You are either not logged in or not registered with our community. Click here to register.
 
December 06, 2016, 12:09:27 PM

Welcome, Guest. Please login or register.
Did you miss your activation email?

Login with username, password and session length

Click here if you are having problems.
Default Wide Screen Beige Lilac Rainbow Black & Blue October Send us your theme!

Hark!  The Herald!
Holiday Issue 2016

Wiki Blogs Dicebot

Author Topic: A modest proposal for Healthcare Reform in the US  (Read 2479 times)

0 Members and 1 Guest are viewing this topic.

Offline Sandman02Topic starter

A modest proposal for Healthcare Reform in the US
« on: January 29, 2011, 08:36:53 PM »
  What to do about Healthcare Reform? This is a difficult topic because it seems like efforts to meaningfully reform healthcare since Johnson's Great Society legislation have been scuttled. I know that the legislation that was just passed through is termed healthcare reform - and it *is* better than nothing - but it does not address the real issue of healthcare costs rising out of proportion to inflation.  Trade organizations will not help address this issue, not meaningfully. I really think the best solution is to find a way to turn the trade organizations against each other.

  My idea: Promote medical tourism. For those that don't know, "Medical Tourism" refers to going to other countries in order to get costly medical procedures done. The idea is that is is far cheaper to get them done in other countries (like India), that one would even save money after taking into account traveling expenses. I know that this is an extreme suggestion, and people would not be too amenable to going on a pseudo vacation to get some procedure done, especially since there are potential complications with any surgery. I know it may be a tough sell, but it's the only way I can think to inject some real, vitriolic fear into the healthcare system to force providers to find ways to do these procedures at reasonable costs. At the very least it would get the discussion.

  And it's also somewhat of a trap, since the American Medical Association has no grounds to oppose Medical tourism on principle. They even established guidelines for the practice of medical tourism, and there are places overseas that are accredited with regards to the quality of care.

http://www.ama-assn.org/ama1/pub/upload/mm/31/medicaltourism.pdf

  The idea is that insurance companies could very well come to love the idea due to the potential for cost savings, and would push for it in lieu of enough popular support, forcing doctors to bring costs down since the AMA cannot condemn Medical Tourism in theory. The only piece of the puzzle is how to make Medical Tourism the next hot button issue - I'm thinking a documentary-style production starring some famous celebrity, like Oprah, detailing the issue could help galvanize some interest.

  *sigh* I know it's a bit of a pipe dream, but this is the best thing I can think of, short of waiting for all state governments to drastically cut the majority of Medicare/Medicaid benefits as a result of going bankrupt. A guy can dream, I suppose. Anybody else have any ideas on this subject?

Offline Inkidu

  • E's Resident Girlomancer, Dedicated Philogynist, The Compartive of a Superlative, SLG's Sammich Life-Giver
  • Lord
  • Addict
  • *
  • Join Date: Jul 2008
  • Location: In a staring contest with the Void.
  • Gender: Male
  • My Role Play Preferences
  • View My Rolls
  • Referrals: 0
Re: A modest proposal for Healthcare Reform in the US
« Reply #1 on: January 29, 2011, 08:45:09 PM »
So your plan is to have people spend loads of money on airfare, luggage, hotels, food, travel fares, and whatever else so they can have cheaper medical operations done in foreign countries where the people won't feel at home and have to deal with local laws and customs and the language barrier (on some level).

At best it will come out slightly cheaper once you add in all the travel expenses, at worst it costs more for the same care. I'm not saying health care in America is perfect but I don't think promoting medical globetrotting is the best solution to fix it. That's a benefit afforded (as it always has been) by the rich.

Also in regard to the title: What, no eating Irish babies?

Offline Sandman02Topic starter

Re: A modest proposal for Healthcare Reform in the US
« Reply #2 on: January 29, 2011, 08:53:26 PM »
Yes, well I agree with you that I should have laid on more swift-like satire given the title... I also agree that my proposal is hyperbolic and unrealistic, and by no means a long-term solution. But goddamnit, I cannot think of any other way to light the proverbial fire under the health care industry's ass to reign in costs...

