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Incidentally, I am considered a new patient, even though I have been a patient of Mayo, and spent 69 days in their facility in the last 3 years. The reason I wanted into Mayo so badly, and was so concerned, was that the majority of my problems are the result of a medical "accident" at a hospital here that almost killed me. You might say I'm "gun-shy" now, and want to go somewhere that I already trust
I'm all for that. My wife and I are looking for a new OBGYN for her. We are using the same techniques that I advised others to do. There is a lot of research that goes into it. And I'm all about patient's rights. There are a lot of physicians that got into medicine for the wrong reasons and are not patient advocates. This is why I try to spend a good amount of time researching doctors including PCP's for myself. It's difficult. For me, it's not about where they got their degree or how many years they have been practicing. It's about their attitude. I've seen brilliant doctors make mistakes because they were in a hurry or didn't care to spend enough time checking their work. I've seen other doctors from less spectacular schools make Top Docs and have practices that are so busy that they can't accept new patients simply because they are humble and respectful. Go to mdratings and azmd.gov to research physicians. Also, do a plain google search and go to yelp.com
Sure, she can't see a doctor 'tomorrow' - but then again, I called my doctor for my annual physical in January and was given a date - no kidding - in May.
The difference is that you can call a PCP and get an appointment this week if you wanted to. Not all doctors are booked out that far in advance unless they are extremely popular. I'm a cardiologist who treats many Canadians who were denied service in their country and that too after waiting nearly a year to see a cardiologist there.
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Your figures take the worst case (family vs. single) from the report (for singles, it's almost the same tax in both countries - 4% difference).
My figures compare families with families. Most of this heath care crisis concerns families ie parents with children. And with regard to families, the Unites States has a considerably lower income tax than the European countries.
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But more importantly, in the US, your healthcare premiums are not included in the 'tax' figures, nor are private retirement plan costs. I'm plugging $15,000 p/a into my 401K here, and I pay several more thousands for my group medical coverage (plus, I'm anticipating another $10-15,000 anually in premiums if I were to try to retire at 55) - since healthcare and retirement are covered in UK, it's not an apples-to-apples comparison.
No one is forcing you to retire at 55. You are choosing to do that so of course you will pay higher premiums. The UK doesn't provide pension until you are 65. You can't live off your pension in the UK. The average annual pension in the UK is 12,000 pounds (25K) which includes personal pension fund contributions. If you rely on the state pension fund alone (which is what you are alluding to), that is only 4000 pounds per year. So it's disingenuous to say the UK pays for your retirement because you will be required to save for retirement even there. Your non-income tax is higher too so the highest tax bracket in the UK pays close to 70% in total taxes. Obviously, that is where your free health care comes from.
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Compare US income tax+healthcare premiums+retirement plan costs to a UK tax, and the comparison will be more interesting.
I just did above.
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But perhaps even more vital is the concept of 'no coverage'. In my case, I'm reasonably healthy so will probably - if my luck continues to hold - be able to get coverage at, say 55 in the private arena, but my girlfriend cannot - at any price. And any recurrence of her cancer will literally bankrupt her. So - what's the point of 'only paying 11%' tax if, when you reach 55, you can't retire. I've worked hard all my life, and gladly paid taxes, and saved lots of money for the future; but NO AMOUNT of personal savings can insulate you from a catastrophic illness - and THAT is what I'm now realizing as I get to my 50's and want to consider retirement.
That isn't true. If you are insured prior to developing cancer or a terminal illness, you will be covered. You can also purchase disability that will pay in the case that you can't work as a result of your illness. I'm sorry to hear your girlfriend is suffering but for many Americans, they don't prioritize their health care. There are over 10 million people in this country that can afford to pay for health insurance but choose not to do so. These people are irresponsible and choose to live dangerously and then when they get sick, they want to cry foul at the insurance companies for denying them coverage or charging high premiums. I'm not saying your girlfriend is one of these people but there are people who want to point fingers when they should take some responsibility for their lack of foresight. I see patients on Medicaid driving BMW's and talking on I-phones or they will spend over 10K per year on cigarrettes. And if you are dirt poor, you can qualify for Medicaid. Insurance premiums have gotten out of control but just the same, there are irresponsible people who don't prioritize and spend money on health care.
