National Health Care-Obama Plan

[Boomhauer]

As an employee of the federal gov't, let me assure you of one thing:  you do NOT want any employee of the federal gov't making any form of health care decisions for you.

Also a Fed .gov employee, the idiocy and insanity I witness everyday is nothing short of amazing.

[buzz_knox]

Also a Fed .gov employee, the idiocy and insanity I witness everyday is nothing short of amazing.

Yup.  Supporters of Obamacare need to understand that it will basically consist of taking the worst run health insurance company around and giving it sovereign immunity.  That's a sure recipe for success.

People keep talking about leaving the country in order to get treatments not authorized by the feds (which is the sole reason to seek health care outside the US).  Does anyone seriously believe that these treatments will suddenly become allowed under Obamacare?   There's no chance of that happening. 

[KD5NRH]

--Make it law that congress can have healthcare no better than Joe and Martha Sixpack,  No gold plated plans if Joe and Martha can't get theirs gold plated.

I've said before that if you want to see a lot of problems go away, change the VA to an overall government employees health plan; when Congress and POTUS are limited to the same level of government-provided care as Buck Private Bubba, the system will either fall apart, or at least veterans will start getting the care they've earned.

[KD5NRH]

Also a Fed .gov employee, the idiocy and insanity I witness everyday is nothing short of amazing.

I worked for a relatively small chunk of the state government for a while, and I really don't want to see what kind of incompetence can be gathered when you have a barrel the size of the entire country to scrape employees from the bottom of.

[buzz_knox]

I've said before that if you want to see a lot of problems go away, change the VA to an overall government employees health plan; when Congress and POTUS are limited to the same level of government-provided care as Buck Private Bubba, the system will either fall apart, or at least veterans will start getting the care they've earned.

I support that 100% if for no other reason than your second point.  With all the complaining about insurance companies, the person I knew who got screwed the absolute worst was a vet.  He took rounds through his knees, and the VA wouldn't get him knee replacements until he found someone who could work around the bureaucracy.

Byrd and Kennedy would likely be dead right now if they'd had to work through the VA system.

[Racehorse]

Just a small example on this. My father-in-law is an anesthesiologist in Germany, but he also goes out with the ambulance on emergency calls. It's the law in Germany that a doctor go out on emergency calls because he has to make the decision on whether they should try to keep people alive. If they're too old or not likely to survive, etc. they may not try to resuscitate, primarily because it's too expensive to revive someone who will most likely die in a day or two anyway.

I'm not terribly familiar with the U.S. ambulance/emergency system, but I believe that they try to keep everyone alive regardless of the cost and leave the decisions about unplugging, etc. to the family.

Just one example of the wonders of socialized medicine.

Having said that, though, the actual quality of care in Germany is better in some ways and worse in some ways than in the U.S., but overall, I'd say they're about equal. People do pay less out of pocket for care there, and it's generally very good. But if you factor in the taxes and the cost-based medical decisions, I'd vote for the American system.

[Headless Thompson Gunner]

Can you name any specific advantage to this system over others?

Yes.  Quite simply, this system works for me, my family, and everyone I've talked to.  It's expensive, but that's going to be true of anything valueable that everyone wants.  TANSTAAFL.

The people I've spoken with who live under socialized systems complain about their systems and seem envious of ours.  Their complaints match up with what you would expect from a socialized system given a bit of thought and common sense: care is lower quality, waiting times are longer, and there is always some form of rationing limiting the care they have access to.

Funny thing is, none of these foreigners seem at all comforted by the "expert" studies extolling the virtues of socialized medicine.

[Iain]

I'm not particularly envious of yours. I doubt I could get better care than I do.

[Headless Thompson Gunner]

I'm not particularly envious of yours. I doubt I could get better care than I do.

I read a newspaper article the other day about some member of the Saudi royal family flying over to Durham to get medical treatment at the Duke University med center.  Apparently it is common for the royal family to do this, and whenever they do they donate a new building to the hospital or pay to have a wing remodeled or somesuch.  Over the years most of the hospital has been built or re-built by these donations.

