Universal Healthcare and OS

[Kach]

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[Squished Rat]

Dr. Mill, Pulpal Insult –

I am aware that we pay postage fees for each letter sent. As far as healthcare, I'm not suggesting free universal health care, just universal health care. The system, just like the postage service, should be paid for with tax dollars.

To address your comment about paying extra through FedEx, you suggest two things. 1) Private companies can compete with the govt by providing the same service and 2) for a little more money we may receive better service through a private company like FedEx. This can be paralleled in the health market as well. In other words, govt facilities (ie. hospitals) can exist along side private health facilities. But here's the beauty of our economic system - after Fed Ex perfected its system of overnight delivery, UPS (the govt postal system) was forced to provide the same service. That is, our government improved its system so that it could compete successfully with private companies. The result is that I can send my package through either service and my mail will be delivered on time. This can be paralleled in healthcare. Not only will this give the average American alternatives, but the two services will force one another to improve service. The bottom line however, is that the average person will have access to some basic care.

Dr. Mill - In response to a comment about the current status of the public school system, are you suggesting that because the current school system is less than perfect that we should eradicate it completely?

Also, the idea that "…MRI, CT, or other expensive tests..." would no longer be affordable or perhaps available is non-sensical. After all, don't Europeans and Canadians receive these tests? Of course they do! And yes they are taxed highly (a quick google search reveals that UK tax rate is a max. of 40%). But the American tax rate (although it's a sliding scale) is also between 30-40% of income.

As far as political big wigs deciding the type of care we receive, research must be used to decide which diseases are most prevalent. Then treatment for these illnesses should be priority of care.

More Later...

It should be pointed out that in Canada they have to wait months to get an MRI. There is a huge waiting list. That is not the kind of care most people expect to receive in America.

 

[Kach]

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[1992Corolla]

Wow, months to get an MRI sounds terrible. Is this here-say or did you experience this? Why does it take this long?

Let's not forget that Americans wait too, however. It may take weeks to see an OS who can take out a wisdom tooth (personal experience) and it can take years to receive a kidney transplant (also personal experience).

Wisdom teeth can wait unless it is an emergency (I know the OS I worked for was booked solid for 4-5 months out - you have to wait). Kidney I can also see because of donor matching, but an MRI? I needed one on my knee a few years back and got it the next day. Every situation is different though, just providing an argument because that is what SDN is for right?

 

[Kach]

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[gryffindor]

Wow, months to get an MRI sounds terrible. Is this here-say or did you experience this? Why does it take this long?

Let's not forget that Americans wait too, however. It may take weeks to see an OS who can take out a wisdom tooth (personal experience) and it can take years to receive a kidney transplant (also personal experience).

http://www.buffalomri.com/canadian.html

This facility is in a little strip mall down the street from my dental school. They catered to a lot of Canadians who could afford $465 + trip to Buffalo because of the wait in Ontario for MRIs and other studies. I think it takes a longer time over there because they just have fewer machines to meet the demands of the number of MRIs ordered. It's the "health care gets rationed" part of "universal health care."

 

[ptrianon]

I dare any one of those people who champion European healthcare systems to seek treatment for a serious illness abroad. I would love to see them sweat out a wait for a coronary bypass while their American counterpart is already well on their way to their second heart attack. A few things that people never mention: European healthcare systems actually deny treatment, something that American hospitals don't seem to do to often. When adjusted for population numbers I am willing to bet that we intubate more super-premies and dialyze more fat assed hopeless diabetics than any country in the world. This brings me to my second point. The US is a large multicultural country filled with a bunch of lazy overfed whiners. If you think that a system that works in some small significantly less diverse country is gonna work just fine here they you are just flat out wrong. I do think, however, that there are a lot of things they do overseas that we should do here. Take for instance the free nurse home visits new parents get in Britain. Maybe instead of performing neonatal surgeries we should be making sure newborns are receiving proper nutrition/care. Actually, with all the money we could save from proactive medicine maybe we could afford to do both! Oh and while we are at it why don't we make people more accountable for their healthcare with higher co pays. Maybe that way the next time a 1 year old inhales bubbles her mother won't feel so compelled to take her to the ER (yes this actually happed at a Hospital I once volunteered at).

 

[SororityOMFS]

I do think, however, that there are a lot of things they do overseas that we should do here. Take for instance the free nurse home visits new parents get in Britain. Maybe instead of performing neonatal surgeries we should be making sure newborns are receiving proper nutrition/care. Actually, with all the money we could save from proactive medicine maybe we could afford to do both! Oh and while we are at it why don't we make people more accountable for their healthcare with higher co pays. Maybe that way the next time a 1 year old inhales bubbles her mother won’t feel so compelled to take her to the ER (yes this actually happed at a Hospital I once volunteered at).

On the surface this seems like an ok idea but the insurance companies have set their fees at a certain price for a reason.

Right now, having the patient pay $50 means the patient comes in, gets the treatment. Up that to $150, and maybe less people will come in for apparently stupid stuff as you suggested. But that also might mean someone skips out on that visit because of the increase...and all of a sudden they're illness balloons into something terrible. Terrible things cost SOOOO much money to fix.

