What about healthcare?
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It has been documented that people who cannot pay for health care services, either out of pocket or through private or social health insurance (Medicare), through public programs (Medicaid), or through some other means, may not receive the care they need here in the United States.
This just blows me away! That the number one superpower/country in the world, cannot provide adequate healthcare for it’s citizens!! If you don’t work for a decent size company that provides insurance, and you don’t qualify for Medicare/Medicaid, then you’re pretty much out of luck in this country.
Not to mention, those that DO have insurance, can hardly afford their deductibles, copay’s etc. Personally, I pay 69.24 each month towards my insurance and that’s just for myself. And my yearly deductible is 600 dollars! Once my girlfriend and I get married and I put her and her daughter on, I can’t even imagine what it will go up to.
Granted I’ve got PPO and not HMO…but don’t even get me started on the state of HMO coverage in this country! THAT in itself is a whole other post! There are 45 million people in this country that lack health insurance. The United States spends nearly $5,000 per person on health care — more than twice the amount of some other industrialized countries. But it’s not making us live any longer. Canada, for example, spends about 60 percent less per person than the United States but has longer life expectancies.
Some experts say one reason that the costs in health care are rising so fast is that thousands of insurers, hospital groups, physician groups, medical equipment providers, drug makers and health care unions are all trying to get the biggest cut of the health care dollar they can. The majority of health care organizations, drug makers, physicians etc have all had significant gains in profit in recent years. So why do costs continue to go up??? It’s spiraling out of control and is going to blow up in our faces!
How can we be such a great country and be ranked 37th in the world in overall health care for it’s citizens?? Polls show that most Americans believe our current system is not working and want to convert to universal coverage. I personally believe following in Canada’s footsteps would be the way to go.
There’s so much to say regarding health care I could write pages and pages on how I feel. What are YOUR views towards the health care system in this country? Should we change things? HOW can we change things?
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0 Massachusets recently passed legislation requiring universal health coverage of all it’s residents.
I don’t know the details of the California plan.
Now, the big, preachy, part…
The problems of the current healthcare systems are myriad. The main problems I see are disparity (the difference between those who have coverage and those who don’t…) inflated insurance company salaries, decreasing government reimbursment (for medicare/medicaid), and add to that the fact that the U.S. is one of only 3 (yes, that’s THREE) industrialized nations WITHOUT universal coverage. Examples below:
Disparity: A diabetic patient without insurance has to use insulin syringes and needles several times before discarding them because of their high cost. In addition, it is difficult for uninsured or underinsured patients to tightly control their blood sugars because glucose testing strips also have high costs.
Insurance companies: In 2004, the CEO of HealthSouth (the nation’s largest private insurer) earned $95 MILLION dollars, the CEO of Aetna (another large company, and one who formerly carried the insurance contract for EIRMC) made $19 MILLION Dollars. The insurance lobby is one of the most powerful in Washington, spending millions of dollars each year to sway the votes of senators and congressmen (this alone would be a HUGE barrier to making any changes in the current system) Each year, insurance companies post massive profits while continuing to raise premiums and cutting reimbursments to providers to match government cuts in reimbursments.
Decreasing reimbursments: The government has cut Medicare and Medicaid reimbursments each year for the past 10 years by as much as 3% per year (This data is according to a local physician with whom I work). As these cuts are made, overhead costs continue to rise (malpractice insurance, leases/rents, employee salaries, etc.)
Bottom line, I think that the U.S. healthcare system is completely broken, but because of the insurance lobby, and the American people’s fear of ‘government involvement’ in our healthcare system, we will ride the current system into the ground. In the interim, many people will continue to go without healthcare, and taxpayers will continue to pay for those who go without.
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0 0 Exellent post Ronin! My sentiments exactly! It really IS sad that we’re the richest country in the world and we can’t even supply our people with affordable healthcare. It’s pretty bad when a country as poor as Cuba, has a better healthcare system set up then we do! Granted, the majority of their clinics and hospitals are is such a poor state of repair, mostly caused by the embargo we imposed on them, but at least everyone in that country has access to free healthcare. Not to mention their infant mortality rate is lower and their life expectancy rate is higher then ours! That’s just crazy! (that was the statistics from 2000, but I’m sure they haven’t changed too much) It’s all about the almighty dollar here. The drug and insurance companies keep lining their pockets with cash and the average American struggles to pay his medical bills! It’s a disgrace. Every election the next candidate promises to make changes, but nothing ever happens. Instead our premiums continue to rise each and every year! I moved to Idaho last year without having a job. And although I had money put aside to be able to survive for a few months with no work, I was very fortunate to be able to find a new position with the same company here, that I worked for over 10 years in Florida, so being under the 90 days, my health and 401K benefits continued right where they left off. The thing is they’ve raised the deductibles and the amounts taken out of our checks each week, every year for the past 5 years. I was REAL nervous about going on COBRA insurance coverage until I found a new job, the premiums for that type of coverage were just outrageous!
