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Another Bogus Report Card for U.S. Medical Care

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Posted by: Calabrio

Another Bogus Report Card for U.S. Medical Care
By John Stossel
Wednesday, August 29, 2007

In May, the Commonwealth Fund issued its latest comparison of the U.S. medical system with five other wealthy nations' systems: Australia, Canada, Germany, New Zealand and Great Britain.

Predictably, the study begins: "Despite having the most costly health system in the world, the United States consistently underperforms."

I was immediately suspicious, considering the loaded study by the World Health Organization seven years ago. (I wrote about it last week.)

My suspicion was justified. It turns out the new study is almost as biased as the WHO's. The authors write, "The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes."

I see. America "underperforms" because we don't have enough government intervention.

But while the U.S. lost points for not having national health insurance, the authors added, "[i]f insured, patients in the U.S. have rapid access to specialized health care services."

That's an understatement. Insured Americans have almost immediate access to cutting-edge procedures performed by some of the best-trained doctors. It's why our outcomes for such diseases as prostate and breast cancer are markedly better than in Canada's and Britain's socialized systems. The Commonwealth Fund doesn't mention that.

The United States is the center of medical innovation for the world. When internists ranked the world's top 10 medical innovations, eight were developed thanks to American innovations. The Commonwealth Fund ignores all that and focuses almost exclusively on the problems of our uninsured population.

As I've noted previously, the problem of the 45 million uninsured is exaggerated. The statistics represent a snapshot, and many uninsured people are reinsured in less than a year. The same people are not uninsured year in and year out.

The Commonwealth Fund study divides "quality" into right (effective) care, safe care, coordinated care and patient-centered care. The U.S. placed fifth or sixth in the last three.

But where did the U.S. place in "right care"?

First.

"Right care" is the most important criterion because it includes things like how often women have mammograms and whether diabetics get proper treatment.

The Commonwealth Fund ranked the U.S. last in "equity": "Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care ... because of costs."

But how much of that is due to the government's increasing the cost of care and insurance through mandates, a tax code that encourages reliance on expensive insurance and bureaucratic red tape?

The Commonwealth Fund's study has other problems. It was based on telephone interviews with patients and doctors. So it grades nations on people's perceptions without controlling for their expectations. Yet patients who live in a country with long waits for medical care and bureaucratic inefficiency may have low expectations.

More ridiculous is the arbitrary way the Commonwealth Fund assigns weight to each of its measures. The proportion of patients who say they got infected at a hospital counts about the same in the "quality" measure as the proportion of doctors who use automated computer systems to remind them to tell patients their test results. Those things aren't equal in my book.

The study's authors also consider having high administrative costs and spending the largest share of GDP on health care worse than having the highest share of patients who wait four months or more for surgery. This seems designed to make the U.S. look bad.

Finally, the study penalizes nations for having large numbers of patients who spent more than $1,000 on medical care out of pocket, as if third-party payment is somehow superior.

Michael Cannon, the Cato Institute's director of health policy studies, summed up what's wrong with the study: "The report does nothing more than reveal which nation does the worst job of satisfying the subjective preferences of the people who conducted this study."

Fans of the Canadian system should note that Canada ranked fifth out of six and did worse than the U.S. in many ways.

Are you listening, Michael Moore?

John Stossel is an award-winning news correspondent and author of Myths, Lies, and Downright Stupidity: Get Out the Shovel--Why Everything You Know is Wrong.



Posted by: Joeychgo

I dont know exactly what to make of this political football.

But, there are a few things I have experienced that makes me thing our Health care system is some big issues.

For one. I noticed something interesting when my wife left her job a few years back.

When the cobra papers came in, they wanted around $600 a month for her health insurance to be continued. Yet, I was able to insure her privately for about $160 a month. The plans were pretty similar as far as coverages go. So why the disparity?

Not to leave the doctors out. I had another eye opening experience. I had tendonitis in my elbow. I went to a Dr and was exampined and given a shot of cortizone. The whole visit lasted about 20 minutes. When I got the bill, I was shocked. The bill broke down like this:$180 to stick the needle in? That took all of about 1 minute. Maybe 2. More time was spent with the paperwork. Can you imagine hiring a plumber and he charges you $100 for his time to install a faucet and another $180 to turn the water valve?

Once more, the Insurance company said I had to pay it because it was considered part of my deductible as a - get this - surgical procedure.

I dont know how we compare against other countries and I dont really care. But the idea that our Health care industry is based on our capitalist principals is hogwash. If your hurt, you go to the closest hospital. If your not insured, you pay much more. Twice as much as an insurance company would for the same treatment. There isnt any comparitive shopping, nor any benefit to doing so if you have insurance. Your usually stuck with the insurance company your employer provides, and the medical practitioners they contract with, unless your willing to pay through the nose yourself.

I dont care what happens in Canada, I just know, what we have isnt working as well as it could and should. I suspect that we could do alot to fix the system with a few regulations.

For example, require hospitals and doctors to have 1 price, regardless of insurance or private pay. A visit to a Doctor should cost the same for the insured as the uninsured.

Doctors and hospitals should be one some kind of fee schedule and maybe a rating system. Some kind of fee averaging rating or something, indicating how expensive the Dr is overall so you can compare one doctor's prices to another.

Just a few thoughts randomly tossed out there.



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
I dont know exactly what to make of this political football.

But, there are a few things I have experienced that makes me thing our Health care system is some big issues.

For one. I noticed something interesting when my wife left her job a few years back.

When the cobra papers came in, they wanted around $600 a month for her health insurance to be continued. Yet, I was able to insure her privately for about $160 a month. The plans were pretty similar as far as coverages go. So why the disparity?

Not to leave the doctors out. I had another eye opening experience. I had tendonitis in my elbow. I went to a Dr and was exampined and given a shot of cortizone. The whole visit lasted about 20 minutes. When I got the bill, I was shocked. The bill broke down like this:
  • $15 for the medication
  • $100 for the office visit
  • $180 for the Dr to give the injection.
$180 to stick the needle in? That took all of about 1 minute. Maybe 2. More time was spent with the paperwork. Can you imagine hiring a plumber and he charges you $100 for his time to install a faucet and another $180 to turn the water valve?

Once more, the Insurance company said I had to pay it because it was considered part of my deductible as a - get this - surgical procedure.

I dont know how we compare against other countries and I dont really care. But the idea that our Health care industry is based on our capitalist principals is hogwash. If your hurt, you go to the closest hospital. If your not insured, you pay much more. Twice as much as an insurance company would for the same treatment. There isnt any comparitive shopping, nor any benefit to doing so if you have insurance. Your usually stuck with the insurance company your employer provides, and the medical practitioners they contract with, unless your willing to pay through the nose yourself.

I dont care what happens in Canada, I just know, what we have isnt working as well as it could and should. I suspect that we could do alot to fix the system with a few regulations.

For example, require hospitals and doctors to have 1 price, regardless of insurance or private pay. A visit to a Doctor should cost the same for the insured as the uninsured.

Doctors and hospitals should be one some kind of fee schedule and maybe a rating system. Some kind of fee averaging rating or something, indicating how expensive the Dr is overall so you can compare one doctor's prices to another.

Just a few thoughts randomly tossed out there.
Joey,

You're complaining largely about the costs of healthcare in this country. That isn't in dispute. But you are failing to recognize the reasons behind the cost of healthcare.

1. Malpractice actions - these are the biggest offender, forcing healthcare costs through the roof. Lawyers like John Edwards have enriched themselves off the pocketbooks of insurance companies who have to pay up every time some doctor misses a diagnosis that caused Aunt Maude's dysentery to act up. Who do you think pays for that? Follow the trail - malpractice insurance companies raise premiums, doctor has to pay those, doctor raises prices, you pay more. Doctors also are being forced to practice defensive medicine to protect themselves from lawsuits, which means more tests and multiple diagnoses and prognoses for you every time you visit. They must cover every possibility in order to avoid being sued. This drives costs up as well.

2. People don't have to go see a doctor for minor things. But many people visit the emergency room for a splinter or a piece of chalk in their eye or something. What do you think it's going to cost?

