percentage_plyr

In my limited opinion from working in healthcare in Bronx, there r 2 problems in the community:

1. Too many people r uninsured.

2. Many procedures/ailments not being covered by insurance.

3. Insurance firms having too much of a say in the patient management.

Of course as I said this is The Bronx, things in California or Connecticut suburbs might be radically different.

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crooks

Of course, but for someone on the fringe, that's fine....they're the people that lose out (generally too poor for full private healthcare, too rich for state healthcare) so I wouldn't have a problem with that.
Another option is of course to give everyone a basic "threshold" that the government insures you on (life-threatening maladies etc) and leave it up to everyone else to take care of the more trivial, niched branches (Dental care) with private healthcare.
IMHO a fully public healthcare system will never work properly, but nor will a Fully private one.

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McFire

Health care in the US does cost a lot, but for many reasons. Multi-million dollar payouts for malpractice (that's how John Edwards made his fortune ) and high cost malpractice insurance has raised doctors fees.
The system is also bogged down by hypocondriacs and others who do not really need medical care. A lot of people use ambulances as taxis to the hospital, rather than take a bus, ride with a friend, etc., for minor ailments. In Tampa, Florida, for example, a ride in a BLS (Basic Life Support) ambulance is $500. A ride in an ALS (Advanced Life Support - paramedics) is $900. A lot of my ambulance crew friends have "regular" riders who call 911 and use the ambulance to go to the hospital, when they otherwise could get to the hospital on their own. Ambulance crews cannot deny medical care, so there goes a lot of your money from health care premiums.
HMOs also cause problems by refusing to pay for medical care. Some of that stems from having unqualified people screening medical cases.
US healthcare is excellent. What typically gets compared with the rest of the world is our "free health care", that is, care for the poor. If you have insurance, you'll get care. But even if you don't, a hospital cannot turn you away if it is a "true" emergency.
When you look at the numbers of uninsured Americans, I bet about twelve miilion of those are illegally here Most single young people (under thirty) who are healthy and have no previous medical history aren't going to waste their money on health insurance until they get married and have children.
I actually find Moore's films funny and informative, to a degree. He is very one-sided and tends to omit large chunks of an issue. He sensationalizes to make his point (whether it is right or wrong). He isn't so much a documentary maker as a propagandist. We recently watched "Bowling for Columbine" and laughed about the comparison with Canada because the very next day, there was a school shooting in Toronto, which he had praised for being so non-violent.
Moore is infuriatingly entertaining, but you cannot take his view of issues at face value.

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McFire

Stan187

Well the ***** of it is that nowadays, regardless of whether it's life threatening or not, it costs so much. Health care is not only to keep you alive but to help insure good quality of life. Plus, it all depends on definition. There are a lot of things that can be life-threatening, but not immediately. So where do you draw the line? High cholesterol leads to heart disease which leads to death. So is it life threatening, well no, but sort of. It'd be interesting to think of what sort of qualifier system would be decided upon, and whether it gets as complicated as our taxation system .

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gunnut

Some very good points. Allow me to augment a little:

You can sue doctors and private insurance companies. If we have universal health care by the government, do you really want to sue the government? Can you win suing a federal agency?

And universal health care will only exacerbate this problem.

Are the HMOs a product of our current health care system? If we abandon the employer paid model and go for a self paid model, will the result be better?

That's exactly it! Our free care isn't good. Michael Moore never mentioned our paid care. He only mentioned the stuff he wanted to and discarded the rest.

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Stan187

That's was along the lines of my thoughts. And then I tore my meniscus and walked around on it for a year until I could finally get insurance without having it listed as a pre-existing problem that they are not responsible for.

gunnut

If there's a profit to be made, the services will be provided.

The problem is our insurance cost is so high that people can't afford to buy on their own. It is not economical for insurance companies to offer lower cost health care when the cash cow still exists.

If we can junk the current system, put the money back into consumer's pockets and let us choose, our health care system will come down in price in less than 10 years.

FibrillatorD

I think the strongest case to be made for a more liberalized healthcare system is that lots of money can actually be saved through preventative care. One of the things I was struck by in Sicko is that doctors in the UK, under the National Health Service, are paid according to how many patients they get to lower their blood pressure, stop smoking, get mental health reviews, etc.

In all honesty, I've known people whose knees lock up or they start peeing thrice an hour or they can't cough without pain and I've suggested they see a doctor and their response is "a doctor won't do anything" or "its not that bad." Then, if the condition doesn't go away, they may have to take a $900 ambulance ride to the hospital and spend a few days in intensive care or the OR, with costs piling up the whole time when the situation could've been prevented at a fraction of the price.

glyn

[quote=FibrillatorD;390760]One of the things I was struck by in Sicko is that doctors in the UK, under the National Health Service, are paid according to how many patients they get to lower their blood pressure, stop smoking, get mental health reviews, etc.

At the risk of being called a raving communist (what, me?) I would like to state that I consider the NHS to be a suitable system for any civilised country. It's not perfect, but people do not live in fear of sickness or accidents. We also have private medical services. Their main benefit is that patients can pick the time and dates of any treatment - which is clearly of benefit to busy people.

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VarSity

I completley agree with glyn.

How one of the party hasn't just gone "We will make an NHS" and inst-win the white House I have never worked out.

You just work out how much people pay for private health insurance, take a percentage off because you don't need profit and the 40 odd percent of people who have no health cover in the us will pay the tax aswell, and boom. Insta national insurance tax. (im aware its not that simple but you know what I mean)

How any American can wave a flag shouting 'I love my country' then watch their neighbor who has no insurance, get hit by a car and lose their home and everything they own just to pay their medical bills I can never understand.