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That was my understanding/perception when I left UK about 25 years ago; it is not the case today. My brother lives there and is in a very mediocre job, and has BUPA provided by his employer. It is not an expensive option for him. This is an area worth a lot more investigation as it gets to the heart of what the scare-mongers are suggesting in the US. Now, MOST people over there simply don't see the point of it, and thus don't pay for it; but it is there and is not terribly expensive.
If it isn't terribly expensive then explain why the overwhelming majority don't buy it. The answer is because it is considerbaly more expensive. A good friend of mine is an anesthesiologist practicing in central London so I'm very well aware of the private plans and they do cater to the wealthy.
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After many years in various high-tech fields, I find myself now working in the technology area of medicine. I have never seen such a mess. Every insurance company has its own 'standard', 'format', 'process'. Every doctor has to conform to each and every different standard if they want to work with 'insurance company x'. Each state has its own reporting standards, licensing standards, etc. There is an entire cottage-industry dedicated to massaging and dressing up 'claims data' beteen doctors' offices and insurance companies. The statistics on 'administrative overhead' in the US are staggering.
Agreed and that is one of the flaws in our system. No system is perfect. However, I still believe we provide the best health care in the world. I've seen how UHC countries deny certain medications and classify surgeries as being "elective" when those same surgeries would be approved of here without question such as a cholecystectomy. The people who accuse others of fearmongering havent' really worked in the govt run mediums in this country like the Veterans Administration health system which serves all the current and ex soliders in this country or Medicaid. You mention the UK but our country is not the UK. We will not adopt a European taxation system because even the biggest liberal understands that concept directly opposes what this country was founded on. Therefore to compensate, the govt will be forced to ration care just like it does with the VA and Medicaid. It's not going to be like Medicare.
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If we addressed the 'un-necessary' (defensive) procedures, frivolus lawsuits, and enforced various cross-company standards and cross-state standards, as well as eliminating some 'high-profit' but not very necessary capital investments (too many CT scanners, not enough basic clinics), we may be able to provide the same care at a much lower cost.
Agreed, I agree we need to reform our system but I don't agree with taking the best aspects of our healthcare and socializing it. Instead, why don't we focus on what is wrong with our system, and address those aspects. I agree that insurance companies need to be reformed but why don't we regulate them directly? The reason we don't is because the administration wants the govt. to take control of health care. Obama himself stated he wanted to create our healthcare system based on the European model. He only bactracked this summer because of the public revolt and is trying to resell his mantra as a consumer-choice driven plan.
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The final piece of the puzzle is the true cost of the great numbers of uninsured citizens. Bush made the ridiculous and insulting statement that 'all Americans have access to healthcare- they can visit an Emergency Room'. Well, if you don't offer any preventive care (checkups, minor 'repair') to the poor, then they eventually get sick and DO go to the emergency room, costing the government thousands.
Bush was right. People without insurance show up to the ER all the time.The number of unisured is exaggerated. 42 million is quoted of which 12 million are illegals. Another 10 million are people who can afford health insurance but choose not to pay for it. Another 10 million are minors who qualify for health insurance but whose parents don't fill out the necessary paperwork to get health insurance. We have about 10 million people who are the working poor who desire health insurance but don't earn enough to pay for it. I would safely say that in Arizona, easily 60% of the uninsured patients in the ER are illegals.
Preventive medicine is important but overstated. I know plenty of diabetics who don't watch their insulin, don't exercise and don't watch their weight. These patients are informed but make bad decisions. I have many patients who still smoke, do drugs and not exercise despite having had a heart attack 10 years ago. There is only so much a doctor can do in the office. This is one of those b.s. proposals that Obama makes to talk about reducing the cost of health care. In the Price Water House/Coopers study, 200 billion or a 1/3 of the health care costs in this country was due to irresponsibility of people themselves. How many people in this country eat healthy, sleep enough, exercise daily, manage their stress. Sorry but people in the United States often put their health on the back burner and don't prioritize it. People like eating high fat food. They like staying up late instead of going to be on time. They don't want to exercise and would rather watch television. I'm guilty of many of these sins but its a part of American culture.
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A final comment on taxes - the last govt. just spent about a trillion dollars fighting a war we didn't need; THAT has to be paid for somehow. I'd rather pay my taxes and see the money go to healthcare than to a war that was unnecessary.
