Looking forward to Hillary Care?

[mountainclmbr]

I was working with Canadian Ministry of Defense personnel a few years back. I asked about the nationalized Canadian Health care system. They said "great, really great. If your dog is sick, it will be treated months before you are." I was in Boston with a coworker on business and we were taking the train into the city to get dinner. He was talking to a young woman who turned out to be Canadian. He asked, "how do you like the Canadian health care?" She answered, "it is not really great, but at least it is free". 


http://www.ibdeditorials.com/IBDArticles.aspx?id=270338135202343

A Canadian Doctor Describes How Socialized Medicine Doesn't Work
By DAVID GRATZER | Posted Thursday, July 26, 2007 4:30 PM PT

I was once a believer in socialized medicine. As a Canadian, I had soaked up the belief that government-run health care was truly compassionate. What I knew about American health care was unappealing: high expenses and lots of uninsured people.

My health care prejudices crumbled on the way to a medical school class. On a subzero Winnipeg morning in 1997, I cut across the hospital emergency room to shave a few minutes off my frigid commute.

Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care.

Dr. Jacques Chaoulli faces the media in Montreal in June 2005, after he got Canada's Supreme Court to strike down a Quebec law banning private insurance for services covered under Medicare  a decision the rocked the country's universal health care system.
I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic  with a three-year wait list; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks.

Government researchers now note that more than 1.5 million Ontarians (or 12% of that province's population) can't find family physicians. Health officials in one Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment.

These problems are not unique to Canada  they characterize all government-run health care systems.

Consider the recent British controversy over a cancer patient who tried to get an appointment with a specialist, only to have it canceled  48 times. More than 1 million Britons must wait for some type of care, with 200,000 in line for longer than six months. In France, the supply of doctors is so limited that during an August 2003 heat wave  when many doctors were on vacation and hospitals were stretched beyond capacity  15,000 elderly citizens died. Across Europe, state-of-the-art drugs aren't available. And so on.

[Nitrogen]

I hope we come up with something better than the current system.  Having spent more on insurance this year than I have my car, I'm sure we can come up with something better.

We put people on the moon for crissakes, we can figure out how to do this.

[Headless Thompson Gunner]

Our current system is the best on the planet, the best mankind has ever known.  It could benefit from some free market reforms, and perhaps a bit of an attitude adjustment from average folks (not everyone needs, or even necessarily deserves, the best cost-no-object treatment whenever they step into a hospital).  But overall, what we have here in the States is good and right and proper.  We're quite fortunate.

The libs like to claim that universal free coverage is the end-all definition of "good healthcare".  That's how you get guys like Mikey Moore claiming that Cuba's health care system is better than America's.  What they fail to realize is that it doesn't help anyone to have universal free coverage if the coverage everyone gets universally sucks. 

[Perd Hapley]

Even high on pain-killers, he made more sense than you do. 

But regarding Hannity, putting his name in the same sentence with "knee-jerk" and "mindless" is redundant. 

Edited to add: I'll bet you're a renter.

 

[Nitrogen]

Our current system is the best on the planet, the best mankind has ever known. 

When you get dropped by your insurance company once you get sick, and are slowly slipping toward bankrupcy, unable to get any other insurance, call me back.

[Perd Hapley]

 

Experience, Riley?  Is that what you used to "unsuccessfully dis" the Headless One?  No, it appeared to be a bunch of irrelevant comments about his vocation, his radio-listening habits, and whether he owns or rents.  Sorry, you can't say stuff like that and then whine about being dissed. 

RE:  Healthcare
I'll leave it to solipsists like yourself to judge everything by their own experience.  When I comment on health care, I'll try to base it on facts and reason.  Besides, I'm too young to have much experience with health care, especially since I don't drink like some people.  Have a nice trip. 

[charby]

Oscar the cat needs to go pay a visit to Hillary

-C

[Manedwolf]

I hope we come up with something better than the current system.  Having spent more on insurance this year than I have my car, I'm sure we can come up with something better.

Simple. Make it like car insurance. Single payer.

And legalize risk-based pricing. Not for illness, but for lifestyle choices. If someone can prove they visit a gym regularly, lower their rates. If someone smokes and is morbidly obese, raise their rates, because it's a given they're going to have a lot more health problems, they're a high risk due to their own choices.

