health insurance bill

[LostInTheWoods]

I say the market is already inefficient because of the lack of consumer information. In many cases, the patient goes in not fully knowing (a) what's wrong with them (b) which service provider can best help them or (c) what it's going to cost. Even after identifying what's wrong and what service provider you want to use, I find it impossible to get a straight answer about what the services are going to cost.

What other business is run this way?

I don't believe there can ever be a solution to these problems. At least (a) and (b).

The nature of medicine is to (a) aid the patient in discovering just what IS wrong with them, then (b)either providing them with care or directing them to the proper caregiver. If patients always knew ahead of time what was wrong with them, I'd be looking for a new job.

To an extent, determining (c) depends in great part on both (a) and (b), which we've established are unknowns until the service has already been provided.

Keep in mind that if you boil medicine down to its basic function, it is essentially providing an educated guess. Based on your ability to elicit an accurate history and to interpret any associated labs/X-rays/etc, it is a process of deduction. You select what is MOST LIKELY as your diagnosis (your "best guess") while at least eliminating other possible guesses that are often called "red flags". An example would be that back pain is usually just plain old musculoskeletal inflammation. Unless your patient is 70 years old, and his pain wakes him up in the middle of the night. Then you'd better be thinking cancer until proven otherwise. Realistically, it is impossible for the medical layman to piece the puzzle together (despite WebMD ), any more than its realistic to expect me - a mechanical layman - to know how to rebuild a motor. I understand what a motor is, its basic parts and functions, but beyond that...not much. Hence, the reason why the "business" of medicine is often frustrating.

Best Regards,
Lost

 

[MikePA]

**** of a country ain't it?

Yep, the best country in the world with, for now, the best health care.

Canada's per capita spending on health is about half that of the USA. In fact we're 10th for spending but 30th in the World Health Organization's ranking for quality of health care - not great value for money but by no means the worst. France is first in the health care ranking and are 4th highest spenders. USA tops the spending league but is only 37th in the health care ranking. Italy appears to get the best value for money, being 2nd in the league table but only 11th highest spenders.

Per capita spending has to be one of the most useless numbers to compare countries. Every country with socialized medicine has a health care budget set by a bureaucrat. What they spend on health care is a line item in a budget. In the US what we spend consists of millions of individuals making a decision to spend the money, at least it used to be.

 

[canoetrpr]

Per capita spending has to be one of the most useless numbers to compare countries. Every country with socialized medicine has a health care budget set by a bureaucrat. What they spend on health care is a line item in a budget. In the US what we spend consists of millions of individuals making a decision to spend the money, at least it used to be.

I'll play devil's advocate here since I'm from Canuckistan. Not many Americans I know make direct decisions about which heathcare procedures they pay for. When they get sick they are at the mercy of a 'bureaucrat' who works for the insurance company they happen to be covered by. If they don't like the bureaucrat's decision, they are already sick and are not about to go shopping for better insurance.

Per capita spending IS important to compare but only when you also compare health outcomes. The reality is that as a population, for a country that spends as much per capita as the USA does on health care, the very basic outcomes, such as infant mortality and life expectancy are worse than most other first world countries - like Canada - who spend less per capita.

I'm not suggesting that we don't have our own problems as well, or what the right way is for you to fix your problems and/or whether your current health care bill is in the step in the right direction. However ignoring the data will not get you anywhere.

The reality in my opinion is that the USA does have the best health care in the world for those that can afford it.

Being the only first world country to have health insurance tied to the employer makes for a significant inefficiency to the free movement of labour in a capitalist society. There are a number of people that remain underemployed or are unwilling to risk starting their own enterprise that could employ hundreds - simply because of the risk of losing health coverage.

Just some food for thought.

 

[MikePA]

I'll play devil's advocate here since I'm from Canuckistan. Not many Americans I know make direct decisions about which heathcare procedures they pay for. When they get sick they are at the mercy of a 'bureaucrat' who works for the insurance company they happen to be covered by. If they don't like the bureaucrat's decision, they are already sick and are not about to go shopping for better insurance.

You are not very informed about how health care or insurance works. None of this is true.

Per capita spending IS important to compare but only when you also compare health outcomes. The reality is that as a population, for a country that spends as much per capita as the USA does on health care, the very basic outcomes, such as infant mortality and life expectancy are worse than most other first world countries - like Canada - who spend less per capita.

What's your source for this information? See information at the end of this post with the facts about infant mortality in the US. To repeat, per capita spending in countries who have socialized health care is irrelevant since what is spent is not developed based on need, rather it is simply another line item in a bureaucrats budget.

I'm not suggesting that we don't have our own problems as well, or what the right way is for you to fix your problems and/or whether your current health care bill is in the step in the right direction. However ignoring the data will not get you anywhere.

The only data that was ignored were the polls that showed well over half the population didn't want this bill passed.

The reality in my opinion is that the USA does have the best health care in the world for those that can afford it.

