Americans spend an average of $8,300 per person for health care per year.
45 million people have no health insurance at all.
Injuries and medical problems are the reason for about 60% of US bankruptcies and in the vast majority of those cases, the individuals had health insurance.
From the AARP (yes, I'm a member):
266,000 companies dropped health care coverage from 2000 to 2005. Just because you have health care through your employer now is no guarantee you'll have it tomorrow.
In recent years, the average employee health insurance premium rose nearly 8 times faster than income.
On page 24 of their health article: The Commonwealth Fund, a New York City-based foundation that supports research on health care practice and policy, estimates that health care reform will cost roughly $600 billion to impolement but by 2020 could save us approximately $3 trillion.
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I note the article did not say HOW they would reform health care. Everything I see indicates this will be a hybrid, not socialized medicine. The Republicans say socialized medicine. The Democrats say universal health care. The article did say that some experts favor a single-payer system similiar to Medicare or the health program offered to federal-government employees. I'm on the health program offered to federal government employees and there are no long lines, etc. It works great and I can choose which insurance plan I want. I've got Blue Cross Blue Shield at the moment. The article continues to say that all proposals being discussed today would build on our current system, which means private insurers nd the government will likely both play roles.
What wasn't mentioned in the article that bothers me is the decline of the quality of health insurance offered by those companies that retained health insurance. When my husband first went to work for a major corporation, his health insurance was much better than mine. Now, his insurance has a $2,500 yearly deductible per family member and doesn't cover nearly as much as it did before. More, there are rules and stipulations designed to make it less convenient to obtain care. [We both carry family plans to cover the other spouse and yes, it's more expensive but it also lessens the likelihood that we'll be uninsured if one of us loses our job.]
Most of my friends and family members are seeing a decline in coverage (the ones that are lucky enough to stay employed) and my daughter and her husband (small business owners) cannot aford to offer insurance to their employees and thus don't have decent health care themselves. I would sincerely like to see the government offer SOMETHING that covers basic needs.
The AARP Bulletin had an article about 9 people in Texas being responsible for 2,678 ER visits. One of the 9 was at the ER 100 times a year for 4 years. These individuals were middle-aged and spoke English. Some had histories of substance abuse and mental health issues.
[quote=lindajdunn;804545]I would sincerely like to see the government offer SOMETHING that covers basic needs.
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I just wish that it was cheaper for individuals to purchase health insurance. $300/month is not affordable.
I'm not sure about other states, but when I was in Michigan (1.5 years) I didn't have health insurance. I was a college student working part time until I increased my courseload and couldn't work at all. One of the people living in my apartment building was a pre-med student. He referred me to the Department of Human Services. I was able to get on the county health plan. The copay was $5 for doctor's visits, $5 for prescriptions and $10 for specialist visits. It wasn't perfect but it was something. Though it did really piss me off when I asked for a referral to an ENT and the nurse practioner just said no, and couldn't understand why I wanted to see one. This was after I explained to her more than once why. She then went to say that they don't have an ENT to refer me to anyway.
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Ahmadinejad's wife to Ahmadinejad: Why are you always smiling? Nobody likes you. http://www.youtube.com/watch?v=EjwyQnEdATA- Set Adrift on Memory Bliss by my loves BSB
My preference is not on your list of options, which seems to assume the status quo as baseline and sees everything as going "up" from there.
I would like to see LESS government involvement in health care. IMO this interference is one of the biggest reasons for the rising price of medical care. I would abolish Medicare and Medicaid for a start, and probably the VA system as well. I would eliminate most regulation of doctors, hospitals and pharmaceutical manufacturers. ( I am not talking about safety standards or licensing and training standards, but rather about the thousands of bureaucratic straws which are piled upon the camel's back by all tiers of government, things like reporting requirements and paperwork burdens. )
Consequently, you know how I voted. Not that I would have done otherwise in any event, but still.
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Use the Shift key, people! Keyboard manufacturers everywhere are ineffably saddened when you ignore what they made just for you!
My preference is not on your list of options, which seems to assume the status quo as baseline and sees everything as going "up" from there.
I would like to see LESS government involvement in health care. IMO this interference is one of the biggest reasons for the rising price of medical care. I would abolish Medicare and Medicaid for a start, and probably the VA system as well. I would eliminate most regulation of doctors, hospitals and pharmaceutical manufacturers. ( I am not talking about safety standards or licensing and training standards, but rather about the thousands of bureaucratic straws which are piled upon the camel's back by all tiers of government, things like reporting requirements and paperwork burdens. )
Consequently, you know how I voted. Not that I would have done otherwise in any event, but still.