3. I, too, had tendinitis, back in 1999. In both elbows. I knew what it was and rather than opting for the cortizone shot, I treated myself by wearing an elbow sleeve and by ceasing the activity that caused it. Finally went away after about a year.

4. Fee schedules? What you're advocating is socialistic healthcare, just like Hillary wants. What you don't realize is that the unintended consequences of this will result in very poor quality of healthcare in this country. You have to ask yourself - is it better to have low cost healthcare, or good healthcare? You can't have both. That is a fact. If you depress the market, there will be less of an incentive for more young, bright people to enter the healthcare profession, which means eventually you will be treated by some yahoo who might really screw you up.

5. Any time you want to save money on a doctor visit, go to your local free clinic. Observe the quality of the care you receive there, and WATCH OUT for the cockroaches skittering across the floor!

6. COBRA is designed as an incentive to find new employment or to purchase your own plan. I'm glad you found a cheaper alternative, but think about it - it's a market issue that the government should stay out of. Governments are not good at "helping" markets. They are better at hurting them.



Posted by: Calabrio

"Nikola Tesla visited Henry Ford at his factory, which was having some
kind of difficulty. Ford asked Tesla if he could help identify the
problem area. Tesla walked up to a wall of boilerplate and made a
small X in chalk on one of the plates. Ford was thrilled, and told him
to send an invoice.

The bill arrived, for $10,000. Ford asked for a breakdown. Tesla sent
another invoice, indicating a $1 charge for marking the wall with an
X, and $9,999 for knowing where to put it."



Posted by: MonsterMark

Quote:
Originally Posted by Joeychgo View Post
[*]$15 for the medication[*]$100 for the office visit[*]$180 for the Dr to give the injection
So you bought the good doctor a nice chrome wheel. What's so bad about that.

Heck, I had a $800 bill to have a mole removed that took literally 12 seconds. Of course I had to sit in a cold dank room for an hour for the 'doctor' to show up and perform his $800 procedure. To be fair, they did do a biopsy but that added another $400.



Posted by: Calabrio

The entire point of the article has been lost here.

The issue isn't whether health care is expensive. It is. You're dealing with high end technology. High over head. People who have to get expensive schooling and training for nearly a decade. And then you have the legal problems and market factors entering into the price.

But Stossel is taking direct issue with the way that these "quality" surveys are determined. They repeatedly say that the U.S. system doesn't "perform," but then use a completely biased and ridiculous way of making this judgment.

"The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes."

So, if the government ensures everyone gets the same level of inferior care, or if everyone has to wait four months for routine surgery, according to these surveys, the system performs better than ours according to these reports..



Posted by: fossten

Quote:
Originally Posted by Calabrio View Post
The entire point of the article has been lost here.

The issue isn't whether health care is expensive. It is. You're dealing with high end technology. High over head. People who have to get expensive schooling and training for nearly a decade. And then you have the legal problems and market factors entering into the price.

But Stossel is taking direct issue with the way that these "quality" surveys are determined. They repeatedly say that the U.S. system doesn't "perform," but then use a completely biased and ridiculous way of making this judgment.

"The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes."

So, if the government ensures everyone gets the same level of inferior care, or if everyone has to wait four months for routine surgery, according to these surveys, the system performs better than ours according to these reports..
I did not lose the point of this thread, I was merely correcting some misconceptions.

You do make a good point here. Look at our wealthy economy. We eat, drink, drive, live in, and entertain ourselves how we want, when we want, and for as much as we want to spend. Why should our healthcare be any different? It's the best in the world, so why should we complain about the cost?

Hell, everybody in this forum drives either a Caddy or a Lincoln. Those cars are not cheap. Even if you bought it used for a pittance, I guarantee you've shelled out a few thou fixing it. I know I have. So why should I complain about the cost when I want the ability to accelerate effortlessly through traffic and punch buttons on a computer while I sit in the cockpit of my Mark? Same goes for the rest of you. If you're so cheap, go buy a used Civic and quitcher bitchin. See the obvious parallels to healthcare?



Posted by: Marcus

I have to go on a side track, sorry...

Quote:
Originally Posted by fossten View Post
1. Malpractice actions - these are the biggest offender, forcing healthcare costs through the roof. Lawyers like John Edwards have enriched themselves off the pocketbooks of insurance companies who have to pay up every time some doctor misses a diagnosis that caused Aunt Maude's dysentery to act up. Who do you think pays for that? Follow the trail - malpractice insurance companies raise premiums, doctor has to pay those, doctor raises prices, you pay more. Doctors also are being forced to practice defensive medicine to protect themselves from lawsuits, which means more tests and multiple diagnoses and prognoses for you every time you visit. They must cover every possibility in order to avoid being sued. This drives costs up as well.
This is the biggest myth of all, and just burns my britches every time it mentioned. Give me an example of a state that enacted tort "reform" where insurance rates went down. You can't. Even the insurance companies openly admit that tort reform will have little or no effect on malpractice insurance rates.



Posted by: fossten

Quote:
Originally Posted by TommyB View Post
I have to go on a side track, sorry...

This is the biggest myth of all, and just burns my britches every time it mentioned. Give me an example of a state that enacted tort "reform" where insurance rates went down. You can't. Even the insurance companies openly admit that tort reform will have little or no effect on malpractice insurance rates.
Uh...

That's baloney. You know zip about this subject. I personally view the documentation of three dozen healthcare providers per day and I can tell you that their malpractice insurance rates are COMPLETELY dependent on how often they and/or their colleagues in their specialty get sued. Malpractice insurance rates can climb into the six figures annually. So...

Wrong again.



Posted by: Calabrio

Quote:
Originally Posted by fossten View Post
Uh...

That's baloney. You know zip about this subject. I personally view the documentation of three dozen healthcare providers per day and I can tell you that their malpractice insurance rates are COMPLETELY dependent on how often they and/or their colleagues in their specialty get sued. Malpractice insurance rates can climb into the six figures annually. So...

Wrong again.
I have close friends who are doctors that confirm to me what Fossten says as well. Those high rates and liabilities also are discouraging some doctors going into the high risk/specializations.



Posted by: JohnnyBz00LS



http://www.centerjd.org/private/myth...alpractice.htm

Quote:
FACT: Limiting a patient's right to sue will do nothing to control insurance rates. A 1999 Center for Justice & Democracy study, Premium Deceit; The Failure of "Tort Reform" to Cut Insurance Prices, co-written by J. Robert Hunter, was the first-ever exhaustive look at the impact of tort restrictions on state-by-state insurance costs over the last 14 years. According to Hunter, "Despite years of claims by insurance companies that rates would go down following enactment of tort reform, we found that tort law limits enacted since the mid-1980s have not lowered insurance rates in the ensuing years. States with little or no tort law restrictions have experienced approximately the same changes in insurance rates as those states that have enacted severe restrictions on victims' rights." Following the release of Premium Deceit, spokespeople for the American Tort Reform Association (ATRA) agreed. Both ATRA's president and general counsel said in published statements that lawmakers who enact restrictions on consumers' legal rights should not expect insurance rates to drop.




Posted by: Marcus

Quote:
Originally Posted by fossten View Post
Uh...

That's baloney. You know zip about this subject. I personally view the documentation of three dozen healthcare providers per day and I can tell you that their malpractice insurance rates are COMPLETELY dependent on how often they and/or their colleagues in their specialty get sued. Malpractice insurance rates can climb into the six figures annually. So...

Wrong again.
Of course doctors in "high-risk" specialties are going to pay higher premiums. Tort "reform" isn't going to change that. The real issue, which you have failed to address, is whether capping claims has any effect whatsoever on insurance rates. Based on those states that have enacted tort reform, there is none. Rates have continued to skyrocket. In fact, some insurance companies have found that their liability has increased with award caps because litigants go straight for the maximum award, where they didn't before.

No one is arguing that malpractice insurance rates are astronomical. The question is what's causing them to rise, and what to do about it.

Many states have enacted tort reform, so we have some real-world examples of how well it works. Show me ONE example where rates declined or levelled off due to such "reforms".



Posted by: JohnnyBz00LS

More fodder......

http://www.insurance-reform.org/StableLosses2007.pdf

Quote:
Conclusion
Like earlier Stable Losses/Unstable Rates studies, this updated version analyzes what medical malpractice insurers have taken in and what they’ve paid out over the last 30 years, including during this decade when doctors were hit with skyrocketing medical malpractice insurance rates.

