Healthcare extreme video

aircooled wrote:

GlennS wrote: Was the plan ever to put the government in charge of hospitals or were they going to be another insurer? Unless they were going to take over a bunch of privately run hospitals this argument doesn’t follow.

Are you implying Oldsaw had made a fallacy of division? (inferences from the fact that a whole has a property to the conclusion that a part of the whole also has that property) - A government run health care system implies that they must control the hospitals. ...just practicing my logic...

didnt realize the government was going to run our health care system. Maybe im mistaken. I thought that they wanted to provide a government insurance OPTION to people that aren't old enough for Medicare.

I feel like most of these discusions go like this

Dude A: THE GOVERNMENT WILL RUN OUR HEALTHCARE SYSTEM LIKE E36 M3!

Dude B: They just want to make a publicly available insurance option available. They dont want to nationalize our nations health system.

Dude A: But if you let the government insure us they will eventualy take the entire system over.

Dude B: Yes, and if you let government lightly smear your civil rights every time some yahoo blows up a building the country will eventually be all 1984. God dam slippery slopes, just no avoiding them.

Dude C: Yall suck at spelling/grammer

GlennS wrote: Oldsaw, your expanded arguement makes more sense to me now. Yes, bad policy down the road that piggy backs on what they are suggesting now could lead to bad things down the road.

oldsaw wrote: A real solution (IMO) is to address the root causes of rising costs, costs that have far exceeded the rate of inflation. I humbly suggest that government intervention and over-regulation has a much bigger role in sky-rocketing costs than the profiteers of insurance companies. To believe government will perform better than the private sector, to me, is just madness.

What are some examples of government causing sky rocketing insurance costs? Canadas government seems to be out performing our private sector, at least cost wise. Their country spends about half as much per person as ours does.

I'll reference this study (performed by the Cato Institute) that was conducted in 2004:

http://www.cato.org/pubs/pas/pa527.pdf

As of six years ago, regulatory costs were twice the amount of average household benefits. Who knows the ratio as of today, but it certainly is not for the better.

One can also note the anecdotal history of SVrex spending less than half the "covered" cost of childbirth when direct payment from the consumer is used. I would in no way attribute those cost differences to federal interference; state and local governments plus administrative requirements for insurers also have a great influence. But, the tremendous discount SVrex received says a lot about the overhead costs associated with structured and regulated care. Because government dictates the re-imbursement rates for services offered to Medicare/Medicad patients, losses must be covered by raising the costs to others paying for coverage.

Canada's system (and others) have benefits, but those in the system have longer waits for care and that care is often sub-standard compared to what's available in the US. There is a reason Canadian Premier Danny Wilson chose to have heart surgery outside of his province and his country and it wasn't because of state-of-the-art technology and advanced care procedures.

As far as our Federal government merely funding insurance coverage, again I defer to the current status of Medicare/Medicaid. These programs lose money and force an increase of costs in the private sector. By expanding the rolls of the government-insured, the costs will increase for everyone regardless of the promises coming out of politician's mouths.

As always, just my .02$.......

Are hospitals required to accept medicare/medicade?

i really dont know the answer to this. Just asking.

It does sound like a screwed up situation if hospitals are being forced to provide service at a government mandated rate that results in a loss every time the service is provided.

I think one of the biggest problems our countrys politics has is that politicians always want to increase government services while reducing taxes. HOW IS THAT SUSTAINABLE! Happens on both sides of the isle.

I remember seeing advertisements in England for some politician that was promising " If elected i will not lower any taxes".... i was like "whaaaaaaaaaa, thats a selling point here?"

oldsaw wrote: Canada's system (and others) have benefits, but those in the system have longer waits for care and that care is often sub-standard compared to what's available in the US. There is a reason Canadian Premier Danny Wilson chose to have heart surgery outside of his province and his country and it wasn't because of state-of-the-art technology and advanced care procedures.

I have heard this a few time before as an example of how bad the Canadian system is, I suspect it is not quite as damning as it is represented as.

If you think about it, it is very similar to someone who is insured in the US under a private company, (e.g. Blue Cross) who is a person with some money that need heart surgery. This person wants the best surgeon available, but Blue Cross is not very interested in paying for the top heart surgeon in the country (they are after all a for profit company, not a charity) and wants him to go to their preferred doctor (you know, that rationing thing P was yelling about).

