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If you hope is to get a point across, try fewer words. Of course it would also help to understand that there are various ways to accomplish UHC, none of them pretend to be free. Further, as a VA Health patient, I think your reference to it being incompetent, is disgustingly false.
I think the VA has its problems, for sure. However, living in an area with lots of disabled vets and retired disabled vets, they have had nothing but fantastic care. My friend's father has had phenomenal care since the end of the Viet Nam war where his feet were basically blown off. He is now in his 70s and the VA has aggressively treated him so he still retains his ability to walk. I've been amazed at how proactive they have been.
Actually, there is a lot of misinformed people, and you are no exception.
Without making a direct comparison between the UK and US systems (our system is irreparably busted, corrupted and not to be trusted), I'm afraid that the UK's socialist UHC system is also a disaster that serves as no model for which one should want to mimic.
Contrary to the Utopian liberal mindset of a perfect world where everything is both freely available and easily affordable and of the highest quality, all at the same time ... nothing will ever achieve that status, and certainly not healthcare. That universal rule ... "You get what you pay for" will always enjoy preeminence.
The very base nature of a "Single Payer" system necessarily involves a single decision maker about what is to be paid for ... and that is it's fundamental flaw that cannot be avoided. The single payer will ultimately decide what it is able or willing to pay for, with those decisions based on the financial, rather than the scientific.
Here in the US, we have a microcosm example of a UHC system in the form of the Veterans Administration which attends to military healthcare, and it is an unmitigated disgrace. The VA hospitals have the most incompetent level of care anyone could imagine, and the horror stories would curl your hair. Furthermore, we have the Medicare system which serves as a quasi single payer system for seniors, and indeed, medical decisions are almost always based on the guidelines established by the medicare bureaucracy rather than sound medical science. And that plays both sides of the fence in denying certain needed treatments while allowing a lot of unnecessary costs that are routinely abused to the greatest extent. It is estimated that medicare fraud, waste and abuse can account for as much as 30-40% of the overall expenditures annually. And this might be a conservative estimate. The efforts to address Medicare's financial problems inevitably centers on cost cutting in the form of reduction of services covered and not the outrageous costs being charged for services. And when medical decisions are dictated by the financial considerations of bureaucrats hundreds and thousands of miles removed from the individual patients and doctors, disaster lurks, and medicine invariably becomes a political football.
Now, I don't pretend to have the ultimate "solution" to the problem of affordable high quality medical care, because there is an inherent conflict of interest inbuilt into the equation ... that being a system (regardless of structure or who pays) who's responsibility to deliver healthcare services is in direct conflict with it's own self interests. The medical establishment, ranging from pharmaceutical corporations to hospitals to doctors all thrive on sickness and the treatments for those illnesses, rather than good health. So long as good health remains the enemy of healthcare profits, one can hardly expect good health to be the ultimate goal. That's a fundamental problem that no one wishes to discuss. So we all simply pretend that the the healthcare industry enjoys an extraordinary exception which no other industry possesses, and operates in a "Florance Nightingale" mindset of selflessness and benevolence .... which is preposterously naive.
Until this fundamental conflict is solved, the question of "who pays" and "how much" is totally irrelevant. The ever increasing costs of healthcare cannot be corralled so long as sickness serves the system better than good health. The moment a system is devised that ties good health to increased profitability for the industry, that is the moment we'll see costs going down and good health on the rise, and not a moment before.
A "single payer" universal healthcare system does NOTHING to solve that conflict, and only assures equal access to whatever the system offers. By the same token, open market healthcare does allow for individual choices that leave those with the financial resources to attain the highest care available, but leaves the not so fortunate, inferior levels of care.
We need to structure healthcare as we have all other industries ... that is .. outcome based profitability. When you take your car to the auto repair shop, they aren't "practicing mechanics" ... you only pay when they successfully fix your vehicle. If they could charge you regardless of whether they actually repaired your automobile satisfactorily, you'd wind up with a very high bill and a poorly repaired vehicle, GUARANTEED. There would be no incentive to actually do a good job. Now if you passed a law that required EVERYONE to take their car to that particular shop, you'd simply have a universal disaster of high bills and poorly repaired vehicles for everyone.
Not a good solution.