Its findings are startling. While insurer payouts per doctor directly track the rate of medical inflation, medical insurance premiums do not. Rather, they rise and fall in relationship to the state of the economy. This has been true for the last three decades and true for the last few years. Not only was there no “explosion” in lawsuits, jury awards or any tort system costs to justify the astronomical premium increases that doctors have been charged in recent years. These rate increases were rather driven by the economic cycle of the insurance industry, driven by declining interest rates and investments.




Posted by: Joeychgo

Quote:
Originally Posted by fossten View Post
3. I, too, had tendinitis, back in 1999. In both elbows. I knew what it was and rather than opting for the cortizone shot, I treated myself by wearing an elbow sleeve and by ceasing the activity that caused it. Finally went away after about a year.
Trust me, ask Jibit. I avoided going to the doctor, tried the sleeves, etc. It was so bad I could almost not lift a cup of coffee. Thats when I went.


Quote:
Originally Posted by fossten View Post
4. Fee schedules? What you're advocating is socialistic healthcare, just like Hillary wants. What you don't realize is that the unintended consequences of this will result in very poor quality of healthcare in this country.
I might not have explained my thought well. I want to have a way to compare Dr A's fees to Dr B's fees. I dont want to dictate their fees, just have a way to compare costs before I choose a Doctor. In a free market, comparing fees is one way of choosing service.

Quote:
Originally Posted by fossten View Post
6. COBRA is designed as an incentive to find new employment or to purchase your own plan. I'm glad you found a cheaper alternative,
On this one, your wrong. The idea of COBRA was so that you could maintain health insurance inbetween jobs.

The part that bothered me about the COBRA thing was this. Accirding to the Dept of Labor "Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan." -- Why can I get private insurance for $160 and employers are paying $600+ ? The 2 plans were comparable, so the variance doesnt make any sense to me. Healthcare is a major issue in our economy, so its something I wonder about.

Quote:
Originally Posted by fossten View Post
it's a market issue that the government should stay out of. Governments are not good at "helping" markets. They are better at hurting them.
Ah - thats where things get wierd. Healthcare shouldnt be a "Market", moreover, the end user, the consumer, is usually not the driving force. Its a game played by the healthcare providers and the insurance companies. Think about it, what role do you play in that "Market" that resembles a real free market?



Posted by: fossten

Quote:
Originally Posted by TommyB View Post
Of course doctors in "high-risk" specialties are going to pay higher premiums. Tort "reform" isn't going to change that. The real issue, which you have failed to address, is whether capping claims has any effect whatsoever on insurance rates. Based on those states that have enacted tort reform, there is none. Rates have continued to skyrocket. In fact, some insurance companies have found that their liability has increased with award caps because litigants go straight for the maximum award, where they didn't before.

No one is arguing that malpractice insurance rates are astronomical. The question is what's causing them to rise, and what to do about it.

Many states have enacted tort reform, so we have some real-world examples of how well it works. Show me ONE example where rates declined or levelled off due to such "reforms".
First of all, stop attributing the tort reform canard to me as I didn't bring it up. You did. You've made your point, but it is actually only tangentially relevant to my point about malpractice claims. Maybe you ought to point the finger at insurance companies instead of siding with the Shrillarites advocating socialization.

Second, show me ONE example of a country with a socialized healthcare system with a quality of care that rivals ours and I'll cede you a point. Until then...



Posted by: shagdrum

I would hope everyone realizes on average about 50% of a doctors income goes to malpractice insurance.



Posted by: JohnnyBz00LS

Quote:
Originally Posted by shagdrum View Post
I would hope everyone realizes on average about 50% of a doctors income goes to malpractice insurance.
More complete

http://www.azinjurycenter.com/CM/Cus...TruthAbout.asp

Quote:
4. Medical malpractice premiums have not increased rapidly over the last several years. "In fact, when adjusted for inflation, malpractice premiums dropped by nearly a third from 1991 to 2000. It would take a hike of 50 percent to bring rates back to their 1991 level. Insurer pricing practices, under-pricing in a soft insurance market followed by sharp increases as the market becomes more competitive - are the key culprit in the severe rate increases that are now occurring."

According to the 2000 Statistical Abstract of the United States, page 125, the Average Physician Salary has increased from $112,200 in 1985 to $199,600 in 1997. Average Malpractice Premiums increased from $10,500 to $14,200 in this same period of time. Thus, the percent of doctor's salary for malpractice premiums decreased from 9.4% to 7.1%.

According to the Health Care Financing Administration, doctor's salaries went up 41.7% from 1988 to 1998 while medical malpractice costs only went up 5.7% during this same period of time. Health care costs went up 74.7%.




Posted by: JohnnyBz00LS

Quote:
Originally Posted by fossten View Post
First of all, stop attributing the tort reform canard to me as I didn't bring it up. You did.
WRONG, from the 3rd post in this thread.........

Quote:
Originally Posted by fossten
1. Malpractice actions - these are the biggest offender, forcing healthcare costs through the roof. Lawyers like John Edwards have enriched themselves off the pocketbooks of insurance companies who have to pay up every time some doctor misses a diagnosis that caused Aunt Maude's dysentery to act up. Who do you think pays for that? Follow the trail - malpractice insurance companies raise premiums, doctor has to pay those, doctor raises prices, you pay more. Doctors also are being forced to practice defensive medicine to protect themselves from lawsuits, which means more tests and multiple diagnoses and prognoses for you every time you visit. They must cover every possibility in order to avoid being sued. This drives costs up as well.




Posted by: shagdrum

Quote:
Originally Posted by JohnnyBz00LS View Post
More complete
Yeah, "B.S." straight from the doctors mouth.

I got my info straight from doctors in my family.

I would trust this, as opposed to a law office that wants to color things in there best interest (against tort reform)

average salary of $199,000?! You do realize how meaningless that is. The few highly specialized doctors who make millons bump up the average for the rest. It's like saying the average income in the US is $125,000. Because we have a few very extremely rich people (like Bill Gates) that average (spread around) is going to jump up.



Posted by: JohnnyBz00LS

Quote:
Originally Posted by shagdrum View Post
Yeah, "B.S." straight from the doctors mouth.

I got my info straight from doctors in my family.

I would trust this, as opposed to a law office that wants to color things in there best interest (against tort reform)

average salary of $199,000?! You do realize how meaningless that is. The few highly specialized doctors who make millons bump up the average for the rest. It's like saying the average income in the US is $125,000. Because we have a few very extremely rich people (like Bill Gates) that average (spread around) is going to jump up.
Lest I remind you that YOU are the one who stated.........

Quote:
Originally Posted by shagdrum
I would hope everyone realizes on average about 50% of a doctors income goes to malpractice insurance.
If you got your numbers from your family member(s), then you are un-qualified to speak about "averages".





Posted by: Joeychgo

Quote:
Originally Posted by fossten View Post
Second, show me ONE example of a country with a socialized healthcare system with a quality of care that rivals ours and I'll cede you a point. Until then...
So your saying that we are not able to give high quality health care and universal health care coverage at the same time?



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
So your saying that we are not able to give high quality health care and universal health care coverage at the same time?
That is correct. Look at our universal education system, our universal failed "war on poverty" welfare system, and our POS federal tax system. Every time government gets involved it reduces quality to the lowest common denominator.



Posted by: rmac694203

Just an example that I heard the other day. My sister's bf and I were talking about Canada, and we got to healthcare. He told me that someone he knew had been living in Canada, and went to the doctor to get some help w/ an issue he was having. Doctor told him he had herpes. So, he starts being treated for herpes however he can, and ceases his sex life. It never really gets better and after a while of not getting help from his Canadian doctor, he went to a doctor in the US. The new doctor immediately knew it wasn't herpes, but was in fact crotch rot. Low and behold, soon after, it was fixed.



