Another chance to argue over American health care.

Thanks for the well thought out insult, Jones.
Having lived under the vaunted NHS for a long period before a mass of Britons switched to more privatized care, I thought the emergency care was wonderful, but the routine, everyday care left a lot to be desired.

Ours is not a problem of access, necessarily, but of paying for the best care available across the board. Most of you want someone else to pay for it, it seems.

 

Want nationlized healthcare, look no further than the current VA system. Some of my friends are vets and the way they're treated there? I think I will take my chance with my own health insurance.

 

Ah, the problems to which you refer with the VA system are fairly recent, and they have come because we have an administration that did not prepare for massive casualities and did not particularly care about funding the national economy in a sensible fashion. (Taxcuts in wartime! Whoo-hoo!) This is the latest mantra -- we hate government so we fucked it up so, therefore, government doesn't work.

 

Yeah, but changing the oil in my car doesn't cost $200.

The last time I tried to go to a doctor, several years ago, I was told that I needed a referral (or something, I don't remember exactly). I could pay for the routine appointment and try and get reimbursed, but it was unlikely I would be. That routine appointment was going to be something like $225. Granted, it was a specialist, but it was just a routine appointment. And I doubt it included blood work, etc.

The problem I see is that people who've been on insurance for a good long while have no true idea of just how much stuff costs anymore. Health savings accounts? I think they'd be depleted pretty quickly for most people.

The thing with the car analogy is that I have choices. If I want to save a little cash, I can go to a cheaper oil change place and it'll cost me 12 bucks. If I want a more complete inspection, I can go to the dealer for 50 bucks. If I want to be in and out in 15 minutes, I can go to a quick-lube place, where it might cost 30 bucks. That sort of choice doesn't exist in the health-care field.

And I'm sorry. Having read the vast numbers of stories of people being denied various treatments by insurance companies, I do not trust for-profit enterprise to make the best decisions regarding my health. If you want proof, go read that Jerry Brewer series on the girl with cancer. Her parents stopped cancer treatments, so the insurance company will now no longer pay for tests to check on the status of her cancer. Even if she got the miracle they're hoping for, they wouldn't be able to get conclusive proof.

I'm not saying nationalized health care would work. I am saying the current system doesn't.

 

Is the anxiety of worrying over bills really worth it? I shouldn't have to see co-workers debate whether to go to the doctor when they're going on their fourth week with a horrible cough.

I really don't see how national health care would cost us more than the current system. If we just transfer what we're already paying (and what the company we work for is picking up) into a tax system, we're already way ahead of the curve because we've eliminated the insurance company. Now of course there may be some additional costs, but to know that I won't be hassled to death when I'm sick (literally), I think it will be worth it.

 

Bingo.

The current system is like Alice in Wonderland: preventative care like physicals aren't covered, thus forcing huge expenditures down the line that could have been nipped earlier. But there is a huge disincentive to actually USE the services you (or your employer in some way, shape or form) are paying for.

Not quite two months ago, I went in for a routine checkup on some elements that were bothering me, including a pain in my stomach and lower back. An EKG revealed an irregularity that my doctor wanted to inspect further with a stress test.

Ultrasound, blood test, X-rays? No problem. But I can't get approval for a test my physician says I need. If that doesn't tell you something's terminally wrong with the current system, well, I don't know how to spell it out any clearer for you.

The system is broken, folks. And all the carping about "socialized medicine" won't fix it. This, in a nutshell tells you what's wrong.

The majority of the G-8 countries may pay a higher rate of taxes than we do. But at least they get something in return.

 

And privatized health care is only going to get more expensive, because, yes, the boomers are aging. And those employer-sponsored plans are going to get more and more expensive, and they're going to start disappearing, because they're simply not worth it.

My previous employer, over the course of about a year, first raised the biweekly premium about $8. Not too bad.

But when the plan came due for renewal, they changed it. The premium stayed the same -- about $70 a pay period. But, the first $1,500 in medical expenses weren't covered. BUT, the company knew what a hardship that would be, so they provided a $500 debit card -- which could be used after you spent $750. So you spent $750, used the card, then spent another $250, and then, and only then, did the coverage you were paying $140 a month for kick in. So, $2,800 came out of my pocket before I saw any benefit.

And that's gonna happen more and more. And that's what happens to those of us who have access to insurance. Doesn't even count those who don't. And tax credits aren't gonna fix it.

Any system where a doctor says "this is what you need," and the insurance company says "Nope, you can't have that" is broken. Any system where an actuary makes decisions about your health, rather than a doctor, is broken. We may have the best doctors and the best technology in the world, but our system doesn't work.

 

There is no doubt that change will occur in the American system to deliver medical care. I am uncertain as to what format might take or which might be the better system.

The current insurance model is broken because of many of the mandates that are required of insurance coverage. Should your insurance plan pay for artificial fertilization, birth control, vasectomies and Viagra or should those funds be spent on preventive medicine?

That said, I wonder about comparing statistics between countries. I cannot compare violent death rates among countries, but it takes many people to live past 80 to make up for one teen killed in an inner city gang shooting. High risk teen pregnancies will yield a higher infant mortality rate.

The big key will be what trade offs will occur in a new medical paradigm. Will people have true risk based insurance premiums; higher for smokers, those with DUI arrests or those participating in risky hobbies. do we "tax" those who are overweight? How do we pool risk if active people in Colorado do not want to be associated with Wisconsites?

How do we arrange to have access to physician care when the population continues to grow and no new medical schools have been opened in almost thirty years? If More people work in the health care field, how does that affect productivity and competition in other industries if a worker shortage develops?

Lots of question...sorry, no answers.

 

I have a family member who worked in several VAs in the 90s and they were just as fucked up then as they are now.

 

Well that will never happen so it's a moot point.

 

Good contribution DocTalk. And you're right. There are way more questions than there are answers at this point. Certainly, an incentive-based plan approach is one possible way to go. Ideally, the healthier your lifestyle, the cheaper your insurance. But how, then, do we address the issue of those who don't have those medically-harmful vices but are still in bad health (genetic heart problems, etc.)?

 

Yeah, that's a problem, but replacing the actuary with a government employee doesn't sound too great to me either.