Finally! A reasonable and valid opinion! Government is the PROBLEM, NOT the solution.
Three things though:
Safety standards aren't necessary. When companies aren't under artificial pressure from big brother (or is it "brotha'" these days?), they'll have more time for safety testing. Also, if for whatever reason that fails, the free market will make unsafe products unprofitable.
What we DO need from the idiots in Washington is TORT REFORM, to stop greedy crybabies from suing doctors and medicine companies. Now sometimes, people screw up, and that's part of life. But it has become very profitable to start wasting everyone's time and money by suing, so now doctors and medicine makers are under undue burdens, driving the cost of healthcare up.
BUILD A WALL. Illegal immigrants are like leeches, sucking this nation dry. They ride welfare (which shouldn't exist in the first place), healthcare, and sometimes have the nerve to sue LEGAL CITIZENS' companies/hospitals/etc. George W. Bush was soft on them, and hussein obama looks like he's going to be even softer somehow (I really wouldn't be supprised if he gave them a welcome package with their amnesty "Welcome to our country! Here! Have a Prius, a big welfare check, free medical care, a union job, classes taught in spanish, looser college admissions standards, and a big scholarship check! If you need anything else, just ask any hard-working American citizen!")
Oh, Jeez.... I know that's just a trollcall to provoke response, but let's have a look at reality.
When companies aren't forced to conform to safety regulation, not only do they frequently not do more testing, or improve their competitive position by being safer, but they go out of their way to cover up threats to health and safety in their products. We have decades of dangerous products to prove it.
Let's see: Ford Pinto. Decades of the auto industry fighting against safety regulations (things like seatbelts). Vioxx. Phen-fen. Thalidomide - well, we dodged that bullet, thanks to regulators. The tobacco industry (denying that it was addictive or bad for health when their internal documents proved they knew otherwise. In fact working their formulations to be more addictive, and denying it under oath.). The toy industry with toys that were poisonous or otherwise dangerous. The paint industry and lead paint. The entire meat industry as it works even now: with hormones, antibiotics, other additives, unsanitary conditions, and "downer" cows all coming towards your table. The list goes on and on. And, with the disparity of knowledge between producer and consumer, how is the consumer supposed to know that a particular car is a death trap, that their food is dangerous (how long ago is that peanut butter fiasco?), or that their drugs can kill them - when the manufacturer can keep those facts locked down tight. Let me make it clear: it's not that "somebody screwed up" - after all, accidents do happen - but in many of these cases the manufacturer knew they were shipping dangerous products and kept on selling them.
In many, many cases, the only thing keeping companies from producing dangerous products is government regulation. It's not that companies set out to harm their customers, it's just not a priority, and is sacrificed to "make the numbers".
Frankly, many responsible people in business like regulation, because it provides a level playing field. Without it, companies feel forced to race towards the bottom in order to compete without disadvantage against companies willing to ship unsafe product.
Oh, tort reform and immigration are part of the healthcare problem, but they are very far from being the major components. So, that part - while not totally disconnected from reality - isn't right either.
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"In theory, theory and practice are the same, but in practice, theory and practice are different."
I have been in medical practice 22 years now. My payments are less now and going down. I'm being squeezed on one side by the Feds to "reduce my costs", be more efficient and not administer unnecessary tests or procedures. Medicare is cutting payments annually, and now imposing more regulations and "quality controls" IOW, more hoops to jump through if I want to get paid at all.
I'm getting squeezed on another side by the private insurance carriers who want to pay less (so they can keep more of the money they collect for themselves), and yes they do offer incentives to their staff to keep costs down via denials. I have to have extra staff just to track down and make the insurance companies pay what they by contract have agreed to pay me, but don't.
I'm squeezed on the third front by the lawyers for every patient who doesn't have a "PERFECT" outcome. BTW, it doesn't matter if the person didn't follow directions, didn't take their medication, didn't show up for their follow up, didn't keep their wounds dry, took their bandages off because they felt like it, etc. I have to show that I not only told them what to do/not to do, but have to prove it and then show that I did "diligent" effort to make sure they understood what I explained and that I made every attempt to follow them home and wipe their butts for them.....
