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

[turbo]

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

If we had a public health insurance option, this situation could be resolved, resulting in more reasonable charges for procedures. Also, as WhoWee pointed out, giving the currently uninsured/underinsured access to preventative health care should help resolve potential health problems before they become more serious and require more expensive interventions. There are some potentially huge improvements in efficiency and cost-containment that could be brought about by a well-crafted reform bill. It's a shame that most of the GOP in Congress can't bring themselves to participate, because simple nay-saying and obstruction will not result in the best possible bill.

 

[Hurkyl]

For-profit hospitals and medical practices do not simply "eat" those costs - they pass them on in the form of higher charges. ... If we had a public health insurance option, this situation could be resolved, resulting in more reasonable charges for procedures.

Those costs do not magically go away -- they are just going to be passed on in the form of "taxes" rather than in the form of "higher charges".

 

[WhoWee]

If we had a public health insurance option, this situation could be resolved, resulting in more reasonable charges for procedures. Also, as WhoWee pointed out, giving the currently uninsured/underinsured access to preventative health care should help resolve potential health problems before they become more serious and require more expensive interventions. There are some potentially huge improvements in efficiency and cost-containment that could be brought about by a well-crafted reform bill. It's a shame that most of the GOP in Congress can't bring themselves to participate, because simple nay-saying and obstruction will not result in the best possible bill.

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

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

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

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

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

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

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

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

Our elected officials need to start acting like adults and do their jobs. I expect our elected politicians to read the Bills and understand what they are voting on - if they can't - we need to find better qualified people to make the decisions.

 

[f95toli]

Insurance companies and health care networks operate at a profit. Their operations are efficient.

Operating at a profit does not mean that they are efficient for society as a whole.
A lot of of republicans have attacked the NHS here in the UK over the past few days claiming it is inefficient etc.
Now, if the NHS is that inefficient, why is it that the total cost of health care in the UK is HALF of what it is in the US (in terms of GDP)?

 

[gravenewworld]

Emotions say tort reform would save a lot of money, but the facts (or lack thereof) so far say otherwise:

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

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

 

[turbo]

Those costs do not magically go away -- they are just going to be passed on in the form of "taxes" rather than in the form of "higher charges".

My point is that we already pay these costs in the current system, in the form of higher fees for service. Hospitals and medical practices pad their fees because they know that they are going to have to treat the uninsured and need to keep their profits up. With the recent job-losses, many more people are losing insurance coverage, and that will place additional pressure on ERs, etc.

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

There really needs to be a public option that will cover all people. I have a disability (pre-existing condition) that would prevent me from ever getting private insurance if my wife should lose her job. How many people in this country are at risk this way? Getting denied insurance coverage puts you just one serious illness away from bankruptcy, and that's unconscionable.

 

[WhoWee]

Emotions say tort reform would save a lot of money, but the facts (or lack thereof) so far say otherwise:

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

The cost isn't just from lawsuits.

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

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

 

[gravenewworld]

The cost isn't just from lawsuits.

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

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

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

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

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

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

 

[WhoWee]

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

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




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

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

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

Perhaps the trial lawyers helped draft the reforms?

 

[gravenewworld]

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

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

Perhaps the trial lawyers helped draft the reforms?

Effects on Defensive Medicine

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

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

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



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

 

[WhoWee]

Here's something else to consider, how many of the service providers in the study operate in states outside of the one's with reforms? How many of those hospital networks have system-wide policies in place to protect the organization as a whole?

Insurance companies and health service providers deal must conform to the rules of each individual state - this also adds cost.

 

[WhoWee]

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

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



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

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

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

Isolated incidents where patients ultimately pay for unnecessary tests based upon emotions is unfortunate and unacceptable.

