Good national health care possible?

[CCS]

I heard california hospitals, at least some of them, are going bankrupt because of all the illegal immigrants getting treated. I also heard Hawii sociallized health care for about 6 months, but then went back to private because the lines got too long. I heard in britain, if you go to the hospital, you want in line at least a day. Some people are suing the government. Do you think the United States could do national health care better?

I don't just mean in theory, mean even if there is a bit of corruption involved, which there usually is.

 

[CCS]

It is not possible for private companies to compete with government programs. The programs are funded by tax dollars, which can partially or fully substidize the program, under cutting the lowest theoretical private price. Government programs can set their prices by their funding. Private companies must make ends meet with real numbers.

The only way Obama's health care can be fair to HMO's is if it is just a huge program funded only by people's payments to it, and directed by government workers. If any other tax dollars fund it, the private companies will have trouble. And since the tax dollars come from companies like the HMO's, their bottom line gets sucked up and puts them out of business faster.

 

[CCS]

If Obama really wants competition, he should have everyone send him money, and he should administer the health care himself from just that money, not from taxes. Then we could see if he could do it cheaper. You can always do it cheaper though if the CEO is willing to work 90 hours per week for 40 hours of pay.

 

[Bryan]

Illegal immigrants take a HUGE toll on ALL the resources - not just healthcare! They literally drain the already existing welfare system dry, which includes free healthcare.

Yes, but consider this: even if we still had SLAVERY in this country, those people (the slaves) would still have to be fed and cared for. They would still "drain" those resources, even though they weren't even being paid!

So the right-wing pundits on the radio who b**ch and complain on and on and on about how illegal immigration is a "drain on our resources" are conveniently overlooking an important issue: those people are hard workers, and work for nearly slave-wages. My sister (the former Ambassador) tells me that they are worth their use of public resources like healthcare, because they work so cheaply.

 

[The Gardener]

Hear hear, Bryan.

If you measure worker overhead costs relative to the value being saved by the employer of "illegal" labor, these migrant workers are the bargain of the century for this country. Think about it. This is why Bush has done NOTHING to stem the flow of immigrants... he knows that they fill a niche need in the American labor market that NO natural born American would even consider doing unless the wages were increased three-fold. And, if these employers were actually forced to increase wages three-fold, then our FOOD PRICES at the grocery store would be increased three-fold as well.

 

[Starseed]

I heard in britain, if you go to the hospital, you wait in line at least a day.

Simply not true!!! You have to wait only if you visit the ER room, and it's non-urgent. I went to my local ER a couple of months back, and waited about 25 minutes. There were only about 6 others waiting. I think you may have to wait longer in other places but "at least a day" is ludicrous. It would simply not be permitted.

Recently I had a shoulder problem, visited my family physician ("General Practitioner" or GP over here), who gave me anti-inflammatory pills. When these didn't work, I went again & he tried a cortisone injection. When this failed, he diagnosed "frozen shoulder" & referred me to my local hospital. Each GP appointment was booked by me over the phone, and I got to see him the next day. I had to wait 2 weeks for the first physio appointment at the hospital, and since then have been having weekly physio and hydrotherapy, all free, no waiting around involved. The only thing you'd have to pay for in all this would be the prescription drugs at the beginning - about$10, and free to children and seniors.

Yes there ARE waiting lists for some non-urgent surgery, but even these have been reduced in recent years.

If you wish, and have the cash, you can go with private healthcare/insurance, so there is the choice. Most people don't. (and the premiums are much lower than in the US )

( And yes, you need to do something about the mass invasion of illegals. Apart from anything else, they're a kick in the teeth for those of us who might like to emigrate legally to the USA )

.

 

[iamnaked]

The NHS has always been very good when I wanted to use it. (Don't get me started on NHS dentistry though!). I am also proud that they won't deny anyone emergency treatment based on their ability to pay, even though they make substantial losses on foreigners coming over for treatment and then dodging the bills.