« Last Edit: January 29, 2011, 09:33:51 PM by Sandman02 »

Offline Vekseid

Re: A modest proposal for Healthcare Reform in the US
« Reply #3 on: January 29, 2011, 09:25:25 PM »
So your plan is to have people spend loads of money on airfare, luggage, hotels, food, travel fares, and whatever else so they can have cheaper medical operations done in foreign countries where the people won't feel at home and have to deal with local laws and customs and the language barrier (on some level).

At best it will come out slightly cheaper once you add in all the travel expenses, at worst it costs more for the same care. I'm not saying health care in America is perfect but I don't think promoting medical globetrotting is the best solution to fix it. That's a benefit afforded (as it always has been) by the rich.

Also in regard to the title: What, no eating Irish babies?

Before getting state assisted insurance, I was quoted a bill of $3k just to get examined for my hernia.

Not treated. Examined. And that was the starting price.

For that price, I could fly to Prague, get it taken care of, spend a couple weeks cavorting with Elliquiy members there, and fly back. And bring back a few hundred dollars worth of souvenirs.

Medical tourism works not because it makes sense, but because Americans really are getting jacked over when it comes to health care costs.

Offline Will

Re: A modest proposal for Healthcare Reform in the US
« Reply #4 on: January 29, 2011, 09:29:02 PM »
So your plan is to have people spend loads of money on airfare, luggage, hotels, food, travel fares, and whatever else so they can have cheaper medical operations done in foreign countries where the people won't feel at home and have to deal with local laws and customs and the language barrier (on some level).

At best it will come out slightly cheaper once you add in all the travel expenses, at worst it costs more for the same care. I'm not saying health care in America is perfect but I don't think promoting medical globetrotting is the best solution to fix it. That's a benefit afforded (as it always has been) by the rich.

Also in regard to the title: What, no eating Irish babies?

Unless you have actual numbers to compare and contrast the price of health care in America with health care abroad, you're just guessing.

Offline Inkidu

  • E's Resident Girlomancer, Dedicated Philogynist, The Compartive of a Superlative, SLG's Sammich Life-Giver
  • Lord
  • Addict
  • *
  • Join Date: Jul 2008
  • Location: In a staring contest with the Void.
  • Gender: Male
  • My Role Play Preferences
  • View My Rolls
  • Referrals: 0
Re: A modest proposal for Healthcare Reform in the US
« Reply #5 on: January 29, 2011, 09:34:26 PM »
Before getting state assisted insurance, I was quoted a bill of $3k just to get examined for my hernia.

Not treated. Examined. And that was the starting price.

For that price, I could fly to Prague, get it taken care of, spend a couple weeks cavorting with Elliquiy members there, and fly back. And bring back a few hundred dollars worth of souvenirs.

Medical tourism works not because it makes sense, but because Americans really are getting jacked over when it comes to health care costs.
Well here's a simple question. Why didn't you go get it done in Prague if it was so cheap? :\

Offline Sure

Re: A modest proposal for Healthcare Reform in the US
« Reply #6 on: January 29, 2011, 09:39:29 PM »
Well here's a simple question. Why didn't you go get it done in Prague if it was so cheap? :\

Because Veks doesn't have three thousand dollars laying around to start with? (My guess, Veks knows the truth, but the point would be relevant for many people: affordable healthcare would be cheaper, unaffordable healthcare is more expensive than Veks Prague-cation.)

Offline Inkidu

  • E's Resident Girlomancer, Dedicated Philogynist, The Compartive of a Superlative, SLG's Sammich Life-Giver
  • Lord
  • Addict
  • *
  • Join Date: Jul 2008
  • Location: In a staring contest with the Void.
  • Gender: Male
  • My Role Play Preferences
  • View My Rolls
  • Referrals: 0
Re: A modest proposal for Healthcare Reform in the US
« Reply #7 on: January 29, 2011, 09:44:24 PM »
Because Veks doesn't have three thousand dollars laying around to start with? (My guess, Veks knows the truth, but the point would be relevant for many people: affordable healthcare would be cheaper, unaffordable healthcare is more expensive than Veks Prague-cation.)
Okay, so it only stands to reason that it's unrealistic to expect people to pay even more money in flight costs and other foreign expenses. I'm not trying to make an argument in money, I'm trying to make it in hassle, and in inconvenience. People are willing to pay a lot for convenience. Don't get me wrong though. I believe earnestly that health care needs reform.

