News The US has the best health care in the world?

[mheslep]

...
4). 50 million people who can't afford health insurance

More like 10 million

 

[Ivan Seeking]

Specific problems:

1). Lifetime limits on coverage that are exhausted in the event of a serious illness
2). Dropped coverage when illness strikes
3). Denial of coverage due to preexisting conditions
4). 50 million people who can't afford health insurance
5). Increasing costs that will certainly overwhelm the country as the baby boomers retire and the cost of medicine skyrockets
6). We pay far more per capita for medical care than do than other nations, for less in terms of results.

Objectives:
1). Eliminate lifetime caps
2). Eliminate dropped coverage when illness strikes
3). Eliminate the denial of coverage due to preexisting conditions
4). Provide a means to affordably insure 50 million more people
5). Reduce the cost of medical care
6). Increase the efficiency of the medical care systems

Some options considered in no specific order:
1). Government regulation of the terms of insurance
2). Create competition for the private insurance industry with a government option for those without insurance - the universal health care option
3). Create a single-payer system with the government acting as the central agent for insurance.
*Note that This is not government run health care. It is government run health care insurance. Calling this government run health care is like saying that Farmers Insurance runs the local hospital now.
4). Form co-ops to create competition for private insurance
5). Through part of the existing government stimulus programs, invest in state-of-the-art information technology to streamline everything from the tracking of drug interactions, to the ordering of studies, to payment, for the entire healthcare system. Consider for example, it is claimed that as much as 50%-80% of the cost associated with running a doctor's office can be attributed to paperwork and insurance regulations. Also, many of the errors made in hospitals that result in death or injury are preventable though information technology.
6). Here is one of the latetest suggestions being considered: Implement a program like that instituted by Gov Romney, in Massachusetts.

 

[WhoWee]

The sausage making has been going on in Congress for many weeks, but unless you happen to make a living debating and negotiating in congressional committees, you would really have no way to know what is being argued. As of right now there is no single plan. There are about five plans. Apparently you haven't been paying attention.

Specific problems:

1). Lifetime limits on coverage that are exhausted in the event of a serious illness
2). Dropped coverage when illness strikes
3). Denial of coverage due to preexisting conditions
4). 50 million people who can't afford health insurance
5). Increasing costs that will certainly overwhelm the country as the baby boomers retire and the cost of medicine skyrockets
6). We pay far more per capita for medical care than do than other nations, for less in terms of results.

What is your "specific" source - an Obama town hall meeting?

Problems, objectives, and solutions - I see a few general talking points on your list - no specifics.

1.) Some private policies have $1.0 million limits and some have $7 million.
2.) Can you please explain this - under what specific circumstances does this happen?
3.) Denial of coverage is what happens when the person (under your #2 example) loses coverage and re-applies. This is a major problem but a general category of pre-existing doesn't begin to describe the overall situation.
4.) Are any of these 50 million people illegal immigrants, people who choose to self-insure, people already on public assistance, people already accounted for in #2 and #3, are any of these people on the extended COBRA plan and just developed a problem that will now be considered pre-existing - or are these people not in any of these categories that can't afford coverage? Again, a statement of "50 million uninsured" does not fully describe the actual problem - it is a talking point.
5.) Obama says reform will save money, even though the CBO doesn't agree - again, another talking point with no factual support.
6.) As Astronuc pointed out above. Could the reason be that our lifestyles have something to do with the data - WE ARE A FAT NATION - diabetes, high blood pressure, etc. Junk food and lack of exercise need to be factored in and then re-evaluate the data.

I have been paying attention - and nobody thus far has presented a comprehensive plan that itemizes all of the problems, objectives, and solutions. Writing a fast 1,000 page Bill and ramming it through won't solve anything - do you trust your life to Barney, Nancy, and Harry? This Bill needs to be understood. Obama promised a "line by line" review of anything that he signs - did HE read the stimulus Bill? Will he read and understand this Bill?