Posted by: Marcus

Let's all be realistic. Our healthcare system is a nightmare, and there's no evidence that it's getting better. This article pretty well sums up my thoughts:

http://www.pbs.org/wgbh/pages/frontl.../patients.html

From the last paragraph:

Quote:
Our civilization holds that some aspects of life should be off-limits to the market. Government, the police and fire departments, and the military should not be for sale; nor should profits be made selling sexual intimacy, or children for adoption. Our constitution recognizes a compelling public interest in religious free speech, and in unfettered discourse on public policy. Here, commercial interests have no standing. They should have none in medicine.
For the record, I'm against the government directly handling health care, if for no reason other than the fact that I don't trust them with my personal information. On the other hand, I think the government has an obligation to ensure that everyone is covered and given equal treatment, with profit not being a factor. A person's life should not rest on decisions by the "bean counters" in the accounting department, but by his doctor (novel idea huh?). It's disgusting and morally reprehensible that people die every day or suffer life-long debilitating illnesses in the richest nation in the world because it would put a dent in the bottom line. As the paragraph above states, the free market has its place and works wonderfully. But not in healthcare. After all, I can decide whether I want to spend my cash on that new plasma TV or car, but when it comes to my health and my family's health what choices do I really have? If I can afford it, I take it, period. If I can't afford it, I live with the risk that I'm one accident or illness away from either death or financial ruin. This is not the free market in action. It's a protection racket.

The inefficiencies built into the for-profit insurance industry end up wasting billions of dollars. The reams of paperwork (different for each company) that must be filled out by you and your doctors. The thousands of people each company hires to look over your files and decide whether they will pay for treatment or not. And the hundred other factors that add costs to the process outside of the costs of actual treatment.

So, while I don't trust the government to handle our healthcare directly, I do believe they have a role in reforming a system which has become corrupt and bloated, simply because no one else can or will do it. That means regulation, and possibly a change to a non-profit system. I know these words strike fear and loathing into the hearts of die-hard disciples of free-market capitalism, but the free-market is not the answer to all things. It certainly is not working in the case of health care.



Posted by: fossten

This is long, but worth it.

ABC’s John Stossel Provides a Welcome Change to Usual Health Care Spin
By Scott Whitlock | September 14, 2007 - 13:40 ET

On Friday’s "Good Morning America," token conservative reporter John Stossel told portly filmmaker Michael Moore, "Forgive me. More of us look like you" and that obesity explains why Canadians live longer than Americans, not universal health care. Stossel appeared on the morning show to promote his program debunking the myth of "free," government-run health care. His "20/20" special, which will air September 14 on ABC, includes a quarrel with the left-wing director.


Stossel’s appearance on GMA, and his conservative take, also strongly contrasts with the morning show’s own coverage of government controlled health care. In June, Moore appeared on the program to promote "Sicko," his movie bashing the United States system of private care. Back then, GMA co-host Chris Cuomo mildly questioned the filmmaker’s trip to Cuba to lavish praise on the communist country’s health system. After the director noisily objected to this offense, Cuomo backed down, saying, "Look, I like the stunt."

Another example that demonstrates the difference between Stossel’s take and the usual liberal spin provided by "Good Morning America" is the case of Karen Jepp. The "20/20" host explained, "Government rationing in Canada is why, when Karen Jepp was about to give birth to quadruplets last month, she was told all the neo-natal units she could go to in Canada were too crowded. She flew to Montana to have the babies." And yet, as noted on NewsBusters, GMA covered this exact story in August and the show's hosts never managed to explain why the Canadian hospitals were too crowded.

ABC and "20/20" should certainly be applauded for airing a non-liberal take on universal health care. In the special, Stossel will make points rarely heard on network television, such as noting that Canadians wait an average of 17 weeks for treatment, that one town in that country has "a lottery just to get an appointment with a family doctor." However, it would also be nice if John Stossel wasn’t such a lonely voice in providing a different perspective on this (and other subjects).

Perhaps conservatives shouldn’t be too optimistic about such a change. On Friday, Cuomo teased the contrarian segment by wondering, "Is free health care really the best health care?" As John Stossel will demonstrate on Friday night, calling it "free" health care, doesn’t make it so.

Stossel’s "20/20" special will air on ABC at 10pm on Friday, September 14.

A transcript of the September 14 segment, which aired at 8:43am, follows:

Chris Cuomo: "Now, when we come back, this is a very interesting question for us to look at. This doctor, when you go to see your doctor, what can happen in a country with free health care other than everyone being frozen in time. Like what you’re seeing right now. [Footage of people waiting in long lines to see a doctor.] Why are these people waiting in line? Is free health care really the best health care?"

8:43am

ABC Graphic: "Does Free Health Care Really Work? John Stossel Investigates"

Diane Sawyer: "As we know, it's one of the single most important decisions Americans have to make: What should the health care in this country be? Can it be made better? Is government health care the answer? ‘20/20's’ John Stossel has been asking that question and a lot more in tonight’s special hour ‘Whose Body is it Anyway? Sick in America.’ John looked at other countries' health care systems to see if they have better ideas. And he’s here to tell us some of what he found. John?"

John Stossel: "And a lot of Americans say government care is the answer, that health care in countries like France, Germany, Britain, Canada is great because it's free. Government pays and no one has to worry because free is great, right? But not so fast. It's why the British National Health Service made news by promising it would reduce wait times for hospital care to fewer than 18 weeks. But that's still more than four months. [Video of people waiting in line.] These people are waiting for a dentist appointment. Waits are so long, some people do it themselves. [Picture of a man with a missing tooth.] He used super glue. People pull their own teeth. Dental tools? Pliers and vodka. Government rationing in Canada is why, when Karen Jepp was about to give birth to quadruplets last month she was told all the neo-natal units she could go to in Canada were too crowded. She flew to Montana to have the babies."

David Gratzer (author, "The Cure: How Capitalism Can Save American Health Care"): "People line up for care. Some of them die. That's what happens."

Stossel: "Canadian doctor David Gratzer, author of "The Cure," thought the Canadian system was great until he started treating patients."

Gratzer: "The more time I spent in the Canadian system, the more time I came across people waiting for radiation therapy, waiting for the knee replacement so they could finally walk up to the second floor of their house."

Stossel: "People wait in line?"

Gratzer: "You want to see your neurologist because of your stress headache? No problem. You just have to wait six months. You want an MRI? No problem! Free as the air! You just got to wait six months."

Stossel: "But fans of Canada's system, like Michael Moore, point to the fact that Canadians live longer. Isn't that proof that the Canadian system is better, even if they have to wait in line?"

Michael Moore: "That's the line where they live three years longer than we do. That's the line I want to be in."

Stossel: "But Canadians live longer because of things unrelated to health care. Americans are three times as likely to die in car accidents and ten times as likely to be murdered. Take those factors into account, not to mention obesity, and Americans live longer than Canadians. In America, we kill each other more often. We shoot each other. We have more car accidents. Forgive me. More of us look like you."

Moore: "Me, yeah."

Stossel: "That's the reason they're living longer in Canada."

Moore: "I will say, in part, it's because they never have to worry about paying to go see the doctor."

Stossel: "They may not worry about paying to see a doctor, but they do have to wait on average 17 weeks to see a specialist. We found one town in Canada where they have a lottery just to get an appointment with a family doctor. But you can be seen within 24 hours if you meow or woof, because if you're a dog or cat, vet care is privately run."

Sawyer: "Privately run. All right. It is so hard to get perspective on this! Thank heaven you’re doing it. And it is tonight you can see all of it. ‘Whose body is it anyway? Sick in America,’ a special edition of ABC's ‘20/20' tonight at 10:00, 9:00 central. Good to see you, John."

It's only hard to get perspective on this because of lib wackos like you, Diane.



Posted by: shagdrum

Quote:
Originally Posted by TommyB View Post

So, while I don't trust the government to handle our healthcare directly, I do believe they have a role in reforming a system which has become corrupt and bloated, simply because no one else can or will do it. That means regulation, and possibly a change to a non-profit system. I know these words strike fear and loathing into the hearts of die-hard disciples of free-market capitalism, but the free-market is not the answer to all things. It certainly is not working in the case of health care.
Yes, the system is corrupt and bloated. But, when the government tries to "reform" anything, they just bloat it and add corruption. In fact, much of the corruption and bloated system can already be traced back to the government. The answer is not more government in health care, but less.



