Health Care Transparency and CSPAN

[Fencergrl]

I just want to point out, as a Canadian it's assumed we never have to deal with insurance companies. We do. Our basic medical is covered. Our extended medical (which pays for prescriptions, eyewear, dental, medical devices etc...) is private. We either purchase this, or use our employer's plan (they pay half & we pay half).

If your insurance companies are anything like ours... I feel bad for you. My husband's wheelchair gets replaced every five years but the $700 cushion he requires needs to be replaced every year but they only cover one per lifetime.

Catheters are covered but the gel for inserting them is considered unnecessary . I could go on, but you get the idea. It's odd what they choose to cover & not cover. None of these things are life threatening... just annoying. I would not want to deal with these people over serious issues such as surgery etc...

Also, if you want to opt out of the public route you can. You just have to pay for it. There are private practises for plastic surgery etc...

[PretAllez]

For every one story like yours, assuming they are true, and not just made up to make a point, there are 10 stories of people dying while waiting to see a doctor.

(emphasis added)

No. Not even close.
So you want to argue numbers, do you.... (although I have a feeling even cold hard facts won't sway you from your irrational ideological position)
By international standards, Canadian healthcare beats US healthcare hands down (better life expectance, lower probability of dying, AND LESS spent on healthcare per capita)
******************************************* Canada vs. U.S.
Life expectancy at birth m/f (years):**************** 78/83 vs. 75/80
Healthy life expectancy at birth m/f (years, 2003): ***** 70/74 vs. 67/71
Probability of dying under five (per 1 000 live births): **** 6% vs. 8%
Probability of dying between 15 and 60 years m/f
(per 1 000 population): ************************** 89/55 vs. 137/80
Total expenditure on health per capita (Intl $, 2006): **** 3,672 vs. 6,714
Total expenditure on health as % of GDP (2006): ******* 10.0 vs. 15.3

Figures are for 2006 unless indicated. Source: World Health Statistics 2008
World Health Organization http://www.who.int/countries/usa/en/

BTW My mom is in the Montfort hospital, Ottawa, doing very well actually, thanks for asking!
The nurse said she may even be allowed to leave tomorrow, depending on how she does with physio. She had an "oxford"-type partial knee replacement... do you need further details???...
And no one I know has ever mentioned to me anyone they know of who died while on a waiting list, so it can't be that common. I am not saying it doesn't happen, only that I have never heard of it happening (and remember, my elderly parents have elderly friends, who in turn, have elderly relatives, etc.) So ten times as many sad stories as happy stories ... uh...No. Not happening.

Can you say you have never heard of anyone being refused treatment due to a pre-existing condition, or because they did not have insurance?

I just can NOT understand this resistance to change displayed by so many Americans ... it boggles the mind ... kind of like the Flat-Earth Society ...
Ok, so don't adopt a "socialist" Canadian system, go with a European, or Japanese model, or ...or anything ... puuuuleease;
I mean, failing to adopt a universal healthcare system of SOME kind is just ... backward.... (shakes head)

[Slim]

Y'all are letting chase get to you.

This is not meant to be a dupe of the Almight Health Care Thread. The point of the thread was absolutely not having to do with what health care system is better than what.

With that said, congratulations chase. You've been one of the most succesful trolls I've seen in a long time.

chase isnt a troll. He's a highschool kid who thinks he knows everything...like most highschoolers and twentysomethings do.

What is most revealing is watching people here continue to argue, berate and attack chase over and over and over while calling him a troll. Amazing. You know his positions, and you know what his come backs will be. Even the supposed "elders" seem to enjoy kicking chase around like a half flat soccer ball. I guess it makes you feel good, but I just dont get it. Its such an easy target. Kind of like jessicasimpson who has a hard time putting more than three coherent sentences together. Where is the challenge? Its just gratuitous pummeling.

But watching it really is getting pretty tedious.

[I_luv_saber]

chase isnt a troll. He's a highschool kid who thinks he knows everything...like most highschoolers and twentysomethings do.

A troll is not necessarily a sockpuppet. I think he's a "real" person, probably exactly what you describe. But that doesn't mean he ain't a troll. A troll is someone who posts with intent to cause a ruckus, and I definitely believe that's the case here, sockpuppet or no. He obviously gets off on ruffling feathers, and that's what a troll does.