 

[turbo]

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

Doctors who own diagnostic equipment or who own a share of a local hospital can certainly drive up costs in the quest for profit. You might be surprised to learn, though, that some of the "unnecessary" diagnostic testing is done to satisfy the insurance companies. If a doctor performs a procedure on a patient without jumping through all the insurance companies' hoops, the claim will be denied. Each insurance company has its own requirements, and if the doctor has not provided the specific diagnostic evidence they require, they will not pay for the treatment. Insurance companies drive up the administrative costs in medical practices and hospitals and actually foster more spending on diagnostic testing than one might expect.

 

[WhoWee]

Doctors who own diagnostic equipment or who own a share of a local hospital can certainly drive up costs in the quest for profit. You might be surprised to learn, though, that some of the "unnecessary" diagnostic testing is done to satisfy the insurance companies. If a doctor performs a procedure on a patient without jumping through all the insurance companies' hoops, the claim will be denied. Each insurance company has its own requirements, and if the doctor has not provided the specific diagnostic evidence they require, they will not pay for the treatment. Insurance companies drive up the administrative costs in medical practices and hospitals and actually foster more spending on diagnostic testing than one might expect.

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

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

I'm 100% in favor of Government investment in hard assets and underwriting high risk insurance pools - just not anything that involves administration or control.

 

[turbo]

I should add that not only do the diagnostic tests have to match the insurance companies' requirements, but that the tests, diagnoses, and treatments have to be coded to match the insurance companies' coding requirements before they will reimburse the doctor/clinic/hospital.

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

 

[WhoWee]

This is an example of hidden costs

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

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

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

We are all paying for these Government mandated regulations.

 

[WhoWee]

Now consider the irony of the IRS enforcing health insurance mandates.

 

[Count Iblis]

http://www.independent.co.uk/news/w...-about-americarsquos-healthcare-1772580.html"

 

[sylas]

http://www.independent.co.uk/news/w...-about-americarsquos-healthcare-1772580.html"

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

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

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

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

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

The whole comment is just surreal.

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

Cheers -- sylas

 

[cristo]

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

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

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

and

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

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

 

[sylas]

That guy's clearly an idiot, though.

Of course. He or she represents an extreme that is sometimes used as a stereotype of the ugly american. I'm noting that the extreme is there, but that it is an extreme, and not fair as a generalization of Americans. But imagine, if you can bear it, how it comes across to readers in the UK... where the article appears.

Cheers -- sylas

 

[Al68]

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

Being against the current proposal, as I am, does not constitute being in favor of "wanting insurance companies to decide who lives and dies", and again, you know it.

It's obvious you have contempt for the idea that an insurance policy is a voluntary agreement on both sides, which means it can be withdrawn by either side for any reason. This is what freedom of contract means.

My contract with my insurance company isn't a "system", it's a voluntary agreement on both sides that government is not a party to. Why is the concept of a private agreement so difficult to understand?

Bottom line is that those who advocate the government's use of force are the ones that have an obligation to defend their position. Those of us that think people who want to be left alone should be left alone have no such obligation, despite the hateful lies accusing us of wanting to perpetuate some imaginary system.

 

[lisab]

Of course. He or she represents an extreme that is sometimes used as a stereotype of the ugly american. I'm noting that the extreme is there, but that it is an extreme, and not fair as a generalization of Americans. But imagine, if you can bear it, how it comes across to readers in the UK... where the article appears.

Cheers -- sylas

Given that there are over 300,000,000 of us, I don't think there is a "fair generaliztion of Americans." In fact when I read any statement that begins with "Americans are...", my eyes automatically roll. I would call it a knee-jerk reaction but my knees aren't affected .

And as far as how we come across to the Brits...well, they're our closest ally (despite that little spat some 230 years ago). I feel confident that idiots like that commenter aren't going to affect the bond between our countries. I do wish that their experience with their medical system was better known and understood by my fellow citizens, though.

 

[Al68]

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

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

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

I just read that link, and while I don't agree with everything he said, you misinterpreted it completely. He was referring to the fact that the words "liberal", "progressive", "diversity", "social justice", etc. are commonly mis-used to refer to oppression. He was saying that "social justice" was used as a a code word for policies he disagreed with, not that he actually disagreed with social justice.