This person then decides they will fly to Florida to thier preferred doctor and pay for it themselves, because they can afford to do that. Thus making the US healthcare system as bad as the Canadian system (or not).

Yes, the US has some of the best doctors and care available anywhere, that does not make it the best healthcare "system" in the world (as is commonly "yelled"). The BMW 7 series may be the best car in the world, but if almost no one can afford it. Does it really make the transport "system" the best in the world since it is available, when the vast majority of the population can only afford to drive a Camry?

Hospitals and physician practices are not required to accept medicare/medicaid - but from a needs standpoint - most everyone goes the first 40-60 years with minimal healthcare needs. Then the aging process kicks in full steam and the needs go full on - the vast majority of healthcare costs are for the geriatric population. Most docs/nurses are in health care for humanitarian reasons - so they care for this population (btw, it is possible to be profitable as a hospital with medicare level reimbursements). From what I see, medication expense and technology are the driving factors on costs. There is a significant amount of ineffeciencies and waste, that contributes as well - but nothing like the meds and tech.

I think there is a bigger cultural issue in play. What's good for the whole vs. what's good for the individual. I've seen cases where a patient with stage IV cancer - and very poor prognosis insists on continuing to seek treatment with the intent to cure (it actually happens around 1% of the time). The patient accumulated nearly $2 million in bills before they died. That's a lot of resources that insurers will be making up for - a lot more than perhaps the $20k that would have been billed out for hospice. The good for the whole - well, would have been for the patient to not have smoked for 30 years and not burned through a lot of resources that didn't really affect the outcome. The other side is that we're in America and have the whole life, liberty and pursuit thing going on and if one chooses, can use any resource at hand to pursue those things regardless of cost (with the right insurance or deep pockets). What's good for the whole is that individuals may have to take one for the team. To not burn resources on low probability outcomes. In car terms - you don't go for heroic restorations on rusty 83 oldsmobile sedans with bad motors and trans. Sounds fine right up to the point it's you or your family - but when grandma is 85, has copd, clogged arteries and cancer people start throwing a fit at the suggestion that perhaps we shouldn't throw a bunch of resources at her to extend her life a few months. Other countries have gotten to grips with these issues - or perhaps we have as well - we're just not happy about the cost of the decision.

My family and that of my wife, are all in Canada. Within both families, we've endured 3 cancers and a quadruple bypass over the last several years. I have not heard any of our siblings or parents complain about the level of care they received. Did they get instant care? My mother had stents put in 48 hours after diagnosis and a year later had a bypass operation within a week of it being discovered. The doctors know how to prioritize and get the critical patients to the front of the line. The cancers were treated in a timely and effective fashion. Could I get faster,or better treatment here in Michigan? I think so, my family doctor could have me in for a bypass tomorrow, I'll bet. There are pros and cons to either system. The ideal would be the American level of service, somehow integrated into a system that prevents people form going broke when sick, or being denied coverage all together. I don't have the magic bullet, but I do have the luxury of being in a position to chose which country to live in. Right now, I'd give the healthcare advantage to Canada. There are a number of other factors in making the choice that aren't related to healthcare, so it's not an easy chioice by any stretch of the imagination. Having lived with both systems, I've seen a lot of differences. Luckily ,I've been pretty healthy, but I did have a bilateral hernia repaired a few years ago. I got it done within 10 days of it being "discovered" during my annual physical (I knew it was there!). But here's what I thought was a real waste of time and money. I ended up having 3 EKGs before the operation ! That was just everybody covering their butts at the expense of the insurance company. I think there's too much unnecessary testing. Just my $0.02 worth.

oldtin wrote: ..From what I see, medication expense and technology are the driving factors on costs. There is a significant amount of ineffeciencies and waste, that contributes as well - but nothing like the meds and tech... ..What's good for the whole vs. what's good for the individual. I've seen cases where a patient with stage IV cancer - and very poor prognosis insists on continuing to seek treatment....

I think you are absolutely right on with this. There are hard choices that need to be made, if you want to reduce healthcare costs, you, at some point, need to just let people die. Advanced medical procedures are great technological advancement but they can also be the financial downfall of the healthcare system.

Of course talking about the good of the whole vs the individual makes you a Commie Pinko Socialist. You are supposed to be focused on what is good for you, only Commies think about the population (or country) as a whole. You also apparently want to kill peoples grandmothers, that makes you a bad person. These are things I have learned from listening to those who like to "yell".