You don't socialize one sixth of the US economy to provide health insurance, insurance not health care, for 30 some million people.

Being the only first world country to have health insurance tied to the employer makes for a significant inefficiency to the free movement of labour in a capitalist society.

Again, what's your source for this 'significant inefficiency' statistic?

There are a number of people that remain underemployed or are unwilling to risk starting their own enterprise that could employ hundreds - simply because of the risk of losing health coverage.

Given the condition our economy has been put in and the new taxes to pay for the health care bill, no one in their right mind would start a new business now. Also, what's your source for yet another 'statistic' about 'a number of people' who won't change jobs or 'start their own enterprise that could employ hundreds'.

Just some food for thought.

I'm still hungry.

BTW, here are some facts about the so-called infant mortality 'problem' in the US.

The only flaw in the CEA's diagnosis of the ills afflicting the American health care system is the extensive discussion of the supposed U.S. low performance in life expectancy and infant mortality. This is the standard conventional wisdom, supported by unverified data from the Organisation for Economic Co-operation and Development (OECD) and the World Health Organization (WHO). However, the data do not account for the different standards that countries use to report live births and, by implication, infant mortalities.

The United States has the most inclusive definition of live birth, and as a result reports a higher infant mortality rate than other countries would report in the same circumstances.[7] In other words, births that would be reported in other countries as stillbirths are reported as infant mortalities in the U.S. This also reduces the reported U.S. life expectancy, because the U.S. reports more "near-zero" life lengths in the data because of its inclusive definition of live birth.

Furthermore, U.S. infant mortality statistics and, consequently, life expectancy figures are sometimes adversely affected by factors reflecting improvements, not defects, in the health care system. For example, high rates of treatment for infertility reflect the widespread availability of advanced, expensive treatments that provide substantial benefit to many people who want, but would otherwise be unable to have children. However, they also result in a disproportionate number of high-risk pregnancies and infant mortalities. In addition, social factors also contribute to an increasing average maternal age, which increases the percentage of high-risk pregnancies and infant mortalities for reasons having nothing to do with defects in the health care system. Furthermore, attempts to save babies with conditions that are more frequently "treated" by abortion in other countries skew U.S. infant mortality rates compared to the rates in those countries.

In addition, the U.S. has a higher rate of accidental death than other advanced countries. While this is no comfort to Americans, it reflects many social and other factors besides the quality, efficiency, and accessibility of the U.S. health care system.[8] When adjusted for the higher rate of accidental death, the U.S. life expectancy is the highest in the world.[9]

All of these problems are distinct from the problem of insurance coverage, and these problems could conceivably persist even if every American had health insurance. Indeed, if the only achievement of health care reform is to provide health insurance for all Americans, these substantial systemic problems would remain, harming patients and increasing costs.

 

[dave1949]

The reality in my opinion is that the USA does have the best health care in the world for those that can afford it.

Being the only first world country to have health insurance tied to the employer makes for a significant inefficiency to the free movement of labour in a capitalist society. There are a number of people that remain underemployed or are unwilling to risk starting their own enterprise that could employ hundreds - simply because of the risk of losing health coverage.

Just some food for thought.

USA people do make employment/work decisions everyday - based at least partly upon health insurance out of pocket costs. That's a good point. It will remain so as long as some employer's pay health insurance premiums in lieu of wages. It is also a very high hurdle for small business and startups.

It's also true, but not a universal experience, that health insurance 'bureaucrats' are making decisions about health care. Just because is has not happened to someone personally, doesn't mean it does not happen to others. I don't know what 'mainstream' press refers to. Haven't TBN members related such experiences ?

It's difficult to say the US has the best, or one of the best, medical care abilities and then doubt how an additional 30 million patients will be serviced. That is quite a contradiction.
Dave.

 

[aczlan]

Being the only first world country to have health insurance tied to the employer makes for a significant inefficiency to the free movement of labour in a capitalist society. There are a number of people that remain underemployed or are unwilling to risk starting their own enterprise that could employ hundreds - simply because of the risk of losing health coverage.

I agree. I think that a more useful "healthcare reform" would be to make it so that rather than being in a group with the other people at your place of employment, you were able to buy health insurance like you buy car insurance, independent of who your employer is and with more options than the current plans. If you were to do that and keep all health insurance premiums as deductible on taxes, I think it would be a net positive thing.
If we want to "do it right" we should also do tort reform and other things (such as possibly making it possible for a doctor to be "disbarred" by the doctors trade group (like the ABA and lawyers)) to keep "problem doctors" out of the medical system.

Aaron Z

 

[LostInTheWoods]

Being the only first world country to have health insurance tied to the employer makes for a significant inefficiency to the free movement of labour in a capitalist society. There are a number of people that remain underemployed or are unwilling to risk starting their own enterprise that could employ hundreds - simply because of the risk of losing health coverage.