Posted by: Joeychgo

Quote:
Originally Posted by shagdrum View Post
Yes, the system is corrupt and bloated. But, when the government tries to "reform" anything, they just bloat it and add corruption. In fact, much of the corruption and bloated system can already be traced back to the government. The answer is not more government in health care, but less.

I honestly dont know what the answer is. Its a very complicated issue, but having 47 million americans uninsured isnt acceptable to me.

Further, those 47 million, when they do need medical care, pay through the nose because insurance companies are able to negotiate lower rates, the uninsured are not.

ALl I know, is that what we have now isnt working well, and isnt going to get better, only worse. So something needs to be done.



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
I honestly dont know what the answer is. Its a very complicated issue, but having 47 million americans uninsured isnt acceptable to me.

Further, those 47 million, when they do need medical care, pay through the nose because insurance companies are able to negotiate lower rates, the uninsured are not.

ALl I know, is that what we have now isnt working well, and isnt going to get better, only worse. So something needs to be done.
47 million is a myth. That number is false. Stop spewing falsehoods. You're just swallowing Michael Moore's bullcrap as gospel.

The fact is that 10 million of those people aren't Americans, they are illegals. Approximately 17 million people can afford health insurance and opt not to carry it. Furthermore, I posit that many of the remaining 20 million are single people under the age of 30 who don't even really NEED health insurance. I know when I was a 20-something I almost NEVER went to the doctor. Hell, I still don't. Either way, 20 million is only about 7% of the population, which is very small, not much larger than the unemployment rate (gee, what a coinkydink). Wise up, Joey.

EVERYBODY WATCH 20/20 TONIGHT!



Posted by: shagdrum

Quote:
Originally Posted by Joeychgo View Post
I honestly dont know what the answer is. Its a very complicated issue, but having 47 million americans uninsured isnt acceptable to me.

Further, those 47 million, when they do need medical care, pay through the nose because insurance companies are able to negotiate lower rates, the uninsured are not.

ALl I know, is that what we have now isnt working well, and isnt going to get better, only worse. So something needs to be done.

We have the best health care system in the world. It isn't perfect, but that doesn't mean its bad. It is interesting that this has never been an issue in america before the 1990's. Now it is a neccessity that everyone have health care! How did we ever survive until now? No one can justify it as a "right", they just claim it is (Tommy I am talkin at you here). Well the fact of the matter is that it isn't a right. Besides, when the numbers are crunched, this country couldn't afford healthcare like Canada for its citizens.

Joey, you are missing the other side of things. First, everyone in America already has healthcare to a degree because hospitals are required by law to provide life saving and stablizations services reguardless of if someone can pay. Second the biggest group of people paying less then the going cost for certian procedures isn't people with insurance, it is those on government programs like Medicare and Medicaid. Those programs set the price they will pay for a given procedure and it is most always less then what the going rate is. The doctors have to make up the cost by charging other patients that aren't on medicare and medicare; basically, those with insurance. So don't try that "people with insurance pay lower rates" argument. It is inaccurate and misleading.



Posted by: Calabrio

-that's the most incredible thing about this debate, as MM broke it down based on the 47 million myth- what they want to do is ruin the health care system for 93% of the population in order to accommodate the uncovered 7%



Posted by: Joeychgo

How about US news?


One of the consequences of higher health insurance costs, Altman noted, has been the rise in the number of uninsured, which reached 47 million in 2006, a 5 percent increase over the previous year.

Health Insurance Costs Rise Again


Thats my source - Ive never even been to Michal Moore's website.

Here are a few more. How about the CDC? Good enough for you? Or are they working for Michael Moore too?

In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8 percent of the population.
http://www.cdc.gov/od/oc/media/press...07/b070625.htm


I know better then to quote Michael Moore around here.


shagdrum, I agree we have the best doctors and the best medical care in the US, however, that care doesnt extend to 100% of the population. I dont buy into the "its good enough" argument. I am sure you wouldnt buy that argument either if your family was one of those without insurance.



Posted by: Joeychgo

Quote:
Originally Posted by shagdrum View Post
So don't try that "people with insurance pay lower rates" argument. It is inaccurate and misleading.

Its a fact. Insured pay less then uninsured for the same procedure. People on government programs didnt enter into my statement. If 2 people go to the hospital for a broken leg and receive the same treatment, one insured one not, the bill for the uninsured will be dramatically higher.

While those who are poor may have their bill forgiven by the hospital, that wont apply to the family who is scraping to get by without insurance and lose thier house because someone has a heart attack or other serious illness.



Posted by: shagdrum

Quote:
Originally Posted by Joeychgo View Post
Its a fact. Insured pay less then uninsured for the same procedure. People on government programs didnt enter into my statement. If 2 people go to the hospital for a broken leg and receive the same treatment, one insured one not, the bill for the uninsured will be dramatically higher.

While those who are poor may have their bill forgiven by the hospital, that wont apply to the family who is scraping to get by without insurance and lose thier house because someone has a heart attack or other serious illness.
You realize, the more you argue, the smaller you are effectively claiming the group with health insurance problems is. The poor don't matter because they can have their bills forgiven. Now its about people who are "scraping by"...

The only way your claim can be seen as accurate is by looking at out of pocket cost. Of course the insured pay less then, because they just pay the premium while the uninsured pay the entire bill out of pocket. But that is obviously misleading. If they are "scraping to get by without insurance" then they are eligible for medicaid (weather they are smart enough to realize and apply for it is another story). Those people (as well as medicare patients) pay less for medical procedures then anyone. For the most part, if someone is not covered health wise it is do to their choices in life. They are not society's resposibility! No one has proven otherwise.

Even if there is a gap in medical coverage in some way, you must realize two things:
1: It isn't the governments job to make people equal, or to make life fair
2: Any gap between the classes would be magnified a great deal under more government control



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
How about US news?


One of the consequences of higher health insurance costs, Altman noted, has been the rise in the number of uninsured, which reached 47 million in 2006, a 5 percent increase over the previous year.

Health Insurance Costs Rise Again


Thats my source - Ive never even been to Michal Moore's website.

Here are a few more. How about the CDC? Good enough for you? Or are they working for Michael Moore too?

In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8 percent of the population.
http://www.cdc.gov/od/oc/media/press...07/b070625.htm


I know better then to quote Michael Moore around here.


shagdrum, I agree we have the best doctors and the best medical care in the US, however, that care doesnt extend to 100% of the population. I dont buy into the "its good enough" argument. I am sure you wouldnt buy that argument either if your family was one of those without insurance.
Sorry, those figures are incorrect. Mine are based on the United States Census. But as I've said to you before, I could hit you over the head with facts and you'd believe whatever you want. Jesus Himself could appear in front of you and you'd say He was just shilling for Bush.



Posted by: Joeychgo

Quote:
Originally Posted by fossten View Post
Sorry, those figures are incorrect. Mine are based on the United States Census. But as I've said to you before, I could hit you over the head with facts and you'd believe whatever you want. Jesus Himself could appear in front of you and you'd say He was just shilling for Bush.

Well, call the CDC and tell them. I didnt make it up, im sure they didnt either. I didnt bring bush into this whatsoever. This isnt about Bush. I dont care if there is 1 million without healthcare, its too many. I believe we can do better. What in the HELL is wrong with believing we can do better as a nation? Is it that you DONT want everyone covered for some reason? I said earlier, I dont know what the answer is, but I believe we can do better. Are you reallying saying that as a nation its totally ok to have some people unable to afford health care?



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
Well, call the CDC and tell them. I didnt make it up, im sure they didnt either. I didnt bring bush into this whatsoever. I dont care if there is 1 million without healthcare, its too many. I believe we can do better. What in the HELL is wrong with beliiving we can do better as a nation?
You really are a glass is completely empty kind of guy, aren't you? Can't look at it like, we have over 90% of the people in this country who have health insurance, eh?

I wonder, why weren't you crowing about this stuff when Clinton was president? After all, there were "millions of people" without healthcare coverage back then, too. Of course, his wife tried a government takeover of our healthcare system back then, and the smart people of this country didn't go for it. You wanna vote for her and see her try it again?



