Healthcare Reform?

[SinA]

Surely something should be done to change the atrocious mess that is our current healthcare system.

For one, it currently focuses on disease treatment rather than prevention.
It's also basically government subsidized drug dealing.
And if that weren't enough the whole system is racist, classist, and generally corrupt.

I'm usually moderate or anti-socialist about most things, but this is a case where I think more regulation/oversight would help us (the people) get back on track. In fact, I think that if the government offered affordable public-healthcare (optional, buy-in, etc) that it would compete with other providers.

[SinA]

Don't wan't to talk about it? Fine.

When you get sick, don't say that SinA didn't try.

[Fat_Sunny]

SinA, It's A Good Topic, You Just Need To Entice People In With A More Exciting Thread Title. Try One Of These:


Hayden Panettiere's Thoughts On Healthcare Reform

Anorexic Angelina Jolie Loses More Weight Over Healthcare Reform Worries

2007 New York Yankees Healthcare Reform Listening Thread


Just Improve The Bait...And You'll Up The Response!

[HBox]

Don't wan't to talk about it? Fine.

When you get sick, don't say that SinA didn't try.

I've tried this a few times over my career on the board and I've had the same response. Bottom line: No one REALLY cares until they get REALLY sick.

[SatCam]

I've tried this a few times over my career on the board and I've had the same response. Bottom line: No one REALLY cares until they get REALLY sick.

thats how it was with you, right?

[KC2OSO]

Ever wonder where all the money goes? (http://en.wikipedia.org/wiki/Medicare_Prescription_Drug%2C_Improvement%2C_and_M odernization_Act)
What a mess.

[prothunderball]

I've tried this a few times over my career on the board and I've had the same response. Bottom line: No one REALLY cares until they get REALLY sick.

I'm not really sick, and I do care, I'm just almost a little sick of talking about it at this point. There was already a whole lot of talk about it in the Sicko thread. For me it's really coming down to that I really don't know what the answer is, but something has to be done. The thought of my health care being in the hands of the Government scares me, but then I realize that right now it's in the hands of a bunch of greedy corporations and they certainly aren't handling it well, so maybe we should give the government a shot. I don't know if they could do much worse.
anyways yeah I don't know, and I'd be really surprised if anything gets done about it anytime soon.

[HBox]

thats how it was with you, right?

Pretty much.

[Recyclerz]

The REAL bottom line of this problem is that life is still pretty good in the US so nobody wants to die. Well, almost nobody, and we won't even let those who do want to die die because it is Jesus' job to wack people and we shouldn't be so presumptuous to get in His way.


The only real way to have a reasonable health care system in this country is to have a flat out honest debate, like adults, about what we want it to do and then how much we're willing to pay for it. The two questions are inextricably linked and you can't answer one without the other. The only way to control costs is to ration care. The only way to make the system fair and accessible to everyone is to control costs. Right now those who have good coverage tend to milk the system because they pay less than full price as individuals. Those who don't have coverage miss out on what should be cheap and effective treatment in way too many cases. It boils down to the essence that those who have good coverage now are going to have to give up some of what they have to make the system more rational. What do you think the odds are of that happening voluntarily?

[HBox]

Read this craziness. (http://www.latimes.com/news/la-fi-reddy8jul08,0,2089992.story?coll=la-tot-topstories&track=ntottext)

[SinA]

The REAL bottom line of this problem is that life is still pretty good in the US so nobody wants to die. Well, almost nobody, and we won't even let those who do want to die die because it is Jesus' job to wack people and we shouldn't be so presumptuous to get in His way.



true. also, i blame the mormons for a lot of our problems. don't they know we're on the verge of a domestic over-population crisis, and marie osmond has eight kids?

[scottinnj]

I'm not sick, and I'm willing to discuss this too. I'd like to have a debate on the French system. HBox, thanks for all the help in finding good links for that.
It's a really cool system, and it could work here if we really try. Or at least come up with a working plan that is based on that model. Give and take on both sides though. I'm willing to see some taxes go up if I can get premiums down and maintain the level of healthcare we get from my wife's policy. Or maybe I'll go to a policy at my job, we'll split the difference and get good care with a combination of the two plus the tax money that is withdrawn from my check.


We'll see.

