1, 2008 #10

    ShawnD

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    True, but in turbo's previous posts he has stated that Maine has a pretty bad economy, and the median income was equivalent to something like 30k per year. When the economy is bad like that, people are willing to work for low wages and fewer benefits.

    Of course that could be true on the other side of the border as well. Eastern Canada is sort of the welfare side of Canada, so they'll probably work for low wages as well.
     
  12. Apr 1, 2008 #11
    The economy isn't bad because people don't feel like working. It's bad because there is already a lack of good jobs. If you make pay-cuts, people won't buy as much crap any more. Meaning stores will lose money, meaning delivery (like trucking) and manufacturing will lose money since stores won't be able to afford it all, meaning there is now a lack of jobs.

    Cutting health benefits means people are too afraid to do risky things with money, since if they get sick they NEED it for medicine or worse.
     
  13. Apr 1, 2008 #12

    turbo

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    Apart from teachers, law-enforcement and relatively few manufacturing jobs, there is very little unionization in Maine. Unemployment is high, wages are depressed, and the collapse of the housing market makes it difficult for people to sell out and move to another area (if they are lucky enough to find another job). Another problem is that real-estate prices have historically been depressed in more remote towns. That was OK when it allowed a fellow to take a low-paying job and still hope to make the mortgage on a modest house, but it makes moving quite problematic, because the equity (even if the mortgage is fully paid-off) in such a house wouldn't amount to much more than a down payment on a house within driving distance of Bath or Portland, where there may be some jobs at the shipyard, dry-dock, or other heavy manufacturing facilities. Affordable universal health care for all would at least provide a bit of a safety net for people facing our bleak economic prospects. I'm glad my wife and I aren't starting over again, and that she has an employer (New Balance Athletic Shoe Co.) that values their skilled employees and provides them with affordable health insurance and contributes to their 401K plans, etc. If I hadn't been covered by her health insurance, some of the medical problems I've had would have been a real drain on our savings. As it is, some treatments recommended by my primary care physician and specialist have been denied by the insurance company.
     
  14. Apr 1, 2008 #13

    mheslep

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    Anecdotal evidence is meaningless
     
    Last edited: Apr 1, 2008
  15. Apr 1, 2008 #14
    Er, considering the OP is far from being anecdotal evidence, I'm hardly resting my case on it, am I? If I was trying to say that its bad just because a few physicians said so you might have a point (it just backs up my anecdotal evidence and shows the concerns are more endemic). But since I've given a half a dozen other reason on as many threads, I don't feel the need to cite all the other stuff as well.

    In that case Drankin (no one was prepared to debunk The Economist either) so i was trying to say because he made it to the top that was evidence that anyone can or that it was somehow related to social mobility statistics. In that case yes anecdotal evidence is meaningless. In my case I'm not working on anecdotal evidence alone, there are some pretty convincing statistics and well as I said the OP as well.
     
    Last edited: Apr 1, 2008
  16. Apr 1, 2008 #15

    mheslep

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    The fix for that is to eliminate the employer based health deduction and thereby get employers out of the health care business.
     
  17. Apr 1, 2008 #16

    mheslep

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    No one could read the subscription only link to read it.
     
  18. Apr 1, 2008 #17

    turbo

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    My evidence may be dismissed as "anecdotal", too, but when you talk to doctors who are in private practice - especially specialists with convoluted coding requirements for procedures that are not commonly done, you'll find out what the biggest drag on their business is. Let's say a surgical laser craps out and it is a vital part of their business. They've got to go to the bank to get the big $$$$$ to get another one right away. They have their practice and their billed receivables as collateral, but they often have to demonstrate to the bank that their receivables are in good order. In other words, if the insurance companies are stalling, refusing payment, etc and billed receivables show ages of 60 and 90 days out, the bank will not consider them worthy of collateral. A practice that can keep its receivables aged primarily in the 30 days or less class stands a better chance of getting the loan at a reasonable interest rate. Insurance companies drive up the cost of health care for everybody and negatively effect the quality of care available.

    Most doctors, especially those in small private practices would benefit from the establishment of a single-payer system. The drag and friction caused by the insurance companies makes it expensive for them to operate and requires them to over-staff to keep up with the work load.
     
    Last edited: Apr 1, 2008
  19. Apr 1, 2008 #18
    That's not true actually, many people could, those that could just chose to dismiss it. I think you'll find one or two people can read subscription material in The Economist. And besides how is someone like me supposed to find an article that the proletariat can read? I tried, unfortunately most of the articles were by subscription only. Anyway someone kindly supported it with a source that was readable by all, my apologies for not having the sources at my finger tips, but that doesn't mean I was relying on anecdotal evidence alone. Any more than when someone here puts up a scientific paper only they and a few others can read are relying on anecdotal evidence alone. :smile:

    Anyway the point still stands, and Turbo I don't think you have to support anecdotal evidence when the OP has 59% of Dr's agreeing with you it just adds. If it's on its own then it doesn't mean much on its own.
     
    Last edited: Apr 1, 2008
  20. Apr 1, 2008 #19

    mheslep

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    That depends. If you're chronically ill (diabetic) then yes and that needs to be fixed. Otherwise try an HSA. For example, quote from ehealthinsurance.com for 30 yr old male no family:
    Humana, PPO, $5000 deductible, 0% coinsurance, $43/mo
    Unicare, PPO, $2000 deductible, 30% coinsurance, $64/mo
    Kaiser, HMO, $2500 deductible, 20% coinsurance, $110/mo

    For comparison, avg cost of food, low cost plan, is $201/mo in the US, 2007 per USDA.


    Private clinics have been opening in Canada at the rate of about one per week since the Montreal Supreme Court decision that stopped the govt. from blocking private care.
    http://www.apatheticvoter.com/Newsletter_Articles/CanadianHealthcareSystem.htm
    http://opinionjournal.com/editorial/feature.html?id=110010266
     
    Last edited: Apr 1, 2008
  21. Apr 1, 2008 #20

    mheslep

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    The overhead due to the insurers you have described hear and elsewhere sounds bad. The question is how did it get that way.
    Given Maine's history of the government trying to run the health system, I would think you'd be more cautious about having .gov run the entire thing. In '93 the Maine legislature got in the insurance business w/ its 'community rating' plan and went about telling the insurers what and how to do.

    Health Care News,2004
    http://www.heartland.org/Article.cfm?artId=15674
     
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