Offline Sandman02Topic starter

Re: A modest proposal for Healthcare Reform in the US
« Reply #8 on: January 29, 2011, 09:46:02 PM »
  Not to blow my own horn there, but the stats are out there to show how much money people can save with medical tourism, even after taking into account travel costs (statistics that are found in published studies, not just random places on the internet). I studied it in college. So Vekseid's anecdote would hold true for anyone considering medical tourism.

  I understand Inkidu's skepticism, because traveling overseas is a huge pain in the ass, especially if you don't have the passport. But who knows? This could change if the benefits of medical tourism are publicized more to people - that's where Oprah comes in on my initial proposal :) Perhaps Insurance companies could play a role in this as well...

  Maybe we'll all live to see the day where some guy from India can conduct our surgery by remote-controlling a laser from the comfort of a computer chair...

Offline RubySlippers

Re: A modest proposal for Healthcare Reform in the US
« Reply #9 on: January 29, 2011, 09:49:37 PM »
So your plan is to have people spend loads of money on airfare, luggage, hotels, food, travel fares, and whatever else so they can have cheaper medical operations done in foreign countries where the people won't feel at home and have to deal with local laws and customs and the language barrier (on some level).

At best it will come out slightly cheaper once you add in all the travel expenses, at worst it costs more for the same care. I'm not saying health care in America is perfect but I don't think promoting medical globetrotting is the best solution to fix it. That's a benefit afforded (as it always has been) by the rich.

Also in regard to the title: What, no eating Irish babies?

Real information I went to India with my mother for a procedure on her heart here it would have cost my parents out-of-pocket $120,000 and more with complications. In India at a tourist private hospital specializing in cardio care with airfare, all costs, a ten day hospital stay in a private room with a private nurse and physical therapy for BOTH of us cost $21,000. And all her doctors were top notch thenonly thing that cost was having me along for $3000 of that as an added expense. And they can do any non-emergency procedure there from minor cosmetic things to cancer care FAR cheaper with better TLC. So yes the posters plan makes total sense.

Offline Vekseid

Re: A modest proposal for Healthcare Reform in the US
« Reply #10 on: January 29, 2011, 10:25:19 PM »
  Not to blow my own horn there, but the stats are out there to show how much money people can save with medical tourism, even after taking into account travel costs (statistics that are found in published studies, not just random places on the internet). I studied it in college. So Vekseid's anecdote would hold true for anyone considering medical tourism.

  I understand Inkidu's skepticism, because traveling overseas is a huge pain in the ass, especially if you don't have the passport. But who knows? This could change if the benefits of medical tourism are publicized more to people - that's where Oprah comes in on my initial proposal :) Perhaps Insurance companies could play a role in this as well...

  Maybe we'll all live to see the day where some guy from India can conduct our surgery by remote-controlling a laser from the comfort of a computer chair...

I think a better solution would just be to actually look at what is costing such an obscene amount of money and addressing that.

But people opposed to universal health care don't want that discussion.

Well here's a simple question. Why didn't you go get it done in Prague if it was so cheap? :\

Because I wasn't able to scrape together $3k, and even if I did, blowing all of my 'wealth' on one chance wouldn't be a very respectable choice. I got onto state subsidized coverage a few months later, which has done pretty well for how little I use it.

Online Oniya

  • StoreHouse of Useless Trivia
  • Oracle
  • Carnite
  • *
  • Join Date: Sep 2008
  • Location: Just bouncing through. Hi! City of Roses, Pennsylvania
  • Gender: Female
  • One bad Motokifuka. Also cute and FLUFFY!
  • My Role Play Preferences
  • View My Rolls
  • Referrals: 3
Re: A modest proposal for Healthcare Reform in the US
« Reply #11 on: January 30, 2011, 12:45:38 AM »
I think a better solution would just be to actually look at what is costing such an obscene amount of money and addressing that.

But people opposed to universal health care don't want that discussion.

The question is, if people were suddenly made aware of and started using the cheaper alternative (thereby taking income away from the people who are charging the obscene amounts of money) would that make anyone sit up and take notice?  And maybe start talking about what to do 'in order to keep healthcare jobs in 'Merca.'

