"Our Ailing Health Care"

Welcome to the political forum Octavia! (Cause that's where this is headed).

 

Without getting political and saying why, yes, the health care in almost all developed countries is better than what we have in the States. We have a good ER system, but we do poorly with everyday care.

Tom

 

I imagine the folks here will take this in a political direction, but it needn't be a political discussion.

We have excellent health care in the U.S. for those who can afford it, and little or no waiting time for elective surgery for those who can afford it. But we accomplish this by making health care a commodity whose price is set by the market (supply, demand, willingness and ability to pay) and thereby leaving out large numbers of people.

We ration health care according to ability to pay. Care goes to the highest bidder.

In some other countries, there are long waits for elective surgery, and care is limited, not by ability to pay, but by degree of need.

I lived in Mexico for 4 1/2 years and in Spain for a year and a half. I had to visit doctors in both places. In Mexico it was rather spooky. One doctor I visited had his office in an enormous and windowless room with nothing but his desk, a chair for himself and his patient, and sphygmomanometer. I am sure Mexico has good doctors for the rich, but I didn't know how to find one. When I did see a doctor I paid cash, and I paid very little for my non-care.

While I was in Spain I began to experience a heart arrythmia, and I went to a cardiologist and had a treadmill stress test, as well as other tests including a Holter monitor for 24 hours. On another occasion I developed a urinary-tract infection and had to go to the emergency room. In all cases I went to a private hospital and paid cash. What I paid was between 1/4 and 1/3 of what is charged in the U.S. for the same services, and the quality of care I got in Spain was excellent, as good as I get here at home.

It is clear to me that our health care system is inefficient. The co-pays alone in the U.S. are more than the full cost of care in Spain!

 

I would actually be a bit pedantic and say access to health care (health care coverage) in almost all developed countries is better than the US. I know the colloquial meaning of "health care" covers both access and the actual medical care but I believe it's important to be very specific in this debate.

For those that can afford it (via insurance or their own personal assets) the US has some of the finest health care in the world, and I would include everyday normal "maintenance" care in that (checkups, minor medical issues, vaccinations, general health, etc). Obviously that's a bit of a simplification (I'm sure poorer regions don't have the quality care that richer regions have) but I'd say it holds for the majority of US citizens.

If you don't have insurance or sufficient assets though you're access to quality care is either severely restricted or eliminated completely.

And those with insurance aren't necessarily out of the woods. Many people who require hospitalization or sustained medical care end up with crushing medical bills even if they have insurance. Additionally, if you have the hideous gall to actually get seriously sick or come down with a chronic condition, or if you have any sort of pre-existing condition, good luck finding insurance outside of a job if you lose your current coverage.

 

"I wonder if it's the same with medical insurance companies. Do you think there is a difference? "

Yes. There are rating out there on this. Some of them deny as many as 1 in 5 claims. Some will use anything, like acne or a previous C-section, in order to claim pre-existing condition on unrelated health issues. Some aren't so petty and cold-hearted.

 

Very insightful observation. In my experience, the difference is that I've seldom had many choices for health insurance. Mostly I've had Blue Cross Blue Shield, because that's about the only thing available. There seem to be many more car insurance companies than health insurance companies.

BS/BC pays so little of my actual costs, and charges so much for coverage, that I finally realized I'm better off with a high-deductible policy and a health savings account. This way I know they're not going to pay anything other than catastrophic, but the reduction in premium is greater than my out-of-pocket maximum. But the schedules were so complicated, that it was hard to figure this out.

But my general impression is that more people are left out by the high cost of premiums than by the pre-existing conditions exclusion.

 

"But my general impression is that more people are left out by the high cost of premiums than by the pre-existing conditions exclusion. "

Those are related issues. When people are between jobs, they can't afford the insurance that their previous employer provided, now that the ex-employer is not paying 75% of the premium. So they go without coverage until they get a new job. The new employer offers insurance through X provider, who then sees the lapse in coverage.

 

Of course, you raise a third issue as well: The fractured nature of health insurance. Instead of one unified single-payer plan, people are stuck with whatever is offered by their employer (and not all employers offer health insurance!) and if they lose their job they are kicked out of the insurance plan.

Making health insurance dependent on having the right job is a national disgrace.

Under the guise of offering "choice" to the consumer, the insurance industry screws us royally.