 

[ali777]

The British NHS is a double edged sword. The cost of NHS is £2000 per British citizen, making the total budged somewhere in the £120 billion region. You could run a whole country for that money, not just hospitals.

I support the NHS, and I think it should be there, but I don't think we get value for money. At £2000 per person, it is an extremely expensive service. In principle, I don't support privatisation, but it's a well known fact that the private sector is much more efficient when it comes to resource utilisation. If the private sector can provide me with health services for less than £2000, I'd be happy to get rid off of all the overpaid hospital managers and consultants.

The British GPs are another joke... On average they get paid more than £105k, which is apparently more than the specialists working in the hospitals. £105k for working 35 hours a week is an organised extortion.

In short... I like the NHS and I support it, but it's in desperate need of restructuring. By restructuring I don't mean recruitment of even more overpaid fat managers that are the problem in the first place.

 

[badasshairday III]

Recently I had a shoulder problem, visited my family physician ("General Practitioner" or GP over here), who gave me anti-inflammatory pills. When these didn't work, I went again & he tried a cortisone injection. When this failed, he diagnosed "frozen shoulder" & referred me to my local hospital. Each GP appointment was booked by me over the phone, and I got to see him the next day. I had to wait 2 weeks for the first physio appointment at the hospital, and since then have been having weekly physio and hydrotherapy, all free, no waiting around involved. The only thing you'd have to pay for in all this would be the prescription drugs at the beginning - about$10, and free to children and seniors.

Yes there ARE waiting lists for some non-urgent surgery, but even these have been reduced in recent years.

If you wish, and have the cash, you can go with private healthcare/insurance, so there is the choice. Most people don't. (and the premiums are much lower than in the US )
.

You can see a GP with ease because the UK has a lot of them. They pay them well, so seeing a physician is not a problem in terms of waiting, which is great. However, you pointed out that non-urgent surgery could have a long wait list. How long? Americans are not use to waiting for 6 months for hip replacements or knee surgery etc. I know for sure that I wouldn't want to be waiting around on cruches for half a year or more on cruches. But then again you point out that private insurance is not illlegal, and I'm sure that would speed up the wait time for surgery.

I definitely would support a system like the UK, but not Canada. We need more Family Physicians in this country and they need to be compensated accordingly. Unfortunately in a system ran by profits, under qualified individuals have started to take a brunt of primary care in this country (namely Nurse Practicioners). With their training base they simply cannot treat many problems so they are turning primary care into a referral base to specialists. This ultimately drives up the costs of healthcare. If the US wants to save money on health care they need to shift to a more primary care and preventative medicine slant rather then a wait till you are really fucked up (or have a problem that can be treated by a Family Physician but the Nurse sees you) then go to a specialist. Also the way that primary care doctors are reimbursed in this country is unfair, they are under pressure of falling reimbursements to see more patients per hour, so even the Family Physicians who can take care of complex problems would rather refer a patient then spend a lot of time figuring out the problem because they are paid on a per patient basis. So dealing with a simple problem that takes 5 minutes vs taking 35 minutes to deal with a complex problem pay about the same. Bullshit.

The British GPs are another joke... On average they get paid more than £105k, which is apparently more than the specialists working in the hospitals. £105k for working 35 hours a week is an organised extortion.

