Healthcare in the US

Corporate America is totally missing in action on this. They all bitch about their healthcare obligations, but they refuse to lobby for universal healthcare because it would contradict their "free market" ideology. So their solution is just, "We should pay less for employee health care," let people get "Medical Savings Accounts" (because your average middle-class family is really going to be able to put away enough every year to pay for cancer treatments or heart surgery), and if you're not rich then for god's sake have the good sense to not get sick. (Meanwhile, none of them are too devoted to the "free market" to refuse taxpayer bailouts on their underfunded pensions.)

And I even understand their position, even if I think they're basically immoral assholes. What I don't understand is why the 70 or 80 percent of the country that's getting screwed puts up with it.

the last time I was at a Kaiser center in SF, waiting for a blood test, there were two kids in the waiting room. one obviously had a concussion, and was holding a bloody rag to her head, completely out of it (and to my eyes, not 'acting') and the other was at the desk saying "what do you mean you can't look at us? we've just been in a collision, her head hit the windshield!"

and he was sternly replied to saying that they'd be happy to put them on a shuttle for the city hospital that leaves every 15 minutes, but that policy forbade them from looking at non-Kaiser members at that facility

I want to believe this, and I will if you explain how. How does the numbers add up? Show actual numbers to get the point across.

But...

The problem with using averages is that in Europe, while you can say that everyone recieves the same treatement, in the US you cant. Who's to say at what point what an American spends that they recieve better treatment then a European?

Just an example, in Europe no matter what amount you spend on health care, the public system will always have the same infancy death rate, the same child immunization rate, the same hospital visit rate, etc etc, whether they spend $1000 $2000, or $3000. In the US however, if you seperate it into tiers, you can bet youll see a difference. So while someone who spends $2000 or less on health care might not see a doctor as frequently as someone in Europe, someone who pays $4000 dollars might see a doctor a lot more frequently then someone in Europe. So their comparison is a bit irrelevant and silly. You can't compare apples to oranges

Also, comparing costs of socialized healthcare in other countries to those of costs here in the US is misleading. Most countries with socialized medicine also do not allow for malpractice suits, where we in the US have mountains of them. This is one of the main reasons healthcare here in the US is so expensive in the first place.

that doesn't contradict what people said though. there is a city hospital and they will be treated there. I don't know why they would even be in the kaiser emergency room if they weren't kaiser members; no ambulance would take them there (maybe they were right outside, I dunno).

I wasn't contradicting anyone... just chipping in an anecdote about the reality of 'you will be treated'

someone correct me if I'm wrong but if you go to a state hospital in california for an emergency and tell them you have no insurance, they will treat you anyway and charge it off to blue shield, correct? because my wife and I both did this when we had no insurance and never got billed. was this a fluke? is there a limit on how much the charge can be (these weren't serious problems)?

No, but you also didn't clarify if the injured people had coverage other than Kaiser, just that they didn't have coverage from Kaiser. It also doesn't sound from your post that you were in an emergency room waiting. I've been turned away from treatment at an urgent care center where I had coverage, because the injury I had was too severe for them to treat - and yes, I had to get myself to the emergency room. My statement that it is not true that you will be denied treatment in the US if you don't have insurance still holds. The reality may be difficult to deal with, but the truth is you can still get treatment.

you may be on to something here. call morgan spurlock!

You pay your taxes so that poor people can receive the same police aid, can use the same roads, are defended by the same armed forces; so what's the deal with healthcare?

I recently chose to see a private pay psychitrasit (there were only three on my health plan) and the differnce in quality from past plan-approved psychs was amazing. His whole office is private pay - no insurance accepted - and I had to pay $240 for the initial appointment. (cost of seeing him is not included in my above average). But damn was it worth it. he talked to me for an hour and a half, really getting to know me, my history and family history and past treatments. It was amazing. Unlike past pyschs who would just throw one pill after another at me 'till one stuck b/c the insurance only allowed for 15 minute visits, this doctor truly got to know and I feel better in trusting his judgement for my treatment.

Now I'm not among the poor and uninsured but I'm certainly not rich. Choosing to go to a private pay dr. was a big sacrifice for me, but worth it. It's a shame though that not everyone who needs that kind of care will be able to get the quality I was able to afford.

I save the most money on medications, a presciption drug card is a godsend.

The Reaganite mantra of "waste, fraud and abuse" that was aimed for so long at the federal government should be trained at the insurance industry, pharmeceutical industry and for-profit hospital corporations. The amount of profits being made is astronomical, while the care becomes worse and worse. You can almost track the deterioration year to year, it is crumbling so fast.

However, since the ideology of conservative Republicans and Libertarians both forbid any criticism of profit-making under any circumstances, no matter how it weakens the nation or undermines the economy, we can't expect to see any reasonable discussion of this problem in the political arean as it is currently constituted. Things are going to have to become catastrophic before the issue will be addressed in a serious way.