I love being a provider, but it becomes so infuriating when people assume that health care is a god given right and should be free. I have patients who have no problem coughing up $40 for their acrylic finger nails, but don't want to pay a co-pay for a medical visit - because "why should they have to pay for health care??".
If your toilet backs up, you pay for a plumber to come out (and starting at $100 for the house call - its not cheap).
If your car breaks, you pay the mechanic to fix it (also not cheap at $45 + per hour for labor - plus parts).
But if you break your arm, and I put a cast on you, God forbid when I hand you a bill for $40...... People freak out.
Here is an example from my own experience:
I have great health insurance via my spouse. I needed surgery on my elbow. The surgery bill was $2700, my insurance payed $700 - that's what they felt it was worth (reasonable and customary). I had pre-authorization saying it would be fully covered, but after the surgery I was told it wasn't going to be covered. It took me 6 months of arguing with my carrier before the bill was finally paid to the surgeon. The surgeon waited 6 months to get paid 25% of what he charges. Was $2700 an unreasonable amount for me to have my arm fixed - was $700 a reasonable payment for the MD and all his staff? Personally, I think at $700 it was a steal.
Would my auto mechanic accept $700 for a $2700 bill he charged me to fix my car, and wait 6 months to get paid? Yeah right!
PS, I am so sick of hearing about how health care is free in England, talk to anyone who has been on that system (or Canada for that matter), and most will tell you they prefer our system here. While it may be "expensive", it's good care. And BTW, nothing is "free" - Brits pay heartily for their "free" care.
Expanding medicare is NOT the answer - ask those who use it.
Socialized / goverment run health care is NOT the answer - (we can't get Medicare / Medicaid right) - talk to the Brits / Canadians
If we TAX healthcare benefits because afterall they are sort of a type of "income" afterall, then they aren't really "benefits" anymore are they?!
Reduce fraud and waste and eliminate unnecessary tests/procedures - hmmm - talk to the lawyers about that one, I'd love to, but then I may get sued for not having done all the tests/procedures.
What is the answer?? I have no idea - but I think going back to a cash up front system for routine services with universal catastrophic coverage of some sort may be an answer.
Let's not talk to the 'Brits', they and France can't even defend themselves. We should have a good insurance thing that everyone can buy into - it's another money maker for the feds, it could bring up the standard in Public Health for example. The area that they would want to iron out would probably by the cost of health care in general - doctors and hospitals in general charge a bit much for procedures and general checkups.
In talking about health care costs - I refer back to the 1980's and when DRG's were implemented into the Hospital system. it was supposed to bring down the costs. What they did was itemize all the procedures that a hospital offered and assign a time period for a hospital stay and a cost for each procedure - then they assigned codes to each procedure which then became a career in itself.
There's a lot of different plans that could be offered: employers could go back to offering insurance at 80-20; 70-30; where the employee would have to make a contribution to their hospital stay instead of their insurance picking up 100 of the cost. All I see in 35 years of employment in the NE; South; Midwest; and Pacific is that much of what is done is based on racism. They guys with the dough did everything in their power to keep the poor minority populations from having anything - including health care. Anyone taking their side was treated with suspicion.
There are Brits on the board. What would you like us to tell you about the NHS?
Let me start with a short list:
1. How long is the waiting period for a simple procedure like (for example) a meniscus tear (knee surgery)?
2. How much does the average person pay (excluding what you pay to the government)?
3. How happy are you with the quality of care?
4. How does the income level/work hours of the average doctor/nurse/medical technician compare to the average white collar worker?
5. How difficult is it to get health care that you think you need but the doctor doesn't? [For example, when I had knee problems, the doctor diagnosed bursitis. It was two meniscus tears, per an MRI. Would I have been able to get that MRI in England?]
6. Just out of curosity -- what about abortions? Are those covered in England?
Yes, I think it would be best to hear from the Brits to learn what they think of the NHS. In particular: would you be willing to switch systems with the one in the US.
Now, my source of information on the NHS is a physician who works for it. While she lives in Newcastle now (and helpfully translated from Geordie to English when we visited), she's proudly from Scotland - and I don't think she would like to be referred to as a Brit!