This country must find a solution and we need to find one fast!
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0 0 State-sponsored health care would be a HUGE mistake in American … besides the concept that it’s not the government’s job to provide health care, there are practical issues - which taxes will pay for the health care? Which companies will insure every American? Will Americans with health problems be charged more, or will healthy Americans pick up the tab for the non-healthy? Isn’t universal health care a Communist ideal? And on one final note, have you considered what universal health care would do for the cost and value of heath care? Isn’t it true that health care is so expensive because of health insurance companies in the first place?
[For the record, I am one of the millions of Americans who lives without health insurance, so it is not my personal interest I am talking about here. I’m talking about what our government’s job is vs. personal responsibility.]
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0 0 I have heard Canada has months-long waits for doctor appointments, as a result of their universal health care system.
Perhaps a strict triaging system could help alleviate that problem?
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0 0 I will limit my comments here as I could easily write a book about every aspect. Having worked for a major health care insurance, working with drug development and provide direct patient care and being a patient myself, I’ve seen about as many sides as there are to see.
Ronin’ s estimates of how much Medicare and Medicaid decreases payments yearly may be accurate for ID. I assure you, since ID is only 5-10% capitated, the Medicare payments are much higher than at least 3 other western states.
Medicare was headed for another cut. However, in JAMA ~ 10 days ago, the AMA lobbied sufficiently to stop that.
In another JAMA publication from early fall, a physician calculated the three specialties that see the most chronic patients and who are paid the least by Medicare (not that anyone is overpaid for Medicare patients). When all costs of doing busy were calculated, the three specialties who saw the patients with the most disabling conditions made an overwhelming $4.04/hr. for their work. I believe these physicians would LOVE to get minimium wage for their Medicare work.
I have too many other views to write here. Although I do want to as Ronin a bit more about the CEO of HealthSouth. Is this the one who was sentenced to prison?
Healthcare is extremely complicated and part of the formula for success is wise and educated consumers, IMHO.
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0 0 Correction: I should have said Idaho’s Medicaid (not the federal Medicare) payments are higher than at least 3 other western states.
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0 0 Thanks, Ok4Now for your clarifications, that is some great info. I, too, am so opinionated about this subject that I could write a book. I will try to make this comment and then restrain myself. In the interests of full disclosure, it should be noted that I work in healthcare as a surgical technologist and I am attending ISU to get my BSN and RN. I find it amusing that I sometimes joke with a surgeon that I am making more than him on a particular case, turns out that I am not joking at all, how disturbing!
As far as the CEO of healthsouth thing, I am not sure if that is the same man that went to jail.
To Jeremy, I would respectfully point out that we ALREADY pay healthcare costs for the uninsured and underinsured. These costs come in Medicare/Medicaid taxes we pay as employees of wherever, they come because these people avoid care until problems become acute (acute problems are much more expensive to treat than seeking preventative care, under insured people are not able to seek preventative care because of the prohibitive cost). They also come because health care providers increase the costs to insured customers to recoup some of the losses they get by treating underinsured who fail to pay their bills. (Please note that this is not meant to be a reflection or character judgement on people w/o insurance, I’m certain that most try very hard to meet their financial obligations…)
Funding issues aside, the biggest problem with providing universal care is two-part. Such a system, especially if set up in the U.S., would need to have two components, FAIRNESS, and EQUITY. The problem is this: in any system where you try to increase the fairness for those involved (in this care, who receives what kind of care), there is a decrease in the equity (efficency and cost effectiveness) of the system. The reverse is also true, if you try to make the system more equitable, then it will not be as fair for those involved.
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0 0 Interesting discussion. I have a few questions as this isn’t an area of my expertise.
1) Can anyone name a government-run program that is cost-efficient and equitable?
2) Can anyone refer me to an article where an American went to a foreign country for some sort of healthcare procedure instead of a foreigner coming to America for their healthcare procedure?
3) Has anyone got statistics or figures on what it costs our healthcare system to sustain the massive tort claims and lawsuits filed against healthcare providers (there was a great article on this in the Reader’s Digest)?
Thanks.
