Ask Me Help Desk - Putting it in perspective

To all the critics of american health care reform in this place, I think you should read this
US Health Care Bill Passed |
If Obama has prevented some part of this nightmare you call health care he should be congratulated not abused
I also think you should read this
Timeline: When health care reform will affect you - CNN.com.
Now I have heard the objections, like why should I pay for someoneelse's sickness that's the same selfish argument that is used by someone who doesn't insure their car or save money for retirement, the now generation who will one day realise that they too require care. It's a shame your politicians didn't have the guts to pass a public option, or a single payer option, to get the shonks out of your system but one day you will see the wisdom of such approaches

In your first link, why did he come to the US to have

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I went to live in the US in 1999 for my American-born husband William to have treatment for a brain tumour. Over 10 years he had four brain operations, six weeks of radiation, numerous rounds of chemotherapy, immunotherapy and multiple prescription medications.

If other countries have such wonderful medical care, why did he not have his care in England or Australia or Canada??

The fact is that cancer care is top rate in the US - better results.

U.S. Cancer Care Is Number One | Publications | National Center for Policy Analysis | NCPA

This was from the Lancet - an English medical journal

Would this man have been allowed one let alone 4 operations and rounds of chemo had he been in Australia or England or Canada?
Or would he have waited till he was inoperable and then offered hospice care - that is cheaper.

G&P

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Originally Posted by paraclete

why should I pay for someoneelse's sickness that's the same selfish argument

How about: isn't it selfish for me to expect others to pay for my healthcare?

Isn't selfish that the healthy [ primarily the young, that are just finishing school, with a lot of loan debt, starting a family, trying to buy a home ] subsidize the unhealthy [ generally the elderly in the last 6 months of their life ] ? BTW this is the same question that Dr Ezekial, Rahm's brother and Obama's chief of staff, Emanuel has in his "complete lives system."

http://econopundit.com/ezekiel_emmauel.pdf

G&P

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that's the same selfish argument that is used by someone who doesn't insure their car

I don't know how auto insurance works there ;but here , the only mandatory insurance on a car is the requirement to insure against the damage and injury to the other person... not for the primary driver. That part of the insurance is optional ;as it should be.
Also ,in this country the auto insurance is a state requirement and not a national government concern because our national government has no madate for requiring insurance of any kind.

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or save money for retirement,

I am a frugal person and have over the years sacrificed and prioritized my resources and have in that course of action come close to completely funding my future retirement (I'm not quite there yet... hence I still work).

Do you want to tell me again why a good chunk of the money that gets withdrawn from my paycheck is going to fund retirees who chose not to sacrifice and plan for their retirements ? I cannot think of any good reason why my daughter will have to pay for my retirement ;or those of my peers who compulsively spent their money on the newest gadget and didn't forswear or deny themselves any convenience ?
You cannot make a good case for them .

Yes a reasonable safety net is the prerequisite of a civil society... but it should not be constructed to catch everyone of means to take care of themselves.

“A government big enough to give you everything you want, is strong enough to take everything you have.” Gerald Ford

It's wise to put the burden of our health care costs on our children and grandchildren?

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Originally Posted by inthebox

In your first link, why did he come to the US to have

if other countries have such wonderful medical care, why did he not have his care in England or Australia or Canada???

The fact is that cancer care is top rate in the US - better results.

U.S. Cancer Care Is Number One | Publications | National Center for Policy Analysis | NCPA

this was from the Lancet - an English medical journal

Would this man have been allowed one let alone 4 operations and rounds of chemo had he been in Australia or England or Canada?
Or would he have waited till he was inoperable and then offered hospice care - that is cheaper.

G&P

To answer your second Question first, we have excellent treatment facilities here and no bar on treatment however that is not to say that other countries don't have specialists in a particular field who might be able to provide a higher chance of success. This person obviously had some ability to pay and US medical insurance, the question isn't who has better facilities or doctors but how the costs are met and even with the best standard of care this patient still died. To answer your first question we are not told why the patient though he had a higher chance of success in the US, he may well have been advised that a particular specialist offered him that. We see a small number of patients who seek treatment overseas each year.

I'm sure you can be justly proud of the medical facilities available in the US but you should realise that you pay a very heavy premium for their availability, and they have not been available to everyone. In the case of my country, Australia, it is only elective surgery that you have to wait for and only if you are uninsured. We don't get the nonsense about elegibilty you apparently go through, we are either insured and able to be treated in a private hospital or we are not, but for us the oncology units are attached to the major public hospitals so the point becomes somewhat mute in such cases. The competition is so strong in our market that the insurers will waive the elegibility periods just to sign you up. The reasons we don't have some of the same problems you have is the insurance belongs to the individual and is not tied to employment. There is a government levy which is levied on the uninsured and a government incentive to be insured and these mechanisms appear to be effective in providing coverage for a high percentage of medical costs. You have an incrediable level of complexity in your arrangements

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Originally Posted by tomder55

I don't know how auto insurance works there ;but here , the only mandatory insurance on a car is the requirement to insure against the damage and injury to the other person ....not for the primary driver. That part of the insurance is optional ;as it should be.
Also ,in this country the auto insurance is a state requirement and not a national government concern because our national government has no madate for requiring insurance of any kind.