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
Well, call the CDC and tell them. I didnt make it up, im sure they didnt either.
The Congressional Budget Office states that 45% of the uninsured in this country are uninsured for four months or less. That's usually an employment flux issue, not an availability or inability to afford issue. So the 47 million uninsured claim is misleading at best, phony at worst.



Posted by: Joeychgo

Quote:
Originally Posted by fossten View Post
You really are a glass is completely empty kind of guy, aren't you? Can't look at it like, we have over 90% of the people in this country who have health insurance, eh?

I wonder, why weren't you crowing about this stuff when Clinton was president? After all, there were "millions of people" without healthcare coverage back then, too. Of course, his wife tried a government takeover of our healthcare system back then, and the smart people of this country didn't go for it. You wanna vote for her and see her try it again?
Nope - Im a "we can fill it a bit more" kinda guy.

And how would you know what I was or wasnt spouting when Clinton was President?

Finally, I havent decided who to vote for. I dont vote in the primaries since im not registered with any party. I wont decide until much closer to the general. Right now, I am not looking forward to the next election because I dont really like any of my likely choices for president.



Posted by: Marcus

Why is it that whenever someone wants to demonstrate the horrors of government-run healthcare, they always cite Canada, and then imply that if Canada's system is so bad, then ALL government-run healthcare systems must be bad? As if all government-run systems are equal? That's not the case. Germany has nationalized healthcare, and the wait times and quality of care are as good, if not better than the U.S. Speaking of which, the whole argument about wait times may be a myth. There are many procedures that Americans have to wait for, but it's because of delays by the insurance companies.

Here's an interesting article:

http://www.businessweek.com/magazine...8/b4042072.htm

The Doctor Will See You—In Three Months


The health-care reform debate is in full roar with the arrival of Michael Moore's documentary Sicko, which compares the U.S. system unfavorably with single-payer systems around the world. Critics of the film are quick to trot out a common defense of the American way: For all its problems, they say, U.S. patients at least don't have to endure the endless waits for medical care endemic to government-run systems. The lobbying group America's Health Insurance Plans spells it out in a rebuttal to Sicko: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care."

In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. "I completely freaked out," Susan says. "I couldn't imagine spending the summer with this hanging over my head." After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. "The system is clearly broken," she laments.

It's not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy.

All this time spent "queuing," as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn't get in to see their regular doctor, a significantly higher rate than in other countries.[Something that contributes greatly to your costs and mine]

There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.

The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says.

The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.

Few solutions have been proposed for lengthy waits in the U.S., in part, say policy experts, because the problem is rarely acknowledged. But the market is beginning to address the issue with the rise of walk-in medical clinics. Hundreds have sprung up in CVS, Wal-Mart (WMT ), Pathmark, (PTMK ) and other stores—so many that the American Medical Assn. just adopted a resolution urging state and federal agencies to investigate such clinics as a conflict of interest if housed in stores with pharmacies. These retail clinics promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick. We're quick."



Posted by: Calabrio

Why is it that whenever someone wants to extoll the virtues of some socialist system, they always cite examples from countries that in no way resemble ours.

Tiny little cultures with ethnic homogenized cultures can do things that we can't do in here. Let me restate that, they were able to do things longer than we could have. Ultimately all of these socialist systems are going to collapse, another aspect no one talks about.

As life spans increase and birthrates decline, how do you expect to pay for this cradle to grave government coddling?



Posted by: fossten

Quote:
Originally Posted by TommyB View Post
Why is it that whenever someone wants to demonstrate the horrors of government-run healthcare, they always cite Canada, and then imply that if Canada's system is so bad, then ALL government-run healthcare systems must be bad?
Because, Einstein, every time somebody (lefty like you) wants to bash the United States' healthcare system in order to promote a "Utopian" government-run healthcare system, they use Canada as an example. Canada is your torch, so the sword cuts both ways. Get used to it.

Do you so quickly forget that Michael Moore just put out a movie that FALSELY runs down the American healthcare system? Where the hell do you get off getting defensive about this? Talk about being able to dish it out and not take it.



Posted by: shagdrum

No one has explained yet why every American is entitled to health care. Until you do that, all other talk about health care is irrelevent.



Posted by: shagdrum

Quote:
Originally Posted by TommyB View Post
Why is it that whenever someone wants to demonstrate the horrors of government-run healthcare, they always cite Canada, and then imply that if Canada's system is so bad, then ALL government-run healthcare systems must be bad? As if all government-run systems are equal? That's not the case. Germany has nationalized healthcare, and the wait times and quality of care are as good, if not better than the U.S. Speaking of which, the whole argument about wait times may be a myth. There are many procedures that Americans have to wait for, but it's because of delays by the insurance companies.

Here's an interesting article:

http://www.businessweek.com/magazine...8/b4042072.htm

The Doctor Will See You—In Three Months


The health-care reform debate is in full roar with the arrival of Michael Moore's documentary Sicko, which compares the U.S. system unfavorably with single-payer systems around the world. Critics of the film are quick to trot out a common defense of the American way: For all its problems, they say, U.S. patients at least don't have to endure the endless waits for medical care endemic to government-run systems. The lobbying group America's Health Insurance Plans spells it out in a rebuttal to Sicko: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care."

In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. "I completely freaked out," Susan says. "I couldn't imagine spending the summer with this hanging over my head." After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. "The system is clearly broken," she laments.

It's not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy.

All this time spent "queuing," as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn't get in to see their regular doctor, a significantly higher rate than in other countries.[Something that contributes greatly to your costs and mine]

There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.

The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says.

The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.

Few solutions have been proposed for lengthy waits in the U.S., in part, say policy experts, because the problem is rarely acknowledged. But the market is beginning to address the issue with the rise of walk-in medical clinics. Hundreds have sprung up in CVS, Wal-Mart (WMT ), Pathmark, (PTMK ) and other stores—so many that the American Medical Assn. just adopted a resolution urging state and federal agencies to investigate such clinics as a conflict of interest if housed in stores with pharmacies. These retail clinics promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick. We're quick."
Your article gets its info from a bias source, which would be enough for you to discredit if you didn't agree with their position.

There are so many blatant holes in that article, I don't know where to start. They purposely leave things vauge in places to suggest what they want. In fact most every place you highlight, highlights a flaw in the article.

You can't truely be foolish enough to believe this article and question the waiting periods. Yes, you may be able to find incedental exeptions to the rule, especially if you are comparing apples and oranges (as in this article). But the fact remains that by and large the waiting times are MUCH larger in ANY universal healthcare system then in ours.

here is an interesting film on the subject:
http://www.onthefencefilms.com/video/brainsurgery.html

Basically, it comes down to incentive. Universal healthcare has none for the doctor, while ours still does. Under universal healthcare, a doctor is payed a set amount per day regardless of how many patients they see (the government may require a certian number, say 10-15). In our system, the doctor is payed by the patient. If he can see more patients in a day, thats more money. It really is that simple.



Posted by: Joeychgo

There is another side to that. There isnt any incentive to compete among most doctors. Do you chose a doctor based on any real criteria? Do you look at cost or quality of service? I think what most people do when choosing a new doctor is check to see who is signed up with their insurance company and is local to them.

We are not good consumers when it comes to medical care, and there isnt really a system to evaluate a doctor like we would a plumber or other professional. Even if there was, there is no incentive or reward to bother worrying about the costs of one doctor over another.



Posted by: shagdrum

Quote:
Originally Posted by Joeychgo View Post
There is another side to that. There isnt any incentive to compete among most doctors. Do you chose a doctor based on any real criteria? Do you look at cost or quality of service? I think what most people do when choosing a new doctor is check to see who is signed up with their insurance company and is local to them.

We are not good consumers when it comes to medical care, and there isnt really a system to evaluate a doctor like we would a plumber or other professional. Even if there was, there is no incentive or reward to bother worrying about the costs of one doctor over another.

Good point. The system isn't purely dictated by competition. There is already too much government involvement for that. Still, you choose your insurance company. You can always leave them for another, if you want.

We are talking about waiting periods for healthcare in socialist systems vs. the American system. In America, doctors have incentive to see more patients due to the profit motive. That incentive is removed in socialist systems.