I disagree. See my above. Shifting towards primary care requires an incentive, and ultimately cuts costs. Compare the US healthcare budget to the UK. Note that also the ratio of GPs to specialists are completely reversed. The US is specialist heavy, while the UK is GP heavy. In America you have people going to a Cardiologist to treat their hypertension, which is completely in the scope of practice for a primary care Doctor. And get this, when the patient goes to the cardiologist for hypertension, the cardiologist is not going to see them for such a simple problem, they send in their Nurse Practitioners to see the patient. So not only are you getting more expensive care (because it costs more to be seen at the cardiologists office), but you are getting care from someone who is less trained (the NP) rather then the full fledged family PHYSICIAN. Also specialist treatment include procedures that require hospitals in terms of using a hospital's equipment, rooms, and staying in the hospital. As a matter of fact, this is were the gut of spending is being spent. Hospital costs are enormous due to the fees they charge, and they have to because they have a crap load of administrators. If you look at a pie chart of Medicare spending (which is the government run insurance), they spend only a mere ~6% on physician fees, while the rest of the budget goes to hospital fees and drug rx. So even by reducing physician payout to zero, there would be not much of a savings in the overall budget because they are not the main expense. But they are the easiest to cut out because they do not have the best lobby.

 

[badasshairday III]

By the way, any nationalized healthcare proposal would be beaten down by the mighty rich insurance lobby. They'll line the pockets of our politicians really well to make sure no such thing is passed.

 

[CCS]

Illegal immigrants take a HUGE toll on ALL the resources - not just healthcare! They literally drain the already existing welfare system dry, which includes free healthcare.

Yes, but consider this: even if we still had SLAVERY in this country, those people (the slaves) would still have to be fed and cared for. They would still "drain" those resources, even though they weren't even being paid!

So the right-wing pundits on the radio who b**ch and complain on and on and on about how illegal immigration is a "drain on our resources" are conveniently overlooking an important issue: those people are hard workers, and work for nearly slave-wages. My sister (the former Ambassador) tells me that they are worth their use of public resources like healthcare, because they work so cheaply.

It is not that simple Bryan. The problem with halfway enforcing a law is some people get caught and others don't. Half of businesses employ illegal workers at a lower price, under cutting their law abiding competition. The competition, which does not use illegal labor because of fear of getting caught, then goes and complains about it to the public.

Here is where it gets funny: The companies that employ and benefit from illegal labor DO NOT contribute any of that money to the health care system. Instead, they use some of the money to bribe politicians to look the other way.

So even though the total benefit of illegal work may be greater than the drain, the people getting the benefit are not the same people paying for hospitals and other stuff. Do you really think these law breaking companies pay taxes on the illegal labor? Or course not.

We must either legallize it for all companies (hurting unskilled citizen labor, such as high school students), or crack down on it completely (sending hard working mexicans back home to the drug infested country).

The only solution to make everyone happy is if we fix Mexico so the illegals go home willingly. We must legalize entrapment for drug deals, at least on the buyer end. Once the drug lords see a huge drop in demand, they might leave, and Mexico can then have a chance to rebuild.

 

[Starseed]

Veru informative badass. And we have also got a "crapload of administrators" in our hospitals too.

Is it true that Medicare is not a right by citizenship, but you need to have a work record of several years in the US, otherwise you're disqualified?

i'm thinking of a situation where I retire to the US, am self-financing, marry and get my Green Card ( highly hypothetical here! ), but I would still be screwed because without Medicare after age 65, I would be unable to find affordable health insurance?

 

[Grantspots]

A friend of mine with strep throat visited the urgent care clinic just two days ago. It was clear she had strep, and the doctor was supposed to run a throat culture, but instead opted to save money, avoid criticism from "big insurance", and sent her home with a prescription for antibiotics. She told her "It may be viral, or it might not" .... and ... to wait 3 or 4 days and "see if it gets worse". If so, it would "probably be strep" and she could begin the antibiotics.

My friend is a high powered business woman who has quarter-end accounting going on right now. Every hour away from work this week is a detriment to her and her company. This doctor, due to fear of ordering "unnecessary diagnostic tests" and risking her monetary reward from insurance companies for "keeping costs down" just added 4 days to my friends illness by instlling doubt that the antibiotics would help. She was supposed to run a throat culture and get her started on antibiotics immediately. Just another small example of how doctors avoid necessary diagnostic tests to keep insurance company costs down and simultaneously harm the consumer.