 

[WhoWee]

Objectives:
1). Eliminate lifetime caps
2). Eliminate dropped coverage when illness strikes
3). Eliminate the denial of coverage due to preexisting conditions
4). Provide a means to affordably insure 50 million more people
5). Reduce the cost of medical care
6). Increase the efficiency of the medical care systems

Some options considered in no specific order:
1). Government regulation of the terms of insurance
2). Create competition for the private insurance industry with a government option for those without insurance - the universal health care option
3). Create a single-payer system with the government acting as the central agent for insurance.
*Note that This is not government run health care. It is government run health care insurance. Calling this government run health care is like saying that Farmers Insurance runs the local hospital now.
4). Form co-ops to create competition for private insurance
5). Through part of the existing government stimulus programs, invest in state-of-the-art information technology to streamline everything from the tracking of drug interactions, to the ordering of studies, to payment, for the entire healthcare system. Consider for example, it is claimed that as much as 50%-80% of the cost associated with running a doctor's office can be attributed to paperwork and insurance regulations. Also, many of the errors made in hospitals that result in death or injury are preventable though information technology.
6). Here is one of the latetest suggestions being considered: Implement a program like that instituted by Gov Romney, in Massachusetts.

Again, what is your source? What politician has listed these things?

 

[Ivan Seeking]

Again, what is your source? What politician has listed these things?

For one, Obama has talked about some of it; esp wrt universal care vs single-payer system. HE did just a few days ago in his press conference, and he did again this morning on Conservative radio.

Where do you get your news? What do you think people have been talking about for the last several months? There are I believe five active committees in Congress. What do you think they are debating?

 

[Ivan Seeking]

During his campaign for the White House, President-elect Barack Obama proposed lowering health care costs and helping the 45 million uninsured Americans. Now he faces the tough task of implementing those reforms during a likely recession...

http://www.pbs.org/newshour/indepth_coverage/health/uninsured/index.html
http://www.pbs.org/newshour/indepth_coverage/health/uninsured/map_flash.html

Also to be considered, the underinsured.

 

[Ivan Seeking]

Here is one version discussed in the House. A vote was not taken before the summer recess, so the issue is being discussed in town halls all around the country, every day. Perhaps the problem is that nuts like Sarah Palin have tried their best to misdirect the discussion with crackpot claims.

http://energycommerce.house.gov/Press_111/20090714/aahca.pdf

 

[Ivan Seeking]

The Palin effect:

https://www.youtube.com/watch?v=nYlZiWK2Iy8

 

[drankin]

The Truth About Record-Setting U.S. Life Expectancy
http://news.yahoo.com/s/livescience/20090819/sc_livescience/thetruthaboutrecordsettinguslifeexpectancy


Interesting.

I don't think we are looking at all the factors in life expectancy. How does the American diet compare to those of other developed countries? The Japanese, for example, have a very healthy diet (variety of fish and rice products) in comparison to Americans (hamburgers/french fries/bacon). In my experience with people in the UK, American meal serving sizes are much larger. A lifetime of that has to have an impact on life expectancy.

 

[cristo]

The Palin effect

Comparing Obama to Hitler.. genius Methinks a little history and/or politics needs to be taught to people asking such questions. It's all well and good defending first amendment rights (which I agree with, by the way) but no one takes such claims seriously, do they? I liked that representative's response.

 

[WhoWee]

http://www.pbs.org/newshour/indepth_coverage/health/uninsured/index.html
http://www.pbs.org/newshour/indepth_coverage/health/uninsured/map_flash.html

Also to be considered, the underinsured.

Obama says a lot of things...is it 45 million or is it 50 million? It makes a difference when we're talking about people.

I'm afraid the collective result of your posts is that you made my point for me.

Also, while I appreciate your posting of the 1017 pages of HR3200, I have to admit I can't comprehend what specific problems it addresses, the clear objectives of the Bill, or the intended solutions - or consequences of implementation.

When I hire an attorney to work on a complicated problem, I expect him to understand the problem and resolve it. I also expect him to explain all of the possible outcomes, remedies, and consequences of our actions/agreements.

I also expect our elected officials to do the same. Our elected officials need to understand the specifics of the problems they address, have a clear understanding of their objectives in dealing with the problem, and consider all possible solutions.

I expect every politician who votes on a Bill to read the Bill and understand what they are voting on - if they can't, maybe they aren't qualified to represent us.

This is too important. This is 20% of our economy. This is life and death. This should not be a political matter. Why is health care political?

Again, we need our elected officials to act like adults and address the problem in a professional manner - regardless of how long it takes.

 

[Count Iblis]

Many of those life expectancy factors have little to do with medical practice or insurance.
http://repository.upenn.edu/cgi/viewcontent.cgi?article=1012&context=psc_working_papers
If the deaths from homicides and accidents and the like are also corrected for the US moves to or near the highest in life expectancy.