EDIT: On a more serious note: I read the Spectator, which is extremely Tory and has lashed out at Blair and now Brown for raising the overhead and costs of the NHS while reducing quality, introducing band-aid quality rules that are widely circumvented (like: patient stay lengths are to be minimized, so patients nearing the deadline are discharged and readmitted so the numbers look good), and not dealing with MRSA and other problems. My question is: how much of this is accurate, and how much partisan attack from a journal that is anti-Labour and pro-Conservative?
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"In theory, theory and practice are the same, but in practice, theory and practice are different."
I have great health insurance via my spouse. I needed surgery on my elbow. The surgery bill was $2700, my insurance payed $700 - that's what they felt it was worth (reasonable and customary). I had pre-authorization saying it would be fully covered, but after the surgery I was told it wasn't going to be covered. It took me 6 months of arguing with my carrier before the bill was finally paid to the surgeon. The surgeon waited 6 months to get paid 25% of what he charges. Was $2700 an unreasonable amount for me to have my arm fixed - was $700 a reasonable payment for the MD and all his staff? Personally, I think at $700 it was a steal.
^This. I honestly think the bulk of the problem lies in insurance companies' rigging of the system and pharmaceutical companies. I've seen insurance companies get away with so much crap, completely legally, it's not even funny. The insurance companies feel so much like a casino, with all the games rigged in their favor, and ability to kick out anyone who's started "winning too much".
Don't get me wrong... insurance companies should be able to make a reasonable profit... just like the credit card companies. But, just like the credit card companies, that profit should not come as a result of dirty business practices and doing things that are or should be illegal. It's amazing what a good lawyer can get you out of (or what a good lobby can keep you out of in the first place)...
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"I may disagree with what you have to say, but I shall defend, to the death, your right to say it."
Last edited by I_luv_saber; 06-15-2009 at 11:59 AM..
1. How long is the waiting period for a simple procedure like (for example) a meniscus tear (knee surgery)?
I would have to find out. You see this is not a simple question to answer. The real answer is "it depends". Generally the time you wait for simple things can depend on your location. I am fortunate enough to live in a major city where the health provision is very good. So my wait time is not long. The closest example where I've had experience is where I tore my calf muscle. There was no waiting list to speak of. I could attend a physiotherapist as soon as I could make the time (following week). I also had a choice of physio'. However you might not have to go far to discover that the waiting list for something that minor is quite long. Of course you can opt out if you wish and pay for private care.
I suppose that's not really what you wanted to read.
I even hesitate to give you a guestimate because I just don't know.
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2. How much does the average person pay (excluding what you pay to the government)?
What do you mean pay? I pay taxes.
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3. How happy are you with the quality of care?
In general very satisfied. I am not going to lie. I have had the occasional bad experience but then I believe there's always the risk of receiving a bad experience of just about anything in life.
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4. How does the income level/work hours of the average doctor/nurse/medical technician compare to the average white collar worker?
In general... they work longer hours. Nurses don't get paid as much as perhaps they think they should (controversially). And it's shift work. What hours a doctor works depends very much on what they do (GPs generally do something akin to 9-5, surgeons or A&E doctors are likely to work shifts - but it depends on a number of factors). Similarly pay varies quite a lot across the range.
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5. How difficult is it to get health care that you think you need but the doctor doesn't? [For example, when I had knee problems, the doctor diagnosed bursitis. It was two meniscus tears, per an MRI. Would I have been able to get that MRI in England?]
You can get an MRI if it's thought to be required - but you will wait if there's little access to a scanner. If it isn't necessary you don't get it. If you think you need it you can seek a 2nd opinion or pay. In fact it's quite likely to be the same staff that do the private work (unless you have insurance and are at a private hospital - and even then...). Anyone can opt out and have stupid-complementary medicine if having someone wave a crystal over you is your thing (sometimes even on the NHS!).
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6. Just out of curosity -- what about abortions? Are those covered in England?
Of course they are legal. Though some think they shouldn't. There are rules but I don't know the ins and outs. I've know a couple of people who've had abortions - all done for free on the NHS.
Jeff:
What I find interesting is that the few people I know who've had actual experience of the US system (for example while working over there) prefer the UK one.
And by the way. I don't live in England. I live in Scotland which is part of the United Kingdom.
Ah, how the mighty have fallen. Once the pinnacle of freedom, the United Kingdom has devolved into a socialist nightmare where you have to pay for your helpless infant neighbor's murder. What would Winston Churchill say? That his bravery and the bravery of the Allies was all for nothing, since things are exactly as they would be if Hitler had taken over (socialism/anti-Semitism running rampant)?