Insurance companies are out there to make money so I would think they have the price set to maximize their profits in the long run.

One huge reason why you often don't need a referral to see a specialist now. The benefits of skipping your family doc are beneficial to the insurance company. Something like <5% of specialist referral requests are denied...

But I do think increasing copays is an interesting idea. Although an increase of just $50 can be quite straining for some families...think about a kid with bad asthma. That might mean a few extra hundred dollars a month just on copays.

 

[cel083]

I don't have anything to contribute here, but I just wanted to commend all of the posters here for keeping it professional-sounding, instead of like trolling and bs-throwing contests. Kudos.

 

[cel083]

I don't have anything to contribute here, but I just wanted to commend all of the posters here for keeping it professional-sounding, instead of like trolling and bs-throwing contests. Kudos.

Now, any second now MacGuver should be on scene.

 

[TucsonDDS]

Wow, months to get an MRI sounds terrible. Is this here-say or did you experience this? Why does it take this long?

Let's not forget that Americans wait too, however. It may take weeks to see an OS who can take out a wisdom tooth (personal experience) and it can take years to receive a kidney transplant (also personal experience).

Sorry to hear about the kidney transplant, if only more people were dying and donating their organs. Well, maybe that could be a stipulation for access to a universal health care system.

 

[Squished Rat]

Definitely, corolla, let's debate this here so we can get differing points of view. If someone brings up an argument that has sense, then we take it for what it's worth. If their argument is nonsensical or an iteration of health care dogma in US media, let's talk about it. But more to the issue, who says that MRI takes months in Canada? And why does it take months?

I suppose, one would argue that there are so many people that need MRIs under a nationalized care system, that the wait times would necessarily increase. Funds are limited in purchasing more machines since there is a limited pool of funds. But is this truly the case? Is this the case everywhere? Can a Canadian physician or health administrator please speak on this issue?

Also, why is it OK for OS surgery to take weeks or even months, but preposterous for MRI to take as long? My third molar hurt like HELL when I called my OS (thank God for ambesol). And more than just pain, had this toothache been a result of an abscess, infection could have spread. The bottom line: with the pain I was experiencing, my problem WAS an emergency and if you've ever had a painful toothache, you know what I'm talking about!

As far as kidney transplants, you are right about the donor matching, but a wait is a wait. In other words, I'm trying to pull apart the argument that the nationalized health care is inferior because they have longer wait times. They aren't the only ones with longer wait times.

Waiting for an MRI is not the same as waiting for a kidney in my opinion because there isn't near the limited amount of MRI machines as there are kidneys available not too mention all the concerns about immunocompatibility. And I am going to say that waiting for a wisdom tooth is not life or death while waiting for an MRI can be. It may hurt, but you are unlikely to die from it compared to someone who has cancer or had cancer surgery and needs an MRI. In any system, you will be limited by the number of personnel who treat disease. I was just suggesting that in a system where there isn't competetion for services i.e. a free market, there is not the same drive to get the work done. You have limited resources and you can't bring in someone else's resources to help relieve that need. In a free market, when there is money to be made, someone will tap into that.

 

[Kach]

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[Pulpal Insult]

Alright, I'll bite...
Kach, I reside in the state of Minnesota, which is to say it is one of your more socialist states in the union. Something called the 'Minnesota Mandate' was past in legislation which stipulates only MN insurance companies can offer health insurance in MN. May sound good to some but this limits competition. To make things worse, MN has one of the HIGHEST corporate tax rates in the union at 9.8%. We also have a 2% tax on all health care providers on their gross sales reciepts before any itemized deductions. Tack on the 35% Federal income tax to any Professional Service Corporations (PSC's are any health care provider, architect, vet, accountant, etc.) So for every dollar that is billed out you got to pay the gov't 47 cents. Keep in mind that you never collect 100% of what you bill out. Oh yeah, that 2% health care provider tax is on gross receipts so if you get stiffed on the payment by your pt you still owe. Still wondering why health care costs so much? Don't even get me going on the trial lawyers factor!

Kach, have some faith in the free market. The gov't impedes the 'invisible hand' that directs where and how the free market allocates its resources so as to provide the lowest, most competitive price. I think that polititcians are so afraid that the free market will provide much better health care, or any other 'need', that their voters will soon realize that they don't need to depend on them.

The "problem" isn't from individual-to-individual as you say, but rather from govt-to-govt (State-Fed). Massive Gov't entitlement programs that are forced upon the medical field are making clinics/hospitals shift the financial burden to the people who have "real" insurance. Remember, there are no free lunches. Thankfully, dentistry hasn't gone down this path as much ...yet.

Wake up, not everyone values their health as the next person. I personally know people who literally could care less if they lived or died. Believe it or not, one of them was actually given a kidney transplant even after years of personal neglect brought on by himself. Don't make me share in the misery of the few by forcing UHC on all the rest. Just recently, a transplant surgeon here in MN went on the record as being in favor for a non-UNOS system where one could purchase organs via free market because so many of his pts die while on the UNOS list (We can discuss this on another entry).

Got more to say, but this is all I have time for. PI