Oughta change my handle to Redtin

Last week we got a call from a local gas station - patient had snuck out (in a hospital gown with chemotherapy pump still attached) to the station to grab a pack of smokes. Grrrr

The debate is easier when it's extreme cases - really fuzzy when things are on the borderline or investing in expensive technologies with no clear or immediate payoff - but the possibility of a big payback later. Unfortunately we have representatives who are only working with black and white facing a technicolor issue.

aircooled wrote:

oldtin wrote: ..From what I see, medication expense and technology are the driving factors on costs. There is a significant amount of ineffeciencies and waste, that contributes as well - but nothing like the meds and tech... ..What's good for the whole vs. what's good for the individual. I've seen cases where a patient with stage IV cancer - and very poor prognosis insists on continuing to seek treatment....

I think you are absolutely right on with this. There are hard choices that need to be made, if you want to reduce healthcare costs, you, at some point, need to just let people die. Advanced medical procedures are great technological advancement but they can also be the financial downfall of the healthcare system. Of course talking about the good of the whole vs the individual makes you a Commie Pinko Socialist. You are supposed to be focused on what is good for you, only Commies think about the population (or country) as a whole. You also apparently want to kill peoples grandmothers, that makes you a bad person. These are things I have learned from listening to those who like to "yell".

I'm straying out on the proverbial limb, but I'll suggest there are a couple of generations of Americans who busted their asses to achieve the "dream" and realize their dream is now a nightmare.

Government and private sector policies influenced workers for over fifty years, encouraging them to work hard and enjoy the fruits of their labors in the later years. Because government and business don't work on long-term plans, all the financial benefits generated by those who actually "produce" have been sqaundered - to the detriment of those who bore the burden.

Now, government wants to dictate the terms of "equitable" application of resources and vested "special interests" are lining-up on a gravy train of federal subsidies that aren't sustainable. And too many of those with vested interests are way too dependent on government largesse to even exist on a stand-alone basis.

It's pretty clear why people distrust government, Republicans, Democrats and Big Business and are making a long belated stand against the hypocrisy.

Just sayin............as always.

oldsaw wrote: Canada's system (and others) have benefits, but those in the system have longer waits for care and that care is often sub-standard compared to what's available in the US. There is a reason Canadian Premier Danny Wilson chose to have heart surgery outside of his province and his country and it wasn't because of state-of-the-art technology and advanced care procedures.

I'm curious as to what sub-standard and longer waits mean to you?

If its life or death, you get the treatment. Its pretty simple. If it can wait compared to somebody else in more dire need, it waits. Sounds pretty good to me! Having been subject to this "terrible" system all my life (being an asthmatic for one thing, and having had shoulder surgery for an abnormal bone growth caused by a dislocated shoulder), I think I've faired pretty well. Considering a lot of people (from what I understand) can not afford health care in the US, or (from the sounds of it) stingy health care providers will not provide certain care, I can't really complain in this system. I could not imagine NOT having health care like we have though.

As for actual quality, its pretty good. Considering the point of our hospitals is to help people rather than take their money, I can abide by that. A person I go to school with got a really, REALLY bad ear infection while down in California. The checkup plus prescription for antibiotics was $700 :o Here, it would have been $40 at the walk in, plus a couple of bucks for the perscription. Yes, our taxes are higher, but $700 out of pocket right then and there? Yeesh.

I'm not saying there is anything inherently wrong with either system. But to quote reports that (IMO) are not the status quo and (again, IMO) biased doesn't help your position much. If you ask most Canadians, they are pretty pleased with the system.

If I earned the kind of money politicians did, wouldn't you go buy the quickest, best surgery/care you could afford? Thats just common sense with regards to Premier Wilson. I wouldn't want to wait either!

No one wants to wait when it's their problem. Take kidney stones, for instance. I've had those damn things and while not life threatening the sumbitches HURT.

Down here, I see immense amounts of waste. The local hospital chains rent billboards, take out two page newspaper ads, have huge TV ad campaigns (there is one which shows an EXTREMELY busty blonde sliding into an MRI. Freud, anyone? ), use internet advertising (every time I log on Bon Secours St Francis has some video at the right side of my screen) and advertise stuff like valet parking to attract customers. a couple of the hospitals down here look like something from a resort; high end tile, marble everywhere, huge fancy chairs, gigantic salt water aquariums, the list goes on. That stuff does NOT add to the quality of care one iota (yeah, yeah I know, nice surroundings blah blah blah) but you better believe it costs a wad. I figure at least 20% of medical costs go for incidentals like that. I'd gladly forego ficus trees in the lobby for a 20% reduction in health care costs.

