National health systems: too much vs too little medical care: which is worse? (salaries, illegal)
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I think people's biggest hang up with single payer are the lines. However you have to ask yourself if there are lines with single payer but not so much with what we have now, what is happening to those people? They just die.
You are confusing single-payer with single-provider, which is nationalized healthcare. Single payer is like Medicare. But Medicare is not the provider, you still can go to whoever you want. There are no lines for services when you are on Medicare. It mostly just replaces insurance.
This is very far from the reality. The reality is that many people can't get doctors to take their concerns seriously at all. Doctors tell patients they're "fine", nothing's wrong, or they tell them to see psychiatrists. And that's just for relatively common concerns like hypoglycemia and other blood sugar disturbances, thyroid (insurance refuses to pay for the thyroid disease blood tests that many thyroid patients need), parasites, food allergies, and a variety of other easy to test for and treat conditions. For more serious and somewhat more rare issues, doctors simply refuse patients altogether.
I'm starting to suspect that doctors are trained to deny testing and any serious discussion of medical concerns to patients as a way to keep costs down.
Doctors, even some specialists, are very poorly informed about basic facts within their field of study. Endocrinologists are very limited in what they tread: only diabetes and thyroid, and they don't even do a good job of those, let alone anything else in the endocrine realm.
That aside, a lot of money could be saved if insurance companies operated on a non-profit basis, and if hospitals and clinics did the same. Insurance has become a cash cow to a lot of doctors and physical therapists, so private for-profit clinics are burgeoning, right when the public and policy-makers are talking about cutting costs.
Yesterday my father (78, visiting from another state) was in distress with stomach issues that affected his mental state. We took him to the ER and every resident and nurse and attending dismissed our concerns over his stomach problems even after a chest xray hinted at an abnormal position for his diaphragm. They kept saying it's just depression and nothing more. I spent the day advocating for him to get some sort of further test or ultrasound which they finally did and surprise, I was right. He had a hernia that needs to be repaired. It concerns me to think of the millions of seniors who have no one to advocate for them and get rushed through without truly diagnosing their problem.
One possible defense against failure to diagnose, is to Google the symptoms and find discussions of them. By discussing the symptoms, or reading discussions by other people of the same symptoms, you can get a clue of what might be happening. Then, when you see a doctor, mention that as one of the things to check for. Because they can't check for everything. They need clues to know what to look for. "Bellyache" is too vague a clue because there are thousands of things that can cause bellyaches and most of those are not serious. It should be more like "I get a bellyache when I do this" or "the bellyache gets better when I do this".
A hernia is generally not considered an emergency, unless it has unusual complications, which might be why ER doctors might not notice one. One way you can sometimes self-diagnose a hernia is to push on it. If pushing on it changes the amount of pain, usually reducing the amount of pain, that usually indicates it's probably a hernia. But doctors often don't notice that, unless they're specifically checking for a hernia. They have no way to know what actions increase or decrease the pain, unless the patient tells them.
The vast majority of all bellyaches are caused by gas pressure. Which is one reason why doctors don't take them seriously. I'm reminded of an episode of a TV sitcom starring a well known comedian. His mother or aunt or someone like that had a severe bellyache and they thought she must be dying. So they drove a long distance to check up on her. Then, when they arrived, the gas escaped. And the comedian was very funny the way he said something like "we drove 200 miles for a f*rt?!?!"
Your example never happens. So one member using hyperbole "sniffles" is no different than your rash hyperbole.
You're jumping to socialized medicine without even considering tort reform FIRST, which was something that the GOP tried to get with Obamacare but because Obama is owned by trial attorneys, it was not even a consideration.
You are confusing single-payer with single-provider, which is nationalized healthcare. Single payer is like Medicare. But Medicare is not the provider, you still can go to whoever you want. There are no lines for services when you are on Medicare. It mostly just replaces insurance.
One thing single-payer could do is force doctors, hospitals, etc., to accept their dictated rates, by leaving them with almost no patients if they didn't. Presently hospitals, etc., charge astronomical rates, which get negotiated down by insurance companies. But there are so many complications in those negotiations and in the fine print of the coverage that a lot of patients end up bankrupt in spite of having insurance they thought was good.
With single payer, there would never be any surprise out-of-network penalties imposed on patients who thought their doctors were in-network but turned out to be temporarily out of network due to a paperwork error. And patients would never even have to ask doctors if they were in network, because single payer would be one big network for everyone. A lot of patients, sick in a hospital, are visited by out-of-network doctors they didn't ask for, and are in no condition to verify their status. They're just asked to sign a form, even when their brains might be affected by fever or something.
Free market capitalists argue single-payer is anti-capitalism. But what kind of capitalism involves negotiations with patients whose brains are affected by fever etc.? And what kind of capitalism requires insurance companies to cover people with pre-existing conditions? Capitalism in medical care is nothing but a stupid pipe dream of capitalism purists.