[scottinnj]

Read this craziness. (http://www.latimes.com/news/la-fi-reddy8jul08,0,2089992.story?coll=la-tot-topstories&track=ntottext)

Dude, that is what happened at my wife's first hospital she worked at when she graduated from college. A bunch of fuckos came in bought it up and added it to a chain of hospitals they had all over the Midwest. They tried to fuck over senior citizens on Medicare payments and were busted and wound up losing the whole thing. I forget if anyone was indicted or put on trial though. The douche bags really fucked over a lot of people vis a vie Enron.

[scottinnj]

Read this craziness. (http://www.latimes.com/news/la-fi-reddy8jul08,0,2089992.story?coll=la-tot-topstories&track=ntottext)



Dude, the fun shit is at the bottom of the story:

Examples of price changes for selected services and products at Desert Valley Hospital

2005 2006 Percent
Service charge charge change
Use of mechanical ventilator, first day $256 $6,144 +2,298%
CL drug-eluting stent, to prevent blood clots $16,000 $63,900 +334%
Vaginal delivery in maternity ward $1,475 $4,061 +175%
One-hour ambulatory surgery $2,500 $4,000 +60%
Blood test (CBC) $54 $76 +40%
Pacemaker, single chamber $32,500 $22,500 –31%
Angiogram $5,211 $2,957 –57%

[prothunderball]

Dude, the fun shit is at the bottom of the story:

well you good as long as your only health concern is heart problems.

[HBox]

CL drug-eluting stent, to prevent blood clots $16,000 $63,900 +334%

That would even strain Fezzie's wallet.

[HBox]

Here is an article from Malcolm Gladwell, author of The Tipping Point, examining "The Moral-Hazard Myth." (http://www.newyorker.com/archive/2005/08/29/050829fa_fact)

The theory of Moral hazard is the idea that when you give someone a good or service for free that they will consume more of that good or service. Which obviously makes sense most of the time but does it apply to health care? I think the answer is obvious but a lot of people feel differently and most of those people push Health Savings Accounts.

[scottinnj]

I'm 50-50 on that one HBox,
Dental coverage no matter where you go FUCKING BLOWS!!! I don't see a whole lot of potential abuse of people going to clinics for "free" healthcare if we get socialized medicine above what I see now of uninsured people going to emergency rooms for what is supposedly "routine" healthcare.
But there is always abuse no matter what system is being used. Hopefully the lawmakers will think of that and provide a way to cover the inevitable.

[empulse]

You have to get over the Profit is God hump. Too many people will say (like the dumbasses on air today did) that its up to the individual. I thought Ron was smarter than this (St. Bennington please forgive) but he actually said we don't know the factors as to why hospitals charge so much, we don't know their overhead cost. Here are the current excuses:

0- Drugs are expensive to research, and therefore its past (cost) onto you.

This is true...initially. But drug manufactures can substitute an ingredient in a drug, rename it, renew the patent and call it new. Bullshit.

0- Trial lawyers, ooga booga bitches. They sue and sue and sue. doctors are afraid to deliver babies.

Trial Lawyers and malpractise actually only account for less than 1% of the costs associated with running a hospital.

0- You could have healthcare if only you tried harder, get a 3rd job. It's uniquely american.

Goddamn. I make 20+ an hour, and still can't afford it on top of Fuel, Food, Car Payment, Mortgage payment, and Marijuana addiction.


0- Anything other than corporate, for profit, healthcare that is based on dollars and cents, as oppossed to caring for the common good (thats in that constitution so many wipe their asses with daily) is nothing more than pinko commie socialist healthcare, we do that and suddenly our schools are all Madrasas , and our children will be homosexuals that goose step to school so they can pray to Bin laden.

God damn it people wake up. Anybody who answers to a board of directors doesn't give a flying fuck about you. And NO ONE IS PROPOSING SOCIALISED MEDICINE. That is the name given to health care for all by those who don't want it, those who love (and profit) from the current system.

0- Taxes.

You give 480 Billion to the DoD every year. SO they can keep fighting the coldwar.

The cost of this War has NEVER been figured into any budget, its now into the trillions.

Medicaid / Medicare prescription drug plan, was said to cost around 500 million, actually will cost BILLIONS. Not to mention the fact it removed any possibility of trying to negotiate a lower price with the drug companies. You support the troops? The fuck you do -- this bill also says the VA is NOT allowed to try and get drugs cheaper.

But people will still piss an moan about this evil tax and spend liberal idea while they get pounded in the ass by the drug companies and HMO's.

People in this country are brainwashed. They think everything has to be debated, not realizing that sometimes the argument against something is just made up shit, yet they still latch onto it in the name of their favorite football team..err political candidate /party.