Interesting post, but I don't think you can compare doctors to auto mechanics. Doctors do have an incentive to do a good job because mal practice suits can be very expensive, so is the insurance for that.
I had an insurance company do that to me, too! We actually ended up in arbitration over it. They told me that statistically it was nearly impossible that I could be diagnosed with my disorder (since only around 10,000 people worldwide have been diagnosed) and that they weren't going to treat it based on statistical anomoly. Even though I'd been diagnosed by two different doctors and had the genetic tests, pathology reports from when I had my spleen out etc. to prove it.
They basically told a 12 year old girl and her family that she didn't deserve treatment because it was statistically unlikely I had the disorder. One insurance guy even had the balls to tell my mother it was a bad case of allergies. Yes, I had my spleen taken out due to bad allergies. They also sent me to an ear-nose-throat doctor for it... it's a genetic lysosomal storage disorder and that poor doctor sent me home because he had no idea what I had.
Since I was 18 or so (so, about 10 years) at least once every other year I get a call from a collection agency asking me to set up a payment plan for a couple hundred thousand dollars. This is the insurance company 'accidentally' billing the insurance wrong hoping I'll accept the debt so they don't have to pay it. My credit has been destroyed because it takes months to get it off my record, and by the time that happens, they do it again.
I'm glad I have insurance, don't get me wrong, but there are a lot of problems with it in this country.
Thanks for sharing your story. I'm sorry to hear about your condition and do hope that justice comes your way in the future. Maybe citizens should campaign for some type of independent advisory board that does investigations into insurance companies.
I had an insurance company do that to me, too! We actually ended up in arbitration over it. They told me that statistically it was nearly impossible that I could be diagnosed with my disorder (since only around 10,000 people worldwide have been diagnosed) and that they weren't going to treat it based on statistical anomoly. Even though I'd been diagnosed by two different doctors and had the genetic tests, pathology reports from when I had my spleen out etc. to prove it.
They basically told a 12 year old girl and her family that she didn't deserve treatment because it was statistically unlikely I had the disorder. One insurance guy even had the balls to tell my mother it was a bad case of allergies. Yes, I had my spleen taken out due to bad allergies. They also sent me to an ear-nose-throat doctor for it... it's a genetic lysosomal storage disorder and that poor doctor sent me home because he had no idea what I had.
Since I was 18 or so (so, about 10 years) at least once every other year I get a call from a collection agency asking me to set up a payment plan for a couple hundred thousand dollars. This is the insurance company 'accidentally' billing the insurance wrong hoping I'll accept the debt so they don't have to pay it. My credit has been destroyed because it takes months to get it off my record, and by the time that happens, they do it again.
I'm glad I have insurance, don't get me wrong, but there are a lot of problems with it in this country.
JetJockey, I remember you from other posts about what you've gone through. My wife's condition is rare but no where near yours. She has Reflex Sympathetic Dystrophy, a neurological disorder. Although rare, about a million americans may have it. It's also called CRPS. Her insurance company absolutely knew what her disease was. My wife worked at the corporate headquarters, in the Benefits department. She told me what they would do because she seen it first hand what happened to others over the years. I didn't absolutely believe her until I acquired insurance at my place of work after her termination. She received immediate care literally overnight after 4 years of struggle with her former employer's insurance (two different companies). I then took this issue up with 2 law firms who were very interested in her situation because they've seen this happen before with other companies. Both did their home work, Both knew it to be true, both declined to pursue it because they said its hard to prove and her former employer is too powerful. Another words they did not have the resources to go after them.
If your hope is to get a point across, try fewer words. Of course it would also help to understand that there are various ways to accomplish UHC, none of them pretend to be free. Further, as a VA Health patient, I think your reference to it being incompetent, is disgustingly false.
You know bob, the reason why we never agree on anything is likely because you're wrong about most everything.
The VA Hospitals have been examined for decades, with the poorest levels of care of any hospital setting overall.
Year after year and decade after decade, special investigative reports have been done uncovering the malpractice experienced by veterans which far exceed that in the civilian system (which itself has many problems).
But that's not my opinion Bob ... that's the conclusion reached by the GAO, and congressional investigations too.
Interesting post, but I don't think you can compare doctors to auto mechanics. Doctors do have an incentive to do a good job because mal practice suits can be very expensive, so is the insurance for that.