The word "liberal" is rarely used according to its dictionary definition in the U.S. It is mostly incorrectly used as a synonym for "socialist". Actual liberals in the U.S. are referred to most commonly as "right wing wacko extremists".

 

[noblegas]

Insurance is meant to be used in case of emergencies, i.e. when you are diagnosed with cancer or when you cut off your hand and subsequently lose a ton of blood; Insurance is not meant to be used when you have a minor ailment like a cold or body aches; If americans would allocate their earnings that would be used for typical doctor visits and used there health insurance exclusively for emergencies, health care insurance would not be as expensive; Look at it this way; Most people wouldn't used their car insurance to add extra car accesories like Monster wheels , rims , those neon lights on the bottom of some cars ,or a better quality engine, they used their insurance when their car is severely damaged, because the owner knows the cost of insurance will increase; People should used their insurance when its absolutely necessary

 

[sylas]

I just read that link, and while I don't agree with everything he said, you misinterpreted it completely. He was referring to the fact that the words "liberal", "progressive", "diversity", "social justice", etc. are commonly mis-used to refer to oppression. He was saying that "social justice" was used as a a code word for policies he disagreed with, not that he actually disagreed with social justice.

I don't agree; I think I understand him just fine, and that he -- and you -- use words in ways that don't fit with normal usage in the rest of the world. That's the point. We can add "oppression" to this list of words, in my opinion.

Cheers -- sylas

 

[lisab]

Insurance is meant to be used in case of emergencies, i.e. when you are diagnosed with cancer or when you cut off your hand and subsequently lose a ton of blood; Insurance is not meant to be used when you have a minor ailment like a cold or body aches; If americans would allocate their earnings that would be used for typical doctor visits and used there health insurance exclusively for emergencies, health care insurance would not be as expensive; Look at it this way; Most people wouldn't used their car insurance to add extra car accesories like Monster wheels , rims , those neon lights on the bottom of some cars ,or a better quality engine, they used their insurance when their car is severely damaged, because the owner knows the cost of insurance will increase; People should used their insurance when its absolutely necessary

Not sure where you're posting from, noblegas. Are you aware of what health care costs in the US? It's very expensive. Something simple, like a broken arm or a root canal, can cost thousands of dollars...an expense many people can't afford.

 

[f95toli]

Just out of curiosity:
How many of those opposing the suggested health care reform are "extreme" laissez-faire liberals? I.e. they oppose the very idea of the state being involved in health care at all (i.e. not even in case of emergencies: if you can't pay you don't get the necessary treatment even if it means you die).
I've seen a quite a few comments that could be interpreted that way; but only one or two where someone has openly expressed that opinion.

I must say I find it hard to understand how someone could think that it is right to e.g. let a child die if the parents can't afford to pay for treatment (which was the essence of one of the comments I saw, from a town hall meeting).

 

[noblegas]

I must say I find it hard to understand how someone could think that it is right to e.g. let a child die if the parents can't afford to pay for treatment (which was the essence of one of the comments I saw, from a town hall meeting).

There is no outrage over starvation in this country about starving children and there is no big push in washington for food insurance because starvation is minimal to non-existent in the US or no push in washington for "universal food coverage". Why is universal health coverage seen as a good and benevolent force for our society? We basically have universal education for all of our children, yet our kids our performing badly compared to other industrialized countries plus acquiring poor reading skills and critical thinking skills after they graduate; Yet when someone suggest to privatize such institutions like education or healthcare to improve efficiency and quality , they are labeled as "greedy" and "cold-hearted" "robberbarons" out for only profit; I also wanted to add that children are covered for those who can't afford it; http://en.wikipedia.org/wiki/Medicaid ; http://en.wikipedia.org/wiki/State_Children's_Health_Insurance_Program

 

[mheslep]

Yes, generally, regarding Medicaid it is true.