Personally, I'm tired of paying higher rates just because of the drain on the system from people who shovel McDonalds into their faces, never exercise, then have all sorts of health problems from heart problems to falling injuries as a result. Or people who smoke like chimneys, then hit up the insurance company when, surprise, they get lung cancer.

[mtnbkr]

And legalize risk-based pricing. Not for illness, but for lifestyle choices. If someone can prove they visit a gym regularly, lower their rates. If someone smokes and is morbidly obese, raise their rates, because it's a given they're going to have a lot more health problems, they're a high risk due to their own choices.

It's not quite that simple though.  For example, my brother, until recently, was morbidly obese and ate horribly.  However, all measures of health other than his weight were good to excellent.  Cholesterol, blood pressure, pulse rate, blood sugar, etc were great.  On the other hand, I exercise quite a bit and eat reasonably well, yet I have to work to keep my cholesterol down and my BP has been up lately.  Based on your factors, my insurance would be lower even though I have more medical problems that need attention.

Not saying I disagree with the idea, just pointing out that it's not so cut and dried.

Chris

[Scout26]

Here's what I sent as a LTTE this week:

Does your employer pick your car insurance ??  How about your Renters or Homeowners Insurance ??  What about your Life Insurance ??  Then why does your employer pick your health insurance ??

During World War II, in the effort to curb wage inflation, the federal government changed the tax code so that employers could offer tax deductible benefits rather then raising wages as more and more men and women entered the armed forces, shrinking the labor pool available to work in the various industries needed for vital wartime production.
During the war everyone won.  The Government won by taming inflation and preventing disruption of needed wartime supplies and material.  Employers won as they were able to provide a benefit at essentially no cost, since it was tax deductible and relatively inexpensive at that time.  Employees won the least, because instead of wages that they could spend as they shoes, they something they had not asked for, even though it (at that time) cost them nothing or next to nothing. 

As we see the Government has gotten more and more involved in Healthcare and like everything else the Government gets involved with the price of that rises, a lot.  So whats the solution.  Many would argue that Single Payer Universal Healthcare system (Meaning Government Provided Healthcare) is the solution.  We already have several of those programs in place.  Medicare, Medicaid, and the VA system are some examples.  Ask any people in any of those programs about the level of service they receive and if theyd prefer the government provided healthcare or private insurance.   The current budget stalemate in Springfield and Cook County gives us another glimpse of what would happen if the Government ran Healthcare.  Budgets and costs spiral out of control, Bureaucrats far from the patient and doctors determine whether treatments are cost effective.  Waste, fraud, abuse, nepotism and patronage inflate costs while reducing needed care and treatment for patients.  And those costs are borne by the taxpayers.

What will happen to the excellent private healthcare system we currently have ??  Notice that when the rich and famous of the world get sick, they dont go to Canada or Cuba for treatment, they come to the US.  Because our healthcare system is still the finest in the world precisely because it is not yet total run by the government.  It allows and encourages  innovation and development of new and better treatments.  Private insurers, doctors and hospitals are like any business, they know that they have to provide and deliver value to their customers (patients) with high quality treatments and service at the lowest possible price, otherwise their customer will take their business elsewhere.  The government has involved itself to the extent that prices are distorted and some of the costs for treating underinsured or government insured patients are absorbed by patients with private insurance.

To really solve the problem of Healthcare Crisis would involve getting the Government out the healthcare insurance and provider business.  The first step would be to move from Employer provided health insurance to privately purchase.  Allow individuals and their families to purchase their own tax deductible health insurance in much the same way that they currently get their auto, home, and life insurance.  Allow the market to set rates and prices.  Like we have seen with auto insurance rates and costs will drop as competition forces insurers to compete and provide the best coverage for the lowest price.  Then we will truly see healthcare reform.

I don't know if I want to buy my health insurance from Cavemen......but I'd trust them more then Hillary......

[mountainclmbr]

I have a brother who is a MD and another brother who is a veterinarian. Many of the medications they prescribe are identical. The medications perscribed for people is MUCH more expensive. The drug companies have to cover the insurance against lawsuits. Most people can get good healthcare for their pets without getting insurance.

[Manedwolf]

I have a brother who is a MD and another brother who is a veterinarian. Many of the medications they perscribe are identical.

A lot of people I know who work in vet offices will buy USP-grade (okay for human use) antibiotics from a vet supplier instead, because it's exponentially cheaper, if not "technically legal". If it's for personal use, though, nobody's going to hit you for it.