Agreed but adding to the debt doesn't really make sense. We don't want to make things worse. I think healthcare reform is necessary but the liberals are falsely trying to convince Americans than unless reform has a govt option then it's no good. That isn't the case at all. There are a lot of reforms that can take place now which would improve health care such portability, allowing pre-existing conditions, freeing state restrictions when shopping for plans, negotiating with insurance companies to stabilize premiums.
Last edited by azriverfan.; 08-23-2009 at 05:20 AM..
Why is this on the Arizona board? No offense. I fully hope for a seasoned debate, but this is a national bill and should be on the national boards.
I did not intend to start a debate about the national insurance. My question was a response to the shock of being turned down at Mayo. I really did not know until I talked to a doctor whom I don't see for 6 months at a time (wrong specialty) that anyone turned down medicare. Then when I called Mayo I became very concerned, and then posted asking (I thought) if that was the policy of all medical in Phoenix. I have a closing on the sale of my home here on the 28th, with the intention of moving to Phoenix. No available medical would have changed my plans.
Japanese Pay Less for More Health Care : NPR
Maybe we should stop looking at Europe and start looking at Asia. This is the kind of government dept I would love to see. haha Doctors in America are very spoiled ay. You're certainly not a doc in Japan for the money. It's the same old education system theory, it's not the money that makes a good system or doctor, it's the people, and what they think of the career, and why they got into it in the first place. I see many people complain about putting too much money into education to solve it's problems but it seems like the same people do think money will solve our health care problems. Why is this? Are you really afraid if you don't pay the doctors a lot of $ the care will suffer? We are really brain washed from repeated system failure. Insurance is a failed idea, and just a money maker.
It's broken beyond believe, and so is our education system. Why is it we can't just admit we failed at both. It's overhaul time, lets stop dragging our feet and get on with it!
Food for thought any how.............................oh, and I don't think the current proposal is going to do anything, it's too cautious. Maybe we should start importing our docs from Asia like we have done with everything else to lower cost. Thats a thought *_*, after all it's all big business right? We look better thanks to Japan, our homes are furnished at prices we can afford because of Japan, so, lets just look to importing some doctors. ASAP Isn't this the American way? Sure it is! Maybe then we can pay China back.
And Dentist let me tell you, we go to an Asian dentist who only charges you what your insurance pays, yet he does everything! Root Canals, Veneers, crowns, it's all covered. He has saved me 10,000 dollars treating my whole family and he has a respectful chair side manner. The only difference is he doesn't expect a 6 figure salary for his work. He has all the latest equip, just a simple office. No fish tank. lol He told me he tried working for an office with other dentist(chain) but he was told he had to make a quota. He said it just seemed wrong to do work people didn't really need, so he started his own practice. I was told by another dentist i needed 4 root canals, went to him and he said i really only needed 1. The others were fine with fillings. My teeth are done and get this, I paid nothing out of pocket, nothing! The other dentist quoted me $3500 after insurance. Geez! ViewArticle
"We have about 10 million people who are the working poor who desire health insurance but don't earn enough to pay for it."
I wonder, of those 10 million, how many qualify for Medicaid or AHCCCS (or other similar programs)? I'm guessing it's a pretty high number.
"I agree we need to reform our system but I don't agree with taking the best aspects of our healthcare and socializing it. Instead, why don't we focus on what is wrong with our system, and address those aspects."
Yes! Let's not forget that most of the great advances in health and medicine come from the good ol' U.S. of A. So while some report may say some country gets "better" health care for "less", their healthcare would not be nearly as good as it is if not for the great advancements that happen in America. (And you have to wonder why their care costs less--where are they cutting corners, and who is suffering or dying because of it?).
We should focus on and fix what is wrong with our current system: government regulations that stifle competition, high taxes, slip-and-fall attorneys, illigal immigration, etc.
I also think if people saved more and had less debt, they'd be in a better financial position when it comes time to pay medical bills. I understand not everyone can do that (and I have too little saved and too much debt myself), but I think it's called "personal responsibility" and an essential element of the civil society.