Offline Serephino

Re: A modest proposal for Healthcare Reform in the US
« Reply #12 on: January 30, 2011, 08:49:51 PM »
Personally, I think it's pretty ridiculous that I got charged $500 for an ambulance ride.  They only had to drive 2mi to my house, then about 15mi to the nearest hospital. They spent about 45 mins of their time.  It would have cost me about $3 in gas to drive myself, but I was in way too much pain.

When I needed my gallbladder taken out, it was $120 to meet the surgeon, and all he did was show me the scan, tell me the whole thing had to come out and would not grow back (it scares me to think someone might have asked him that), and to tell me I needed to pay him another $1300 for the surgery. 

If I could have gone to another country cheaper, then yes, I might have.  I spent another three months being very sick, and that isn't right.  I'm also having serious dental problems because those costs are insane too.  $400 for a root canal??  Tell me where I can go to get good care for half the price, and I'm there!  It's better than spending 3 hours in an ER to get antibiotics when my teeth get infected. 

Something needs to be done about this.  If things keep going as they are (which seems like it will) then we'll all be bankrupt and screwed for getting sick.   

Offline Xenophile

Re: A modest proposal for Healthcare Reform in the US
« Reply #13 on: January 30, 2011, 10:05:38 PM »
I really don't know if I should gloat or feel pity for the lots of ya.

I spoke with an American friend, who had two of his wisdom teeth removed. It cost him 1800 USD in total (after health insurance), 900 for each tooth removed. I had the same thing done to me a year earlier in my homeland, Sweden for the record's sake, and after the exchange rates, I had to pay about 300 SD in total (1800 Swedish Kroner, for record's sake).

Now, I won't just leave now with a simple "Well gee, I have to pay less so suck it, 'Murka" post. I do not have a degree in national economics, nor have I taken any studies in it, so I am not expert, nor will I try and pretend that I am. But having lived in another country than the US, and use the USA as an example in numerous comparison studies in my entire life as a student, there are a few differences that stand out.

I want to know if the simple act of increasing taxes will provide the American people with more beneficial health care, if the taxes where to be increased.
I spoke with someone in the USA, who said that she had to pay around 7% income tax, and that was one of the highest tax rates in the nation. In Sweden, we currently have a 25% income tax (straight to the 'Federal' reserves, a few additional %'s go to the municipalities), and that's the lowest they have been in almost 30 years.

Now, I'm genuinely curious to know, would you be interested in in paying more in tax to decrease the healthcare bills? And would it make a difference/would it even be feasible?
« Last Edit: January 30, 2011, 10:47:32 PM by Xenophile »

Offline Ket

  • Electroslut Extraordinaire
  • Dame
  • Enchanter
  • *
  • Join Date: Jun 2008
  • Location: You'll find me under the gun of a tattoo artist...
  • Gender: Female
  • The Onion Queen - crispy fried goodness
  • My Role Play Preferences
  • View My Rolls
  • Referrals: 5
Re: A modest proposal for Healthcare Reform in the US
« Reply #14 on: January 30, 2011, 10:46:24 PM »
To answer your question about taxes - people in America abhor paying them. Time and time again, politicians use lowering taxes as one of their platforms to get elected. Any sort of tax rate increase is big news in the states, and is met with disdain. Would the majority here be willing to fork over more taxes to have socialized health care that would cost thousands of dollars less a year and be available to all?  Short and sweet - the answer is no. Sure, there are those (including myself) who would be willing to pay more in tax for health care that is easily affordable and available to all, but most here do not think that way.

Back on topic, some US health insurance providers are looking into medical tourism (and that article is two years old).  It is becoming a growing thing. Sure, there is the question of credibility; however, international medical organizations are coming around that are certifying these hospitals and after-care centers. Then of course there is the convenience aspect. Why hop a plane halfway across the world when you can just go to the hospital down the street? I'll tell you my take on it, for a savings of tens of thousands of dollars, if I'm healthy enough to travel, I'm hopping on that plane. These aren't third world facilities, these are hospitals that are as good as or even better than facilities in the US.  But is someone without a good income or health insurance that covers such a thing going to be able to afford it. No, they aren't. They can't even afford to go to the doctor to get a check-up to find out if they'd even have a problem that medical tourism could take care of.