There was a special on 60 minutes a couple years ago revealing that insurance companies actually reward doctors for keeping diagnostic tests below a certain threshhold for the fiscal year. I cannot count the number of times this problem has affected friends and family, and even myself.

 

[badasshairday III]

A friend of mine with strep throat visited the urgent care clinic just two days ago. It was clear she had strep, and the doctor was supposed to run a throat culture, but instead opted to save money, avoid criticism from "big insurance", and sent her home with a prescription for antibiotics. She told her "It may be viral, or it might not" .... and ... to wait 3 or 4 days and "see if it gets worse". If so, it would "probably be strep" and she could begin the antibiotics.

My friend is a high powered business woman who has quarter-end accounting going on right now. Every hour away from work this week is a detriment to her and her company. This doctor, due to fear of ordering "unnecessary diagnostic tests" and risking her monetary reward from insurance companies for "keeping costs down" just added 4 days to my friends illness by instlling doubt that the antibiotics would help. She was supposed to run a throat culture and get her started on antibiotics immediately. Just another small example of how doctors avoid necessary diagnostic tests to keep insurance company costs down and simultaneously harm the consumer.

There was a special on 60 minutes a couple years ago revealing that insurance companies actually reward doctors for keeping diagnostic tests below a certain threshhold for the fiscal year. I cannot count the number of times this problem has affected friends and family, and even myself.

That is unfortunate. But this is the way it works these days. It is called managed care. As a patient you are completely sheilded from the costs due to third party payers. These third party payers make doctors sign contracts with them, and basically take some autonomy away from the physician. Back in the day this wasn't the case. Back in the day physicians would do what they deemed appropriate for the patient (which obviously makes sense), and insurance companies would pay for whatever the costs were. Now these companies are cutting costs and screwing over doctors as well as patients. It really is terrible and I hope things get better in the future.

 

[badasshairday III]

Veru informative badass. And we have also got a "crapload of administrators" in our hospitals too.

Is it true that Medicare is not a right by citizenship, but you need to have a work record of several years in the US, otherwise you're disqualified?

i'm thinking of a situation where I retire to the US, am self-financing, marry and get my Green Card ( highly hypothetical here! ), but I would still be screwed because without Medicare after age 65, I would be unable to find affordable health insurance?

Citizenship? You would simply need a green card and be over the age of 65 to be a Medicare beneficiary. You can collect social security too, without ever having paid into the system.

 

[Eureka]

I think it's a bit overstated on how long you wait. In Canada if it's non urgent and your waiting in your local hospitals outpatient ward you'll spend about 2-6 Hours waiting. If it's serious your immediately admitted.

 

[souldoctor]

The British GPs are another joke... On average they get paid more than £105k, which is apparently more than the specialists working in the hospitals. £105k for working 35 hours a week is an organised extortion.
.

Not true, the "average" i.e salaried (non-partner) GP probably earns around 50-60k, only partners who have a stake in running the practice would be earning upwards of 100k and partnerships are becoming hard to come by now because there are so many people qualifying and willing to work as salaried GPs due to the general shortage of jobs. GP is something I was considering going into but part of the reason I'm not going to do it is because you will earn much more in a specialty (and I think it is more satisfying intellectually to be a specialist). Psychiatry or dermatology for me I think.

 

[Starseed]

Citizenship? You would simply need a green card and be over the age of 65 to be a Medicare beneficiary. You can collect social security too, without ever having paid into the system.

I need to check on this. It sounds too much like the madness of the British system ( anyone can come here, and everyone gets free everything! ) to be American. I's SURE I read that I need some years of contribution before receiving anything.

 

[badasshairday III]

Maybe I am wrong with the social security, but I am pretty sure about the Medicare. Also there is a state by state basis for this rule.

I think for social security you have to work in the country for 40 quarters. They say the same for Medicare but I know of people who have never worked here in their life and have a green card + Medicare benefits. Some kind of loop hole.

 

[badasshairday III]

double post