Health Care: One way to do it right...

Health Care: One way to do it right... (Full Version)

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SugarMyChurro -> Health Care: One way to do it right... (5/5/2008 4:05:53 AM)
"Japanese Pay Less for More Health Care" http://www.npr.org/templates/story/story.php?storyId=89626309&ft=1&f=1007 ----- I still don't see the point of the insurers, but why argue with success?

pahunkboy -> RE: Health Care: One way to do it right... (5/5/2008 4:51:05 AM)
shift nurses from paper work to "some" primary care.

Archer -> RE: Health Care: One way to do it right... (5/5/2008 5:19:44 AM)
"So here's a country with the longest life expectancy, excellent health results, no waiting lists and rock-bottom costs. Is anyone complaining?Well, the doctors are. Kono says he's getting paid peanuts for all his hard work. If somebody comes in with a cut less than 6 square inches, Kono gets 450 yen, or about $4.30, to sew it up."It's extremely cheap," he says. Kono is forced to look for other ways to make a yen. He has four vending machines in the waiting room. In a part of Tokyo with free street parking, he charges $4 an hour to park at his clinic. " "But while the patients may be healthy, the hospitals are in even worse financial shape than the doctors." I had to read all the way through before finding the gapping hole in the bottom of the Japanees Healthcare ship. But when I got there wow what a hole. Think they retain their best doctors in country with a success oriented social culture? Think the fact that they artificially set the price of MRI's and all the other medical proceedures and use them more often than the US might might might have anything to do with a 50% hospitals in the red ink? How long till those hospitals have to cut back on jobs since the only costs they seem to have control over is labor costs? But they had me wndering how they did it, right up until the end of the article. Nobody going broke for medical costs other than the doctors and the hospitals.

toservez -> RE: Health Care: One way to do it right... (5/5/2008 12:25:33 PM)
Frontline had an excellent program where a reporter went to five countries that offered versions of universal health care. England: Was found to be not a good system mostly for the long waits to see specialists or non emergency surgeries. Japan: Considered good but the price controls the government has put on the procedures has most of the hospitals losing money. Germany: Considered good but their doctors are not paid nearly as well as others and let the rich op out of the program which hampered funding. Taiwan: The newest and the most streamlined so it appears great. (Yeah Taiwan!) But their cost controls are shaky and currently the system is running at a loss and the government is too afraid to raise the premiums because they are a Democracy. Switzerland: Was the best according to this reporter and did not see any major problems except for the cost to the individual. One of the things that struck me was in all of these countries the people had very minor costs in treatment but all did have substantial premiums to pay. This reporter’s recommendations which I agree with 100% were: 1) Take profit out of the medical treatment for the insurance carriers and hospitals. Switzerland did this and no insurance carrier closed up. Profit was in keeping administrative costs down and managing of the extras like type of hospital rooms for example. For comparison purposes the average U.S. hospital about 24% of all costs are administrative and as a hospital employee many of us thinks that is a fake low number. The average administrative costs in Switzerland and Taiwan were running 3%. 2) Everyone gets covered. Insurance companies cannot pick and choose and have a system designed that employer does not offer coverage there is another way that the charge to the individual is the same. 3) Price controls set by the government. Countries that have done this have not seen their quality of care diminished but have seen the most innovation like much cheaper MRI machines. 4) Make the individual pay. This was critical as the people pay their own premiums and not the employers. It has the direct effect of them taking an active interest in what goes on.

meatcleaver -> RE: Health Care: One way to do it right... (5/5/2008 12:39:26 PM)
Having lived in Britain, Germany, France, Holland and Belgium, all run slightly different systems, each have their plus and minus points but all citizens are covered and there is no panic about medical costs and all cost much less than American healthcare and one doesn't have to look at any small print and be told one is not covered when one needs medical care. My brother lives in the US and still keeps up his British national insurance costs because despite his love of America, even he admits the medical system over there sucks and one can't guarantee care when one needs it. My youngest daughter is Japanese and I've got to admit I was impressed with their health servce when she was born. Again, it is there when anyone needs it. The whole idea of a success orientated culture is just an American red herring. If success orientated culture produced the goods, all Americans would be covered and have the best medical care. The statistics show American healthcare compared to other developed countries is just mediocre in results and expensive in costs.