I agree that feeding the troll is getting old, however calling someone out as a troll isn't feeding a troll - feeding a troll is engaging in the "argument" put forth.

[Gav]

Ah well... Petersen's Law rings true again, I see....

What's this?

[I_luv_saber]

What's this?

The new Godwin's Law - All discussions eventually lead to health care. Here's where it popped up...

[Gav]

The new Godwin's Law - All discussions eventually lead to health care. Here's where it popped up...

Ah, I missed that.

[jessicasimpson]

chase isnt a troll. He's a highschool kid who thinks he knows everything...like most highschoolers and twentysomethings do.

What is most revealing is watching people here continue to argue, berate and attack chase over and over and over while calling him a troll. Amazing. You know his positions, and you know what his come backs will be. Even the supposed "elders" seem to enjoy kicking chase around like a half flat soccer ball. I guess it makes you feel good, but I just dont get it. Its such an easy target. Kind of like jessicasimpson who has a hard time putting more than three coherent sentences together. Where is the challenge? Its just gratuitous pummeling.

But watching it really is getting pretty tedious.

Slim is projecting his faults onto other people again. It would be hard for me to dumb down my post any more for you, but I will try.

[chase]

I don't think that I know everything, just more than liberals, which isn't alot. I am not posting to upset people, I am posting to teach them. Somebody has to correct the liberal lies out there, otherwise, people like Obama get elected.

[Black Sunshine]

I don't think that I know everything, just more than liberals, which isn't alot. I am not posting to upset people, I am posting to teach them. Somebody has to correct the liberal lies out there, otherwise, people like Obama get elected.

The problem is you don't correct liberal lies. You just make **** up. There are plenty of conservatives who can make legitimate and convincing arguments to support their beliefs. You aren't one of them.

PS--You are never getting laid.
PPS--The devil made me do it. I love his Underwood brand of fine canned ham products.

[jessicasimpson]

I don't think that I know everything, just more than liberals, which isn't alot. I am not posting to upset people, I am posting to teach them. Somebody has to correct the liberal lies out there, otherwise, people like Obama get elected.

The problem is you don't correct liberal lies. You just make **** up. There are plenty of conservatives who can make legitimate and convincing arguments to support their beliefs. You aren't one of them.

PS--You are never getting laid.
PPS--The devil made me do it. I love his Underwood brand of canned ham products.

I agree, you are doing much more damage to the conservative point of view than you could possibly imagine. People debate if you are a real person, or a liberal trying to make conservatives look stupid.

[davesaint]

For every one story like yours, assuming they are true, and not just made up to make a point, there are 10 stories of people dying while waiting to see a doctor. It is like waiting at the DMV except you ACTUALLY die, instead of just feeling like it.

P.S. We're not rich. My Tahoe was a handmedown from my dad.

Chase,

Do you actually know how claims decisions are made in the insurance industry? I am an underwriter for a major insurance company in the US. Fortunately I do not underwrite Health Insurance, however, the training is the same for the underwriters and claims reps in my field. None of us are Medical Doctors. We are college educated (mostly) who do not necessarily have a degree in a medically related field. We are given about 6 months or so of medical terminology training before we are released to handle active cases. I have been an underwriter for over 12 years. We review peoples medical conditions and make a determination as to whether or not to pay a claim based on Morbidity statistics. The more claims an insurance company pays, the less we make.

If you actually think that people don't die waiting for procedures to be approved by a health insurance company in the US, you are delusional. The most recent case I remember from the news was about an 8 year old girl who suffered from a rare congenital liver disease. They found a match for her and she was scheduled to receive a liver transplant. All they were waiting for was the go ahead from the insurance company to do the procedure. The claim was initially denied, which was the policy in transplant cases for the company in order to reduce costs. The girl died while they were waiting for an answer from the appeal that they made to the claim reps manager. The insurance company saved roughly 250k by not paying the claim. However, the civil lawsuit will likely cost them Millions.

So don't tell me that private health insurance in the US is the best way to go, because often times it isn't. Try getting coverage if you have a pre-existing condition such as Breast Cancer or Diabetes if you lose your job.


Dave

[RebelFencer]

I agree, you are doing much more damage to the conservative point of view than you could possibly imagine. People debate if you are a real person, or a liberal trying to make conservatives look stupid.