Maybe not even then. After all, big corporations have discovered that they can use skyrocketing health care costs as a tool to reduce pay and benefits, weaken the working and middle classes and bring them further under control. Americans in general have no idea what is happening to them, mainly because the great majority of the working and middle classes truly believe the picture of the USA that appears on their television screens 24/7 and that picture seldom wavers in its rosy coloration.

And it may be the case that Europe has private clinics too, but when you have to pump money into a public system you dont use, you're wasting money on what could be better coverage for yourself. Not that it's necessarily a bad thing, if you *choose* to do so. But when the government takes the money from you with no ifs, ands, or buts, then you have a problem. Charity should never be forced.

Jeff-PTTL's post, all you've done is point out the nature of a private system. We're aware that some people recieve better treatment then others, that's no excuse to move to a government system. Id much prefer we fix the errors in our private system then have more of our freedom taken away by the government.

Well, if conservatives stay in power long enough, they'll take care of those other things too. (Why should we have to pay for roads in places we never go?!) Except the army. They like guns.

Id much prefer we fix the errors in our private system then have more of our freedom taken away by the government.

Yes, losing our freedom to be uninsured would be a terrible blow to liberty and justice.

Dude, if the boondoggle of the American private health care system doesn't convince you, nothing I say is going to. Who here do you think you're going to convince by moaning about the "loss of freedom" that would come with universal health care?

Disadvantage
-Higher cost in health care coverage
- -consequence: 45 million uninsured
- - -consequence: lower then average rates concerning health

Advantages
-Greater patient comfort
-Different tiers of health care coverage.
-Greater innovation in medical technology
- - advantages are felt globally (even to those nations which dont spend squat on medical innovation and testing)

That last one is very important. I highly doubt you're going to find cures for cancer, aids, or other disease plaguing our world from a public health care system. And though the US will find them, you can sure bet that everyone else is going to take advantage of it.

What is even more sickening is the fact that you seem to begruge the rest of the world access to American healthcare innovations. Perhaps we should paint stars and stipes on these wonderful new cancer pills you've got so everyone knows their are munching on the 'freedom' cancer cure.

before you open your mouth, why not go and find out ecxactly what medical advnaces do come out of the inferioir public health systems that us poor disadvantaged folks suffer in the rest of the world.

Greater innovation in medical technology

you do know that NIH research gets just a lil' public funding, right? and that a publicly funded health system would not detract from private investing in health tech, right?

xpost

So, yeah, wot Ed said.

"A major difference between the Canadian and American health spending is on investment in technology. This is a long-standing difference noted long before government polices on health diverged in the 1960s. American doctors and hospitals are far more likely than their Canadian counterparts to purchase new and expensive devices and technologies. Canadian doctors have a tendency to be far more skeptical and thus wait until technologies are proven and have fallen in price. The United States has far more specialists for each general practitioner than in Canada. Canada has more hospital beds per capita and Canadian patients spend more time in hospitals than Americans. An American patient is more likely to be rapidly treated by a specialist with the most up to date equipment. A Canadian one more likely to be treated by their GP and cared for over a period of time in hospital. Comparisons have found little difference between the effectiveness of the two styles, but the Canadian one is cheaper. The lack of the most recent technology is one of the most common causes of Canadians crossing the border to seek treatment in the United States. To a certain extent sending some patients south is cost effective for Canada. The most expensive medical equipment is also often some of the most specialized. In much of Canada it makes financial sense to occasionally pay to rent a piece of American equipment than to buy it outright and have it sit unused much of the time."

"None of your advantages sound that great to me and your last two are just plain wrong"

Ha, Id like to see what proof you can produce that public funded system produces the same amount of innovation as our private system. And the different tiers of health care is also known as increased freedom, probably the greatest advantage of the three. Leave it to a European to not value it.

"Public universities and public hospitals do a great deal of medical research, as do private drug companies of course"

Which is part of the reason why US medical schools and hospitals are much more popular and generally better, as well as draw the best doctors from around the world. They might do research themselves, but it's nothing compared to what the US does. We dont have the best schools and best doctors because we decided to cut investment to lower insurance prices. Oh yeah, and we didnt get the funds to support the NIH because we support socialist programs. Even with the NIH, Id rather have them and a long list of other research centers aside from just the NIH specializing in different areas of health research. When it comes to R&D, countries with public health care systems just cant step up, because a publicly funded health system does detract from private investing. The proof is in a simple comparison of the quality of medical centers in the US versus the rest of the world.
http://www.usnews.com/usnews/health/best-hospitals/tophosp.htm
I challenge you to find any nation that remotely compares with what the US produces.

"What is even more sickening is the fact that you seem to begruge the rest of the world access to American healthcare innovations. Perhaps we should paint stars and stipes on these wonderful new cancer pills you've got so everyone knows their are munching on the 'freedom' cancer cure."

We pay for it, why should we hand it out to such ingrates? Dont worry though, for now we'll consider it charity to those in need. As big as our economy is thanks largely to the fact that we dont support such socialist policies, we can afford it.

'"You're taking the short, and very incorrent, financial view of the situation, friend. It's already your responsibility to pay for these people. Universal healthcare would make it cheaper for you."