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0 0 To answer Inside Observers 2nd question: I don’t know of an “article” per se right off the top of my head, but I’m sure if we did a search online, we’d find numerous cases. My girlfriend is taking political science at ISU this semester and they had a discussion like this one this last Monday. Her professor stated that more and more Americans ARE going to other countries such as India & Germany for certain surgerys and operations just for the cost savings alone. Sure we have some of the most advanced medical procedures here in the US, but you have to rememeber, many of Drs around the world come here to study, then return to their own countries to practice. So to think that other countries aren’t as qualified as the US to perform any type of surgical procedure would be naive. Not to mention, there’s alot more new medicines that are available in other countries that just aren’t available here, because of the FDA and the drug companies taking so long to bring them to market.
I’m seeing alot of posts here that are against state or federal sponsered healthcare, but the US is one of only 3 countries out of 191 that DO NOT offer this type of healthcare to its citizens. Obviously the other 188 countries are doing something right. I agree it would be difficult to switch over to something like that here, mainly because the government, insurance & drug companies are too greedy and don’t want to give up that billion dollar piece of the pie their receiving each year. I don’t know the answer here, I just know there needs to be a change sometime soon or before we know it, none of us will be able to afford coverage.
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0 0 Rich - That’s exactly my point, though! Like I mentioned, I am uninsured, and because of health conditions I’ve had since I was born, getting insured would be ridiculously expensive … so I settle for ISU’s student insurance, which I assume you already know is essentially worthless. However, I still pay for those who don’t take care of themselves through medicare and medicaid, and I can’t help but ask when it became my responsibility to pick up the slack for people who want the system to take care of them, rather than assume that responsibility themselves?
The entire health care system in America, from what I can observe, is screwed up beyond repair, and there is no government fix that will resolve it. Universal health care, as noted by other members, would only decrease the quality of health care while making it scarce with long waiting lists and underpaid, overworked health care providers.
Which leads me to my conclusion: Capitalism has its problems, as the current health care crisis illustrates, but it is the system that our nation was founded on. Capitalism allows for individuals to assume responsibility for their own well-being, but unfortunately, that means that from time to time, people get hurt to miss opportunities - but as any TV dad will tell you, “That’s life!” So, should we allow our system of capitalism to continue to guide this nation, problems and all, or should we enslave an entire nation into tax-induced poverty (in multiple senses) in exchange for inadequate health care?
I, even as one who has fallen through the cracks from time to time, will take capitalism and let the government stay out of my business.
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0 0 I saw a 60 minutes story several months ago about ‘medical vacations’ where many Americans are going to Thailand for surgeries.
The doctors are all American-trained, the facilities are modern and clean, the patients recover in vacation resort settings, and the entire trip (including surgery and airfare) is incredibly cheaper than getting it done in America.
I recall a Denzel Washington movie a few years back, the one where he was going to kill himself to donate his heart to his son. I know it was fiction, but there were some scenes of the doctors arguing about America’s medical problems. Part of it was liability issues in our litigious society, but another part was all the pharmaceutical companies essentially bribing doctors.
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0 0 I think that part of the probelm causing healthcare costs to be so high is how sue happy our society has become. People sue over the smallest things these days which drives up the malpractice insurance costs for doctors which get passed on to us.
Now I know this obviously isn’t the entire problem, but I think it certainly adds to it.
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0 0 – So what you are proposing is a system called socialism…? Govt controlled health care…? can that be good?
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0 0 I don’t see where anyone proposed socialism.
Doesn’t the government effectively control most aspects of health care anyways? From the FDA to the state licensing boards to the trillions of rules and regulations to the court systems, it seems the government already has their fingers completely squished into the health care pie.
About the only place government has not stomped all over health care is in organizing all the loose ends into a coherent system that is cost effective.
I’m all for the free market to work out the kinks, but this system is too huge and has too many competing private interests.
I dare say our modern American health care system is in as much a mess as our Depression-era economy was.
Will it take a “New Deal”-style overhaul to fix? There, a socialist proposal!
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0 0 Thank you for your responses to my questions. There is no doubt that our healthcare system needs help and I don’t think anyone has a great answer. There may not be a single answer to the problem. Lawsuits are an obvious problem. So is the problem with the overly burdensome FDA taking so long to approve drugs. But I would hope that we don’t lose the ability to sue someone who commits malpractice, nor lose an oversight committee who makes sure drugs are safe before they’re put out on the market.
A red flag went up in my head when reading Post 10. I am decidedly conservative and would not take anything stated by a political science college professor at face value without doing my own research. Surveys have shown that so many of our college professors are beyond liberal to the point of socialist, that I would want to see his sources before believing that medical care in other countries is better than our own, although the doctor’s capabilites may be the same, the funding behind his equipment, continuing education, support staff, etc., wouldn’t necessarily be as good as ours. I’m not refuting his statement, I would just want to see the sources and learn more about this. If that’s “naive” then so be it. My mother taught me when I was small not to do something just because that’s what everyone else was doing. She told me to think for myself, which I prefer to do. Hopefully the continuing posts here will help us all learn what we can do to try and correct or improve this problem.