The auto mechanic was an analogy to having a system that is outcome based and not simply paid based on volume of ineffective (and often counterproductive) treatments and procedures and poor diagnosis due to the hurried state of medical treatment performed in 10 minute increments without good knowledge of the medical history charted.
But your view of malpractice as a governing mechanism is a very simplistic and overrated view. Medical malpractice is a con game for insurance companies to reap excessive profits, as successful malpractice suits are not as common as one might be led to believe, compared to the incidence rates of actual malpractice.
In absence of a significant violation of established "standard of care" guidelines for doctors, malpractice is extremely difficult, if not impossible to prove. And, the medical community tends to protect it's own.
I'm here to tell you that for the past 40 straight days, I've dealt with 50, maybe 60 different nurses ... well over a dozen doctors, 2 hospitals, a nursing care facility, and an in patient Hospice for my mother who has lung cancer. And I have had to battle every single day, without exception, to see that she receives the treatment she needs, without having that treatment kill her prematurely.
I've been lied to repeatedly ... given false or misleading information, and she has been written off as an old lady that is simply dying, with no medical need to actually even try to treat treatable symptoms. Only through my DAILY interventions did she not die three weeks ago, due to excessive and premature palliative "care" which was nothing short of deliberate euthanasia.
The opportunity for medical mistakes is inbuilt into the very operation of the system itself, which I find no rational basis for. Each and every shift at the two hospitals .... three shifts per day .... a different nurse has been assigned to her care. No continuity or consistency can be possible with 21 different nurses covering a STINKING 7 DAY PERIOD. These nurses, for whatever reason are rotated from wing to wing, and floor to floor ... never having been assigned to care for this patient in 2 consecutive days.
Nurse practitioners change just as frequently, while the actual "attending physician" also changes based on scheduled days off ... even though for the most part, they are invisible, with a rare sighting being an accident.
There is no rational explanation for this type of conduct. How on earth can anyone expect a consistent and congruent level of care when the wheel is reinvented 3 times per day, 7 days per week?
As just one example the evening before yesterday, I had a nurse explain to me the schedule of pain medication being administered to her ... which I knew was erroneous because the physician had already consulted with me earlier that morning and put her on a slow release patch. I corrected the nurse, who defensively informed me that she had 8 other patients and couldn't be expected to keep track of those types of details ... even though she had just presented me with details that were clearly wrong. This was just one of the "minor" issues I've dealt with, as some of the more significant ones best not discussed here.
This has been occurring in spite of my daily presence that includes off time visits each day during each scheduled shift to make sure my mother isn't being left unattended to or worse ... attended to in a manner inconsistent with her best health interests.
Now in all fairness, I've had very good experiences with a couple of the physicians and the large majority of the nurses have been first rate. Unfortunately, of those 50-60 nurses I've dealt with, even a small percentage of incompetent ones poses a serious risk (which my experience shows to be about 10% .... which can equate to 2 or 3 bad ones per week, with 18 or 19 good ones. It only takes ONE to cause a severe problem, and I've had MANY over the course of 5 weeks.
Some are overworked, and simply can't offer the level of monitoring that would be ideal ... while some simply couldn't care less. Dope em' up, and forget em' is often the easiest way for many patients to be "cared for", especially on the "night-shift".
I had one head nurse that didn't seem to have an issue with an elevated heart rate of 160, even though the initial admission to the hospital was for an a-fib condition leaving her unresponsive. I had to tell the attending nurse that we needed another "opinion" ... from someone who might agree that this 160 heart rate should be addressed. I could go on and on .. with similar examples.
So, please don't tell me about the facts of healthcare. I'm living it right now.
You know bob, the reason why we never agree on anything is likely because you're wrong about most everything.
The VA Hospitals have been examined for decades, with the poorest levels of care of any hospital setting overall.
Year after year and decade after decade, special investigative reports have been done uncovering the malpractice experienced by veterans which far exceed that in the civilian system (which itself has many problems).
But that's not my opinion Bob ... that's the conclusion reached by the GAO, and congressional investigations too.
I'm sorry if this isn't "brief" enough for you ... but it really is just a small sample.
Good to see progress from the blanket stupid statements, at least an attempt at supporting evidence is better than none. As with all issues, there are extremes and then there are trends..