I would be all for a pure capitalist system when it comes to health care, and insurance. By that I mean, take the government out of healthcare, and tort reform. That would bring the cost of healthcare down dramatically, and stop the squeeze on the insurance companies. Also, reform, or do away with the FDA.

Wouldn't agree that there isn't incentive to compete amongst doctors. They advertise all over the place. In addition, just because you may not have absolute choice, due to insurance limited opitons, you still can choose from a number of doctors. Like I said, you can switch insurance companies if you need more choices. You can't under socialist healthcare. Your doctor is already decided.



Posted by: Joeychgo

Well, switching insurance companies isnt a real option for most people since the insurance is provided by your employer. Plus, even if your employer gives you a choice of companies, you can only change one a year usually and then during specific times.

One example. I have a fiend with MS. She actually works IN a hospital. Her insurance no longer carries her Doctor, so unless she wants to pay the out of network costs, she cant see him. She doesnt like the 'replacement' doctor and has a hard time getting an appointment to see him. Her last flare up, she had to wait 2 weeks to get in.

I have another friend who recently wanted to see a podiatrist. She couldnt get an appointment in less then 10 days.

Your average Doctor doesnt advertise. I dont see too many "Come in for a physical exam today" ads. What you usually see advertised is elective medical such as plastic surgery kinda stuff.

You keep saying things like "take the government out of healthcare" - what does government do that causes problems like these? I am honestly asking because I dont really see alot of government involvement short of licensing kinda things. From what I see, insurance companies have alot more control.

Ultimately, I dont think individual people are really treated as customers. Insurance companies are, but people largely are not. And why should we? It costs us the same co-pay regardless of the doctor used. Doctors seemingly think nothing about making us wait to get an appointment or even for the appointment we already have.

I spent alot of time with Doctors when my Mother and Gradmother were sick and I can tell you, it was rate that we saw the doctor at 1:00 when that was the appointment time. Usually it was alot later before we actually got in.



Posted by: shagdrum

Don't have too much time to go into it right now (gotta go to a bachlor party; Titties and beer!!!), but the influence of medicare/medicaid on the medical field (and the precedent it sets for insurance companies), the FDA and its excessive procedures (almost 1 year to approve a flu vactination) and torts in addition to excessive government regulation are a good starting list. If I'm not too hung over tommorrow, I will put up some more specific things.

You also still admit that, you still have a choice when it comes to insurances, and therefore doctors. That choice may come at a price, but you still have the choice. That choice wouldn't be there (except for the ultra wealthy) in a socialist system.



Posted by: shagdrum

http://www.economist.com/finance/dis...ory_id=9407716

An unhealthy burden

Jun 28th 2007
From The Economist print edition


America's health-care market is not as unfettered as it seems

TO MANY outside the United States, America's health-care system might seem an example of capitalism at its rawest. Europeans and Canadians enjoy universal health care and cheap drugs thanks to government-run systems, the argument goes, but the market-based approach taken by the world's richest nation leaves many millions uninsured and leads the rest to pay the highest drugs prices in the world. Such doubts are sure to be reinforced by this week's release of Michael Moore's “Sicko”, a much-trumpeted new film on health care that bashes the free-market Yankee model even as it praises the dirigiste alternative north of the border.

So is America's health system really red in tooth and claw? Hardly, according to a growing body of academic evidence. As a result of interference at the federal and state levels, health care is one of America's most heavily regulated industries. Indeed, its muddled approach to health-care regulation may act as a massive drag on the American economy—what one expert has called “a $169 billion hidden tax”.



Costing an arm and a leg
That figure comes from a path-breaking study* of a few years ago by Christopher Conover of Duke University. It looked at the many ways in which the American legal and regulatory systems affect the provision of health services and lumped them into five categories: medical torts; the Food and Drug Administration (FDA); insurance regulation; and the certification of both health professionals and health facilities. His team concluded that the overall benefit to society of $170 billion per year delivered by this system of oversight was far outweighed by the $339 billion in annual costs that it imposed (see chart). Even ignoring the cost of big federal tax breaks for employer-sponsored health insurance (which Mr Conover left out), his study estimated that the net cost of America's health regulations resulted in perhaps 4,000 extra deaths each year and was responsible for more than 7m Americans' lacking health insurance.

Building on this point, a forthcoming paper† by Michael Cannon of the Cato Institute, a libertarian think-tank in Washington, DC, investigates the biggest federal component of this regulatory burden: the FDA's oversight of pharmaceuticals. It notes that some 20 cents out of every dollar spent by consumers goes on purchases under the purview of the FDA, which it calls “one of the most pervasive federal agencies in the country.”

Citing the best evidence to date on the costs and benefits of FDA regulation, Mr Cannon argues that the agency “is too slow and demands too much testing”, ultimately harming consumers. He points out that drugs regulators can make two broad types of errors. First, they might approve a drug too quickly, only to find out after its launch that it is dangerous or even deadly. Second, they could delay the launch of a highly innovative drug by demanding onerous or unnecessary trials and thereby deny many needy patients a new therapy.

Proper regulation requires balancing these two risks, but the pitch may be queered by bureaucratic self-interest. If the regulator allows even one drug to slip through the approval process that later proves harmful to some people some of the time, a hue and cry is sure to follow. Look no further than the recent public backlash against the FDA after several deaths were linked to Vioxx, a blockbuster pain remedy made by Merck.

And yet the second (and probably bigger) risk of leaving people untreated because of restrictions on drugs rarely gets the regulators into trouble. As Mr Cannon puts it, “no FDA official has ever been fired or faced a congressional inquiry for delaying the approval of a promising new drug, however unjustified the delay.” What is more, he speculates, big drug firms may quietly acquiesce to this burdensome red tape because it acts as a barrier to entry against newcomers without the cash or lobbying power to navigate the FDA.

The FDA's caution may result in the biggest federal “tax” on health care identified by the Conover study but an even bigger component is to be found in America's distorted system of malpractice insurance, which is regulated at the state level. That is the conclusion of John Graham of the Pacific Research Institute (PRI), a think-tank in San Francisco. In a paper†† published this month, Mr Graham has taken Mr Conover's federal analysis and applied it to all 50 states. The idea is to rank which states allow Americans the greatest amount of “health ownership”.

Mr Graham's analysis concludes that because regulation of health insurance and overzealous pursuit of medical torts are both typically handled at the state level, states are to blame for most of that $169 billion annual burden imposed by excessive health-care regulation (as the chart also shows). The heavy-handedness, he notes, includes groups of surgeons being denied permission to open specialist clinics because rival one-size-fits-all hospitals invoke state regulations protecting their patch. Meanwhile, enterprising “nurse-practitioners” are blocked from offering simple treatments at inexpensive clinics by state rules requiring costly supervision by doctors.

New York—a liberal bastion and home to Hillary Clinton, who in the 1990s unsuccessfully advocated a sweeping reform of America's health provision—comes out rock bottom on the PRI ranking of health freedom. That will undoubtedly please conservatives who still deride her earlier proposals for a government-run health system, which they dub “HillaryCare”. But the unstated and awkward inference of these studies will not. If America's health-care regulations are as costly as they claim, the system is merely masquerading as a free-market model and may be no better than others.



* A Review and Synthesis of the Cost and Benefits of Health Services Regulations", Christopher Conover, Duke University, July 2003.




† "Do Economists Reach a Conclusion on the Food and Drug Administration?", Michael Cannon, Cato Institute, forthcoming.



†† "US Index of Health Ownership", John Graham, Pacific Research Institute, June 2007.



Posted by: fossten

I watched Stossel's 20/20 special, and I'm convinced that one of the biggest reasons for high healthcare prices, at least with the little things, is the very existence of health insurance. Think about it - with insurance, there's no incentive to shop for bargains b/c someone else is paying the bill. There is no incentive for providers to keep costs down because somebody else is paying the bill. Insurance actually quells the free market.

So people like Hillary want insurance coverage across the country, which will cause prices to go even higher.



Posted by: Joeychgo

Quote:
Originally Posted by fossten View Post
I watched Stossel's 20/20 special, and I'm convinced that one of the biggest reasons for high healthcare prices, at least with the little things, is the very existence of health insurance. Think about it - with insurance, there's no incentive to shop for bargains b/c someone else is paying the bill. There is no incentive for providers to keep costs down because somebody else is paying the bill. Insurance actually quells the free market.