If you want to have a supply of something like doxycycline in case of bioterror, that's the cheapest way to do it.

Here's a quote from one online pet supplier:

Cephalexin Rx, 250 mg x 100 Cephalexin Capsules, USP. $11.48

From a "people pharmacy", it'd be incredibly expensive for the same thing.

[ilbob]

Another thing we forget is that in effect the US health care system provides massive subsidies for all the miserable socialist health care systems across the world. How? Because US health care consumers pay for the research marketing and testing to get new drugs and appliances to market, and then the Brits and Canadians refuse to pay their fair share of that cost, so American consumers get stuck with it.

What we should do is stop trying to make health care insure pay every nickle of health care expenses. make it real insurance like on your house. Home owners insurance does not cover lawn mowing, and your car insurance does not cover oil changes. Those are regular expenses you incur that you should just cover yourself. In the same way, you should cover your own regular health care expenses like inoculations, eye glasses, and dental checkups. Save insurance for cancer and heart attacks.

I would love to see companies be able to couple a $5000 deductible health insurance plan with a medical savings account. The company could toss in $1000 a year and the cost of insurance plan itself for probably $200 a month.

And why should companies be forced to provide insurance at all? And why should they be forced to subsidize spouses and dependents? And why are all kinds of things that are well beyond basic medical care often required? You have a few states that require coverage for such things as aroma therapy.

I concur that people who engage in risky behaviors ought to pay more for their health insurance. But, the fact is that, most of that stuff does not come home to roost until later in life. Smokers and fat people under 40 or 50 are generally not anymore unhealthy then the general population. However, people who engage in risky sexual activity are a serious health care expense. Want to try and charge extra for that?

[HankB]

I have a brother who is a MD and another brother who is a veterinarian. Many of the medications they perscribe are identical. The medications perscribed for people is MUCH more expensive. The drug companies have to cover the insurance against lawsuits. . .

I remember seeing a film clip of a drug manufacturer's representative testifying before some congressional committee. I don't have a transcript, but it went something like this:

Congresscritter: I see here that medication XYZ originally was used to treat farm animals, is that correct?

Drug Maker: Yes sir, it is.

Congresscritter: And is there any chemical difference between medication XYZ and your drug Moneycillin, used to treat people?

Drug maker: No sir, they're the same drug.

Congresscritter: (shouting) THEN WHY DOES THE DRUG USED ON PEOPLE COST 100X MORE THAN THE SAME DRUG USED TO TREAT LIVESTOCK?!?

Drug maker: Because no sheep will ever sue us for 100 million dollars. People do that all the time under the laws YOU and YOUR colleagues enacted, so YOU, SIR, have a direct responsibility for a good part of the added cost!!!

[crt360]

Drug maker: Because no sheep will ever sue us for 100 million dollars. People do that all the time under the laws YOU and YOUR colleagues enacted, so YOU, SIR, have a direct responsibility for a good part of the added cost!!!

If anything, legislators are making it more and more difficult to sue doctors, hospitals and pharmaceutical companies.  In Texas, malpractice damages have been capped - something like $250,000 max for noneconomic damages and $500,000 max damages (against all defendants combined), so even if you go in with a stubbed toe and come out as a paraplegic needing a lifetime of pain management you're not going to recover more than $750,000.  A plaintiff here now has to put up $5000 or an equivalent bond just to file a malpractice suit.  Considering the fact that costs in a medical malpractice case can easily exceed $100,, many lawyers aren't even taking them any more.  I read an article the other day that said doctors were lining up to practice in Texas faster than they could be admitted.

Under our health plan, we pay roughly $350/month per employee.  That's over $4000/year.  Over the past ten years, I've probably spent a total of thirty minutes seeing doctors about allergies, a sprained ankle and a sinus infection.  I got a prescription for some antibiotics, allegra and some other allergy medicine, and told to stay off my sprained ankle.  If they've properly invested my estimated $40,000 in health plan payments, it should cover treatment for every conceivable health problem I encounter during the rest of my life.  Will it?  Hell, no.  On top of that, every visit requires a co-pay, medication is discounted but still quite expensive, and dental is limited to a simple cleaning or two a year.