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

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

...Yet, I quoted from the source:

So did I, more extensively than you did.

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

I never said 'every', I added 'generally' in the second post, and sourced some of the caveats (e.g. large assets). 'Generally' in this case meaning (again) that Medicaid covers

http://www.cdc.gov/pcd/issues/2009/Jul/08_0153.htm"

which is pretty damn general.

Likewise the poverty guidelines are much more complicated than 'something like a wage of $10,000'. It turns out that the poverty level for a family of four in 2005 was $19,350. Some states http://books.google.com/books?id=bs...sult&ct=result&resnum=2#v=onepage&q=&f=false", covering the family of four up to $48,375
http://www.cms.hhs.gov/MedicaidEligibility/Downloads/MedicaidataGlance05.pdf , pg 6.

Your figures just don't add up, yet you try say that I'm wrong. Prove it, or stop making such claims. That's now (at least) two cases of misinformation you've made in this thread, and this discussion is getting pretty tiresome.

These unexamined responses are growing tiresome.

 

[noblegas]

Not sure where you're posting from, noblegas. Are you aware of what health care costs in the US? It's very expensive. Something simple, like a broken arm or a root canal, can cost thousands of dollars...an expense many people can't afford.

Well , as a healthcare insurance provides insurance to a growing pool of people, insurance will inevitably go up for everyone ; So therefore , I expect healthcare expenses also to rise; What has also been contributing to the costly expenses are the health care insurance companies paying for a large bulk of administrative expenses . As much as 30 percent of the costs derive from administrative expenses. (http://www.pnhp.org/publications/nejmadmin.pdf); I think cost would be reduced if competition were encouraged on a global scale , i.e. being able to choose health insurances plans outside the state and nation you live in, being able to buy medical drugs legally outside the country; I think the customers would be happy with the quality of the healthcare they received if the healthcare services provided to them were between just the patient and the doctor;

 

[mheslep]

Given that there are over 300,000,000 of us, I don't think there is a "fair generaliztion of Americans." In fact when I read any statement that begins with "Americans are...", my eyes automatically roll. ...

Amen. It's a huge country.

 

[Al68]

I just read that link, and while I don't agree with everything he said, you misinterpreted it completely. He was referring to the fact that the words "liberal", "progressive", "diversity", "social justice", etc. are commonly mis-used to refer to oppression. He was saying that "social justice" was used as a a code word for policies he disagreed with, not that he actually disagreed with social justice.

I don't agree; I think I understand him just fine, and that he -- and you -- use words in ways that don't fit with normal usage in the rest of the world. That's the point. We can add "oppression" to this list of words, in my opinion.

Well, I suppose you believe he is against what he himself considers to be "social justice", then.

As far as using words differently from others, I pointed out that it was very common for the word "liberal" to be used as a synonym for socialist, and you're right, I don't and won't use it that way because the dictionary defines the word "liberal" to mean just the opposite.

The fact that a word is commonly misused for the purpose of misleading people doesn't obligate me to use it the same way, just because others do as "normal usage".

And I used the word oppression to mean economic oppression, ie the restricting of economic liberty, the same way any libertarian or classical liberal would. And of course it's not "normal usage" today because libertarianism/classical liberalism is not the norm.

Edit: What word should I use, instead of "oppression", to refer to the use of force by government to restrict individual liberty?

Here's an example of the word liberal used according to the dictionary definition:

Just out of curiosity:
How many of those opposing the suggested health care reform are "extreme" laissez-faire liberals? I.e. they oppose the very idea of the state being involved in health care at all...

Although I certainly disagree with the suggestion in that post that anyone thinks it's "right" to let children die, at least the word liberal is used correctly, ie not the way it "normally" is.

 

[Al68]

Just out of curiosity:
How many of those opposing the suggested health care reform are "extreme" laissez-faire liberals?