As mentioned, my dad recently died of cancer. I won't bore you again with the details but I will say that the last three months of his life were very expensive. We are still waiting on some chemotherapy bills to come in for a final analysis of the costs, but $43,000.00 is for sure right now. We may be ale to negotiate that lower. As mentioned earlier by a couple of other posters, the very end of life is where we rack up the highest bills. Unless I miss something entirely, I have never heard of a private insurer backing out of those costs. Why? It's because they are contracturally obligated to do so, would any of you buy an insurance policy which says 'after age so and so you are on your own, buster, even if you are still paying premiums'?

So what happens when the patient's wishes are taken out of the equation? Now we get to the allocation of resources. The amount of money is finite in any system: private, public, a mix, whatever. An 80 year old in poor health would be occupying a hospital bed better used for a 30 year old who needs to convalesce after a car wreck. So just how long do you think it would take for rules to be put in place saying 'based on this formula which says you are no longer a productive member of society and it doesn't matter even if you are the one who's paying you aren't worth the cost to the rest of society, here's some pills, now go home and die'. That's what you'd eventually get with a single payer tax supported system. BTW, there are already formulas in place for determining the 'worth' of a human life, generally used in wrongful death lawsuits. Not much of a stretch to apply those in the other direction.

Regardless of whether that's right, wrong or necessary (and I think it will be eventually ), people will not stand for that. The saying goes 'you can judge a society by how it treats its elderly'. Used to be, the sick, lame and elderly were kicked out of the tribe to fend for themselves which is pretty much the same thing the lower animals do, if there is a reason for the herd to move on if one of them can't keep up they are left behind and they die. That's supposed to be one of the things which separates us from the lower animals.

HiTempguy wrote: ....Yes, our taxes are higher....

But, your healthcare system is cheaper overall (less cost per person). People here are always talk about the higher taxes in Canada to cover the system, but fail to realize you don't have those large deductions (for most) from your paychecks every month to pay for your health insurance. Not to mention the Medicare and Medicade deductions. And remember that that amount is not even the whole cost for most since their employer covers some of it so realistically a taxed national system would not only eliminate the insurance payment, but should raise their salary (or reduce company cost, depending on how that goes).

I also find it frustrating that the Canadian system is constantly portrayed as broken when it seems like almost no one is talking from real knowledge (just constant quips about waiting in line and rationed care).

Would any of you with actual experience with the Canadian system comment about the end of life care there? It is clearly an important issue and I am curious how they handle it.

My brother-in-law passed away before Christmas from the ravages of cancer. He was continually treated right up until he decided that it wasn't worth the pain to hang on a little longer. He told the doctors in Montreal to stop the chemo and radiation treatments. There was never any pressure from the medical staff to cease, they would have continued on indefinitely had he or his wife wished to.

The Canadian health-care system seem to work very well for Canadians. The program has been in place for 50 years and is fully integrated into the national culture. I'll suggest that the system was embraced because private, personal insurance was never as entrenched as it is in the US.

Creating and offering universal coverage in the US doesn't generate much support because people have seen how well the government has managed existing entitlement-style programs. Considering the track record, people in the US have every reason to fear the results of Federal intervention.

And there's always the concern of over-exposure to Governmentium.

A major research institution has recently announced the discovery of the heaviest element yet known to science. The new element has been named "Governmentium." Governmentium has 1 neutron, 12 deputy neutrons, 75 assistant neutrons, and 224 deputy assistant neutrons, giving it an atomic mass of 312.

aircooled wrote: But, your healthcare system is cheaper overall (less cost per person).

Absolutely. The only reason I mentioned taxes is because that is what someone arguing against universal health care would bring up.

aircooled wrote: Would any of you with actual experience with the Canadian system comment about the end of life care there? It is clearly an important issue and I am curious how they handle it.

As has been stated, care until you die. The choice is yours, and yours alone (unless you've appointed someone to make the decision for you) of when you die.

For this reason alone, I've always found the whole "death panel" thing hilarious. That would never fly, ANYWHERE there is socialized health care.