That's what the stupid liberal agenda would have you believe. This Haiti issue is obviously the fault of Barack Obama (Osama) and his quest to destroy America and the honest hard working HMOs with his socialized medi-rape. 6/13 of the Democrats that support him also support abortion, gay marriage, and witchcraft so it is no wonder that we are left with an angry God. Pat Robertson is absolutely correct and I praise him for having the courage to speak out about those uppity brown people, thinking they have the right to not be slaves. Stupid f---ing liberals.

[migopod]

That's what the stupid liberal agenda would have you believe. This Haiti issue is obviously the fault of Barack Obama (Osama) and his quest to destroy America and the honest hard working HMOs with his socialized medi-rape. 6/13 of the Democrats that support him also support abortion, gay marriage, and witchcraft so it is no wonder that we are left with an angry God. Pat Robertson is absolutely correct and I praise him for having the courage to speak out about those uppity brown people, thinking they have the right to not be slaves. Stupid f---ing liberals.

Preach it brother!

[Inquartata]

I have been to most of these countries, I have never seen any lines for healthcare.

Tsk! Don't be so literal-minded!

Actually, I'm sure that there probably are lines somewhere, for some things. I stood in a fairly long line for flu shots a while back, and I can't see how that sort of thing can be avoided. But the real problem is waiting lists. We have these here, too, for things like transplants, and in systems which short-circuit the natural balance of supply and demand these are simply unavoidable...

The queues for the dentist are smaller than my private practice at home.

Come now! "The dentist"?

Most dental work is not urgent, or felt to be urgent. Getting a cleaning and check-up is not like needing chemotherapy.

The following are true stories, and absolutely typical ....

Well, isolated anecdotes trump stuff like this, I suppose:

http://www.healthzone.ca/health/news...article/681882

TOTAL COST to her: 0$ (Canadian)

Wrong, unfortunately. The cost is merely hidden, rather than obvious. It comes in the form of taxes, and other opportunities foregone...

In the magician's trade, this is called misdirection.

I just can NOT understand this resistance to change displayed by so many Americans

It's not resistance to change. It's the resistance to the wrong kind of change. Many of us simply do not trust government's paternalistic claims that it just wants to "help" us.

"The natural progress of things is for liberty to yield and government to gain ground."

I mean, failing to adopt a universal healthcare system of SOME kind is just ... backward....

"Have you jousted with humility lately?"

The new Godwin's Law - All discussions eventually lead to health care.

But again---there is already a Law by that name. It's to do with economics.

PS--You are never getting laid.

Meh, you've never met a woman as far right as Chase? I have...

[PretAllez]

Well, isolated anecdotes trump stuff like this, I suppose:

http://www.healthzone.ca/health/news...article/681882...

Please note that in my previous post I specifically said the Canadian system was not perfect, and could stand improvement. Note that the article above does not call into question the universality of healthcare, only the delivery method, and goes on to suggest improvements. Noticeably absent is any mention of adopting an American-style healthcare system, although comparisons to France, the Netherlands are made.

"it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared. ..In other words, Ouellet believes there could be a role for private health-care delivery within the public system."
(emphasis and italics mine)

This is the system currently in place for GPs in Ontario. They run their own businesses, hire and pay their own staff, pay their own mortgage/rent on business properties etc. and they get paid a set rate per medical act (i.e. a check-up is worth X, a referal is worth y, follow-up is worth Z etc.) There is competition between GPs for patients, and the harder a GP works, the more money he/she makes. But from the patient's perspective, you just hand them your health card. In Quebec, they have a "ticket modérateur" system where the patient pays a modest fee ($10) in order to make him/her more aware of the cost of a consultation, and less likely to abuse the system. You also get dinged for $50 if you fail to show up for an appointment.
The public is fully aware that health care is not free; they see it as a major item every year in the provincial budget. But those taxes are pretty predictable from year to year.
How much do you pay for health insurance? And will it cover (almost) all your expenses? even if you have a pre-existing condition? How much should you save up to cover those potentially bankrupting non-covered expenses? What if you lose your job? What if your employer goes under? There is a lot more uncertainty in the American system

Wrong, unfortunately. The cost is merely hidden, rather than obvious. It comes in the form of taxes, and other opportunities foregone......