I did not intend to start a debate about the national insurance. My question was a response to the shock of being turned down at Mayo. I really did not know until I talked to a doctor whom I don't see for 6 months at a time (wrong specialty) that anyone turned down medicare. Then when I called Mayo I became very concerned, and then posted asking (I thought) if that was the policy of all medical in Phoenix. I have a closing on the sale of my home here on the 28th, with the intention of moving to Phoenix. No available medical would have changed my plans.
There are physicians that don't accept any Medicare. It's unusual but there are some physicians that are busy enough with non-Medicare patients that they can refuse to see Medicare patients but these are usualy limited to highly specialized areas like dermatology. Nonetheless, if a public option goes through, it will hurt communities that have physician shortages like Arizona because many physicians will not accept those plans just like they don't accept Medicaid related plans like ACCHS and Mercy Care.
Last edited by azriverfan.; 08-23-2009 at 02:12 PM..
I wonder, of those 10 million, how many qualify for Medicaid or AHCCCS (or other similar programs)? I'm guessing it's a pretty high number.
No, unfortunately these are people who make too much to qualify for Medicaid but don't earn enough to pay for it on their own if their employer doesn't pay in part for it. I think Medicaid could be expanded to cover those people rather than overhauling the entire system.
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Yes! Let's not forget that most of the great advances in health and medicine come from the good ol' U.S. of A. So while some report may say some country gets "better" health care for "less", their healthcare would not be nearly as good as it is if not for the great advancements that happen in America. (And you have to wonder why their care costs less--where are they cutting corners, and who is suffering or dying because of it?).
Very true. For example, pharmaceutical companies in the United States spend billions to develop drugs while foreign countries essentially pirate those drugs and sell them cheaper. The same concept applies to technology like imaging techniques, surgical tools. What's funny is many of these companies are European and sell their products in the United States for profit; those European companies wouldn't exist nor would they have created that technology if they were forced to sell those innovations to their own UHC driven countries.
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I also think if people saved more and had less debt, they'd be in a better financial position when it comes time to pay medical bills. I understand not everyone can do that (and I have too little saved and too much debt myself), but I think it's called "personal responsibility" and an essential element of the civil society.
Private insurance companies are charging premiums that far exceed their cost so there needs to be some reform however I don't agree that the solution is to go in the complete opposite direction and socialize our healthcare system. And like you said, personal responsibility needs to be addressed. For many, their health care isn't a priority until something bad happens and by then it's too late. In some ways, it reminds me o the housing crisis. People want to blame banks and loan companies but no one forced them to buy a house they couldn't afford or live beyond their means. Likewise, no one forced people to spend their money on luxury items instead of essential items like health insurance.
I think it's an interesting point but there are some points I would like to address
1. The educational requirements to become a physician in the United States versus Japan are different. They have to endure less training and take less exams. I would be all for that if I could become a cardiologist in 6 years instead of 14. Maybe we could let people apply to medical school with just an associates degree and not have to get a 3.7 GPA or higher with a bachelors. In Japan, they don't have high school. They skip high school and go directly to college. They don't have to endure the same residency requirements. They don't have to take the MCAT. They don't have to take 3 licensing exams and two board exams to become a cardiologist there.
2. I paid over 200K to attend medical school. Like Japan, perhaps they should make Medical school free for all it's citizens so that we don't have a large loan burden when we graduate.
3. Like Japanese doctors, I don't think I should have to pay 70K per year for malpractice insurance.
4. Like Japanese doctors, I can practice in a way in which I don't have to fear unnecessary litigation from trial lawyers which will enable me to see more patients and enjoy far less stress.
5. Perhaps we should import Japanese people who have better genetics and lifestyle habits. In Japan, they are thinner, smoke less, have a diet far lower in saturated fat and cholesterol and walk everywhere instead of driving. Maybe we need to import Japanese people. I think that would improve our mortality and morbidity numbers as well.
If I had all of these things, I would take half the money I make now because I would have so many other benefits. It's not about the money like you might think.
Last edited by azriverfan.; 08-23-2009 at 03:17 PM..
The difference is that you can call a PCP and get an appointment this week if you wanted to. Not all doctors are booked out that far in advance unless they are extremely popular. I'm a cardiologist who treats many Canadians who were denied service in their country and that too after waiting nearly a year to see a cardiologist there.