Veks is right, the better solution would be finding out why medical care in the US costs such an obscene amount and addressing that.

Offline RubySlippers

Re: A modest proposal for Healthcare Reform in the US
« Reply #15 on: January 31, 2011, 12:14:24 AM »
I'd go further states should DEMAND Medicaid patiants with expensive care that can be scheduled go abroad, if Medicaid is paying 50 cents on the dollar for care why not reduce that further there are few treatment you can't get done at top facilities. Since they are on the public welfare why not see they get the BEST care for the money?

And in 2014 states will need to find ways to save money.

Offline Xenophile

Re: A modest proposal for Healthcare Reform in the US
« Reply #16 on: January 31, 2011, 12:21:07 AM »
If the USA would just lift the commercial ban on Cuba, there'd be a great deal of savings to be made on the cheap healthcare in that country. Just sayin'.

Offline Jude

Re: A modest proposal for Healthcare Reform in the US
« Reply #17 on: January 31, 2011, 02:43:03 AM »
Medical tourism becoming a viable, widely-chosen option may be the only way that Healthcare in the United States could possibly improve realistically without sweeping cultural change.  I don't think the majority of Americans will ever support heavy-handed government intrusion into Healthcare practices, which is probably what's necessary to sort out the mess that is the American Healthcare System.  If, instead of trying to fix the problem politically, Americans simply opted out of the system entirely, hospitals here would be faced with no choice but to improve.  Right now, "free market" concepts just aren't working because competition among Healthcare providers isn't lively enough (and all that the current reform legislation is going to do is make competition between insurers more lively).

Some facts:

- In 2008 55% of Americans surveyed believed America was "above average" in Healthcare quality.  45% believed America had the best healthcare in the world.
- This is most certainly not true, in fact America has consistently been shown to be about average when compared to its first-world industrialized peers in quality of care (and below that overall health-wise and in terms of life expectancy).
- Americans pay roughly double the average price for average quality care.

Even the insured are not exactly getting what they're paying for, the system is quite inefficient.  Some of that is due to the cost of malpractice insurance undoubtedly, but it definitely can't account for even a substantial percentage of it.  I don't know that socialized medicine is the answer, but it is not true that Canada's socialized system is inferior to America's for-profit system (generally speaking Canada offers services that are about the same or better than their American counterparts).  I suspect that socialization and increased government control aren't the only ways to fix the problem, but could be successful none the less.

Source:  http://www.urban.org/uploadedpdf/411947_ushealthcare_quality.pdf

EDIT:  And the last person we need touching this issue is Oprah.  She needs to stay as far as possible away from questions of science and medicine as possible.  She's done enough damage already.
« Last Edit: January 31, 2011, 02:46:07 AM by Jude »

Online Oniya

  • StoreHouse of Useless Trivia
  • Oracle
  • Carnite
  • *
  • Join Date: Sep 2008
  • Location: Just bouncing through. Hi! City of Roses, Pennsylvania
  • Gender: Female
  • One bad Motokifuka. Also cute and FLUFFY!
  • My Role Play Preferences
  • View My Rolls
  • Referrals: 3
Re: A modest proposal for Healthcare Reform in the US
« Reply #18 on: January 31, 2011, 02:47:36 AM »
Perhaps someone a bit more news-oriented.  One of the guys over on CNN, or something.

Offline Jude

Re: A modest proposal for Healthcare Reform in the US
« Reply #19 on: January 31, 2011, 02:59:22 AM »
Just not Michael Moore.  The last thing this country needs is more simplistic thinking and quick-fix fetishism.

This issue is complicated:  no one thing will fix it.  Even if we chose to socialize the country's healthcare system, how we would go about doing that would determine its effectiveness, not the actual act of accepting generalized Federal intervention.  The success of policies is often not so much about ideology but implementation:  private or public don't matter as much as "how."  Both have a chance of failure and success.