Virtually all of the opposition I've seen to the current proposal has been (at least partially) on that basis, even though some of the objections are from people who are not completely "laissez-faire liberals". None of this opposition has been even acknowledged by those politicians advocating the plan.

They seem to be under the delusion that anyone who opposes their plan must be against their goals and motives, not the substance of their plan. Or more likely they would just rather debate a strawman than the actual objections to their plan.

Edit: Your use of the word "extreme" reminds me of a Barry Goldwater quote: "Extremism in defense of liberty is no vice."

 

[cristo]

'Generally' in this case meaning (again) that Medicaid covers
... which is pretty damn general.

That's not what it means to append the word generally to your previous comment. If you're saying that, in general, the following statement is true:

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

Then it means that most people with an income less than $20,000 a year are eligible for Medicaid support. However, I have shown that the poverty line is around $10,000, and that medicaid doesn't even support all people in poverty, thus most people earning less than $20,000 are not supported.

Likewise the poverty guidelines are much more complicated than 'something like a wage of $10,000'. It turns out that the poverty level for a family of four in 2005 was $19,350.

So now we're talking about families of four. Your previous statement was talking about "one". You should really tell your opposition if you decide to move the goalposts mid match.

These unexamined responses are growing tiresome.

Stop making snarky little responses like this. Since you have refused to retract your previous statements of misinformation, I can only assume that everything you state in future will be liberally sprinkled with false information. Note that this is strictly against PF rules.

 

[cristo]

Of course. He or she represents an extreme that is sometimes used as a stereotype of the ugly american. I'm noting that the extreme is there, but that it is an extreme, and not fair as a generalization of Americans. But imagine, if you can bear it, how it comes across to readers in the UK... where the article appears.

Cheers -- sylas

I am in the UK! I think it does come across as the stereotypical American point of view. Then again, if you read lots of comments to news articles, you will get similar types of comments. I think as a rule, such commenters are a different breed. It is somewhat insulting, as I mentioned above, for someone to "empathise" with me with something they know nothing about (presuming that the BNP situation is what that guy was alluding to).

 

[Al68]

Then it means that most people with an income less than $20,000 a year are eligible for Medicaid support. However, I have shown that the poverty line is around $10,000, and that medicaid doesn't even support all people in poverty, thus most people earning less than $20,000 are not supported.

This is faulty logic, independent of whether the conclusion is true or false.

Clearly not everyone who made < $10,000/yr would not be eligible, since there are other factors. One example is someone who has a lot of cash in the bank while taking time off from working.

That fact doesn't imply anything about the percentage of people who make under $20,000/yr that are eligible, except that it's not 100%.

 

[cristo]

This is faulty logic, independent of whether the conclusion is true or false.

Now you're just picking an argument for the sake of it.

Note that I was not the one making the claim that almost all people earning less than $20,000 a year is eligible for support. I simply refuted this claim.

Of course, such a statement does not have impeccable logic since there are far too many unknowns. However, one needs to make reasonable assumptions. It is a reasonable assumption to say that there are probably around the same number of people earning $10,000 to £20,000 as there are earning under $10,000 (in fact there are probably more). It is also a reasonable assumption to say that most of these people probably do not have extenuating circumstances. Thus, since not all the people earning less than $10,000 are eligible, it is reasonable to draw the conclusion that a lot less than all people earning less than $20,000 are eligible. So, a statement like "And in the US if one has no or very little income (<~20k/yr), then they are eligible for government based health care via the Medicaid program as I posted before, and before, and before." is false.

Of course, had the member above adhered to PF rules and refrained from making unsubstantiated claims, then we would not be having this discussion. Since he did not, and so he has not presented any information to support his claims, there's little more I can do than argue following reasonable assumptions.

