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Do you really want to be stuck with a potential healthcare bill so high
that even selling your home and all your assets cannot pay for?
Before the Affordable Care act was introduced the number of people having to drop healthcare coverage due to no longer being able to afford it was staggering with that number growing every month.
Those here will ask how we can afford this.
I answer by saying if we don't come up with a way to cover our citizenry as a whole concerning healthcare we will find ourselves in the fiscal toilet for good.
The wealthy don't need help.
The poor will get help regardless of any plan.
The people in the middle, the ones who actually pay most of the costs...
can pretty much do OK for themselves without any HI plan.
Pretty much do OK specifically EXEMPT's the catastrophic and traumatic.
This level of care (and the trashing the elderly get at end of life) is the problem.
Because NO ONE who works for a living can afford to pay these expenses and everyone wants to
believe they have a right to receive the highest levels of these services and treatments...
these categories of "healthcare" are the ONLY area of medicine that needs a solution.
So far the best they can come up with is making the rest of our far less serious medical needs
cost outrageously high amounts (well, for those who actually pay those bills)... so that the system
as a whole will have the reserves needed to cover the costs of the rest.
I am not even remotely confident that it will (or even can) work as proposed.
Last edited by MrRational; 12-17-2012 at 11:57 AM..
You make a good point about whether or not an 82-year old, or 86-year old, ought to be having heart surgery. But who gets to make that decision? Personally, I'd rather see that decision made by the patient himself -in consultation with the doctor ...
OK. I'll go a step farther though.
The decision should be made decades before such a need might present.
A balance between established standards of objective criteria and personal wishes.
Quote:
- than to have some politician making the call.
The only role for politicians should be about creating a legal shield for doctors
when they get accused of doing less than what "modern medicine" might be capable of.
OK. I'll go a step farther though.
The decision should be made decades before such a need might present.
A balance between established standards of objective criteria and personal wishes.
Well... Decades ago, it would have been unthinkable that ANYBODY would undergo heart bypass surgery. Now it's an everyday thing. So what was good enough then, is not necessarily good enough now.
Add to that the fact that no two people are the same, and it further complicates things. My 77-year old dad is in great health, is extremely active, and still works every day of his life, because he loves what he does. Even at his age, he has had NOTHING done medically, other than regular physical check-ups. His only "medicine" is an occasional Tylenol. Compare that to my 66-year old buddy Gary, who in the past 10 years has been on death's door more often than not. He's been in hospitals more than he's been out. He takes thousands of dollars worth of medications every month.
It's a good debate to have, but I just don't know how we can make "blanket decisions" for millions of people.
Well... Decades ago, it would have been unthinkable that ANYBODY would undergo heart bypass surgery. Now it's an everyday thing. So what was good enough then, is not necessarily good enough now.
...but I just don't know how we can make "blanket decisions" for millions of people.
We don't. They do. They and their doctors.
Gee we could even have organized counseling sessions with our doctors where things are explained
and decisions can be made without any immediate problem or the emotions interfering.
Their choices are made by using general or at least less specific terms.
General Anesthesia, X units of blood transfused, Days of In Hospital Recovery time,
Weeks of recovery time... and so forth.
It isn't that difficult to translate to a specific condition or treatment. Besides, the reverse could be just as true as well.
Many once risky bloody surgeries and now done endoscopically and out-patient.
The point is that the doctors know what reasonable criteria are and should apply in a given situation.
Being able to get someone through a process, in itself, shouldn't be the fulcrum of the decision to.
Well... Decades ago, it would have been unthinkable that ANYBODY would undergo heart bypass surgery. Now it's an everyday thing. So what was good enough then, is not necessarily good enough now.
Add to that the fact that no two people are the same, and it further complicates things. My 77-year old dad is in great health, is extremely active, and still works every day of his life, because he loves what he does. Even at his age, he has had NOTHING done medically, other than regular physical check-ups. His only "medicine" is an occasional Tylenol. Compare that to my 66-year old buddy Gary, who in the past 10 years has been on death's door more often than not. He's been in hospitals more than he's been out. He takes thousands of dollars worth of medications every month.
It's a good debate to have, but I just don't know how we can make "blanket decisions" for millions of people.
What you say has some superficial appeal to it. The problem is that the alternative to having these decisions made by a national health insurance system is having them made by the free market. Under the free market, Dick Cheney gets a heart transplant. One thousand poor kids may not get a kidney transplant. Old people tend to have more money than young people, so most health care will likely be given to people who are in the least healthy condition with the shortest number of years to live. The person with the most money or the best health insurance plan gets health care. Those without it don't get it.
Money is an unacceptable to way to ration a scarce resource like health care in my book. I think if we took a vote most people would agree. This isn't a debate over "getting to keep your doctor". Its a debate over whether the person with the most money ought to--as a matter of right--get the best health care while others go without.