I point this out to illustrate that Saudi royalty have the option of flying anywhere in the world for their care, including Britain.  They choose to come here.

[Iain]

The best hotels in the world might be in Dubai. Solid gold taps, eiderdown quilts with ludicrous thread counts and butlers on call 24/7. If I want a clean, comfortable spacious hotel - do I have to go to Dubai?

If the Saudi royal family, who can afford anything that they want, find what they want in the US - does that say anything at all about the standard of care that is available to the ordinary US citizen?

That's what matters to me, and the ordinary person. The valid comparision is not between the care that the Saudi royal family receive in the US and the NHS. It is between what American born Iain gets and what British born Iain gets.

I'm not going to participate in this thread really, it is subject that is too personal to me for me to watch people engage in ideological, political internet battles over it.

[makattak]

I'm not particularly envious of yours. I doubt I could get better care than I do.

This is the problem with socialized care. It is very deceptive.

My only question is: have you ever been SERIOUSLY ill while living with socialized care?

Because that is where the socialized system fails. People with cancer being told they can't get the drugs that would help them. People needing surgeries and having to live with pain because their surgery isn't urgent enough. (Also, the general lack of modern technology- I'm not as familiar with Britain's healthcare as I am with Canada's, but getting an MRI takes WEEKS in Canada. I needed one and got it within two hours of first seeing my doctor.)

Most people aren't in those categories. Thus, most people think the medical care is fine.

Socialized medicine works very well if you don't get sick.

[buzz_knox]

I'm not going to participate in this thread really, it is subject that is too personal to me for me to watch people engage in ideological, political internet battles over it.

It's personal for a lot of us.  Many of us know people who will be denied access if the health care rationing being discussed as part of nationalized health care goes into effect. 

Actually, let's get a little more personal.  How much of your hard earned money are you willing to give me so I can have health care?  How much are you willing to contributed?  Let's stop talking about soaking the rich because if we took everything they had, we wouldn't pay for nationalized health care (especially after the economy tanked from the capital flight).  How much are you personally willing to pay? 

[buzz_knox]

This is the problem with socialized care. It is very deceptive.

My only question is: have you ever been SERIOUSLY ill while living with socialized care?

Because that is where the socialized system fails. People with cancer being told they can't get the drugs that would help them. People needing surgeries and having to live with pain because their surgery isn't urgent enough. (Also, the general lack of modern technology- I'm not as familiar with Britain's healthcare as I am with Canada's, but getting an MRI takes WEEKS in Canada. I needed one and got it within two hours of first seeing my doctor.)

Most people aren't in those categories. Thus, most people think the medical care is fine.

Socialized medicine works very well if you don't get sick.

We can't forget that in England, the age of the patient helps determine if they get a bypass or other "routine" procedure.  At least, that's what British doctors are now openly admitting. 

[Iain]

I'll never pay back what I have cost and what I will cost.

There is no point carrying on, my contributions to this topic always provoke strident responses, as they already have.

[Headless Thompson Gunner]

The best hotels in the world might be in Dubai. Solid gold taps, eiderdown quilts with ludicrous thread counts and butlers on call 24/7. If I want a clean, comfortable spacious hotel - do I have to go to Dubai?

If the Saudi royal family, who can afford anything that they want, find what they want in the US - does that say anything at all about the standard of care that is available to the ordinary US citizen?

That's what matters to me, and the ordinary person. The valid comparision is not between the care that the Saudi royal family receive in the US and the NHS. It is between what American born Iain gets and what British born Iain gets.

I'm not going to participate in this thread really, it is subject that is too personal to me for me to watch people engage in ideological, political internet battles over it.

That's an interesting point.  Health care certainly isn't free.  Those who can afford anything they want have their choice of any system in the world.  Those of us who have limited resources have narrower options.  We might naturally prefer a system that makes someone else pay for our health care rather than try to pay for it ourselves.