 

Oh god stop quoting Michael Moore. I love when people have no idea what they are talking about.

 

For-profit healthcare and for-people healthcare are two different concepts.

The highest quality of care is better under the for-profit system, because there will always be people willing to pay for the best. Those who can afford to will travel to another country to get better or faster service. Attracting foreigners is often touted as a sign of a superior system.

The average quality of care, and access to it, is better under the for-people model. Access is based on need, not on ability to pay. This tends to annoy the wealthy, which is where the politics comes in. How you feel about the relative merits of each system depends on your level of wealth.

Full access to whatever my family needs costs us about $100 per month, and my employer about that much again. It doesn't cost us anything extra to go to the doctor or to the hospital, and the cost of most prescriptions is minimal. Dentistry is still expensive, as is cosmetic surgery. But, nobody here goes bankrupt over health issues, you don't lose your coverage when you change employers, and I tend to think the average person is healthier under the for-people system. Derisive cries of "Socialism!" are driven by the insurance companies, who have you by the wallet, and aren't about to let go.

 

.... And what if you need surgery or an MRI or whatever in Canada? You wait... A long time!

In the USA, if you need surgery you get it done tomorrow or by the next week at the latest.

CBC News - Health - Wait times for surgery in Canada at all-time high: study

 

I am being specific. I consider health care as the ability to maintain the health of a population, or in other words, care for health. I consider your definition overly specific in the context of this discussion, but that's just my opinion.

I was not quoting Michael Moore, but if he did say that, he must be a smart man.

As an engineer, I like to do a black box analysis of a system to get a feel for it without getting lost in the details. If we use my earlier definition of health care as maintaining the health of our population, and then look at mortality and life expectancy, it's easy to see that we don't do a very good job when we compare our system with those of other developed countries. We have great technology and great doctors, but it's not effectively applied to the general population.

Tom

 

BINGO! Right on the button! Conservatives get caught up in their ideology of free markets and Adam Smith (who, by the way, argued that the "invisible hand" establishes the true price of goods, but does not always serve the public interest; and he argued in favor of government intervention when business undermines the public good). Conservatives oppose all government involvement in business. But in the discussion of public health, the proof of the pudding is in the tasting, and in simple measures of public health, the United States lags far behind the rest of the developed world, even though we spend several times more money on it.

Clearly, our for-profit health system is not delivering public health. It is delivering top-quality health care to the rich, and abysmal care to the poor, at a cost greater than any other country on Earth.

 

Health care itself is not bad or broken, its the underlying expenses that are broken. There are two groups that have decent health care, those with money, and/or insurance, and those on welfare/illegal immigrants. The latter can walk into any public funded ER and get care, (this is the part where "you lie" came up in his speech) its in the laws that no one can be denied care in a publicly funded hospital. Most people are against current health care reforms being bandied about due to that clause. Others are against it because of fear of losing the decent care we are getting with insurance.

A few solutions that could help turn health care around, Tort reform, reducing the amount of judgments will reduce the cost of malpractice insurance, keeping doctors expenses down. Insurance regulations, making it difficult to receive treatment for existing conditions when going from one carrier to another needs to be stopped. Price control, what I discovered is Blue Cross has set up pricing with certain hospitals and doctors for keeping costs down, negotiating a fair price that they pay out to hospitals and doctors, while non insured patients pay full price. If the insurance companies can do that, why can it be done across the board?

If part or all of the above can be corrected, it would be a good start to bringing down health care costs and make them more affordable for everyone.

 

The overall poor health, higher infant mortality, and shorter life expectancy in the U.S., compared to other industrial nations, demonstrates that the health care system is broken. The fact that we pay three times as much as those other nations shows that our method of funding health care is also broken.

The fact that undocumented immigrants can walk into an ER and get treated, does not mean that they get decent health care. Good health care includes wellness care.

And wanting to turn "illegal" immigrants away from hospitals is selfish, uncaring, barbaric, brutal, and just downright scurrilous. It is one of the more disgusting things about the slime that masquerade as "talk show" hosts on the extreme right.

Agreed! (Except I think you meant to ask "Why can't it be done across the board?" (A bit of proofreading before you post helps reduce misunderstandings.)

 

You might find this funny despite your politics.
WATCH IT BEFORE THEY BAN IT!

"Obamacare,
The Musical"

 

Well, that was a waste of time, and not the least bit funny.