[inthebox]

CozyK,

If anyone in the USA was denied a kidney transplant or use of a dialysis machine because of inability to pay, then the hospital in question should be sued, because that is against the law. In the USA, no patient may be turned away from necessary medical services because of lack of ability to pay.

Please also keep inm mind that not being able to afford medical insurance is not the same as not receiving medical CARE. In the USA there are plenty of people without medical insurance. But NOBODY has to go without medical care. Anyone who does go without medical care is doing so out of lack of knowledge of the law or for their own personal reasons.

You should also be sure to corroborate any stories you hear with some form of evidence. I hear stories all the time too about bad medical care or medical care refused for lack of ability to pay. Most of them (not all) turn out to be false, or else there are parts of the story that weren't given over in the original version. Usually, if a patient dies due to lack of treatment, it is because they didn't want to stay in the hospital because they were afraid of their illegal alien status or something like that. It had nothing to do with being refused treatment. So you should corroborate these stories before assuming they are true.

Elliot

The law is EMTALA

It only refers to ER care. Unfortunantly a lot of folks that don't have health nsurance, or can't afford primary care, get their primary care from the ER.

This;
1] costs society a lot more, because ER care is more expensive.
2] with non-urgent care taking up a greater percent of ER time, this increases time wait time for all.

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This law does not apply to group practices or non- emergent care.

Even medicare and medicaid, the proto typical US government socialized medical plan is no guarantee of acess:

When Doctors Opt Out - WSJ.com


So though, well meaning, "universal healthcare" is not logistically possible.
As much as all of us may want and desire free universal healthcare it won't happen.
You can think of healthcare as goods and services - these are never free, whether it is healthcare, or food, or shelter, or electricity. These things are provide because people work to provide these services; the nurse, the doctor, the farmer, the carpenter, the e;ectric plant worker, the roughneck out on the oil rig, the truck driver that delivers goods, NONE OF THESE FOLKS WORK FOR FREE.

That is why things including healthcare costs.

The question is can government provide a service , quicker, more cost efficient, and at a higher quality then the private sector?

Compare US postal. Would there be Federal Express or UPS if the US postal service did not have some deficiencies?

Compare medicare part D vs Walmart $4 prescription?

Even the US military contracts out to "private security firms" like Bleackwater.

Compare Harvard or Yale or MIT to your local community college or state university.

---------------------------------------------------------------------------------

What third party payors like medicare or private insurance does is add and inflate the costs of doing business. Costs that are passed onto the consumer.

Health Care Spending As Part Of GDP -- Historical
1960 - healthcare was 5.1% of GDP
1993 - healthcare was 13.4 % of
Note that Medicare was passed in 1966


If doctors and hospitals had to compete for business based on price, results, service and what the consumer could pay, then over time the cost for everyone would go down.





G&P

[cozyk]

[QUOTE=inthebox;1690031]The law is EMTALA

It only refers to ER care. Unfortunantly a lot of folks that don't have health nsurance, or can't afford primary care, get their primary care from the ER.

This;
1] costs society a lot more, because ER care is more expensive.
2] with non-urgent care taking up a greater percent of ER time, this increases time wait time for all.

Absolutely correct.
-----------------------------------------------------------------


---------------------------------------------------------------------------------

What third party payors like medicare or private insurance does is add and inflate the costs of doing business. Costs that are passed onto the consumer.

Right again.

If doctors and hospitals had to compete for business based on price, results, service and what the consumer could pay, then over time the cost for everyone would go down.

SO TRUE!! This is what I was thinking all along.

[inthebox]

Why thank you?

Only catch is
1] will doctors and hospitals agree
2] what of those who have been paying into the medicare and medicaid system only to benefit others.








G&P

[excon]

1] will doctors and hospitals agree
2] what of those who have been paying into the medicare and medicaid system only to benefit others.

Hello in:

The doctors and the hospitals don't set the prices... The insurance companies do. Your solution would work if the insurance companies didn't object...

Frankly, I can't believe you didn't mention them. Your side never seems to. Do ALL rightwingers own stock in State Farm??

But, of course, they would object.. In fact, the system you propose WAS the system we had back then when everybody COULD afford their coverage. Then the insurance companies found out that they could make a LOT more money, and they decided to change the equation.

excon

[inthebox]

Yes I forgot to include the insurance companies AND the government.


G&P

[ETWolverine]

Are you going to address my question ET?

Sure they do. But not at the rates of 35-56% that fall through the cracks in the Canadian system.