So which system is better?  One system gives us whatever we can provide for ourselves, and a s a consequence it provides the best cost-no-object care anywhere in the world.  The other system gives us whatever we think we want and then coerces someone else into paying for it.

I can see the immediate appeal of making someone else pay for my health care.  In the long run I know such a system is a road to disaster.

[De Selby]

This is the problem with the healthcare debate in America.

The only hard data available show two things:

1. Health care quality is not superior in America (outcomes are equal to or worse than in comparable economies.)

2. Health care cost is several orders of magnitude higher than anywhere else for the same or lower-quality services.

But because Headless likes his insurance plan, and read an article about a hundred Canadians who came to the US, that's good enough proof that the system ain't broke.

It reads a lot like the anti-gun arguments really: "but a machine gun can kill so many people, why let those be sold!"  "Carrying a gun is crazy, I knew this one kid who shot his own eye out!".  Nevermind that there are mountains of stats that show it's not actually that dangerous...it's media perceptions and "what I see myself" that rule the debate.

It'll be interesting to see how healthcare turns out in America after all of this.  I'm not confident Obama has the stones to take on the medical industry, and I'm also not sure that they could craft a plan that's any good.  Ideally they'd just copy a system that already works, like Australia's. 

In the meantime, I'll continue to be amazed that in a country where capitalism is king, people are happy to pay higher prices for substandard outcomes.  Apparently capitalism does not produce demanding consumers.

[cassandra and sara's daddy]

1. Health care quality is not superior in America (outcomes are equal to or worse than in comparable economies.)

both you and obama ignore one component of health care and its results. understandably unpopular amongst his followers is the term personal responsibility.  i impact my own health and if i fail to take care of myself you can throw all the money in the world with scant results now go get me some beer and a couple big macs  before american idol starts

i think your definition of "orders of magnitude" differs from mine

[De Selby]

1. Health care quality is not superior in America (outcomes are equal to or worse than in comparable economies.)

both you and obama ignore one component of health care and its results. understandably unpopular amongst his followers is the term personal responsibility.  i impact my own health and if i fail to take care of myself you can throw all the money in the world with scant results now go get me some beer and a couple big macs  before american idol starts

i think your definition of "orders of magnitude" differs from mine

Personal responsibility is great, but what does that have to do with costs per service measures?  The exact same procedures are not ten times more expensive in the US because of personal responsibility or a lack of it. 

"orders of magnitude" includes billions of dollars, which is the amount of excess the US pays for its often inferior health care services.  This is what the hard data show on the subject, anyway.

[cassandra and sara's daddy]

i was referring to the cause of the outcomes being to some great degree a result of personal responsibility, or the lack thereof

and then there is this
Orders of magnitude are generally used to make very approximate comparisons. If two numbers differ by one order of magnitude, one is about ten times larger than the other. If they differ by two orders of magnitude, they differ by a factor of about 100. Two numbers of the same order of magnitude have roughly the same scale: the larger value is less than ten times the smaller value. This is the reasoning behind significant figures: the amount rounded by is usually a few orders of magnitude less than the total, and therefore insignificant.


though i do agree "orders of magnitude" sounds more dramatic.

[makattak]

This is the problem with the healthcare debate in America.

The only hard data available show two things:

1. Health care quality is not superior in America (outcomes are equal to or worse than in comparable economies.)

2. Health care cost is several orders of magnitude higher than anywhere else for the same or lower-quality services.

But because Headless likes his insurance plan, and read an article about a hundred Canadians who came to the US, that's good enough proof that the system ain't broke.

It reads a lot like the anti-gun arguments really: "but a machine gun can kill so many people, why let those be sold!"  "Carrying a gun is crazy, I knew this one kid who shot his own eye out!".  Nevermind that there are mountains of stats that show it's not actually that dangerous...it's media perceptions and "what I see myself" that rule the debate.