I want to believe this, and I will if you explain how. How does the numbers add up? Show actual numbers to get the point across.'

This UMaine paper points to the fact that the US health care system despite having the hightest per capita expenditure in the world (and the highest expenditure in proportion to GDP), also has the highest administration costs (approachign 25%) due to the fragmented and complex nature of how healthcare is paid for. It also produces the highest infant mortality rate of any OECD nation and is the 37th best performing system in the world (France 1, Italy 2, both fully socialised systems although both have some form of patient contribution, in France up to 30%). Even the Uk which when these figures were collected was spending half that of the US and 2/3rds that of France was still ranked 18 in the world in terms of performance.

They have no financial incentive to do so.

I'm trying to find a citing for this, but many private companies base their work on research already done by publicly funded/gov't group.

why should we hand it out to such ingrates?

makes it so conducive for argument. Or upsupported statements like,

Private and Public Health care coverage produces the same result in treatment

then later mentioning the varying levels of medical specialists in American vs Canada, which of course don't mean shit if you're too broke too ever see one.

Still, ignoring all this, the tone of your posts is illustrative.

Much of the traction against and framing around doing American universal healthcare has a core of "I shouldn't have to pay for health care that I can't immediately see as benefitting me." I.E. only those who can afford it are worthy(the rich as Blessed by God), and poor folks are poor 'cuz it's just their own damn fault, thus ain't worthy for our help. "Ingrates" in our own borders, even!

Poor folks obviously chosen their status, so they should have to live with the consequences. If you spoil them by reducing their costs to a level they can actually afford, they'll never develop the thrifty, hard-working, disciplined character required for success in our obviously meritocratic society. Why, all those poor black folks in New Orleans were stuck in that city since they were spoiled by relying on government.

Why, just look at our Dear President! He'd never have been so successful in life as oilman, ball-team owner, or elected official, were it not for his rugged individualism! Everything he's enjoyed in his lifetime was all earned thru the determined sweat of his own brow, and a product of his labor and his labor alone.

Etc.

So, to thses folks, it doesn't matter that having a baseline, minimal level of treatment for everybody would save plenty of dosh for all in the end, it's all seen in the framing of "the gubmint is taking my money to pay for those lazy, undeserved layabouts." It's a framework entrenched so deeply that no amount of actual facts will dislodge it, as Lakoff would say.

xpost: again, wot Ed said.

"cost free"

Obviously small beans in the "biggest US healthcare problems" sweepstakes, but still - I have a doctor's appointment coming up on Monday. So far I've been asked to confirm my appointment via the app, been sent two separate text messages to confirm my appointment via text response and just now came back to a voicemail telling me that I also have to call them directly to confirm or else my appointment will be rescheduled.

Just.. what.

have you been a flight risk in the past?

sounds like a policy specific to your doctor's office - if you had already confirmed via the other methods I would definitely bring it up with them

My guess is they've had a lot of no shows recently? I just don't get the point of managing things through an app and efficient text messages if you are still also going to insist on taking the time to have someone from the office also call me and make me call them back.

I did just learn from a coworker that she had the same experience and apparently there is a setting in the app to uncheck that will stop them from also calling you. Good to know now.

A coworker of mine has been going through this with appointments lately, too. I’ve had doctors do this to me in the past.

It’s weird.

I abhor all appointment reminders. Don’t punish me for being 100% reliable.

i doubt it's due to recent no shows. HIPAA compliant medical scheduling software is a huge grift and impossible for the people in the office to maintain/configure. multiple reminders from different systems is exactly the sort of thing you end up with.

mine sometimes reminds me at weird times like 9 days in advance, and then never again, and when you reply "yes" to confirm it says "we don't understand that command"

we don't

understand

that

command

sorry thought I was Thom Yorke for a moment carry on

I had a prescription for mere antibiotics sent to Walgreens over an hour ago. their status said they already filled it, but it's in that dreaded "verifying prescription" status, which is controversial because the AMA claims Walgreens pharmacists are overstepping their bounds and delaying access to needed medications: https://www.namd.org/journal-of-medicine/1632-walgreens-secret-checklist-reveals-controversial-new-policy-on-pain-pills.html

except mine are fucking run of the mill antibiotics, what in the hell. I refuse to wait all night so I requested to move them to another Walgreens that's open later because this one closes soon.

SORRY I FAKED PRESCRIPTION SO I CAN KILL ALL MY GUT BIOME AND BLAST THE TOILET WITH DIARRHEA U GOT ME

https://www.rd.com/article/how-honest-are-dentists/

reader's digest huh

I've always thought that dentists are particularly prone to upselling, perhaps because they are maybe the only medical profession where the most effective care protocol - brushing and flossing - is in the hands of the patient. A lot of the time dentists only seem to be checking that you are doing a good job, so then they shift the focus to cosmetic bullshit in essence to make work for themselves.

I've generally liked my dentists, but I had this one guy, a sub, look at my teeth and suggest some treatment that none of my other dentists have ever suggested. When I told him I never noticed a problem, he countered by saying "oh, you can bank on it." And I told him that was a very poor choice of words.