The comments in Post 12 definitely interest me. If that is true, I’ll have to remember that the next time I need surgery. What a deal - blending my surgery with a much needed vacation to a beautiful country like Thailand! Maybe we should try something innovative like that here! Where would we go? Hawaii? Alaska? Hmm? I see an entrepreneurial (sp?) opportunity here! Any takers?
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0 0 I never said the medical care in other countries was “better” then ours, I just said that their just as good. The physicians in other countries are just as qualified as ours are to perform many of the surgeries and operations that are performed today. However, I would have to think that in SOME instances, the actual “care” in some countries IS better then ours. We’ve got one of the highest rates of infant mortality in the world, AND most other countries have a higher life expectancy as well. So you tell me who has the “better” care. There’s a difference in “care” and “advanced technology” or “state of the art facilities”. Just becauce our country has more advanced and/or state of the art facilities, does not necessarilly result in “better care”. Have you been to see a doctor lately? You sit in the waiting room for 45 minutes to an hour, then the nurse checks you in, takes your vitals and puts you in another room for 20 minutes before the Dr acutually comes in to see you. Once the Doctor comes in, he spends “on average” 5-10 minutes with each patient. It’s like we’re herded in like cattle. They over book and try to take as many patients as possible each day which in turn takes away from the quality of service the Doctor gives each patient. Thus resulting in a misdiagnosis in many a case. Like I said in the beginning…MOST clinics & hospitals….it’s all about the almighty dollar.
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0 0 Healthcare in the US is not about health, and it’s not about care. It’s about sickness, and it’s about money.
It’s a vicious circle. Patients want lower healthcare costs, so they don’t want to pay insurance. Insurance companies want to pay as little as they can to doctors because they need to remain solvent. Doctors still have school loans to pay and want to make a good living, so they have to see more patients to make more money because insurance pays them less per patient. etc etc.
The best way to work your way through this dysfunctional American healthcare system is to get smart, be a good consumer, insist on good treatment, and learn everything you can about your diagnosis and treatment options so you can make the best decisions for yourself.
Learn more:
http://www.EveryPatientsAdvocate.com
Trisha Torrey
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0 0 One of the things that seems to be neglected in these posts is the patient’s responsibility. I admit to being a dinosaur, raised in an era where personal accountability and responsibility for one’s own actions was drummed into our heads. Not anymore. We’re all victims.
We have a piss poor health care system which is the reason I pay exorbitant insurance premiums and medical expenses. Heaven forbid that I should accept that my diet, lack of exercise, smoking, drinking, fast-food, 58-hour work week, etc. is playing any part in the fact that health issues are driving up the cost of care. Nope, I’m a victim of the HMO. If they’d just offer me a reasonable rate for my insurance and insure me for every possible contingency, I can continue to live life as I want, rather than as I should.
The greedy CEOs at my insurance company and hospital may be selling their souls to the devil, but they wouldn’t be able to take such easy advantage of me if I didn’t let them. There are legitimate health problems that are NOT brought on by my own actions, but there are a seriously awful lot of them that are.
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0 0 Chris671
I have vowed to mostly stay out of this discussion as so many people have their views, based mostly on their own opinions. I understand how that can happen.
But, I do want to clarify one thing with you: Infant Mortality in the U.S. I don’t know the answer to this specifc question, but perhaps the proessor who is giving some information might.
I know at how many gms. neonates are considered viable in the U.S. What about in other coutries?
Could it be that much like some hospitals, they have a higher M and M rate than others, because they accept higher risk cases that smaller hospitals won’t, so consequently, they show more deaths than other hospitals?
There are some parts of your discussion I could back, but I need to know more about the specifics of Infant Mortality, ince you’ve mentioned it a few times.
Specifically, what are the numbers for the other countires, that you mention, for a 1,000 gm., 1,500 gm., 750 gm. neonate? Or, do all those countries even bother to try to save those premies?
Thanks for the update and the interesting discussion.
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0 0 And many FMGs stay in the U.S. to practice. Otherwise, there wouldn’t have been J-1s, Visa and Fifth Pathways programs established.
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0 0 I think if people were to take advantage of the current options available with the Health Savings Accounts it could really help overall. I beleive you can put upwards of $5400.00 per year into a tax favorable HSA account and withdraw it for any medical expenses you wish to use the money for. This is excellent as it drops your taxable income by the amount you put in the HSA.