Yanks seem to care more about keeping their guns than their health care system. It boggles the mind!!

Even the drug companys win. Hay Mr Pain relief, want you US customer pool to go up 40%? Support the USHS. You can even give them cool uniforms.

FibrillatorD

There's always the fear, propagated by the likes of Ronald Reagan (the actor), that socialized medical care would give too much control to government at the expense of families. The AMA would define services, set standards, establish committees, call for reports, decide who gets in and who gets out, and, ultimately, kill democracy as we know it.

But with the mostly-privatized system today you have insurance companies filling all of those roles. Instead of deadweight dollars wasted on inefficient bureaucratic administrations and unfulfilled quotas, insurance companies reap billion $$ profits while denying coverages. Families, instead of paying slightly higher taxes, become handcuffed with copays and deductibles - if they're covered - all the while "liberal" politicians like Hillary and Ted Kennedy, otherwise inclined to expanding coverage are bought out by insurance and drug lobbyists (is that democratic?)

The question becomes then, what's the most cost-effective solution? I have a hunch that replications of British or CAnadian systems wouldn't work so well in the US. Too many urban-rural conflicts, primarily, and too many people live outside the system now who aren't used to seeing doctors. Too many fatties, and a weird inclination towards avoiding the clinic whenever possible, exacerbating problems. I would seriously question whether the infrastructure could sustain such a shock. Not to mention how embedded and big the health business is.

So, co-ops? Non-profits? Limited socialism in preventative care, or for those under a certain income?

VarSity

Not saying it would be easy, but every time I see a yank on the TV going on about America being 'the greatest country on earth' I just feel the urge to go out and hug an ambulance or one of the studen nurses that live in my building.

I struggle to work out what the USA spends its money on. Percentage wise isnt you military budget like 7%? What else do you spend it on?

No healthcare system and your benefits system is fairly lax from what im told... (when compared to the Uk system which you can sit on forever like a lazy sod. Oh how proud I am)

glyn

[quote=FibrillatorD;390779]
The question becomes then, what's the most cost-effective solution? I have a hunch that replications of British or CAnadian systems wouldn't work so well in the US.

You are almost certainly right there. An idea that has proven to be the right one in country 'A' is not necessarily the right one elsewhere without certain modification to suit local feelings/ culture/ temperament/ ethos or whatever. If this is 'Americanised' and can be sold to the people as such, there may be a glimmer of a chance.

Bigfella

I am fascinated to hear Americans with little or no experience of a universal healthcare system rattle off phrases like 'socialized medicine' as if they actually had meaning. I don't know enough about the US system to comment with authority (and I don't assume Mr Moore's documentary will change that, even if I see it). Instead, I will give you some information about how the evil socialist system in Australia works (at about half the cost of the US system).

To put it simply, I can get pretty much any theraputic surgical procedure done for free, if I am prepared to wait. If the procedure is an emergency, the wait will be as long as it takes for the ambulance to get me to hospital. The ambulance is free provided I pay $25 per year. If it is not an emergency I go on to a waiting list. It may take months or even years for non-life threatening procedures, but they will get done. The length of the waiting list is essentially determined by how much money governments choose to spend on health. More money = shorter waits.

This, however, is how poor people get surgery. You can opt for private healthcare. This not only speeds up the process dramatically, it also allows you the doctor of your choice. Private health also covers dental & some specialist care not covered under our universal system.

The universal system allows me to see a GP (general practicioner) for free whenever I need to. It provides generous rebates on most specialist care, provided I am referred by a GP.

Medication for most conditions is also subsidized under the Pharmaceutical Benefits Scheme (PBS). Under this the government pays drug companies for certain drugs in bulk, allowing substantial savings. The companies like it because it guarantees sales. The PBS only approves drugs that are substantially different to existing medications - thus encouraging new research, rather than just making 'me too' drugs.

Contrary to some opinions I've seen here, government run hospitals are the most efficient we have. In fact, the difference is dramatic. Governments don't have to make a profit. No need to keep shareholders happy or pay absurdly high executive salaries. Our experience is that 'overservicing' (lots of extra tests, etc) is actually a feature of the private system, where there is money to be made in doing more tests, and where people feel that, having paid their hefty premiums, they should get all the tests they can.

The system here has problems, but they are not of overuse by hypocondriacs or the wealthy, but the steady withdrawal of government funding. This, however, has had to be done by stealth. Our 'Medicare' is about the single most popular government program in the country. To openly threaten it is political suicide. Why? because Australians still believe that if you or your family are unwell, the last thing you should have to worry about is stumping up the dough to get treatment.

And yes, this is all paid for by the taxpayer (side note: anyone else notice how 'taxpayer' has insidiously replaced 'citizen' as the way people categorize themselves - definately a dim development for democracy). There is a levy (about 1.5% I think) on all incomes to pay for the system, though I don't know if this does pay for it, or if, indeed, the money is spent elsewhere. Those with private healthcare can get part of this rebated, though I have never understood quite why a government that claims to hate welfare feels the need to prop up an inefficient private health industry - I guess middle class & corporate welfare doesn't count. Still, you will find few Australians who are upset at the idea that their tax dollars help to fund a healthcare system that everyone can use.

entropy

Can health care in the US be denied to poor people's children who are not insured? The children can't help that their parents are irresponsible lowlifes.
If it is granted, good. If it is not, take a long stick and start showing your system somewhere where the sun doesn't shine.

Health care is not welfare or taxes or any part of the liberal vs conservative dilemma.

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If memory serves...