[MadMatt]

What we need is a new revolution or civil war. And I wish I was kidding about that. I just don't see ANYTHING improving in this country without some kind of radical political change.

I'm not saying I want thousands or millions of people to die - I would definitely prefer non-violent means. However, nothing is going to get better until we change the system that is in place. The major political parties are too entrenched to be shaken loose by anything short of radical action.

[HBox]

I'm 50-50 on that one HBox,
Dental coverage no matter where you go FUCKING BLOWS!!! I don't see a whole lot of potential abuse of people going to clinics for "free" healthcare if we get socialized medicine above what I see now of uninsured people going to emergency rooms for what is supposedly "routine" healthcare.
But there is always abuse no matter what system is being used. Hopefully the lawmakers will think of that and provide a way to cover the inevitable.

Well the theory is that if you give the uninsured health coverage they will get preventative care which would immediately be an increase in spending but in the long term same shit loads more money by preventing more serious conditions and hopefully steering most away from ER care which is the most expensive kind. Unfortunately like in the article I posted above some people are figuring this out and exploiting it for their own gain. Which just goes to show that the free market is applying all the wrong kinds incentives to doctors and health care providers to the benefit of a few and the detriment to the nation as a whole.

But I'm just never going buy that Health Savings Accounts are the answer or that the problem is that people have too much insurance. It's important to the debate that it is honest. There is always going to be rationing of care and you're fooling yourself if you think it's not happening here and now. There is no system that is going to give everybody everything they want. limits will have to be made. But there are much MUCH better and more effective ways of doing so than what we have now.

[epo]

There are so many things wrong with healthcare that I can only do this one issue at a time.

Tonight's edition: Americans are big, fat, lazy slobs.

As we have evolved as a culture, we've become a very lazy people. Men that would have been lumberjacks are now accountants. The farmer is now a technical writer. The ditch digger is now a quality engineer. Those old jobs involved work and sweating. We burned carbs. Now we sit at desks all day and drink soda.

So how does our culture evolve? We eat more food and that food is fucking awful for us. The result of this is that we are the fattest culture in the history of mankind (http://www.healthseminarsinc.com/home.htm).

How do we fix this problem? Of course the answer is that we all eat better & exercise. All of our BMI's should be at least below 30 (http://www.nhlbisupport.com/bmi/).

The question is do we have the willpower to push ourselves away from the dinner table & run to the YMCA (http://www.ymca.net/)? Until we do alot of preventative work, no matter how we cook the pie we are in alot of trouble as a culture.

[HBox]

I'd hope that any kind of health care reform would include healthy living incentives. Whether we still get health care through insurance companies or the government I'd hope people who don't smoke, eat healthy, keep their cholesterol down and exercise regularly would get breaks on their premiums/taxes. Small companies have been experimenting with this as a way to reduce health care costs with encouraging results.

[scottinnj]

Well the theory is that if you give the uninsured health coverage they will get preventative care which would immediately be an increase in spending but in the long term same shit loads more money by preventing more serious conditions and hopefully steering most away from ER care which is the most expensive kind.

That is why I kinda liked the part in Obama's health care plan that talked about the importance of preventative medicine. That is why I was wondering if we can't just split preventative care from the traumatic stuff. Have private insurance be responsible for checkups and tests, and minor surgeries such as skin tags, vasectomies, tooth extractions etc.
When something more serious is diagnosed during a doctor visit, then have the government's part of healtcare step in and do the part of paying for open heart surgery and emergencies and such.
That way health insurance rates will go down, because the insurance companies won't have to worry about catastrophic stuff, and the federal side of spending won't go nutty because it won't have to worry about the day to day costs of healthcare that could otherwise be spent on the serious life saving stuff.

[HBox]

That is why I kinda liked the part in Obama's health care plan that talked about the importance of preventative medicine. That is why I was wondering if we can't just split preventative care from the traumatic stuff. Have private insurance be responsible for checkups and tests, and minor surgeries such as skin tags, vasectomies, tooth extractions etc.
When something more serious is diagnosed during a doctor visit, then have the government's part of healtcare step in and do the part of paying for open heart surgery and emergencies and such.
That way health insurance rates will go down, because the insurance companies won't have to worry about catastrophic stuff, and the federal side of spending won't go nutty because it won't have to worry about the day to day costs of healthcare that could otherwise be spent on the serious life saving stuff.

Do you want to know what that sounds a lot like? John Kerry's health care plan. His plan was to have the government step in and pay for care for catastrophic care thereby limiting insurance companies liabilities and hopefully lowering insurance costs across the board.