No but you must have enough funds in case of third party or personal injury accidents.... NO States have nothing in place to cover auto accident cover of one sort or the other.
The auto mechanic was an analogy to having a system that is outcome based and not simply paid based on volume of ineffective (and often counterproductive) treatments and procedures and poor diagnosis due to the hurried state of medical treatment performed in 10 minute increments without good knowledge of the medical history charted.
But your view of malpractice as a governing mechanism is a very simplistic and overrated view. Medical malpractice is a con game for insurance companies to reap excessive profits, as successful malpractice suits are not as common as one might be led to believe, compared to the incidence rates of actual malpractice.
In absence of a significant violation of established "standard of care" guidelines for doctors, malpractice is extremely difficult, if not impossible to prove. And, the medical community tends to protect it's own.
I'm here to tell you that for the past 40 straight days, I've dealt with 50, maybe 60 different nurses ... well over a dozen doctors, 2 hospitals, a nursing care facility, and an in patient Hospice for my mother who has lung cancer. And I have had to battle every single day, without exception, to see that she receives the treatment she needs, without having that treatment kill her prematurely.
I've been lied to repeatedly ... given false or misleading information, and she has been written off as an old lady that is simply dying, with no medical need to actually even try to treat treatable symptoms. Only through my DAILY interventions did she not die three weeks ago, due to excessive and premature palliative "care" which was nothing short of deliberate euthanasia.
The opportunity for medical mistakes is inbuilt into the very operation of the system itself, which I find no rational basis for. Each and every shift at the two hospitals .... three shifts per day .... a different nurse has been assigned to her care. No continuity or consistency can be possible with 21 different nurses covering a STINKING 7 DAY PERIOD. These nurses, for whatever reason are rotated from wing to wing, and floor to floor ... never having been assigned to care for this patient in 2 consecutive days.
Nurse practitioners change just as frequently, while the actual "attending physician" also changes based on scheduled days off ... even though for the most part, they are invisible, with a rare sighting being an accident.
There is no rational explanation for this type of conduct. How on earth can anyone expect a consistent and congruent level of care when the wheel is reinvented 3 times per day, 7 days per week?
As just one example the evening before yesterday, I had a nurse explain to me the schedule of pain medication being administered to her ... which I knew was erroneous because the physician had already consulted with me earlier that morning and put her on a slow release patch. I corrected the nurse, who defensively informed me that she had 8 other patients and couldn't be expected to keep track of those types of details ... even though she had just presented me with details that were clearly wrong. This was just one of the "minor" issues I've dealt with, as some of the more significant ones best not discussed here.
This has been occurring in spite of my daily presence that includes off time visits each day during each scheduled shift to make sure my mother isn't being left unattended to or worse ... attended to in a manner inconsistent with her best health interests.
Now in all fairness, I've had very good experiences with a couple of the physicians and the large majority of the nurses have been first rate. Unfortunately, of those 50-60 nurses I've dealt with, even a small percentage of incompetent ones poses a serious risk (which my experience shows to be about 10% .... which can equate to 2 or 3 bad ones per week, with 18 or 19 good ones. It only takes ONE to cause a severe problem, and I've had MANY over the course of 5 weeks.
Some are overworked, and simply can't offer the level of monitoring that would be ideal ... while some simply couldn't care less. Dope em' up, and forget em' is often the easiest way for many patients to be "cared for", especially on the "night-shift".
I had one head nurse that didn't seem to have an issue with an elevated heart rate of 160, even though the initial admission to the hospital was for an a-fib condition leaving her unresponsive. I had to tell the attending nurse that we needed another "opinion" ... from someone who might agree that this 160 heart rate should be addressed. I could go on and on .. with similar examples.
So, please don't tell me about the facts of healthcare. I'm living it right now.
I'm sorry you are having such a hard time. Having a disabled child I have had a bad experience or two with hospitals myself.
Citizens of the state have to be able to prove their ability to pay for damages in the event of an auto accident if they are the ones at fault. The unofficial Department of Motor Vehicles guide says that this can be done in a number of ways.
First the motorist can carry liability insurance on the vehicle.
Finally they can file a bond with the Wisconsin Department of Transportation as well.
If a motorist happens to get stopped in Wisconsin by a police officer in the do not have insurance, an independent investigation will be led by the Wisconsin Department of Transportation and the case will be put under review.
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