Think about it your probably going to spend alot of money on over the counter medicines, perscription meds, co pays for doctor’s visits, and for health care deductible’s. If americans are going to spend the money anyway why are very few taking advantage of the net taxable benefits that come with using an HSA?
I beleive there were some flaws in the earlier versions of HSA’s like the use it or lose it provisions, but now that is not the case, money carries over that is not used from year to year and if you stay healthy the money continues to build and you can withdraw it at retirement for whatever reason you wish so it opperates as a secondary IRA.
If more Americans were to do this and were to decrease their dependence on private insurance we would become smarter consumers or our health care and allow capitalism to work it’s magic where now due to government involvement the system is askew and not functioning on any sound economic principle.
Again however, most Americans have any idea at all about HSA’s and don’t use them for their benefit.
Universal health care is not the answer, when I served in the Military for 6 years I can tell you what a joke it was. People went to the doctor for the slightest little sniffle or cough. The waiting was awful, and the bad part was that because you had so many people ‘riding’ the system or misusing it, the doctors took on a very pesimistic attitude towards all patients. Sometimes it was a battle to convince them that you really were sick or really did have an issue.
It got so bad that in some of my duty stations they pretty much just had a ‘motrin’ window so that all the malingerer’s could go to sick call to avoid whatever duty they were trying to avoid, but not tie up a doctors time with nothing.
I spent some time in Canada on a mission and I remember there was major discontent with the system they have. Anybody with money bypassed the Canadian system and came here for surgery due to the wait times and conditions that were in place to authorize a surgical procedure. The doctors there were very disatisfied with their pay and were constantly complaining. I saw more then one over pass that had grafitti telling the doctors that if they didn’t like it to leave. So not alot of love was felt up there especially when it came to advanced procedures.
Last thing and then I will shut up. I think one of the major problems I have with health statistics and mortality studies include the deaths/murders in our big urban centers that are completely out of control at times. Can our healthcare system fix that, or are they responsible for that???? I think not, so we should not place to much credibility in our placement among other developed nations as they do not have the same issues we have in our urban centers.
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0 0 Profits
If you buy stock in United Health Care, Cigna, Humana, Blue Cross, what ever…You want that stock to go up and up and up…
Therefore, service has to go down down down. That way the the stock holders profit and the CEO’s income continue to rise.
Even if you are one of the lucky ones that can afford insurance these days, or have it offered at work, you will get less and less service while getting higher and higher deductibles and premiums.
When I worked for Doctors in the 80’s, most people had a $100.00 - 250.00 deductible - now I am seeing $1,0000.00 - $5,000.00 deductibles for “health” insurance - not major medical. Great, I can go see a doctor but I have to pay the first thousand or so out of pocket.
As the costs go up, the services are dwindling. Very few medical procedures are covered anymore - and even if they are - you often have to fight tooth and nail to get the money from the insurance. Its a pain in the ____ (insert your choice of anatomical body part)
So what is the answer? I don’t know enough about socialized medicine to make a comment, but I will say this.
How come we can spend BILLIONS on the George W’s war, yet there are so many people in our country that could us that money for things like health care and education?
With all that money would could give everyone insurance AND give them 4 years of college….but what do I know. I guess we need to spend billions to find weapons of mass destruc….oops, I forgot, we never found any. Ok, then we needed to free the people from tyranny…But wait, that that cant be the reason or we would be in DARFUR today….well, Im sure there is a good reason we are blowing up and then rebuilding Iraq.
I digress - back to the topic.
I wish I had the answers on what to do about health care, or how to change things…at this point I just feel defeated.
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0 0 KPVI reported our Idaho Governor Butch Otter will be conducting an Idaho Falls meeting as part of his “Governor’s Select Committee on Health Care”. I guess it is to hear what Idahoans feel should be changed about health care in Idaho. The meeting is this coming Tuesday March 18, at the University Place Bennion Student Union Building, from 4-7pm.
http://kpvi.com/Global/story.asp?S=8013602
Some change suggestions are increasing number of nurses, building an Idaho medical school (Pocatello or Idaho Falls?), and providing health care to those who need it most.
What do you think needs to change about Idaho’s health care environment?
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chill, gato, it ain't worth getting your purty fur messed up
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I don’t know what the solutions are here, but it was funny to read in this week’s TIME magazine that Republican Arnold Swarzenegger is planning a universal health coverage plan that is remarkably similar to the Clintons’ failed 1994 proposals.
What I find ironic and dehumanizing is we are legally required to carry car and home insurance but not health or life insurance.
Where are our priorities?