Sorry I didn't answer sooner. I assumed that you read the statistics I posted, which answered that question.

[ETWolverine]

But, you're happy to leave the insurance companies IN the game.... I dunno why. The insurance company never made me well. They're just there sucking off the deal. They don't NEED to be there. If you want to pay them, you MUST be a stockholder. I cannot imagine WHY you want them to make money off your health care. I really can't imagine it.

First off, you say that the insurance company never made you well. How many times has the gubment made you well?

Secondly, you asked why we would want insurance companies to be in charge of health insurance rather than the government.

The GOVERNMENT makes more money if you die than if you live. Not only do they have to pay old people Social Security, Medicare and Medicaid, they also don't get much from them in the way of taxes. 90% of all medical costs are for old people, but they contribute the least to the system. It is in the best interest of the government for old people to die than for them to linger on for years... it lowers their expenses, and anything they don't pay to old folks who are dead goes back into the treasure chest (or their pet pork projects). Old people are an EXPENSE in a government run healthcare system.

But for private insurance companies, old people are sources of income. The longer they live, the more premiums the insurance companies collect. The more old people they can collect from, the richer they get. It is in their best interest to get old people the best care they can get, because for every old person that dies, it's one less premium check they are getting every month. Thar's gold in them thar old folks.

THAT is why insurance companies are a better bet than government-run health care. I'd rather have my insurance decisions handled by a guy who wants me to live so that he can make a buck than by a guy who would prefer that I die so he can make a buck.

Elliot

[tickle]

Sure they do. But not at the rates of 35-56% that fall through the cracks in the Canadian system.

Sorry I didn't answer sooner. I assumed that you read the statistics I posted, which answered that question.

I have found that, just from doing my job, people 'fall through the cracks' as you say, because they either miss appointments, don't follow up with their doctors, and don't understand their afflictions, are non compliant with their meds (which causes innumerable problems all the way down the line).

They have Personal Support Workers, assigned by the Access Centre when they leave the hospital, and think that particular PSW will keep them in line; their family fall through on the job, thinking the PSW will follow through. But we don't do that, we are not assigned to do that. We are their to make sure they are clean, diapers changed, remind them of their meds, keep them fed (sometimes we have to put them right in their mouths) which goes way beyond our scope of practice, just to make sure they have them.

I don't know, Wolvervine, 35 to 56 (? ) of people in our healthcare system fall through the cracks when actually the cracks are initiated by themselves, then they complain when they aren't treated properly. They aren't treated properly because they are non compliant regarding meds and procedures.



Tick

[tomder55]

Regardless of how other nations handle this (and there are recent reports of UK denying cancer drugs) . The fact is that we are getting greater details on how the Administration will handle the "growing costs" of health care. It has a lot less to do with choice ;but more central bureaucratic decisions on what health care should be available to Americans.

Ezekiel (Zeke )Emanuel (Rhambo's brother) is a policy advisor for OMB and author of the book Healthcare Guaranteed . He says that the problem with the US health system is that doctors take the Hippocratic Oath too literally and seriously... especially the part about 'use my power to help the patient to the best of my ability and judgment'. This is of course what a patient going to doctors also expects from them. He argues that medical students should be instructed "to move toward more socially sustainable, cost-effective care." He says the trend "from 'do everything' to palliative care shows that change in physician norms is possible."
http://www.fresh-thinking.org/public...fect_storm.pdf

Among the gold plated services he would eliminate is 'spacious hospital rooms' ."Hospital rooms in the United States offer more privacy, comfort and auxiliary services than do hospital rooms in most other countries,"

Obama cannot allow the doctors to continue to give gold plated treatment to patients and keep his pledge to reduce costs.

Inside the bucket list stimulus bill was the beginnings of the changes the President has in mind. Doctors will be obliged to enter treatments of a patient into an electronic database. The doctor will be advised by electronically delivered protocols on "appropriate" and "cost-effective" care. Harvard's Dr. David Blumenthal has been named the national coordinator of health information technology.
The law gives billions of dollars (19.5 billion allocated ) in incentive payments to doctors and hospitals that buy and use the system, with penalties starting in 2015 for those who don't make the switch.(I won't get into the debate about privacy rights and access to all these medical records here ) .
So there you have it... reduced costs through managed scarcities and government hacks making decisions overruling your doctors on which care is best for you.

[speechlesstx]

Inside the bucket list stimulus bill was the beginnings of the changes the President has in mind. Doctors will be obliged to enter treatments of a patient into an electronic database. The doctor will be advised by electronically delivered protocols on "appropriate" and "cost-effective" care. Harvard's Dr. David Blumenthal has been named the national coordinator of health information technology.
The law gives billions of dollars (19.5 billion allocated ) in incentive payments to doctors and hospitals that buy and use the system, with penalties starting in 2015 for those who don't make the switch.(I won't get into the debate about privacy rights and access to all these medical records here ) .
So there you have it ...reduced costs through managed scarcities and government hacks making decisions overruling your doctors on which care is best for you.

Gee, I must have missed those spacious hospital rooms he's referring to. The only ones I've ever seen were for expectant mothers. All that privacy from a curtain is certainly too much to ask for, and no sense in furnishing decent food or TV when you should be sick and miserable. Perhaps the first thing to go should be the new hospital gowns being designed to provide a little modesty for your backside, but then why waste all the design work that's so far taken nearly 3 years? It only takes a design team 5 years to design a new hospital gown apparently... probably part of the same smart people that think "cost-effective," government directed (rationed) health care is all the rage.

[inthebox]

Tom;

Dr Emanuel is an MD, PHD,

The Department of Bioethics - Our People


But I wonder if he has direct patient care responsibilities day to day or if he is one of those academic ivory tower types that likes to dictate to those in the trenches,

In the linked article he implied that thoroughness in a physician is a bad thing.
I hope he realizes that primary care physicians treat the WHOLE person not just a complaint or one organ system and that thoroughness is what catches things like cancer early. If the diagnosis of cancer is not made in a timely manner the patient sufffers, there is malpractice liaability, and it may cost more to treat the complications.

He does not qualify that US physicians earn double the income. Maybe they work longer hours, specialize, have to pay school loans off, have to pay malpractice, the cost of living here is higher etc.

Then near the conclusion he thinks " many more experiment are needed" -----HMMM I wonder if he is referring to that 1990s HMO experiment in which capitated care helped piss off patients and doctors at the same time .
----- YEAH RIGHT, we need more government intrusion in our lives like we need an overutilized and uneeded colonoscopy.





G&P

[excon]

YEAH RIGHT, we need more government intrusion in our lives like we need an overutilized and uneeded colonoscopy.

Hello again, in:

I'm not a government kind of guy. They're doing stuff they shouldn't be doing, like the drug war. And, they're also NOT doing stuff they SHOULD be doing, like being the single payer in health care.

Even though you Reaganites don't believe government has a role, it really does. For example NOW, you probably want the US Department of Health looking into the Swine Flu pandemic, rather than Swine Flu Busters, Inc. I'd rather drive on a road made by my department of highways, instead of Acme Roads, Inc.

Health care had it's time in private hands. If it hadn't been manipulated for profit, it would still be cheap enough for all of us to use WITHOUT government interference. But, that isn't what happened.

So, to make it affordable again, we need to eliminate all the changes the drug, insurance and pharmaceutical lobby had us make over the last 30 years, or have the government take it over.

Either way is fine with me.

excon

[inthebox]

You forget that it is the makers of Relenza and Tamiflu; those evil profit making, capitalistic, private sector pharmaceutical companies; that make the treatment.

And it is those non-VA, non- governmental physicians, doctors, nurses, hospitals, EMS workers in the private sector that are at the front line and will be responsible for treating the majority of whatever outbreak occurs.

I guess since you believe in single payor government run healthcare that should you get the swine flu, which is not my wish, you will get your healthcare exclusively at a VA medical center?




G&P

[tomder55]

If this becomes an epidemic will everyone thank President Bush for stock-piling Tamiflu and other antibacterials ? Will they thank him for war-gaming pandemic scenarios with senior officials, and increasing the CDC sample identification capabilities... much of which is being shared with the Mexicans now to contain the outbreak ? When they remember the swift calm response of Obama will they also remember that the chess pieces he played with were already on the board ? Will they remember that at the outbreak the HHS Sec was not confirmed yet and there is no Surgeon General ?

I didn't think so.

[speechlesstx]

Will they remember that at the outbreak the HHS Sec was not confirmed yet and there is no Surgeon General ?

I didn't think so.

NO, but thanks for reminding us.

[Tokugawa]

Why must it be so that a social medical plan must necessarily exclude all private coverage? That is most certainly not the case here in Australia. Here, if you should choose to go private, then you will receive some or all of your medical levy back, depending on the coverage you have. Some people choose to go private, as they feel it makes sense for them to do so. Most however, are quite happy with the service provided by the government, and this sentiment does in fact contribute to the quality of product offered by private organizations.