Those other factors are related to the same "small government" ideology that makes health care reform so very controversial. There are many more extremely obese people in the US than in Europe, because a lot of the government policies we have in Europe to fight obesity would be regarded as unacceptable government interference in the US.

The reason why it took so long for the US to curb back on smoking is basicaly similar. In the end, you had to have a Senate hearing to prove that nicotine is addictive and only then could action be taken.

You also believe that people have the right to bear arms.

 

[mheslep]

...There are many more extremely obese people in the US than in Europe, because a lot of the government policies we have in Europe to fight obesity would be regarded as unacceptable government interference in the US...

To what government policies are you referring? What policies does Europe have to fight obesity, aside from research efforts which the US has as well?

 

[mheslep]

The Palin effect:

AKA the http://books.google.com/books?id=ep...p rangel nazis&pg=PA247#v=onepage&q=&f=false".

 

[Al68]

Hmmmm, any reform will have to include the government stepping in in one way or another.

Huh? How about stepping out instead?

I would consider actual "reform" to be a reduction of government involvement from what we have now, not an increase. Free market reform.

Adding corruption and regulation while using force to restrict individual liberty isn't "reform" just because the advocates use the word reform in the name.

 

[Al68]

Objectives:
1). Eliminate lifetime caps
2). Eliminate dropped coverage when illness strikes
3). Eliminate the denial of coverage due to preexisting conditions
4). Provide a means to affordably insure 50 million more people
5). Reduce the cost of medical care
6). Increase the efficiency of the medical care systems

So those of who currently choose to buy a policy with a lifetime cap (because it's cheaper), doesn't cover pre-existing conditions (because I have none and it's cheaper) or anything else I have chosen, should be denied our right to contract? My insurance policy is a private agreement between me and a private company offering the policy. The government is not a party to that contract.

Calling millions of individual private contracts a "system" doesn't change the facts. Government is too involved in our private lives and we should now accept the claim that it's not involved enough?

Why is it so difficult to understand that my health care is my private business?

 

[WhoWee]

Huh? How about stepping out instead?

I would consider actual "reform" to be a reduction of government involvement from what we have now, not an increase. Free market reform.

Adding corruption and regulation while using force to restrict individual liberty isn't "reform" just because the advocates use the word reform in the name.

Are you absolutely sure you don't want the IRS to enforce health insurance? If they are just half as effective as the (car insurance lobby) states enforcing car insurance mandates by suspending drivers licenses - everyone will either be insured or (in jail?), or homeless?

Can anyone find a section in HR3200 that addresses eligibility of persons made homeless by the IRS for not purchasing health insurance - will they still be eligible for medicare/medicaid?

 

[Evo]

Off topic posts deleted.

 

[DavidSnider]

The Palin effect:

https://www.youtube.com/watch?v=nYlZiWK2Iy8

Palin effect? The woman in that video is a Lyndon LaRouche follower.

 

[adrenaline]

http://www.pnhp.org/facts/single_payer_resources.php

I have become a member of PHNP ( physicians for national health plan) after over a decade dealing with all the games the private insurances play. ( And, no national health insurance is not socialized medicine anymore than medicare ( national health insurance for the elderly) socialized our health system.

I personally deal with less beaurocracy from medicare and medicaid.

For anyone who thinks the private sector automatically means less cost and greater efficiency and better care, they don't know about the failure of medicare advantage plans ( privatized medicare ) and privitization of medicaid into HMOs. https://www.cbo.gov/doc.cfm?index=8265&type=0 As a physician, I would have had to hire at least a dozen more administrative personell just to deal with the administrative paperwork from these plans. Thousands of patients in my community who opted into those private plans suddenly were without a single doctor who would take them. ( By the way, none of the medicare advantage plans pays for your first three days in the hospital or past 3 days in rehabilitation...as for the latter, if you are an elderly with a stroke, you only get three days of rehab...)

Remember this, private plans ration to protect their corporate interests and profits. And believe me they do.
The government may ration but ethically, I can stomach rationing based on resources available vs. frank greed.

 

[turbo]

http://www.pnhp.org/facts/single_payer_resources.php

I have become a member of PHNP ( physicians for national health plan) after over a decade dealing with all the games the private insurances play. ( And, no national health insurance is not socialized medicine anymore than medicare ( national health insurance for the elderly) socialized our health system.