Now, add to this the fact that every other modern, industrialized nation has a system of universal healthcare (UHC). This would include the European countries, Canada, Australia, New Zealand, and Japan. Even Taiwan adopted a system of UHC a few years back and they have just made the transition from a third world country to a modern country.
The Affordable Care Act has many imperfections. But, it would suit everyone better to quit whining, get together, and find ways to improve it rather than call for its repeal.
Before the US could do that, it would have to train a lot more doctors, in order to meet the demand. Even now, there aren't enough primary care doctors to go around. If all the uninsured people were suddenly insured, the doctor shortage would be extreme. Reimbursements to doctors would have to be enough to incentivize more doctors to go into family medicine, internal medicine.
Furthermore, something needs to be done about the cost of medical education. Doctors enter their first year of practice saddled with 8 years of med school debt IN ADDITION TO their debt for undergraduate education. France, Germany, Sweden, etc. subsidize medical education, so doctors aren't burdened with enormous debt. The high rate of debt doctors have to pay is one factor that causes them to expect to be paid highly. And then there's the whole malpractice insurance issue, adding to doctors costs. All that has been getting passed on to the consumer until recently, with insurance cutting back on reimbursements. Now doctors are getting squeezed, with rising education costs/loan debt, but shrinking reimbursements from insurance.
Is everyone willing to pay higher taxes to get national health care? Personally, I think it would be worth it. Anything would be cheaper than the rates for individual insurance some people pay. But the public needs to remember--you don't get something for nothing. Higher taxes to pay for national insurance AND to cover most medical education costs would bring us in line with European countries. But that would be a hefty tax bill.
Yes, I agree, I think I put that somewhere in this thread. lol
In Germany for example the doctors are educated for free so that don't have long term debt while working in the medical field. They also pay a minimum in legal insurance. Compared to us they have little worry about law suits. The average family doc in Germany makes about $120,000 a year but has not entered their practices in debt. The average family doctor in the U.S. makes $175,000. But, in the U.S. they enter with school debt and pay high malpractice insurance.
I believe Obama has been modeling Obamacare after Germany and some issues from Thailand. So we might see education for medical declining or covered in the near future. It would really help, I agree.
If we tweak as some have said, we should add a tweak for doctor incentives regarding healthy patients instead of procedures. We should give educational incentives and yes, address the insurance companies. In Germany insurance is still private but not for profit. It is also heavily regulated. It makes money by promising patients more perks, shorter waits, less paper work, etc. They still do well their CEO's just aren't pocketing billions.
I still don't understand why we pay so much for drugs. Nobody else allows this. We shouldn't either. We shouldn't be funding drug research for the world. We can't afford it.
Last edited by PoppySead; 12-17-2012 at 03:39 PM..
You make a good point about whether or not an 82-year old, or 86-year old, ought to be having heart surgery. But who gets to make that decision? Personally, I'd rather see that decision made by the patient himself -in consultation with the doctor - than to have some politician making the call.
I agree, I think everyone would like that better. Right now though we don't have that. We have insurance companies and affordability making that decision. If we tweak as you say then we should tweak it toward giving citizens and their docs the ability to make that choice.
Even in Europe they have gotten the waiting time down to two months or less for joint replacements, etc. You wouldn't have to wait for heart surgery and they have a NHS. We aren't doing it right here if our VA's have to wait two years for heart surgery. Another reason to do a major tweak on the system.
Gee we could even have organized counseling sessions with our doctors where things are explained
and decisions can be made without any immediate problem or the emotions interfering.
Their choices are made by using general or at least less specific terms.
General Anesthesia, X units of blood transfused, Days of In Hospital Recovery time,
Weeks of recovery time... and so forth.
It isn't that difficult to translate to a specific condition or treatment. Besides, the reverse could be just as true as well.
Many once risky bloody surgeries and now done endoscopically and out-patient.
The point is that the doctors know what reasonable criteria are and should apply in a given situation.
Being able to get someone through a process, in itself, shouldn't be the fulcrum of the decision to.
They do if they aren't paying their mortgage with it. I know a lot of surgeons personally. They do a lot of unnecessary surgery because they have a lot of bills like everyone else. I see a lot of gallbladders removed that don't need to be, a lot of hysterectomies, and joint replacements. Heck I've even seen them remove blockage and it wasn't even over 30%. Not all surgeons would work for profit reasons but what else do they do when they don't have enough money coming in? That's what they do, that's how they make their living. We do a lot of unnecessary things for profit here.
We need to stop selling ourselves for one. Diet change, exercise can replace a lot of drugs and surgeries but they don't push it because that's not how they make money. They make money from surgery. It's a business, just like any other. Sure, you could replace it, but do you have to? No, not always.
Embarassing for a rich nation such as ours to be so much behind in health care. Yes we have the best doctors and facilities but most have NO access to them.
We don't privatize Fire Dept or Police they why should health care be private?
Yes, free access to health care should be an entitlement for our citizens. It is just to embarassing to be in the 21st Century to even debate that!
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