I stand corrected. The cost is not $0. But the costs are not hidden, they are distributed among the population, who are all insured, yes, in the form of taxes, and these taxes are specifically spelled out in the provincial tax forms (in Ontario, they are the listed on the tax form as the healthcare surtax). That's why it is called the Ontario Health Insurance Program. (OHIP)

What other opportunities are foregone? Without insurance, these costs would have been paid, in a lump sum eventually, by anyone needing care. And the per capita costs are LESS. The Canadian system is more efficient than the American one, even though every Canadian is covered. The difference is attributed to economies of scale, a streamlined administrative process, and the fact that no money is paid out to shareholders who add no value.

It's not resistance to change. It's the resistance to the wrong kind of change. Many of us simply do not trust government's paternalistic claims that it just wants to "help" us. ...

Instead you place your trust in a FOR PROFIT HMO or insurance company that is not accountable to anyone but its shareholders

[downunder]

Most dental work is not urgent, or felt to be urgent. Getting a cleaning and check-up is not like needing chemotherapy.

mate you know we have private cover as well right? You can get private cover with countless heath insurance companies such as AXA, BUPA, Aviva, Prudential as an individual and many more with your workplace.

The point is in the UK (and Australia and everywhere else in the developed world) we have a minimum level of healthcare that doesn't bankrupt the tens of millions of uninsured or under insured if they need to access it.

I only used dental as an example because it's the only NHS treatment i ever access as a young vaguely healthy male.

[Inquartata]

Noticeably absent is any mention of adopting an American-style healthcare system,

I'm not sure where any intimation to the contrary was made...

"it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared. ..In other words, Ouellet believes there could be a role for private health-care delivery within the public system."

Note that there may be a difference between an expert's assessment of the way things are, eg facts, and his assessment of how things could be, eg speculation.

Remember, Karl Marx's descriptions of the way things worked economically in his day were very shrewd and perspicacious; his prescriptions for a "better way", not so much.

How much do you pay for health insurance?

About US$25 a month, plus a $15 co-pay per visit.

This of course omits what my employer pays ( this is IMO the major failing of our system, the heavy involvement of employers ) and taxes.

It's really difficult to compare the two systems and determine who pays more. Averaged percentages of aggregate national GDP are about the best we can do, but they are sort of blunt instruments...

And will it cover (almost) all your expenses?

Yes.

even if you have a pre-existing condition?

After an initial waiting period ( I think it's six months ).

However, this is an employer-offered plan, not a privately purchased one, which typically are much more restrictive. Also, I work for state government. I'm not sure how plans offered by private-sector employers differ from these, if at all.

There is a lot more uncertainty in the American system

How much is "certainty" worth to you? This is the relevant question. Only the individual country can decide this.

See, I am not arguing that other systems are bad or that they should be discarded in favor of our sort. Nor do I judge those who like them and believe in them as somehow mentally unbalanced, ignorant or foolhardy.

They have drawback, however. Different drawbacks than ours, but drawbacks nonetheless. You guys have not stumbled upon a free lunch or anything, you know.

the costs are not hidden, they are distributed among the population,

They are hidden in the sense that an individual cannot readily assign a figure to his or her actual cost. He cannot say "Having this done will cost me $326.78".

There is no price signal to determine how much he consumes, in other words. Practically speaking, a $100,000 course of treatment is indistinguishable from a 10 cent aspirin. This completely vitiates the most important function of the marketplace: resource allocation. To all intents and purposes, quantity demanded for health care is infinite. Supply is not. That is an equation which cannot be balanced.

What other opportunities are foregone?

This gets at the economic concept of opportunity cost. Simply put, if you spend $1 on good or service A, it is not available to be spent on good or service B. Speaking nationally, the resources you have chosen to spend on health care cannot be spent on other things which your country may need or want. Whether you know it or not, you have given up something in order to have universal "free" health care. Since you don't know what it is, ignorance is bliss, and you don't miss it ( whatever it is ). But there is something you could have had and do not because you have opted for universal health care instead. It cannot be otherwise.

And the per capita costs are LESS.

The costs that are measured are less, possibly. It's unlikely that simple national accounting captures them all. It cannot begin to assess opportunity cost, for example.