So people like Hillary want insurance coverage across the country, which will cause prices to go even higher.

I didnt see the 20/20 special. But yes, this is part of my point all along. Our health care system doesnt make sense to me because of this. Its not really a competitive market and our consumers are not good consumers either because the real customer of health care is insurance companies.

I dont think just giving insurance to everyone is the answer either. I really dont know how to solve the problems. What I do know, is that what we have now isnt the best we can do.



Posted by: shagdrum

Quote:
Originally Posted by Joeychgo View Post
I didnt see the 20/20 special. But yes, this is part of my point all along. Our health care system doesnt make sense to me because of this. Its not really a competitive market and our consumers are not good consumers either because the real customer of health care is insurance companies.

I dont think just giving insurance to everyone is the answer either. I really dont know how to solve the problems. What I do know, is that what we have now isnt the best we can do.

That last post of mine says it best, I think. Basically, we have a half-assed universal health care. All of the drawbacks from a socialized system, none of the benifits. Still there is some competition in our current system which makes it better then the socialized ones. Ultimately, the answer is less government (esp. FDA) and tort reform.



Posted by: Joeychgo

The only real competition in our system is among insurance companies, medical people and employers. Notice, the patient isnt really in that mix?

As a general rule, you get the insurance your employer offers (if they offer).

Generally, employers are not looking at providing the best health care for their employees, they are looking out for their bottom line and own self interests.

Hospitals, doctors and insurance companies negotiate pricing amongst themselves.

The patient is pretty much left out of the mix.

Now, you do have the option of not using the employer offered insurance and instead paying for your own choice of insurance out of your own pocket. But even if you choose to do that, the employer doesnt credit you the money they would have spent on insurance for you. You just lose that and spend more to get your own insurance. Moreover, if you have an ongoing condition such a diabetes, you may not be able to get that covered if you go to private insurance. (pre existing condition)

So you dont REALLY have much of a choice there. Hence, there is no real competition.

And, if your employer doesnt offer insurance, which usually is the case for lower paid jobs, and you cant afford to buy insurance on that lower income salary, then you can get health care if you are in a life threatening situation. But if you cant pay the bills, you face alot of other issues, like your credit being destroyed or losing what little assets you might have.

I knew a bankruptcy attorney once. He was a good friend. He once told me that most of the bankruptcies he did involved medical bills and that they were usually the trigger for a BK.

You've mentioned tort reform on a few notes. Clearly malpractice insurance plays a part in all this. Doctors order all kinds of tests that are really not necessary, but they are covering their backside.

Like I have said before (in another thread) -- I got a cortizone injection in my elbow. 1 doctor visit, medicine was $15, the rest of the bill (after insurance discounts) was $285. Seems high to me. Insurance didnt pay because it was a "surgical procedure" so it went to my deductible.

Anytime it costs an insured person $285 for an injection of $15 worth of medicine, there are problems in the system. Plain and simple.



Posted by: shagdrum

Quote:
Originally Posted by Joeychgo View Post
The only real competition in our system is among insurance companies, medical people and employers. Notice, the patient isnt really in that mix?

As a general rule, you get the insurance your employer offers (if they offer).

Generally, employers are not looking at providing the best health care for their employees, they are looking out for their bottom line and own self interests.

Hospitals, doctors and insurance companies negotiate pricing amongst themselves.

The patient is pretty much left out of the mix.

Now, you do have the option of not using the employer offered insurance and instead paying for your own choice of insurance out of your own pocket. But even if you choose to do that, the employer doesnt credit you the money they would have spent on insurance for you. You just lose that and spend more to get your own insurance. Moreover, if you have an ongoing condition such a diabetes, you may not be able to get that covered if you go to private insurance. (pre existing condition)

So you dont REALLY have much of a choice there. Hence, there is no real competition.

And, if your employer doesnt offer insurance, which usually is the case for lower paid jobs, and you cant afford to buy insurance on that lower income salary, then you can get health care if you are in a life threatening situation. But if you cant pay the bills, you face alot of other issues, like your credit being destroyed or losing what little assets you might have.

I knew a bankruptcy attorney once. He was a good friend. He once told me that most of the bankruptcies he did involved medical bills and that they were usually the trigger for a BK.

You've mentioned tort reform on a few notes. Clearly malpractice insurance plays a part in all this. Doctors order all kinds of tests that are really not necessary, but they are covering their backside.

Like I have said before (in another thread) -- I got a cortizone injection in my elbow. 1 doctor visit, medicine was $15, the rest of the bill (after insurance discounts) was $285. Seems high to me. Insurance didnt pay because it was a "surgical procedure" so it went to my deductible.

Anytime it costs an insured person $285 for an injection of $15 worth of medicine, there are problems in the system. Plain and simple.

Like I said, there is some competition. You always have the option of buying private insurance. In a socialized system, there is no competition. You have the states health care and thats it. If they don't cover what you what, you are out of luck. There definately could be more competition in the current system today. Basically it boils down to two possible solutions for health care; more government regulation or less government regulation. The people who are pushing health care as a major problem want more government even though the heavy government involvement in healthcare is causing the problems today. I don't agree that there is a major problem with the health care system. It isn't perfect, but it is still the best in the world. Where I wanna see reform is in the FDA and tort reform. The problem is, none of those two is likely.

Remember "not much of a choice" and "absolutely no choice" are two completely different things.



Posted by: fossten

Quote:
Originally Posted by Joeychgo View Post
The only real competition in our system is among insurance companies, medical people and employers. Notice, the patient isnt really in that mix?

As a general rule, you get the insurance your employer offers (if they offer).

Generally, employers are not looking at providing the best health care for their employees, they are looking out for their bottom line and own self interests.

Hospitals, doctors and insurance companies negotiate pricing amongst themselves.

The patient is pretty much left out of the mix.

Now, you do have the option of not using the employer offered insurance and instead paying for your own choice of insurance out of your own pocket. But even if you choose to do that, the employer doesnt credit you the money they would have spent on insurance for you. You just lose that and spend more to get your own insurance. Moreover, if you have an ongoing condition such a diabetes, you may not be able to get that covered if you go to private insurance. (pre existing condition)

So you dont REALLY have much of a choice there. Hence, there is no real competition.

And, if your employer doesnt offer insurance, which usually is the case for lower paid jobs, and you cant afford to buy insurance on that lower income salary, then you can get health care if you are in a life threatening situation. But if you cant pay the bills, you face alot of other issues, like your credit being destroyed or losing what little assets you might have.

I knew a bankruptcy attorney once. He was a good friend. He once told me that most of the bankruptcies he did involved medical bills and that they were usually the trigger for a BK.

You've mentioned tort reform on a few notes. Clearly malpractice insurance plays a part in all this. Doctors order all kinds of tests that are really not necessary, but they are covering their backside.

Like I have said before (in another thread) -- I got a cortizone injection in my elbow. 1 doctor visit, medicine was $15, the rest of the bill (after insurance discounts) was $285. Seems high to me. Insurance didnt pay because it was a "surgical procedure" so it went to my deductible.

Anytime it costs an insured person $285 for an injection of $15 worth of medicine, there are problems in the system. Plain and simple.
You don't like the price, so there's something wrong with the system? That's absurd. Did you shop around? Do you complain about the system every time you don't like a price on anything, or do you just look elsewhere? But you chose to pay it. I also had tendinitis and I chose NOT to pay for a surgical procedure and instead just waited for it to go away, which it did. So we do have choices that are money oriented. You also could have shopped around for a cheaper rate by just asking the price of the procedure. If you didn't know you could do that, well sorry.

Hillary's plan takes away ALL choice for EVERYBODY by mandating that every family has healthcare coverage. What will happen is that the government will determine what doctor you can go see, when, and what procedure you can qualify for. To extrapolate, you might have to wait 6 months for a cortizone shot and you'd have to qualify for it. By that time the pain's almost gone, so what's the point? Say bye bye to your choice.

Socialized medicine the likes of which Hillary will foist on this country will take away competition, incentive to innovate, incentive to lower costs, and incentive to pursue medicine as a profession.



Posted by: Joeychgo

Quote: