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Author Topic: Health Care in the United States  (Read 11214 times)

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Offline Zakharra

Re: Health Care in the United States
« Reply #75 on: June 17, 2006, 09:56:05 PM »
 It sounds nice, but it would quickly run into cost overruns and many people using it for anything. The abuse such a system would have is mind boggling. Look at what was ripped off from FEMA. $1.4 billion....  Until the government can tighten up it's currently running programs like Soc Sec, Medicare/Medicade, then this is unworkable.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #76 on: June 17, 2006, 11:23:56 PM »
I agree that's why co-pays and the like are important, and there has to be a stick if a person willingly does not follow treatment for conditions and/or has risky behaviours the costs must be higher. Smoking would be one area we can look at.

An example a patient locally in the same room I was in at the hospital was ON the county health program and had a quadruple bypass. He was in the room smoking, eating PIZZA brought in (and an extra-large meat lovers with extra cheese) and refused to do what the doctors ordered so he was the third Primary Care Provider to drop him. They kicked him off the program that was paying for everything at the time. Was indigent or something but that cannot be tolerated in any program. I pay taxes locally and I'm for the program to help the very poor but that also means the poor have to be responsible to follow the treatments required.

I feel soundly that the party getting it pay fairly but basic things like immunizations, one annual check up plus four other visits maybe to a Nurse Practitioner instead of a doctor and related diagnostic routine tests and some drugs should be available- maybe 4 generics a month free. But of course co-pays and such have to be in there. I'm not saying a free one-payer system just using the money there and laws to make sure everyone gets some care bases on local options that would work. better.


Offline National Acrobat

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Re: Health Care in the United States
« Reply #77 on: June 18, 2006, 08:08:17 AM »
The only problem with instituting a massive overhaul and medical program like this is that it would need to go through Congress.

'nuff said I believe on that end.

Offline Zakharra

Re: Health Care in the United States
« Reply #78 on: June 18, 2006, 11:00:45 AM »
 To think that the men and women in Congress could do it correctly.. *shudders*

Offline National Acrobat

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Re: Health Care in the United States
« Reply #79 on: June 18, 2006, 05:01:55 PM »
To think that the men and women in Congress could do it correctly.. *shudders*

Heh, that's another point, but not entirely the one I was making.

The representatives are elected to represent their constituents, so one can only imagine the wrangling that would have to occur to get them to even get a bill written up to vote on given that.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #80 on: June 18, 2006, 06:17:00 PM »
Oh they are going to have to deal with this problem seriously I see three key crisis points coming together at one time.

Lack of Proper Insurance: Close to 44 million citizens have no insurance and another 88 million are underinsured that is have coverage but the costs of it are so poor its not practical to use or its not sufficient to offer savings compared to what is put into the plan. This includes people using high deductible policies or those that cannot get coverage for a sustained period.

Increased Medical Bankruptcy: Tying into the first point the bankruptcy rates due to medical bill debt is the fastest growing area. Unlike credit card debts it would be socially impossible to shield medical companies like other areas such as College Loan Debt. Add to this many people who have to this HAVE health insurance that still too costly. Example a local company changed its policy to a $5000 deductable and has poor co-pay rates I have a friend that had a medical issue and went bankrupt with that plan because it was still too much.

Rising Costs of Health Care: This is a huge area and will require a fundamental shift in how the whole system works and personal expectations- and how doctors apply medical care. I would think this has the biggest area of concern people want all the health care they want, low cost and choice of all care providers and that is not all possible. One or two sure but not all three. Docotors have to use the lowest cost treatments first like diet and fitness over taking medication, generic pills before non-generic pills and try to conserve resources. And the government have to enforce price controls on fundamental care drugs of life sustaining nature. This all is beyond simple legislation.

Offline National Acrobat

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Re: Health Care in the United States
« Reply #81 on: June 18, 2006, 07:02:13 PM »
I doubt it will happen nationally.

I think you'll see more states start to handle it like Massachusetts if their legislation mandating coverage takes effect and becomes a decent enough working model.

That will be the litmus test. If the Massachusetts plan doesn't work, then you won't hear much more about really trying to nationalize things.

Offline Zakharra

Re: Health Care in the United States
« Reply #82 on: June 18, 2006, 11:20:21 PM »
Quote
The representatives are elected to represent their constituents,

 Which constituents? The ones who elected them or paid for their campaigns?


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Re: Health Care in the United States
« Reply #83 on: June 19, 2006, 06:17:47 AM »
Which constituents? The ones who elected them or paid for their campaigns?



Technically all of them. I feel pretty lucky here in Virginia. Our representatives in my area tend to listen to the people that vote for them.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #84 on: June 22, 2006, 05:49:38 PM »
I had a good idea her PUBLIC HOSPITALS. In Milwaukee where I used to live there was a public run hospital that if you were poor paid on a sliding fee scale for services and if very needy paid nothing and they provided good care. So why not REQUIRE a percentage of the Federal Funds for medical care go to this sort of hospital in areas where there is a certain population? They could extend to clinics in less dense areas attached to the nearest Public Hospital and they could mandate a percentage of the costs be picked up by the state and county. This way people in need could get care and there would always be private hospitals just it would be an option for anyone that needs care and may not have suitable insurance.

After all they mandate for other things at the Federal level I see this as no different.

Offline Zakharra

Re: Health Care in the United States
« Reply #85 on: June 22, 2006, 11:11:53 PM »
 The problem with that is the hospitals would be overrun by people seeking aid for the stupidest things. Often when they do not need medical treatment. Also what doctors and nurses would you get to work there? You would have to likely pay them a lower wage than they would have at a private hospital, then there's the quality of care. Would such a hospital do heart surgery, emergency surgery? What level of insurance would it have? What health care/insurance plans would it take?

 Unless you are prepared to refuse to treat people that can pay for their own medical care, then you would have all sorts of sponges milking this system. Because it would be free.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #86 on: June 23, 2006, 01:10:05 AM »
I never said free. In Milwaukee the cost was based on ability to pay and need. Example my uncle recently needed cancer treatment and was uninsured with an income that was low. They took that into account and provided treatment for a modest sum and that didn't break him. Another relative had insurance and went there and was just another patiant.

As for doctors they were very professional including specialists in return for their work there they paid low malpractice policies because its harder to sue them and they ran the show not people pinching pennies. So salaries are lower but the staff also is able to heal people not having to worry about where the money is coming from. They get fixed salaries and a city pension. 

Also I would seriously have outpatiant clinics attached to this sort of hospital in the area for cases where a normal doctors visit would suffice.

Basic point of a public hospital it offers needed care to anyone and does look at ability to pay the truly indigent do get free care but people that can pay do so based on their incomes and insurance. But frankly most people with insurance would likely choose a private hospital and the one public hospital I used had a clinic in the hospital with nurses supervised by a doctor for routine care. Its a matter of resources you use less skilled medical people for the minor things and save medical care for the ER and other areas.

My view is why should a poor person needing a bypass operation running up a $100,000 bill have to go bankrupt or in debt for many years for necessary lifesaving treatment? A public hospital would treat them at what they could afford to pay. And my view also is health care available is better than none regardless of quality as long as the doctors and care is standard and expected, the most cost effective and the best treatments for a case.

Offline Zakharra

Re: Health Care in the United States
« Reply #87 on: June 23, 2006, 08:40:04 AM »
 It's workable as long as you keep a real tight eye on the expenses and are willing to tell some people 'No' at the door for treatment. Right now, one of the things that would kill the public hospitals are all of the illegals in the US. They'd use the services and likely not pay anythin g. Since under the law, they have to be treated anyways. That's what's caused over 18 emergency rooms in the SW states to close. Over use by illegals.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #88 on: June 23, 2006, 09:08:58 AM »
Well Emergency Rooms its true must treat everyone that's why a triage clinic is useful have a nurse properly trained evaluate the person and treat them if its minor, a doctor can admit them if needed. Of course Emergency cases like an Ambulance with a heart attack patiant comes first. No one would deny that.

My point is its something and with affiliation with walk-in and fee clinics could be a good option for the legitimate poor. I am biased against drug users and alcoholics I'm afraid and smokers three things that are personal choices that hurt the body. But a poor diabetic should get the care they need and medicines since such a hospital would have a pharmacy its standard at lesast good generics and other life saving drugs could be gotten at a fair price.

The point here is get access to care for the poor, make the people pay what they can and let the doctors be doctors and heal people they should have no other worry if qualified.

Offline Zakharra

Re: Health Care in the United States
« Reply #89 on: June 25, 2006, 01:10:27 AM »
 That's well and good, if it can be controlled and run properly without cost overruns and such, then it's a good idea.  but it sounds like one that could end up throwing good money after bad if it runs out of control.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #90 on: June 25, 2006, 01:12:06 PM »
Such hospitals never make money they are public hospitals paid for by taxes to provide needed care for the poor and needy without insurance. You cannot make a public hospital profitable its by its nature there to provide care to those without other resources that does not mean its a bad idea. Right now people are going bankrupt strictly due to medical bills run up because they have no other options. My opinion its better to have these then let people not see a physician when it could make a difference right now in my state if your so sick you can't work for at least a year or are dying you can get on Medicaid. That is when its most expensive to treat these people. A public hospital and clinics staffed by nurses and with a doctor present a common walk-in clinic model charging a low co-pay for care to seek such help perhaps $10 is also needed and serious help with drugs. But lets say if I didn't get treatment and had kidney failure then the state would pay for dialysis, a transplant and after care when getting me proper managed care from a doctor and a few drugs would stop that from happening.

We are talking the lives of the working poor, working is the key word I work. Others don't work due to economics or other problems that are not their fault. This care with central public hospitals would work. People just have to be willing to support and pay a fair payment in local taxes for it. And assume they will lose money that is not the point providing care when it is needed to the poor most of those working hard is.

My new job will eventually get me insured fully after 1 year for my medical needs until then if a major problem came up I would likely end up in deep debts and going bankrupt is that the way we should provide medical care?

What gets me is many are willing to pay 50 cents plus per gallon of gasoline taxes, pay for this useless Iraq War without serious complaints and don't mind paying for public services other than health care. When ones health and that of people that are in society are the most important national asset. Without people healthy and working, being productive and working their best and without going into debt to do that the nation itself is weakened. Fundamentally so since businesses are forced to offer benefits when they shouldn't have to their job is not to run health care its to earn money. The care of the public is the governments job.

As for arguements its not the Federal Governments job neither is maintaining a Federal Army or Air Force or Social Security or Education but you already relegated these to the Federal Government through inaction.

Offline Zakharra

Re: Health Care in the United States
« Reply #91 on: June 26, 2006, 01:00:00 AM »
 Most of what you say I agree with, but I cannot see how a governmental agency for national health care can function  smoothly.

 
Quote
What gets me is many are willing to pay 50 cents plus per gallon of gasoline taxes, pay for this useless Iraq War without serious complaints and don't mind paying for public services other than health care. When ones health and that of people that are in society are the most important national asset. Without people healthy and working, being productive and working their best and without going into debt to do that the nation itself is weakened

 I'd rather not pay the high taxes on gasoline, but those are not going to go away and it's an automatic addition to the price of gass. You want them changed, get people in Congress who are willing to lower the taxes. I do  not see how it is the government's job to provide health care. Worrying about  diseases, yes, but not healthcare.
 I also see the Iraq war as a needed one. It keeps the terrorists over there and is establishing a place where the Middle East can be changed. The economic and demographic dynamics. A part of the War on Terror, but that's an arguement for another thread.  ;)

 
Quote
As for arguements its not the Federal Governments job neither is maintaining a Federal Army or Air Force or Social Security or Education but you already relegated these to the Federal Government through inaction.

 Actually it is the government's job to do that. 'Provide for the common defense' Protecting the nation and people from invaders IS a function of the government that it does fairly well. Social Secutiry and Education have come into being because of Congress passing laws that added to the governmental mandate.

 

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #92 on: June 26, 2006, 10:26:30 AM »
Health care if go to any other first world and many second world nations IS a government responsibility because its the first line of defense to disease outbreaks and other concerns especially a stable workforce. Cuba is a good example true they don't have our technological advances in medicine but EVERYONE is covered and gets care, and might I add excellent care for their national income. In Russia the public health system switched to more like ours and community disease is increasing especially TB and even a major outbreak of Typhoid. National health care no I don't want that but national LED community care run at the state level and more importantly the local municiple level.

There are viable freemarket options. Require insurers to take anyone regardless of pre-existing conditions and cover them immediately then have tort reforms to protect doctors from lawsuits much better than we have now. Price controls on key non-generic drugs and open the US market to foreign first world drug companies. Easing permission to sell drugs demonstrated safe and effective in such foreign markets. Legally allowing HMO's to cap treatments deemed less effective than a certain percent like if a cancer is in Stage 3 and there is a 10% chance of treatments CURING the party they can refuse for pain relief care instead. And make health companies offer cheaper plans maybe like say to Blue Cross Blue Shield you can offer insurance but you have to offer one HMO and that one must be lower cost plan with certain restrictions and benefits we require say that one would be $80 a month for a single person and more for a family. Let companies send people overseas to India and Thailand to upscale hospitals for major treatment where doing a $100,000 bypass procedure costs $25,000 with travel costs that would be good as well.

The second is well within the governments authority to regulate interstate business and national markets OR pressure can be brought to bear on states to comply where needed. But the companies could still compete, offer options and try to get all the new business. And over 40 million people is a huge market.

Offline Zakharra

Re: Health Care in the United States
« Reply #93 on: June 26, 2006, 11:49:45 PM »
 
Quote
The second is well within the governments authority to regulate interstate business and national markets OR pressure can be brought to bear on states to comply where needed. But the companies could still compete, offer options and try to get all the new business. And over 40 million people is a huge market

 That makes it a national service, not state, if the feds force compliance on states.

 
Quote
In Russia the public health system switched to more like ours and community disease is increasing especially TB and even a major outbreak of Typhoid.

 That's Russia. As you said, we have a good CDC, Center for Disease Control, and it works very well. What works in other nations, which are more socialist than the US will not neccessarily work here. I do like the idea of getting lower cost health care, but not if it's forced on me. Force it on me and I will NOT want to use it.  It ends up as more governmental control and many Americans hate that idea. The government controls too much already.

 Hillary care failed big time. In a Democratic Congress.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #94 on: June 27, 2006, 09:31:10 AM »
The Federal Government mandates No Child Left Behind they can force compliance only through refusing its money though. As for forcing no I would in the private health care approach force you to do nothing but make the Health Care Industry offer care plans to anyone that wants to sign-up, enforce price controls (or at least national bargaining) on fundamental drugs those that are needed to protect human life and are not generic and offer serious protections for physicians many lawsuits are unjustified.

But lets say each major company offered a good basic family plan HMO with decent restrictions and covers preventative care fully like Immunizations and doctor visits tp a primary care doctor as medically needed for $150 a month that would be good. A one person plan maybe for $80 a month.

Now I would have an option to have that amount taking out of a paycheck with pre-tax income and maybe a match like a 401k, and I would like to see a minimal plan an employer could offer for maybe $50 a month just doctors visits and medical drugs with fair co-pays and a cap on hospital care of $50,000 (lifetime limit) they could offer free to workers. And you could opt to deduct that from your monthly premium for a better plan most employers might like that. For most workers that would be one days wages.

Offline Zakharra

Re: Health Care in the United States
« Reply #95 on: June 27, 2006, 11:51:37 PM »
 What if you don't want health care? Many of the 40 million uninsured are young adults who do not want it or don't think they need it.  Also what if a company is too small to offer health care? Or you are a private contractor and cannot afford it? 

 Cuba sucks for health care because it is forced. It's not good for anything but very basic care. Dictators are good for offering things by force. Canada isn't to good either. If it was why are so many Canadians coming to the US for health care and operations? Or so many Cubans willing to sneak out of Cuba to come to the US?

 In other countries, health care might be concidered a governmental function, but that is not and I hope it never is the case in the US. The US is not a socialist nation. If it ever becomes one, it will loose that which made it the lone superpower in the world and become a spineless cowardly nation. To afraid of offending the bad guys to defend itself.

Offline Moondazed

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Re: Health Care in the United States
« Reply #96 on: June 28, 2006, 12:10:44 AM »
What if you don't want health care? Many of the 40 million uninsured are young adults who do not want it or don't think they need it.  Also what if a company is too small to offer health care? Or you are a private contractor and cannot afford it? 

Right up to the point where they get in a car accident and end up in debt for decades (as happened to a cousin of mine... accident not her fault, left in a coma for three months).  The last two questions are arguments for having health care for everyone.

Quote from: Zakharra
Cuba sucks for health care because it is forced. It's not good for anything but very basic care. Dictators are good for offering things by force. Canada isn't to good either. If it was why are so many Canadians coming to the US for health care and operations? Or so many Cubans willing to sneak out of Cuba to come to the US?

Somehow I suspect that health care concerns are not what bring Cubans to America.

Quote from: Zakharra
In other countries, health care might be concidered a governmental function, but that is not and I hope it never is the case in the US. The US is not a socialist nation. If it ever becomes one, it will loose that which made it the lone superpower in the world and become a spineless cowardly nation. To afraid of offending the bad guys to defend itself.

Wow, those are some pretty big leaps and bounds, from providing health care to all to being unable to defend ourselves...

Offline Zakharra

Re: Health Care in the United States
« Reply #97 on: June 28, 2006, 01:37:09 AM »
 I had posted a reply to moondazed, but the site wouldn;t accept it for some reason. It was experianing an inconvience.

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Re: Health Care in the United States
« Reply #98 on: June 28, 2006, 09:41:07 AM »
  I think the key figure in comparing the US's health care system to those of other countries is the amount of money spent on researching new drugs, new treatments and overall R&D.  I don't have have any clear cut facts, but it seems like I'm always hearing about new breakthroughs comming out of the US, but don't really hear much about other countries (of course, that can easily be blamed on the biased US media, but that's another discussion).  The topic of research and development was brought up once in this thread's 10 pages as an afterthought, and I honestly think that it is the key factor that seperates US health care from other countries'.
  The question then isn't "Do we want good healthcare?", it's "Do we want progressive healthcare?".  It's easy to look up at the ivory tower and forget about its problems.  In order to keep making new drugs, to keep curing new things, or to find better cures for old things, there needs to be money spent on research and development.  That's the reason why medication HAS to be expensive, why the use of tools HAS to be expensive.  These companies make developments, and are then left with huge budget holes.  What do you expect from them?  To sit around, give away free meds, and never pay back those debts?  Of course there are people making money hand-over-fist...in any situation involving money, it's going to happen.  But the reality is that the pocketbooks of a few rich white dudes don't really compare to the huge expenses in producing new drugs.