I'm not sure you understood my point; I'm fully covered by the best insurance money can buy at the moment, provided through my employer. When I had terrible back-pains, I was able to get an appointment the next day with my PCP, but for my annual physical, he scheduled me 4 months out. The office manager said he only does a small number of annual physicals each week, and he's booked up months in advance. I don't believe he is particularly unusual.
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Originally Posted by azriverfan.
No one is forcing you to retire at 55. You are choosing to do that so of course you will pay higher premiums. The UK doesn't provide pension until you are 65. You can't live off your pension in the UK. The average annual pension in the UK is 12,000 pounds (25K) which includes personal pension fund contributions. If you rely on the state pension fund alone (which is what you are alluding to), that is only 4000 pounds per year. So it's disingenuous to say the UK pays for your retirement because you will be required to save for retirement even there. Your non-income tax is higher too so the highest tax bracket in the UK pays close to 70% in total taxes. Obviously, that is where your free health care comes from.
I would not voluntarily retire at 55. However, given the economy, I certainly need to plan for unemployment as I get older. In either country (UK or US) I would need to have enough savings/investments/etc to cover my living expenses until I reached retirement age of 65 (when both retirement and medicare (and their equivalents) kick in. Getting from 55 to 65 in the US is exceedingly expensive for healthy individuals due to high premiums, and virtually impossible for the sick (see below). In the UK, it is relatively inexpensive as you don't have to pay medical insurance. My point in this regard is that the higher taxes in the UK have very tangible paybacks in this area, specifically for people approaching (but not at) 65.
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Originally Posted by azriverfan.
That isn't true. If you are insured prior to developing cancer or a terminal illness, you will be covered. You can also purchase disability that will pay in the case that you can't work as a result of your illness. ...
I don't understand your point here at all; if I'm wrong, clarify further because this is the biggest concern I have (for her) going forward. My girlfriend has wonderful, top-of-the-line insurance, and her care to date has been great - no complaints. The issue is that, once her cobra runs out, she will be forced to find private insurance and - under current rules - private insurers can simply deny coverage to people with pre-existing conditions. She has a very real pre-existing condition, and would not be given insurance. The only options I'm aware of for her are those 'high risk pools' run by the state, which - in her state at least - are over-subscribed.
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Originally Posted by azriverfan.
If it isn't terribly expensive then explain why the overwhelming majority don't buy it. The answer is because it is considerbaly more expensive. ...
The answer is - you don't NEED it! the base coverage provided by the NHS, despite horror stories to the contrary, is perfectly adequate for the majority of people. My brother has it anyway, because his company offers it, but he said it doesn't really do him any good.
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Originally Posted by azriverfan.
...However, I still believe we provide the best health care in the world. ...
We provide the best healthcare in the world to those who can afford the coverage and are not terminally ill (thus subject to lifetime caps, etc). We don't provide the best healthcare in the world to the uninsured. On this topic, I have to refer to study after study that shows the US ranking very low when it comes to 'outcomes' vs. dollars spent. You can try to spin those statistics any way you want, but they speak volumes.
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Originally Posted by azriverfan.
Preventive medicine is important but overstated. I know plenty of diabetics who don't watch their insulin, don't exercise and don't watch their weight. These patients are informed but make bad decisions. I have many patients who still smoke, do drugs and not exercise despite having had a heart attack 10 years ago. There is only so much a doctor can do in the office. This is one of those b.s. proposals that Obama makes to talk about reducing the cost of health care. In the Price Water House/Coopers study, 200 billion or a 1/3 of the health care costs in this country was due to irresponsibility of people themselves. How many people in this country eat healthy, sleep enough, exercise daily, manage their stress. Sorry but people in the United States often put their health on the back burner and don't prioritize it. People like eating high fat food. They like staying up late instead of going to be on time. They don't want to exercise and would rather watch television. I'm guilty of many of these sins but its a part of American culture.
I'm all in favor of ANY measures taken to reward healthy living and penalize unhealthy living. I quit smoking years ago, started eating fish, fruit, vegetables; exercise regularly; etc. I don't know how they can implement such a plan but I'd be all in favor of it - as would many, I suspect.
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Originally Posted by azriverfan.