The Canadian system is more efficient than the American one, even though every Canadian is covered.

Possibly. How can you be so sure? Have you looked at the spreadsheets? Or has someone just told you so?

If it is so, then you have identified the major reasons. This is not to say that the base conclusion is correct---or even that it makes the system "better" than another.

Instead you place your trust in a FOR PROFIT HMO or insurance company that is not accountable to anyone but its shareholders

Our system has a lot of problems, and a lot of distortions, most ( IMO ) caused by past and present government policies and regulatory practices. No real free market system exists. We cannot compare a state system to a market one for this reason. What we have are just two sorts of state systems...

mate you know we have private cover as well right?

Yes. What's the relevance?

The point is in the UK (and Australia and everywhere else in the developed world) we have a minimum level of healthcare that doesn't bankrupt the tens of millions of uninsured or under insured if they need to access it.

And you pay for it.

That is your choice. It's not my place to tell you you shouldn't have done it, or lecture you on how much smarter we have been not to have done it. It's for your society to decide where it's preferences lie.

I can only say that inasmuch as you have substituted human calculation and action for the costless operation of free market forces, you have chosen a less efficient way of spending your resources...

I only used dental as an example because it's the only NHS treatment i ever access as a young vaguely healthy male.

So you never actually see a doctor?

But you're content to pay some amount of your income in taxes for a service that you do not use?

Very patriotic of you. I'm sure HM's government appreciates it very much!

Me, I'm a bit more selfish than that, I'm afraid. I feel that if I earn the income, I should get to spend it as I choose, rather than how someone else does...

[downunder]

And you pay for it.

That is your choice. It's not my place to tell you you shouldn't have done it, or lecture you on how much smarter we have been not to have done it. It's for your society to decide where it's preferences lie.

I can only say that inasmuch as you have substituted human calculation and action for the costless operation of free market forces, you have chosen a less efficient way of spending your resources...

My point was that we manage to do this on a per capita basis cheaper than the USA. If you can afford it, US healthcare is world class - if you can't and you need treatment you could be in hundreds of thousands of dollars in debt. I know someone with diabetes expenses of over $60,000. As I understand it if you have any pre-existing condition you pay the full price. I don't understand how anyone with any human decency can sit back and let this happen.

You also can't use buzzwords like free-market and efficiency and assume this proves your point.

One example where the Australian healthcare system is much more efficient than the US system is we have the Pharmacutical Benefits Scheme where purchasing drugs from the big pharma companies is negotiated nationally so we get bigger discounts. The government subsidises it further and pensioners get free drugs on the program.

From this 2003 paper: https://www.tai.org.au/file.php?file=WP48.pdf


Celebrex 100 mg
Consumer price (100 tablets): $130.27
Cost of general active ingredients: $0.60
Percent markup: 21,712%

2003 Wholesale Price in the US : $101.48
2003 Wholesale Price in Australia : $24.97


Lipitor 20 mg
Consumer Price (100 tablets): $272.37
Cost of general active ingredients: $5.80
Percent markup: 4,696%

2003 Wholesale Price in the US : $89.50
2003 Wholesale Price in Australia : $49.95


Norvasec 10 mg
Consumer price (100 tablets): $188.29
Cost of general active ingredients: $0.14
Percent markup: 134,493%

2003 Wholesale Price in the US : $35.69
2003 Wholesale Price in Australia : $18.52


Zoloft 50 mg
Consumer price: $206.87
Cost of general active ingredients: $1.75
Percent markup: 11,821%

2003 Wholesale Price in the US : $62.57
2003 Wholesale Price in Australia : $29.28



Do you not see that running healthcare as a business can actually create some serious conflicts of interest and you end up paying higher prices?

So you never actually see a doctor?

But you're content to pay some amount of your income in taxes for a service that you do not use?

Very patriotic of you. I'm sure HM's government appreciates it very much!

Me, I'm a bit more selfish than that, I'm afraid. I feel that if I earn the income, I should get to spend it as I choose, rather than how someone else does...

Putting money into a service I don't use now but will cover me if I need to use it? Kinda sounds like insurance to me?

[jessicasimpson]

I don't understand how anyone with any human decency can sit back and let this happen.

Human decency and economics? These two concepts don't seem to connect.