 

[drankin]

Insurance is meant to be used in case of emergencies, i.e. when you are diagnosed with cancer or when you cut off your hand and subsequently lose a ton of blood; Insurance is not meant to be used when you have a minor ailment like a cold or body aches; If americans would allocate their earnings that would be used for typical doctor visits and used there health insurance exclusively for emergencies, health care insurance would not be as expensive; Look at it this way; Most people wouldn't used their car insurance to add extra car accesories like Monster wheels , rims , those neon lights on the bottom of some cars ,or a better quality engine, they used their insurance when their car is severely damaged, because the owner knows the cost of insurance will increase; People should used their insurance when its absolutely necessary

Here's what's going on. The bulk of the US citizens cannot manage their money far enough to cover themselves in the case of an emergency. There is no savings. So, what does a voter do when they don't have a savings? They vote in a handout.

The purpose for insurance is to cover you in the case of an emergency. An insurance company is a for profit institution. If you don't like it, don't start a policy. And SAVE yourself enough money to cover your azz if you have a catastrophic emergency. It's incredible to me to see so many people think that they are entitled to health care. I just don't get the mentality.

It's fundamental. The more responsibility you do not take for yourself, the less liberty you will have.

 

[WhoWee]

Insurance is meant to be used in case of emergencies, i.e. when you are diagnosed with cancer or when you cut off your hand and subsequently lose a ton of blood; Insurance is not meant to be used when you have a minor ailment like a cold or body aches; If americans would allocate their earnings that would be used for typical doctor visits and used there health insurance exclusively for emergencies, health care insurance would not be as expensive; Look at it this way; Most people wouldn't used their car insurance to add extra car accesories like Monster wheels , rims , those neon lights on the bottom of some cars ,or a better quality engine, they used their insurance when their car is severely damaged, because the owner knows the cost of insurance will increase; People should used their insurance when its absolutely necessary

You've outlined the basic premise of high deductible, catastrophic policies, and Health Savings Accounts (HSA's). A few earlier posts discuss their application and the potential consequences/changes to them under consideration.

 

[mheslep]

Then it means that most people with an income less than $20,000 a year are eligible for Medicaid support. However, I have shown that the poverty line is around $10,000, and that medicaid doesn't even support all people in poverty, thus most people earning less than $20,000 are not supported.

You did not show, you asserted, twice now. The poverty guidelines are as I have posted from the source above.

So now we're talking about families of four. Your previous statement was talking about "one". You should really tell your opposition if you decide to move the goalposts mid match.

yes and I also https://www.physicsforums.com/showpost.php?p=2309163&postcount=387"

Yes, generally, regarding Medicaid it is true. Clearly the eligibility criterion are more complex than my one sentence statement, it includes other things including the size of ones assets, such as a fat bank account or a flashy boat in the backyard.

I did not immediately address dependents. I followed up with the full poverty guidelines posting above. For that matter, 'one' can still be one wage earner, with any number of dependents, and in some states Medicaid eligibility extends up to 250% of poverty, or almost https://www.physicsforums.com/attachment.php?attachmentid=20125&d=1250387948" for one person with no dependents.

You seem to be hanging on the assertion you made above:

...Now, pray tell, if the medicaid guidelines state that being in poverty is not sufficient to receive aid...

which is incomplete. The Medicaid guidelines state, that low income by itself is not sufficient to receive aid. There are other criterion, especially asset size. Never the less, low income groups are the primary target of the program. Again, from the HHS Overview of Medicaid:

In general, you should apply for Medicaid if your income is low and you match one of the descriptions of the Eligibility Groups.

http://www.cms.hhs.gov/MedicaidGenInfo/

 

[cristo]

In general, you should apply for Medicaid if your income is low and you match one of the descriptions of the Eligibility Groups.

What about those who don't fit into the eligibility groups? You're just cherrypicking statistics, and rearranging your argument so it sounds like you know what you're talking about. Dear god, this is like smacking my head against a brick wall.