I am a frugal person and have over the years sacrificed and prioritized my resources and have in that course of action come close to completely funding my future retirement (I'm not quite there yet ...hence I still work).

Do you want to tell me again why a good chunk of the money that gets withdrawn from my paycheck is going to fund retirees who chose not to sacrifice and plan for their retirements ? I cannot think of any good reason why my daughter will have to pay for my retirement ;or those of my peers who compulsively spent their money on the newest gadget and didn't forswear or deny themselves any convenience ?
You cannot make a good case for them .

Yes a reasonable safety net is the prerequisite of a civil society ....but it should not be constructed to catch everyone of means to take care of themselves.

“A government big enough to give you everything you want, is strong enough to take everything you have.” Gerald Ford

Tom it is useful to consider that most ideas get a fly in most parts of the world, it is called internationalisation so we get to be subject to the same bad ideas you do and probably for the same reasons. Pithy quotes don't necessarily mean you are speaking the truth

So here I expect motor vehicle insurance and personal liablility insurance works in much the same way. Obviously the need to have personal liability insurance associated with motor vehicles was seen as a public good in both countries and in both countries the reserve powers exists with the states. It is illegal to have a vehicle on the road which doesn't have liability insurance, the policy attaches to the vehicle not the driver. This is what I was referring to when I spoke of the selfishness of not insuring but my remarks extend also to damage insurance. Unfortunately we both have many in our society who live for themselves and have the it can't happen to me philosophy

We also have a social security contribution which "funds" pension and unemployment entitlements and which has been long since rolled into the general taxation system because it is seen as a public good not to have destitute people in the population. Like yourself I provided for retirement with superannuation, and until recent largesse on the part of the government had no elegibily for a government pension but fairness prevailed and someone thought that if I had contributed I should share in the spoils

Para

The heavy premium we pay is because a third party [ private or public ] pays and people are not aware of the true costs of medical care. Via EMTALA laws ERs are obligated to treat regardless of ability to pay. The costs are passed on to those that have insurance. And yes it is incredibly complex here - because of all the regulations. This adds to costs.

G&P

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Originally Posted by inthebox

Para

The heavy premium we pay is because a third party [ private or public ] pays and people are not aware of the true costs of medical care. Via EMTALA laws ERs are obligated to treat regardless of ability to pay. The costs are passed on to those that have insurance. And yes it is incredibly complex here - because of all the regulations. This adds to costs.

G&P

There must be a reason for the difference in cost between the two nations which is not related to regulation, we are the most regulated nation on Earth but our costs are far lower. We don't have the same level of litigancy as you do and settlements are more modest, perhaps our lawyers aren't at the same level of averice. One thing that keeps the cost down is the price is regulated so that where there is a co-payment the patient has a benchmark against which to measure the fee. There are a large number of procedures which are paid for at the scheduled fee and I haven't seen any starving doctors. Our hospitals also have a duty but they sometimes refuse acute care cases from accidents, nothing to do with ability to pay, but with ability to provide care.

One big difference is that our health insurers are able to operate nationally should they wish to, so the pool any one insurer has access to is larger and a lot of the cost is taken out of billing by the accreditation process and single payer system. This means there are fewer but larger insurers, efficiencies of scale.There is also an integrated billing system also reducing costs. So if a doctor decides a procedure is necessary, this is not challenged but the overall billing history is examined and over billing dealt with by the regulator

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We don't have the same level of litigancy as you do and settlements are more modest, perhaps our lawyers aren't at the same level of averice.

You got it!! When you let the lawyers make the laws they will make them in a manner that works to their benefit.

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One big difference is that our health insurers are able to operate nationally

Again this is a huge difference in systems that has a profound effect. States can limit the number of insurers and that in turn reduces the competition between them .

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people are not aware of the true costs of medical care

Indeed one of the biggest growth industries here is medical identity theft. The patient never sees a breakdown of services and costs so often it goes undiscovered . But ,if patients were to see the services and the costs then perhaps they would quickly recognize the fraud and abuse in the billing system here... or even the fact that there are services being paid for that the patient is unaware of.

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Originally Posted by tomder55

indeed one of the biggest growth industries here is medical identity theft. The patient never sees a breakdown of services and costs so often it goes undiscovered . But ,if patients were to see the services and the costs then perhaps they would quickly recognize the fraud and abuse in the billing system here ....or even the fact that there are services being paid for that the patient is unaware of.

It is mandatary here, Tom, that a Patient see and sign the billing, and of course in certain cases pay for it before claiming a refund. This gives them the opportunity to question it, also procedures such as pathology, radiology cannot be bulked but each test must be individually requested, this operates as break on doing general exploratory testing, but it is the level of survellance which curbs overservicing and fraud. It does happen but the regulatory authority hones in on frequency and volume as well as the total level of billing and, of course, has the power to examine a doctor's case load and patterns of billing. We have had some spectacular medical enterpreneurs being deregistered for over billing