Your example never happens. So one member using hyperbole "sniffles" is no different than your rash hyperbole.
You're jumping to socialized medicine without even considering tort reform FIRST, which was something that the GOP tried to get with Obamacare but because Obama is owned by trial attorneys, it was not even a consideration.
That's why your logic is flawed.
How have you verified that the example never happens? To simply state that it never happens, when you have no way to know that, isn't very credible.
Most tort reform schemes are perks for the 1%. For tort reform to be the answer, it has to be designed to benefit everyone.
As for Obama being owned by trial attorneys, the best solution to that kind of problem might be a constitutional amendment that attorneys can't get involved in politics. Once you get licensed as an attorney, you should forever be prohibited from being a politician, lobbyist, or bureaucrat. Just like separation of church and state, we need separation of attorneys and state.
When people are cured and saved, there is no way to know if they were really cured and saved by medical professionals. It might have been their own immune systems doing the miracles that the medical professionals get credit for.
And a passing spaceship could have fired a miracle healing ray at them.
Meanwhile, the plain facts are that if you intend to protect your health over the long haul, you need to start and maintain a regime of regular professional heath care, moving from primary level generalists to secondary level specialists as conditions may warrant. The consequences of not starting and sustaining such a regime are not specifically knowable in advance, but the generalities all look bad.
You're jumping to socialized medicine without even considering tort reform FIRST, which was something that the GOP tried to get with Obamacare but because Obama is owned by trial attorneys, it was not even a consideration.
LOL! Tort reform is a total sham. Many states already have limits on tort awards and neither health care costs nor malpractice insurance rates are much affected by them. What is affected is the number of doctors per capita. Otherwise, the whole issue has been done over and over and over again, and the bottom line is that it's just a joke.
Remember that the Republicans finally did send their "health care" plan (tort reform and interstate insurance marketing) off to CBO and it came back as MORE expensive than Obamacare while not -- over a period of ten years -- reducing the percent of uninsured Americans at all.
And a passing spaceship could have fired a miracle healing ray at them.
Meanwhile, the plain facts are that if you intend to protect your health over the long haul, you need to start and maintain a regime of regular professional heath care, moving from primary level generalists to secondary level specialists as conditions may warrant. The consequences of not starting and sustaining such a regime are not specifically knowable in advance, but the generalities all look bad.
Agree with your comments above.
Generally speaking, good health care depends on two factors. The first is the ability to pay for regular care and the second is the willingness to pay for it. This is as true in the hybrid public/private system that the UK operates as it is in the USA.
Right now, I pay for a concierge system with - in my opinion - a very good doctor. I get an exhaustive physical every year plus other checks (e.g. colonoscopy) periodically and as required. My insurance covers about half the cost of the concierge system as the fee includes the physical and that is covered by insurance.
The same is true for dental care. I go to the dental hygienist three times a year to have my teeth cleaned and checked for problems. For the first time in 5 years I needed further dental treatment which I had immediately before the problem got worse. I joked with my dentists that he is too good at his job because I don't get to see him often.
For example, if there were no malpractice lawsuits, and if all medical costs were paid by the government, and all medical decisions were made by doctors following guidelines set by panels of medical experts and cost experts, then there might be too little medical care, because people might have a hard time getting the medical care they needed.
But, in our present system, people get too much medical care, because doctors worry that if they don't do every possible test and try every possible approach to every medical condition, they might get sued. A lot of people end up bankrupt trying to pay the bills for all that excessive medical care. Or they might not get the medical care they really need, because the doctors are too focused on the extra medical care, and not the common sense simple solutions people might really need.
But in the other system, with too little medical care, it might actually be a lot easier. In that system, you can't sue a doctor for malpractice, and all costs are paid by the government, so the doctor is more likely to use the simpler solution, even though it gives you a 1% risk of major problems. Life is a gamble, and that 1% risk would be considered part of the gamble of life. Because the person taking the risk wouldn't be the doctor. So the doctor would be motivated to take the common sense approach, in spite of the 1% risk.
Being faced with malpractice suits is not the reason doctors run so many tests. They run many tests because the cause of a patient's symptoms are numerous and varied, and they have to run a bunch of tests to pinpoint the cause, so they can choose the correct treatment. A lot of symptoms are quite vague, and unless the doctor runs tests, he has no clue what's causing it. Say a patient comes in complaining of fatigue and fever. There are 100 things that could cause it: the flu, a cold, a sinus infection, strep throat, ear infection, HIV infection, pneumonia, tuberculosis, measles, meningitis, diphtheria. It could even be the first symptom of cancer. So the doctor does a complete blood count, cultures, pathology testing, urine specimens, and maybe some other tests to determine exactly what it is before treating, so the patient can get better, than guess at what might be wrong, and treat the wrong illness numerous times.
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