Thank you. I knew someone who was in Ireland for a time and there was some difficulty obtaining birth control pills. I'm presuming there are legal differences among England/Scotland/Ireland much as there are legal differences among the states.
Which Ireland? It makes a big difference! There's a sovereign nation, Republic of Ireland, and Northern Ireland which is a country that is part of the United Kingdom. Different laws and social practices apply, to say the very least...
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"In theory, theory and practice are the same, but in practice, theory and practice are different."
Thank you. I knew someone who was in Ireland for a time and there was some difficulty obtaining birth control pills. I'm presuming there are legal differences among England/Scotland/Ireland much as there are legal differences among the states.
Ireland - by which I mean Southern or Republic of Ireland (aka Eire) - has not been part of the UK since the early 20th century. So; yes it is legally different. Woman can get birth control for free if they want it her in the United Kingdom of Great Britain and Northern Ireland.
EDIT: On a more serious note: I read the Spectator, which is extremely Tory and has lashed out at Blair and now Brown for raising the overhead and costs of the NHS while reducing quality, introducing band-aid quality rules that are widely circumvented (like: patient stay lengths are to be minimized, so patients nearing the deadline are discharged and readmitted so the numbers look good), and not dealing with MRSA and other problems. My question is: how much of this is accurate, and how much partisan attack from a journal that is anti-Labour and pro-Conservative?
To be blunt the rot set in much earlier than the current incumbents. I am a bit young to remember the 70s but, prior to the 80s (as I understand it) the NHS was very highly regarded. The tories, who have always detested the NHS, started the ball rolling by effectively cutting funding and starting to introduce private competition into the NHS.
It was [nu]Labour, the true heirs of Thatcher, who have really pushed privitisation further. Probably the biggest single threat to the NHS is the introduction of the PFI initiave. And no, it's not a good deal for us UK tax payers.
As for the health scares. Last time I looked into it the risk was overblown. It's a fashionable health scare. Having said that some hospital acquired infections are serious (e.g. C Diff or MRSA). There is an undeniable risk but I am not convinced that it is as great as certain sectors of the press make it. It has been used as indicator of the parlous state of the NHS that [nu]Labour has dragged it to. Your doctor friend probably knows better than me.
l[nu]labour also ramped up middle management interference and targets (in an effort to make it look like they were improving things) with the end result that some hospitals do indeed game the system.
Ireland - by which I mean Southern or Republic of Ireland (aka Eire) - has not been part of the UK since the early 20th century. So; yes it is legally different. Woman can get birth control for free if they want it her in the United Kingdom of Great Britain and Northern Ireland.
Thank you. I knew someone who was in Ireland for a time and there was some difficulty obtaining birth control pills. I'm presuming there are legal differences among England/Scotland/Ireland much as there are legal differences among the states.
Ireland has always been a little behind the rest of Europe on issues like contraception and abortion. The latter is still illegal. AFAIK the contraceptive pill as always been pretty easy to obtain as long as you are over 16. The Morning after pill was a little trickier but I think thing are are a little simpler. FYI I left Ireland 8 years ago.
One other point to remember about medical care in the UK is that private heath care is available. You can purchase health insurance, there are private doctors and hospitals. Harley street is still booming. Seeing a doctor there costs about the same as seeing a similar specialist on the Upper East Side in Manhattan.
1. How long is the waiting period for a simple procedure like (for example) a meniscus tear (knee surgery)?
I don't really know. Like Gave I also tore my calf last August. I have a friend who is a physiotherapist so I went to her for treatment.
2. How much does the average person pay (excluding what you pay to the government)?
Nothing unless you go private.
3. How happy are you with the quality of care?
Generally very. I have found the quality similar to the US considering my limited exposure.
4. How does the income level/work hours of the average doctor/nurse/medical technician compare to the average white collar worker?
What Gave said. Long hours especially initially but large earning potential at least for doctors and specialist nurses.
5. How difficult is it to get health care that you think you need but the doctor doesn't? [For example, when I had knee problems, the doctor diagnosed bursitis. It was two meniscus tears, per an MRI. Would I have been able to get that MRI in England?]
With a referral yes. There may have been a waiting period. If you were willing to pay then definitely.
6. Just out of curosity -- what about abortions? Are those covered in England?
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