I think the GOP looks a lot more reliable to some voters because they often take the cynical position of Government that has a greater chance of success (or at least includes denial of the responsibility for the failure), whereas the Democrats attempt ambitious things that leave them open to criticism after the fact.  I think there's a certain danger to the "government fundamentally cannot be relied on" mindset in that it easily becomes a self-perpetuating prophecy if half of the wielders of political power in our country truly believe it.
« Last Edit: January 31, 2011, 03:06:37 AM by Jude »

Offline Sandman02Topic starter

Re: A modest proposal for Healthcare Reform in the US
« Reply #20 on: January 31, 2011, 09:06:51 PM »
  Yes, I figured someone would poke fun of my inclusion of Oprah in my proposal :) I'm certainlu not a fan, but not that many celebs have universal appeal amongst primarily democratic and republican audiences (and those in the middle, of course). Certainly Michael Moore would only hurt the cause.

  Hmm... perhaps Charlie Sheen should go overseas for rehab?

  You guys really took my idea and ran with it. I would be supportive of Medicare/Medicaid inducing patients to go overseas for procedures - that more than anything would start making some healthcare providers predict Armageddon, and the change can grow from there. I'm not sure of the viability of this though, for reasons of liability. Maybe if we could come up with a waiver that lawyers would recognize and not try to sue the government regardless...

  As always, thanks for the great discussion. I wish my lectures in college were this engaging  :-)

Offline Jude

Re: A modest proposal for Healthcare Reform in the US
« Reply #21 on: January 31, 2011, 10:41:17 PM »
There's one big glaring problem with medical tourism however:  what about visitation from family?  This is especially important in keeping a patient's morale up during long stays, and even if the cost of treatment is lower overseas, you can't expect your entire family to buy a plane ticket to visit you (and doing so would not result in a cheaper experience overall for sure).

Offline elone

Re: A modest proposal for Healthcare Reform in the US
« Reply #22 on: February 01, 2011, 12:24:41 AM »
There is a lot of medical tourism going on already. I know people out west that go to Mexico for dental work at much more affordable prices by US educated dentists. Obviously, they have low overhead and costs. People are traveling to India for operations. It is a great idea for things that can be planned for. I think that the problem with the idea is that for many procedures it is not practical. Emergencies would not work in that scenario. Also, a great deal of expense for healthcare is diagnostics and tests. Who is going to go overseas for an MRI? Because there are not enough instances where one could take advantage of lower costs overseas, it would not have a big impact on the greedy insurers. Besides, they would just raise the rates for everything else to compensate. 

Health care is too rigged in this country. For instance, if you have health insurance your provider bargains with doctors and hospitals for discount rates on procedures and visits. If you cannot afford health insurance, you have no bargaining power and pay the premium amount. For example MRI cost $1600 without health care.  This cost was discounted to $350 for the insurance carrier. This same cost scenario applies to all procedures and office visits. Why? It is done so the healthcare insurers can scare people into buying insurance. Why should an insured person be charged less than the uninsured? Answer, collusion between doctors, hospitals, and insurers.

As to the tax issue, I for one would gladly pay more for the guarantee of quality healthcare. The problem is the American aversion to taxes. If you told people to pay $1000.00 a year more in taxes, and at then end of the year you would get $2000.00 back, people would still oppose it just because it is a tax.

On quality of care, don't believe we have the best in the U.S. A relative had a heart attack while in Norway. They treated the condition and put in  a pacemaker. There was no charge, she was treated as if a native by national health. Additionally, upon arrival to the U.S. her doctors said the pacemaker was years ahead of anything available here.

The problem here is greed, unnecessary tests (again greed), lawsuits, incompetence, and inflated drug costs.
We pay more for prescriptions than any country in the world. We effectively subsidize everyone else. Drug companies spend more on advertising than research.

Prognosis: dim  Solution: none yet



Offline Xenophile

Re: A modest proposal for Healthcare Reform in the US
« Reply #23 on: February 01, 2011, 12:32:02 AM »
A healthy insurance policy that isn't bound by an occupation, but instead bound by federal or state owned companies/the government itself might do wonders. A steel worker looses his insurance when he's sacked? I don't know about you, but I'd call that inhumane.

Offline elone

Re: A modest proposal for Healthcare Reform in the US
« Reply #24 on: February 01, 2011, 12:39:21 AM »
I agree, tying health insurance to employment is a real problem. I would be in that predicament except for spouse coverage. I was so disappointed when the Dems. caved on the single payor idea. What we have now is not a very fair system. Obama has made a step in the right direction, but I don't think the special interests will ever allow a not for profit system.