It'll be interesting to see how healthcare turns out in America after all of this.  I'm not confident Obama has the stones to take on the medical industry, and I'm also not sure that they could craft a plan that's any good.  Ideally they'd just copy a system that already works, like Australia's. 

In the meantime, I'll continue to be amazed that in a country where capitalism is king, people are happy to pay higher prices for substandard outcomes.  Apparently capitalism does not produce demanding consumers.

Point one is wrong. As you did not deign to back up your statement with anything, I will not waste me time with rebuttal.

Point two is stupid. There are "orders of magnitude" of difference between COST and PRICE. You and your ilk have confused the two and think that if you lower the price, it's the same as lowering the cost.

That is utter foolishness! Lowering the price without affecting the cost (what socialized medicine does) simply increases demand for services and RAISES the cost. That's why you end up with rationing and denial of services under socialized medicine.

But, it's ok, the proponents of socialized medicine SWEAR that would never happen here.

I'm glad we can rely on the good intentions behind a government program.

[buzz_knox]

Point two is stupid. There are "orders of magnitude" of difference between COST and PRICE. You and your ilk have confused the two and think that if you lower the price, it's the same as lowering the cost.

That is utter foolishness! Lowering the price without affecting the cost (what socialized medicine does) simply increases demand for services and RAISES the cost. That's why you end up with rationing and denial of services under socialized medicine.

There's one thing that isn't being mentioned.  The gov't routinely reduces Medicare/Medicaid payments each year.  To make up for the loss, docs have to push through even more patients.  So, next time you have to wait forever in a doctor's office and only get a few minutes of his/her time, thank the gov't.

When you combine that fact with the gov't notorious problems with paying Medicare/Medicaid claims, it's understandable why more than a few docs are considering dumping patients who don't have private insurance.  Dealing with the gov't is absolutely abhorrent (as any vet at a VA can tell you) unless you have Senator or Representative in your title.  I'm sure things will improve greatly when all health care is Obamacare and we are paying far more in taxes for lower levels of services.

[JonnyB]

I work for a not-for-profit hospital that owns a for-profit medical supply company. That company will see a reduction in the reimbursement for equipment and supplies paid for by Medicare and Medical Assistance this year.

Medicare payments will be reduced by 4.5% while MA payments will be reduced by 14.5%. Does anyone here think that the cost of these supplies and equipment have declined by those percentages? Anyone? Didn't think so.

About 60-65% of our hospital patients are Medicare recipients. The payments are such that we might, if lucky, break even on the care they get. Private insurance is better but the big companies are allowed to dictate what we get paid. Self payers are the unlucky bastages that help subsidize the Medicare patients.

Shooting Student - "...several orders of magnitude." Really? A procedure that costs one thousand dollars in America can be had for one dollar (three orders) or ten cents (four orders) in European countries? You can't possibly believe that, can you?

My 83-year-old father is having his hip joint replaced tomorrow. He has early-stage Alzheimer's; would he get the same prompt, expensive care in a socialized system? The appointment was made less than two months ago; more likely 6 weeks. My suspicion is that he'd either be declared ineligible or would wait several years for the surgery in England.

jb

[longeyes]

My mother, who died recently at nearly 97, got cataract surgery through Kaiser at 83.  Lens replacement, both eyes.  The result was that for the last 13 years of her life her vision was better than mine.  Remarkable.  But I'm pretty sure "the national health" would have been content to just let her go blind.  Isn't that what old age is for after all?

[Iain]

Actually it's all true. If you get cancer past retirement age we just shoot you. Babies that look a bit sickly get thrown against a wall.

[makattak]

Actually it's all true. If you get cancer past retirement age we just shoot you. Babies that look a bit sickly get thrown against a wall.

http://www.dailymail.co.uk/health/article-1136844/NHS-kidney-cancer-patients-denied-life-saving-drug-expensive.html

http://www.medicalnewstoday.com/articles/127436.php  (this one is actually good news because, despite it being too "expensive" the health service is now being forced to provide it... how many people didn't get treatment because of NICE, though?)

I found those in 3 seconds of searching.