 

[mheslep]

What about those who don't fit into the eligibility groups

Already addressed, repeatedly. Not every low income person qualifies, yet 53 million are covered by Medicaid

You're just cherrypicking statistics, and rearranging your argument so it sounds like you know what you're talking about.

Nonsense. They figures and sources are there for all to see.

Dear god, this is like smacking my head against a brick wall.

Stop making snarky little responses like this...

 

[cristo]

Not every low income person qualifies, yet 53 million are covered by Medicaid

You use the phrase "in general" but you don't know what the phrase means. It means "in all cases but a few exceptions" but you think it means "oh, this is a really big number.. wow, it's pretty general". You're just wrong: face it, and move on. Seriously. This is really boring.

 

[WhoWee]

The debate over health care is often side-tracked as evidenced in the last several posts. Until the debate re-focuses on the specific problems inherent to both the Government and private insurance programs (plus the cause and effect of current mandates), and addresses specific and well thought out solutions, nothing productive will ever be accomplished.

If the politicians choose to use this to grab power and ram-rod "reform" through Congress the way the stimulus package was handled - no time to read the Bill - just throw money at it - the results could be catastrophic to both health care and the economy.

It's time for a serious adult conversation - no politics - health care (and reform) is too important to fail - and we need to take as much time as necessary to get it right.

 

[turbo]

It's time for a serious adult conversation - no politics - health care (and reform) is too important to fail - and we need to take as much time as necessary to get it right.

Thank you! I don't favor delay for the sake of obstuctionism, but hope that some adults (if there are any) in Congress will try to put something together that works for the common good. Too many people are marginalized or bankrupted by the current system, and that's no way to treat people.

 

[Ivan Seeking]

I thought Tom Daschle put the issue of health care into perspective nicely with this statement on Meet The Press, this morning:

We have islands of excellence in a sea of mediocrity

 

[WhoWee]

I thought Tom Daschle put the issue of health care into perspective nicely with this statement on Meet The Press, this morning:

I'm not sure of the context of the statement, but have to agree if he meant that we do have the best components to start with and can build a system second to none.

 

[Ivan Seeking]

I'm not sure of the context of the statement, but have to agree if he meant that we do have the best components to start with and can build a system second to none.

That is more or less my understanding of his statement as well as my perspective. For example, there is no doubt that advanced FMRI, Spiral CT, PET, and diagnostic imaging technologies generally are second to none. Heck, it is impossible to even keep up at times. But the problem that I saw personally with these technolgies was the cost. Back in the bad old days of CT, I can remember circuit boards covered with perhaps 20 or 30 chips - all TTL and early CMOS - costing $100,000 each. Then, the additional cost of the support contracts was absurd. Like so much of technology, the development costs, and more importantly I think, the cost of continued advances is put on the user [patient].

While a non-invasive scan beats exploratory surgery every time, the continual cost burden of purchasing and maintaining state-of-the-art technologies plays a large role in driving the cost of health care. In the meantime, the essentials of medicine take a back seat and it becomes a money game. That is why in part we see things as ridiculous as a pianist playing a grand piano in the lobby of a major hospital; or a woman vomiting blood until she dies in the ER waiting room, unassisted.

Another minor absurdity that comes to mind is the tendency for hospitals to remodel and install carpeting in areas where hospital workers have to push gurneys. Not only does this present problems when body fluids hit the floor, but it also puts a burden on the workers who have to push the gurney. The reason for the carpeting is that it looks nice for investors, as does a fine grand piano. But perhaps my favorite example was the ER entry [internal access] that was too narrow for a gurney! Talk about missing the mark!

Some hospitals now require medical workers to wear nice clothes instead of scrubs. Why? Is it better or more practical? Heck no, but it looks nice.

The point: Decisions driving the industry are improperly motivated.

 

[wildman]

I finally found a answer on who pays for those emergency room calls by people without insurance. What apparently happens is that the hospital raises its rates on everyone. In other words it is a business cost which is expensed over its insured customers. The charity that Evo was talking about is all of us.