I personally deal with less beaurocracy from medicare and medicaid.

For anyone who thinks the private sector automatically means less cost and greater efficiency and better care, they don't know about the failure of medicare advantage plans ( privatized medicare ) and privitization of medicaid into HMOs. Google 'failure of medicare advantage plans". As a physician, I would have had to hire at least a dozen more administrative personell just to deal with the administrative paperwork from these plans. Thousands of patients in my community who opted into those private plans suddenly were without a single doctor who would take them.

Remember this, private plans ration to protect their corporate interests and profits. And believe me they do.
The government may ration but ethically, I can stomach rationing based on resources available vs. frank greed.

Thank you for weighing in with a doctor's viewpoint. My wife and I had a wide selection of doctors on her old insurance plan, but then her employer switched to BCBS. There are practices here that operate with a single doctor and one or two staff, and they can't afford all the administrative overhead that some HMOs place on them (denials, re-coding, resubmission, delays in payment...) My wife had to find a new doctor, after having had a wonderful country-doctor for years. I was able to keep mine because his multi-doc practice is affiliated with the local hospital.

I was the network administrator for a very large multi-location ophthalmic practice, and I was shocked to see the aging of the practice's receivables. Much of it would get paid eventually, but in the meantime, it limited the practice's line of credit from the commercial banks. When a patient's vision is at risk, they would get prompt treatment, then the insurance companies would play games with coding requirements, bouncing claims, etc. I wrote accounting programs for other businesses before taking that job, and I can assure you that manufacturers, large trucking companies, etc would have had their lines of credit pulled if their receivables were in such a sorry state.

My cousin was that practice's top coding specialist, and she currently works for a pediatric ophthalmologist who takes a lot of Medicaid referrals. She loves her job now - the coding standards for Medicaid are more transparent and the rules don't change without notice. That leaves more time for her to fight the private insurers for payment.

 

[DavidSnider]

I was the network administrator for a very large multi-location ophthalmic practice, and I was shocked to see the aging of the practice's receivables. Much of it would get paid eventually, but in the meantime, it limited the practice's line of credit from the commercial banks. When a patient's vision is at risk, they would get prompt treatment, then the insurance companies would play games with coding requirements, bouncing claims, etc. I wrote accounting programs for other businesses before taking that job, and I can assure you that manufacturers, large trucking companies, etc would have had their lines of credit pulled if their receivables were in such a sorry state.

I've just started writing software geared towards automating some of the administrative work in the health care industry. I am convinced that the overhead is largely due to administrative waste and not "value added services" as the insurance companies claim.

 

[adrenaline]

at least half of the physicians or more favor a single payor national health insurance
http://www.homepages.indiana.edu/011604/text/docs.shtml

Jama has a survey that shows a majority of physicians favor it, and here is one where a clear majority favored it http://www.pnhp.org/news/2004/february/most_physicians_endo.phpand

all in part due to the waste we see on the admininstrative end

 

[Evo]

at least half of the physicians or more favor a single payor national health insurance
http://www.homepages.indiana.edu/011604/text/docs.shtml

Jama has a survey that shows a majority of physicians favor it, and all in part due to the waste we see on the admininstrative end

My doctor is against it, he also said the majority of doctors (at least those he's affiliated with) are against it. I wonder if it depends on the doctor's practice.

 

[Ivan Seeking]

but no one takes such claims seriously, do they?

Yes. Sarah Palin and Rush Limbaugh have orchestrated this fiasco in an effort derail legitimate reform. I don't know if they are delusional or crooks, but they have a large enough audience to distract the media from legitimate discussions. News Fauxs like Fox eat this stuff up! I would wager that 20-30% of the country believes this idiocy.

The irony is that while these people persuade their audiences that they are fighting for America, fighting for freedom, fighting for this that and the other thing, they are in fact trying to steer the public herd right over a cliff. We desperately need health care reform in this country, but these people will do everything in their power to prevent it in order to "hand Obama his Waterloo", as one Republican put it. What they are really doing, whether they know it or not, is working to hand the American people their Waterloo.

This is the paradox of American politics today: It is in the best interest of the Republican party to block health care reform, whether it best serves the public interest of not, because, if successful, Obama will almost certainly be reelected in 2012. The Democrats will have taken-on and handled one of the biggest problems that we face - something the Republicans have never even tried to do.

 

[adrenaline]

My doctor is against it, he also said the majority of doctors (at least those he's affiliated with) are against it. I wonder if it depends on the doctor's practice.