Agreed but adding to the debt doesn't really make sense. We don't want to make things worse. I think healthcare reform is necessary but the liberals are falsely trying to convince Americans than unless reform has a govt option then it's no good. That isn't the case at all. There are a lot of reforms that can take place now which would improve health care such portability, allowing pre-existing conditions, freeing state restrictions when shopping for plans, negotiating with insurance companies to stabilize premiums.
I don't see the 'public option' as being so evil, but since it won't affect me I'll certainly accept whatever comes out of this. If we get all the other things you list above, I'll be happy. However, in principal, I'm in favor of it and would gladly pay more taxes for it - my taxes are better spent helping others get healthcare than implementing 'regime change' in a country that doesn't need it.... What really kills me is - all the republicans now say 'we need health reform' - but they were in charge for a long time and totally ignored the issue. Only now that Obama is truly serious about it are they having to care. I think the absolutely key changes - pre-existing conditions, life-time caps, etc - are only now being talked about as a 'done deal' because of the seriousness brought to the discussion by Obama. Thank GOD he won the election!
I think it's an interesting point but there are some points I would like to address
1. The educational requirements to become a physician in the United States versus Japan are different. They have to endure less training and take less exams. I would be all for that if I could become a cardiologist in 6 years instead of 14. Maybe we could let people apply to medical school with just an associates degree and not have to get a 3.7 GPA or higher with a bachelors. In Japan, they don't have high school. They skip high school and go directly to college. They don't have to endure the same residency requirements. They don't have to take the MCAT. They don't have to take 3 licensing exams and two board exams to become a cardiologist there.
2. I paid over 200K to attend medical school. Like Japan, perhaps they should make Medical school free for all it's citizens so that we don't have a large loan burden when we graduate.
3. Like Japanese doctors, I don't think I should have to pay 70K per year for malpractice insurance.
4. Like Japanese doctors, I can practice in a way in which I don't have to fear unnecessary litigation from trial lawyers which will enable me to see more patients and enjoy far less stress.
5. Perhaps we should import Japanese people who have better genetics and lifestyle habits. In Japan, they are thinner, smoke less, have a diet far lower in saturated fat and cholesterol and walk everywhere instead of driving. Maybe we need to import Japanese people. I think that would improve our mortality and morbidity numbers as well.
If I had all of these things, I would take half the money I make now because I would have so many other benefits. It's not about the money like you might think.
Well, thats pretty much my point! Exactly, we are broken, all those things you mentioned are true. (except for the smoking, they smoke quite a bit if you read the articles I posted it is stated they smoke more in Japan, and most of the Asians in American colleges are in the top 10% of their class)
But, I agree with the rest, we are ridiculous and it's funny how such a young unexperienced country as ours thinks we have nothing to learn from our neighboring senior countries.
We look like little fat baby pigs, just how they portray Americans in most of their movies. Sad really, we don't encourage a good life style through our government because we will throw a fit about it like big babies, they do, we don't trust our government because we view them as the enemy (which is really strange and doesn't occur in many countries that are not 3rd world or under communist rule.
We can't criticize anything because of our weak egos. It's getting absurd and I've had about enough. We need to act our age and take some good lessons from the other countries and fix what's broken like our education and health care before we slip into such a reputation that we can no longer recover.
Japanese kids go to school a lot more than American kids do and receive a far far better education then we do. Their culture required a strong work ethic, despite pay, it's more about self respect and duty. To be frank, they don't really need as much college as we do for medical school. They are way ahead of us from the start. They spend far more time on their studies as young kids then most of us do in college. You should go over there for a trip and check it out. It's a lot different.
Even Asians raised in America with parents who teach the same standards here do much better. If you ask a Japanese person what it takes to be so good at math they will say it takes hard work. Americans will say some people are born better at math than others. Not really, and we need to stop making excuses for ourselves, thats one thing we are good at. Don't you think? We look like a bunch of babies to me. By the way, my dentist didn't come over on a boat recently, he went to college here, so he has the same expenses as everyone else but still charges a decent affordable price and lives a normal life. He is just satisfied with who he is I believe. We are just taught that if we work hard than we need a pay back for it. There are a lot of other cultures that don't have this way of thinking.
This is just food for thought anyway, everyone will have their own opinion but if you stop for a minute and look into it more there are some good lessons from that country that we could apply here. Other countries as well, I just think we are so busy arguing the point that we don't have time to learn anything but new excuses for why we need to be broken.
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