Not true. The ability to obtain health insurance is not solely tied to your employer. Reasonably priced health insurance can be purchased by the individual from a variety of health insurance companies. For example:
https://www.humana-one.com/secured/...LlCjCZAFzEzCjCZBFw5zTw C 7wf z dyww hABfw WBc

 

[LostInTheWoods]

I'll play devil's advocate here since I'm from Canuckistan. Not many Americans I know make direct decisions about which heathcare procedures they pay for. When they get sick they are at the mercy of a 'bureaucrat' who works for the insurance company they happen to be covered by. If they don't like the bureaucrat's decision, they are already sick and are not about to go shopping for better insurance.

Less true here than you might think. In fact, what you stated is what many in the USA fear will happen under the new healthcare reform. We fear that medical providers and patients will lose out to bureocracy when it comes to obtaining effective medical care in an effective manner.

When I read headlines like this, well, if I were a Canadian, I would take this as a slap to the face.

Danny Williams going to U.S. for heart surgery

CBC News - Nfld. & Labrador - Danny Williams going to U.S. for heart surgery

Again, healthcare in the United States is not perfect. Can it ever be? I think not. The enormity of all that is healthcare in the US will always leave room for debate.

Another reason many in the US are leary of yet another "intervention" by federal government is that a significant number of US citizens still exhibit a degree of individualism and self-reliance. Many don't like the redistribution of wealth to support "entitlements". We expect from others the same that we expect from ourselves...hard work, a degree of self sufficiency, and a respect of the rights of others.

Of course, there shall always be cases when even the most self-reliant, hard working individuals fall onto difficult times. But we do have unemployment payments and COBRA laws (that allow them to keep insurance) and the like to keep them afloat for many, many months. If your job dries up, there are scholarships and programs available for retraining that are widely available. Sometimes, tough decisions have to be made...moving to a smaller house, or even moving across the country to find places where jobs are open (just look at the history of the US, this wouldn't be the first time).

And although we expect self sufficiency, you'll also find that many of those same folks are the first to lend a hand to another in need. Putting a little extra in the collection plate for the soup kitchen downtown, or earthquake relief in Haiti for just a couple of examples. When life throws you a curveball, sometimes you will just need help. But many follow the "Give a man bread, you feed him for a day. Teach a man to fish, you feed him for a lifetime" theory. Help when help is needed, but don't be expect me to bake his bread the rest of my life.

When we see how this new healthcare program appears to "redistribute" the burden of cost, well, I personally don't care much for that aspect. I'm at a point in my life where the healthcare bill is not likely to have a tremendous impact on me personally. One problem I have, specifically, is that it appears to force young and healthy individuals to obtain health insurance (whether they like it or not) and at a rate 17% higher than what they would likely pay, should they choose to obtain it otherwise. As a young college graduate or factory worker or struggling artist or entrepreneur, how much of an extra expenditure can you tolerate?

As it is now, both jobs and health insurance are not all that hard to get, even to the untrained and unskilled. I don't know that I have ever entered a McDonalds, a Wal-Mart, a Lowes, or any number of other chain stores that doesn't both have a help wanted sign out and offer health insurance. While in college, I worked at a convenience store that offered health insurance. BTW, it also offered a retirement plan, better than minimum wage pay, and opportunity for advancement.

Does everyone want to work at McDonalds or Wal-Mart the rest of their lives? Maybe not. But you can't complain about not being able to get a job or being able to get health insurance. The opportunities are there. And while you're working there, you can go to college or technical school, or write a book, or paint pretty pictures.

To a fault, we Americans (at least in the US) want it all. We want to get (or keep) the great job, with the great pay and the great benefits. Sometimes, you can't have all three. When it comes to the benefit of healthcare, is it right to force it on some, so that it can pay the cost for others, when the opportunity to obtain it themselves is so readily available?

As for those who are TRULY unable to provide for themselves and actively seek help, I personally have never known of any going without. And I would not wish to see them go without. Could be that I have lived a sheltered life. But I have worked as a volunteer in our relatively small county's free medical clinic (where free dental care is also available) to those who meet the criteria. I know of numerous churches and non-profits locally that provide an outreach for care of all sorts. I simply am not seeing how changing the system by the means this new healthcare bill seems to will be for the overall good of its citizens.

 

[brin]

My 40 yr. old son just went to his family doctor yesterday for a routine visit and for the first time was only seen by a Nurse Practioner...this has never happened before he said..I think we will begin to see more of this - there just are not going to be enough doctors and with many of the 30 Million who will now have subsidized ( free ) health insurance they will go to the doctor for every little thing since it is free - to them.

 

[bstrom]

Yep, the best country in the world with, for now, the best health care.


We may have the most advanced medical technology although that is open to debate too, but only if you are in a position to get it, with good insurance in place for you. From your statement I assume you are in a position where your employer is paying the brunt of your cost for insurance although I don't know. Ever think about what the self-employed and people who work for small businesses are paying, if they can even afford insurance? For me as a hard working self-employed person, it's a good chunk of my income per month and I still have a high deductable so your statement is pretty off the wall from my perspective.