Probably, the specialties most against it are radiologists ( who never have to get precerts or priorauthorizations since the primary care docs do all the work) and anesthesiologists ( once again, the elective surgery has been begged for by the surgeon or primary care doc.) They don't have to hire extra personell to deal with precerts and denials, extra coders and billers etc. In addition, many doctors are republicans and they tend to listin to the misinformation propagated by hannity, rush, etc.

There is just as much misinformation among doctors about national health insurance being "socialized medicine". My retort is ...as a provider for medicare patients, are you in any way a salaried government employee or restricted in ordering necessary tests and treatments ? ( Medicare has far less restrictions than many of the HMOs). Granted, they pay me less but for every 100 dollars I collect from medicare I use probably 3 dollars for administrative work vs almost a third of the 100 dollars I collect from private insurers.

These doctors may not have much sense of the business end of their practice, as senior partner who does not believe all the business end should be handeled by accountants, I am acutely aware where every cent goes to.

 

[mheslep]

at least half of the physicians or more favor a single payor national health insurance
http://www.homepages.indiana.edu/011604/text/docs.shtml ...

The study is in a respected peer reviewed journal. I also read that, the lead author of this study purported to determine the opinion of physicians regarding single payer insurance Dr. Aaron E. Carroll, is on the the board the physicians group advocating single payer insurance - PNHP. It also appears he is a fairly single minded advocate for single-payer from his statements on the web.
http://pnhp.org/about/board_of_directors.php

The PNHP http://www.pnhp.org/news/2008/april/physician_opinion_ti.php" of the study also states:

The findings came from a random sample of 5,000 physicians from the AMA Masterfile. ...

About 500 questionnaires were undeliverable, 197 were returned by physicians no longer in practice, and 2,193 were completed (51% response rate) and returned to Drs. Carroll and Ackermann.

Thus they reported results come not from a random population, but from those that responded.

It also seems odd that PNHP would have only http://www.pnhpwesternwashington.org/about.htm" members in a country with 800,000 physicians, the majority of which per Carroll's study support single payer.

 

[turbo]

(Medicare has far less restrictions than many of the HMOs). Granted, they pay me less but for every 100 dollars I collect from medicare I use probably 3 dollars for administrative work vs almost a third of the 100 dollars I collect from private insurers.

The efficiencies gained from adding under-insured and uninsured people to a public option might make opting out of CIGNA, BCBS, and other plans look like a good deal for smaller practices. Slash administrative costs and reduce the aging of receivables to something attractive to your lenders, if you should need new equipment, etc. Maybe the big HMOs would have to curb some of their greed in order to keep docs participating in their plans. That certainly would not be a bad thing for the doctors. Private practices have been fattening insurance companies (involuntarily) with floating lines of credit in the form of denials and delays, and that's robbery. The banks were forced some time ago to clear our checks promptly instead of holding them for a week or two and investing the "float" - it's time that insurance companies were held to similar standards.

 

[Ivan Seeking]

Granted, they pay me less but for every 100 dollars I collect from medicare I use probably 3 dollars for administrative work vs almost a third of the 100 dollars I collect from private insurers.

As mentioned earlier, I have heard that 50-80% of the cost of running a doctors office can be attributed to paperwork and insurance regulations. Do you think these are somewhat inflated and that the real number is more like 30%, or could the numbers legitimately vary between 30-80%, when everything is considered and depending on the office?

Also, do you have any thoughts as to how the cost of medical care, from an operational point of view, can be reduced [beyond illness prevention]?

 

[mheslep]

...

There is just as much misinformation among doctors about national health insurance being "socialized medicine". My retort is ...as a provider for medicare patients, are you in any way a salaried government employee or restricted in ordering necessary tests and treatments ? ( Medicare has far less restrictions than many of the HMOs). Granted, they pay me less but for every 100 dollars I collect from medicare I use probably 3 dollars for administrative work vs almost a third of the 100 dollars I collect from private insurers...

How do we address losses attributed to Medicare fraud? That is, one can make the argument that Medicare saves administrative costs by not hiring the staff to properly administrate, and this is reflected in the http://www.usdoj.gov/opa/pr/2009/May/09-ag-491.html" in fraud losses every year. Extend such a system as is to the entire country and either the fraud breaks the treasury or the new system must also vastly ramp up administration costs.