[grislyatoms]

My combined Health/Dental insurance premiums for kiddo and I next year = $410 a month. Up from $350 this year, and up from $310-ish last year. This is a group plan and I work for a public hospital, for Pete's sake!

I'm in the wrong business.

I am seriously considering jumping through all the hoops to set up shop as an insurance agent. Grandad did it and he made $$$$$$$.

[MillCreek]

I work on the defense side of medical malpractice cases, albeit not in Texas.  The cap referred to above for non-economic damages is partially correct, but these are the 'pain and suffering' component of the award.  Economic damages, such as wage loss, loss of future earning capacity, costs of future medical care, rehabilitation, cost of durable medical equipment, and the like are not capped and a jury is free to award whatever amount they think is appropriate.

It is incorrect to say that all non-economic and economic damages combined in a Texas medmal case are capped at a maximum of $ 750,000.  In most cases, the non-economic damages are capped at $ 500,, depending on the number of medical defendants in the case and if they are physicians vs. hospitals.

This explains the nature of the damages caps in Texas from the ever helpful McCullough Campbell site: 

Texas has three relevant damage caps:

In a medical malpractice action filed on or after September 1, 2003, regardless of the number of causes of action asserted, non-economic damages are limited to a total of $250,000 from all doctors and other individuals. Non-economic damages are limited to $250,000 from each hospital or other institution and a total of $500,000 from all institutions. Tex. Civ. Prac. & Rem. Code. § 74.301 (Westlaw 2007). The cap applies to each "claimant," which includes everyone seeking damages due to one person's injury or death. Id.; Tex. Civ. Prac. & Rem. Code. § 74.001(a)(2) (Westlaw 2007). A constitutional amendment authorizes this legislation. Tex. Const. art. III, § 66.

In a medical malpractice action for wrongful death, damages (both economic and non-economic) are limited to $500,000 (in 1977 dollars) plus the cost of any necessary medical or custodial care. Tex. Civ. Prac. & Rem. Code. § 74.303 (Westlaw 2007). The predecessor of this statute was intended to apply to all medical malpractice, but was held to be unconstitutional except for causes of action created by statute, like wrongful death. Rose v. Doctors Hospital, 801 S.W.2d 841 (Tex. 1990). The cap is adjusted annually for inflation, § 74.303(b), and is now approximately $1,650,000. In actions filed on or after September 1, 2003, this limit applies to the total recovery, not separately to each defendant, and includes exemplary damages. § 74.303(a).

In any action not based on certain types of intentional criminal conduct, exemplary damages are limited to the larger of the following amounts: (a) non-economic damages (up to a maximum of $750,000) plus two times economic damages, or (b) $200,000. Tex. Civ. Prac. & Rem. Code Ann. § 41.008 (Westlaw 2007).

[The Rabbi]

This is an economic issue and needs economic solutions.
First is to get the people using healthcare to pay for it.  Eliminate the deductions employers get for offering health insurance.  If they want to offer employees the possibility of participating in their group plan, great.  If not, OK.  But everyone pays for his own health care insurance.
Second is to cap damages like in Texas.  The results have been very good, with insurance premiums for doctors down in the state.  Yeah, no wonder doctors want to practice there and are leaving places like MS, where it's jackpot justice.  If you need a baby delivered in MS you are about flat out of luck.
Third is to elminate local requirements so that insurance companies can sell the same product in NY they do in NV.  Currently each state has its own set of mandates and this drives up premium costs.
Fourth is lower income taxes overall so people have more money to spend on their own insurance plans.
Fifth is to get people to quit smoking, moderate their drinking, and lose weight.  If everyone did those three things there would be no health care crisis.  My older brother is a hospice doctor and a good part of what he sees is largely self-inflicted.  The amount of money spent on this is enormous, because you get cancers, diabetes, back problems, heart problems etc etc from all these things.  Obviously you can get them from other sources too, but the bulk of health care costs nationally come from lifestyle issues.

[crt360]

It is incorrect to say that all non-economic and economic damages combined in a Texas medmal case are capped at a maximum of $ 750,000.  In most cases, the non-economic damages are capped at $ 500,, depending on the number of medical defendants in the case and if they are physicians vs. hospitals.