  Also, health care IS a societal issue.  It affects all of us.  At its most basic, keeping your population healthy keeps production strong, and strong production equals a strong economy.  A strong economy equals more tax revenues, and more tax revenues lead to things like military (over)spending, pet wars in unpronouncable countries, pork projects, and more money in the pockets of the extremely wealthy.  Ok, I guess I let my Anarch flag fly on that last one, but it's obvious that a strong economy helps all of us, not just rich.
  To put it in more practical terms, if you're running any sort of business, you need your employees there to do their jobs so that you can stay in business.  You *NEED* your employees...that's why you hired them in the first place, no?  Sick employees = bad production.  It's really as simple as that.  Even though my career is my own problem, it will affect me if Mary-the-Coworker doesn't take her meds, because I will eventually have to depend on her, and she may not be able to get the job done.
  You simply can't live in a community and pretend that your neighbor's problems aren't your own.  In the basest, physical sense, only air seperates one human being from another.  Our flesh is punctured easily, there are way too many things today that can shatter our bones.  Our bodies are fragile, and we're all going to need some sort of help at some point.

  As a final point, I'd like to say that it bothers me when non-US citizens bash on the US.  It's very easy to be that one dude who copies everybody else's homework all throughout high school.  It's hard to actually be the one to step up to the plate, innovate, and lead the way.  The US innovates, other countries copy.  I'm not discounting the contributions other countries make, no, don't get me wrong.  I know that there's good stuff comming out from the global community.  The fact remains, though, that no other country in the world comes close to the scientific advancements...medical, electronic, civil, or otherwise...that the United States has put out.  IBM, for example, holds somewhere around 50 to 60% of all computer-related patents worldwide, followed by several American companies (I worked for IBM, hence that's the only real statistical figure I can provide).
  It's nice when you can just go ahead and copy what others have already invented and just mass produce it.  Production without R&D is simple and cheap.  When you don't innovate and create, you don't bother with those costs.  You don't have to eat the cost of X failures before producing a viable prototype.  So the US invents the transistor, they invent the best methods for miniaturization...and we have China develop it.  The US is home to the largest high tech companies in the world...yet India's tech industry is the one that booms.

Offline RubySlippersTopic starter

Re: Health Care in the United States
« Reply #99 on: June 28, 2006, 11:20:08 AM »
That is why a low cost basic plan should be available for employers. Let's take the average wage of a unskilled worker at $7.00 an hour that's after taxes per day maybe $50.00 a day. Now lets offer a basic monthly plan at that cost. A doctor friend and I did the numbers on what that could buy.

1. Primary Care Visits @ 4 per Year Free plus additional ones at at of $20 each, referals to specialist must be made by the PCP and would cost $30 each.

2. Drugs at a negotiated price generics (would be required before considering name brand drugs) for $15 and name brands drugs at $30 for a 30 day supply limited to 8 prescriptions per month. Discounted medical equipment and testing supplies.

3. Routine Tests for $20 including a chest x-ray and full blood screening, once per year free. Also free vaccinations for children and low cost vaccinations for adults would be available.

4. Discounted Dental Services and Eyeglasses

5. $50,000 lifetime hosptial benefit.

6. Hospitalization for childbirth and day surgery excluded from #5 but have suitable fees perhaps $200 a day for the childbirth services and $500 for day surgery.

7. An optional health savings account.

8. Deductible of $2500 on care before the plan would kick in for hospital care so the $50,000 would not be tapped for less important procedures.

9. Cold cover a family of four with a doubling of the hospital cap for only $50 more a month.

We focused on preventative care, seeing of a primary care doctor and medicine access at the best possible costs. Something employers could easily offer and that the patiant has to take responsibility for health care as well. And they again could take the $50 and buy into a private plan and if they had a family might have to pay extra to cover them maybe $25 per person. And reasonably large hospital care would be available but hopefully prevention would avoid that.

Surely even opponents to universal health care could see this as a good plan and employers would be out one days salary of a low cost worker. You can't tell me to get decent preventative coverage and such you wouldn't be willing to pay for a family of four maybe $125 a month minus an employers share?

The basic plan could even be just open to anyone off the street at that price and people would buy into it.