The problem is the 80/20 rule. 80% of health care spending is used by the sickest 20%. Going even further than that the top 1% account for 22% of health spending and half the population has virtually no health care expenses.

So the problem with that is that the government would be paying for something like 80% of health care costs without a guarantee of universal coverage. That is a shit load of money. It would require a big tax increase and meanwhile people will still be paying insurance premiums. And right now I can't think of ways that insurance companies will game that system but you know they will try.

It also begs the question: Why would insurance companies be necessary if the government is paying for so much health care? The whole idea behind insurance is that a group of people pay into what is essentially a fund and people who get into trouble take out money and those who never get into trouble subsidize it. It acts as a security blanket. However in this case the security blanket would be the government and insurance companies would just turn into glorified payment plans for routine procedures.

Let me put it another way: With the government covering all catastrophic illnesses insurance companies would not be insuring against any significant costs. The insurance companies would be able to predict within a very small margin of error what each person would spend every year on health care. Then they charge you that amount plus their administrative fee. Why wouldn't you just pay for the routine stuff yourself? Insurance companies would be useless.

If you are going to go that far you might as well just go all the way and let the government handle everything.

[scottinnj]

Now my head hurts. What would be a good way to split it up? My mom and dad get cortizone shots sometimes for their back and hip problems, which could be covered under the current insurance policies, but the spinal fusion stuff go to the government. Right now the government is paying 80 percent of both. The coritzone shots are very expensive but can be administered in a profitable way by the insurance companies, but the fusion surgery is astronomical. If that part was taken off the insurance companies till they could do more to cover the stuff that is everyday with better incentives or something. Also take the prescription drug coverage off the government part and put it on the insurance part and that should save some dough too. Make an exception though for IVIG (Intravenous Immune Globuline and IVAB (Intravenous Anti-Biotics) and other IV therapies (enteral, chemotherapy, TPN) which could be placed on the government side which while expensive, is not the enormous amount that overwhelms Medicare right now.

I don't know. I'm trying to think of some stuff here to make it better, but I'm just banging my head here.

[HBox]

American Health Care waiting times. (http://www.medicalnewstoday.com/medicalnews.php?newsid=76295)

While the problem has been largely overlooked by the major media, it was quietly exposed by the chief medical officer of Aetna, Inc. late in Aetna's Investor Conference 2007 in March.

In his talk, Troy Brennan conceded that "the (U.S.) healthcare system is not timely." He cited "recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable," Brennan said.

Brennan also recalled that he had formerly spent much of his time as an administrator and head of a physicians' organization trying "to find appointments for people with doctors."

While Brennan's comments went unreported by the media, his data matches several studies and a report in a June 22 Business Week article which opened by citing the case of a New York woman who had to fight for a timely second exam following suspicious results from a first mammogram and then still had to wait a full month.

[high fly]

We must decide how much we value our fellow citizens and whether everyone should get good health care in a country as wealthy and as allegedly generous as ours.

National health care systems in many other countries outperforms ours in quality of results as well as in costs.

Right now 15% of our population is without health care and that number is rising and there is no indication it will stop rising. This is because costs of health care are rising faster than incomes. An editorial in the Washington Post by a couple of chaps from Aetna said "the number of adults without health insurance increased by 2 million from 2005 to 2006."

We need to get beyond cliches and scare words like "rationing" and "socialism." Those words are used to hide from addressing the situation.
Imagine the same folks squealing about "socialism" arguing against public schools back when our popultion was 80% illiterate.
Notice that those who use the word "rationing" or speak of long lines at medical clinics are never concerned with the 45 million who are rationed right on out of the system entirely and are not able to even get in the back of the line.


A case that helped me change my mind took place about 25 years ago when an in-law had a child born with 2 holes in his heart. The bill the first day was over $100,000 and soaked up every bit of their insurance.
Their church and fund raisers helped, but the family had to declare bankruptcy. The parents, in order to get government assistance had to give up their careers and work menial jobs so they didn't make too much money.
They had 2 other children and the whole family was condemned to being poor and living in a subsidized house in a crappy neighborhood with no way out because of the costs of continual treatment of their child.

We have all seen case after case after case like this.
And I don't want to hear about the cost when we are spending $2 billion a week in Iraq and total costs will be well over a trillion by the time all is said and done, and at the same time are planning to send a space ship to Mars.


I say it's time we took better care of our own.