At the moment, I am quite happy with the government scheme. However I can see the advantages of private insurance, and may at sometime in the future switch to private coverage. A lot of the arguments presented here seem to be based more on ideological or procedural criticisms that are, in my view, quite irrelevant to any "social vs private coverage" debate.

For myself, I consider that NO child should suffer a lack of ANY treatment due to financial constraints. Vaccinations (including for cervical cancer), breast and cervical screening, prostate checks, utrasounds for expecting mothers (plus all number of maternal checks/services which are too numerous too list), all provided "free" under the government system.

A relative of mine recently finished a year long course of treatment for cancer that would total tens of thousands of dollars, for a total cost of something like $500, that was only detected because of the free government check up provided, and the government advertisement that convinced her to have it done in the first place.

[cozyk]

[

QUOTE=Tokugawa;1712019]Why must it be so that a social medical plan must necessarily exclude all private coverage? That is most certainly not the case here in Australia. Here, if you should choose to go private, then you will receive some or all of your medical levy back, depending on the coverage you have. Some people choose to go private, as they feel it makes sense for them to do so. Most however, are quite happy with the service provided by the government, and this sentiment does in fact contribute to the quality of product offered by private organizations.

At the moment, I am quite happy with the government scheme. However I can see the advantages of private insurance, and may at sometime in the future switch to private coverage. A lot of the arguments presented here seem to be based more on ideological or procedural criticisms that are, in my view, quite irrelevant to any "social vs private coverage" debate.

For myself, I consider that NO child should suffer a lack of ANY treatment due to financial constraints. Vaccinations (including for cervical cancer), breast and cervical screening, prostate checks, utrasounds for expecting mothers (plus all number of maternal checks/services which are too numerous too list), all provided "free" under the government system.

Wonderful post. I agree with you that NO child should suffer a lack of any treatment. I also believe that no life saving care should be held back from anyone because of lack of funds.

[speechlesstx]

Canadian Researcher: go die at home, we need your bed

As a way to help free up hospital beds, a Canadian researcher suggests people should be encouraged to die at home rather than in a hospital.

University of Alberta researcher Donna Wilson says that there's been a dramatic change in the location of death of Canadians. Up until 1994, about 80 percent died in a hospital, but that number has dropped to 61 percent.

Wilson says she would like to see the number drop further to 40 percent as baby boomers age because this could reduce wait lists and free up hospital beds for those who need life-saving treatment or surgery.

It's also a much more dignified death for a family member, Wilson says.

Wilson calculated that in the next 20 years the number of people dying could double and if death rates in hospital stay at 80 percent it means a potential tie-up of every single bed in Canada for three days of the year -- because each person takes up a bed for an average of 10 days. (UPI)

Or, just pass the euthanasia bill and get it over with.

[Lowtax4eva]

Wow, I love how a (most likely) republican website that posted that article condensed it down to make it sound horrible. I read that article in it's original form and it stated that more people are CHOOSING to return home to die when they know they have little time left, with today's modern medicine people can be told more accurately how much time they have left when they have a serious disease. There is never pressure to leave a hospital from a government agency or the hospital itself.

Here is another paragraph from that article that most websites that re-posted it left out

"My guess is that a lot of it has to do with the fact that death is no longer unexpected," said Wilson. "A lot of people are dying at an advanced age and you begin to accept that fact that it's going to happen and it [can be] a dignified event. If you take the person to the hospital.. . Care is by strangers rather than family members."

This study, published in Social Science & Medicine, comes at a good time as Canadians watch the population age. Wilson predicts the number of people dying each year will double, maybe even triple, in the next 10-20 years because of the aging baby-boomer population.

While I don't like the suggestion that more people SHOULD do this to bring the percentage even lower, this is one persons opinion, not the opinion of our government.

I'd say overall we have better health care in Canada, no one sits around at home with a serious injury or disease hoping it will get better or that it's not as serious as they think, or worrying about how much it will cost if they go in to a hospital. No one sits in an ER waiting room with a life threatening injury and even in my families case we have been in the ER a few times (broken bones and cuts requiring stitches) and have not waited unreasonably long and we live in a city of 1.2 million. I don't know why so many people in the US want to cast a bad light over government run healthcare, it really helps out those who can't afford it. And for those who want to pay more for faster service can go to a private clinic.

[speechlesstx]

I dont know why so many people in the US want to cast a bad light over government run healthcare, it really helps out those who can't afford it. And for those who want to pay more for faster service can go to a private clinic.

Actually, the heads up came from a Canadian.