You are correct regarding the non-economic damages amount.  I quickly lifted the info from another firm's site and it is mis-leading.  I just went back and checked and they are not even from Texas (it looks they did a quick read of MCL's website and posted it incorrectly).  As you probably know though, non-economic damages are what make a big difference in most cases and that's why capping them was such a big deal.  A minimum wage worker whose treatment costs might only be $150,000 is not going to get a big judgment, even though his pain and suffering might be significant.  A good measure of what an injured plaintiff will recover now is based largely on their position in life.  The law still allows you to recover for calculated medical expenses and future earnings (based on what you were doing at the time of the malpractice), but (to oversimplify for brevity) instead of being able to ask the jury for a few million to compensate you for having the good leg removed, the legislature has put in writing that it is only worth a maximum of X number of dollars to you (currently $250,000 and maybe $500,000).

[Nitrogen]

I hope we come up with something better than the current system.  Having spent more on insurance this year than I have my car, I'm sure we can come up with something better.

Simple. Make it like car insurance. Single payer.

And legalize risk-based pricing. Not for illness, but for lifestyle choices. If someone can prove they visit a gym regularly, lower their rates. If someone smokes and is morbidly obese, raise their rates, because it's a given they're going to have a lot more health problems, they're a high risk due to their own choices.

Here's the problem with that.

My wife's mother has Lupus.  Her aunt has lupus.

That means my wife is at an increased risk for Lupus.  Should she pay astronomical prices for insurance, even though she goes to the gym regularly, eats right, etc?

[Perd Hapley]

Shouldn't that be between her and the insurance industry?  Why should anyone be forced to lose money on her insurance policy? 

[Sergeant Bob]

Shouldn't that be between her and the insurance industry?  Why should anyone be forced to lose money on her insurance policy? 

I basically agree with you on that. I really hate paying for someone else's care.

However, since Lupus tends to run in her family, the insurance companies might just refuse to cover her. She is, after all, high risk. The same as with car insurance, if you're high risk they will either refuse to insure you or make you pay obscenely high rates.

So, what are the choices? We either pay a little more for our insurance or maybe just let her die.

[MechAg94]

Well, do it like home insurance used to be.  If you are in a flood plain, they won't cover flooding.  Now days, I think the state covers flood insurance.

As far as your situation, who do you expect to pay the higher premiums?  If you don't, someone else will have to.  I don't like paying for other's medical care.  It sucks, but it ain't right for people to expect charity, especially when that charity is taken from us at gun point and given to you by the govt. 

[bunni]

Our current system is the best on the planet, the best mankind has ever known.  It could benefit from some free market reforms, and perhaps a bit of an attitude adjustment from average folks (not everyone needs, or even necessarily deserves, the best cost-no-object treatment whenever they step into a hospital).  But overall, what we have here in the States is good and right and proper.  We're quite fortunate.

The libs like to claim that universal free coverage is the end-all definition of "good healthcare".  That's how you get guys like Mikey Moore claiming that Cuba's health care system is better than America's.  What they fail to realize is that it doesn't help anyone to have universal free coverage if the coverage everyone gets universally sucks. 

Spoken like someone who doesn't have to purchase private insurance.

[Headless Thompson Gunner]

Wrongo, bucko.  I buy my own health insurance, and I have been for the past 7 years.  Perhaps you should quit whining and do the same.

Nonetheless, that doesn't change the fact that our current health care system works pretty well, better than most anywhere else.  Even the free clinics and free emergency rooms here in the States provide care that's on par with the state-funded universal health care that citizens receive in the socialist countries. 

The great benefit of our system is that in America, those who want better service can get it, as much of it as they're willing to buy.  Health insurance is available here that enables one to receive the best cost-no-object health care services available anywhere in the world.  That level of care isn't available in the socialist countries at any price (unless you're one of the elites).  Sure, the insurance is expensive, but it's certainly within reach of the average middle class American. 

Too many folks believe in the fantasy that they can get a free lunch.  If only we could legislate universal coverage then everyone will magically receive world class health care for free.  It simply doesn't work that way.  The same thing would happen here as has happened in every other western socialist health care country: the basic free coverage everyone receives will suck.  Long waits, poor services, no innovation, bureaucracy preventing doctors from saving lives.  Sure, it'll be free.  But you'll get exactly what you pay for.

Consider it this way:  government has never been able to do anything well.  From welfare to public schools to road maintenance to winning the war on drugs to collecting taxes efficiently to securing the border, you name it.  The government never does anything well. 

Why on earth would you expect the government to do health care well?