MusicalBoredom -> RE: Health Care: One way to do it right... (5/5/2008 12:42:37 PM)
I am not one for extreme thinking. I do not think that we should completely abandon our current health care structure. We have good doctors, good hospitals and innovative wellness technology innovation. Profit is usually the major motivator for maintaining the constant supply of all of those (yes I'm aware that some people are in medicine as a calling and do so for free or nearly free). So I think we should be willing to pay for quality services. That being said, I just took one of my kids to the doctor for a well kid checkup. The entire thing lasted 15 minutes and included one immunization. The cost was $285.00. In my opinion that's just insane. I have 3 business so I am aware that prices include people behind the scenes that you don't see, infrastructure costs, profit, etc. I still can't get my head around that fee. The pediatrician is my next door neighbor so that figure is even given a break. When I talk to him he talks about how hard he has to work to show a profit. I'm sure he's telling the truth. His major complaints are costs he has to pay (rent for a medical suite is nearly 4 times that of an office suite) and insurance. I have not done or seen any business analysis on the industry so I really don't have and facts there. My nose does tell me however that something is amiss.

meatcleaver -> RE: Health Care: One way to do it right... (5/5/2008 12:46:52 PM)
quote: ORIGINAL: MusicalBoredom That being said, I just took one of my kids to the doctor for a well kid checkup. The entire thing lasted 15 minutes and included one immunization. The cost was $285.00. In my opinion that's just insane. I pay 200 euro for the year for my daughter and don't have to worry about any further costs.

toservez -> RE: Health Care: One way to do it right... (5/5/2008 1:07:50 PM)
The problem is there is no motivation to control a single cost in the whole greedy triangle. Between the medical profession (hospitals, drug companies and so on), insurance companies and the lawyers none of them have it much in their interest to really care about costs. Hospital gets sued, insurance company settles and raises their premiums to the hospital, hospital raises their fees to the insurance company and the insurance company passes those on to the people who pay them. Of course these places have “losses” because they hand out blank checks and when they add them up go whoops we need more money. Look at it this way say you own a company and it made $10,000 last year. You would give yourself a bonus for some of that. Next year you still made $10,000 you would probably give yourself a similar bonus. If you were a hospital you would just assume what bonus you would like and make that part of your regular salary with no concern or thought if you have that money or not. In the hospital industry they are basically paying out huge salaries instead of profit sharing or bonus plans that are not based on any financial point. We need a certain amount of doctors, nurses and on and on and since there is more demand then supply the medical profession writes blank checks and then holds their hands out. Take me for example; I had only mentioned I was thinking about working part time once I was married. That somehow got back to administration and they sought me out to offer me immediately reduced work load roughly 33% with all the same benefits and a marginal reduction in total pay. We have nurses working at our hospital that just graduated nursing school taking jobs that they only work two shifts (24 hours a week) and are getting paid $45,000 with benefits all because they are willing to work on a floor or department that few want to. Free market system does not work when our morality demands (or at least should) that everyone should be entitled to quality care without destroying their lives financially. About all the doom and gloom losses the health industry love to promote my Master will comment “I will start to be concerned about that when I see my doctor shopping the used car lots and playing on the municipal golf courses.” Editd to add the last paragraph.

Archer -> RE: Health Care: One way to do it right... (5/5/2008 1:23:04 PM)
BTW Sugar did it escape your notice that the part I pointed out was related to the point I made that you poo pooed in Catching Wild Pigs? High achieving doctors having to resort to vending machines and charging for parking in order to acheve a profit?

meatcleaver -> RE: Health Care: One way to do it right... (5/6/2008 2:05:47 AM)
quote: ORIGINAL: Archer High achieving doctors having to resort to vending machines and charging for parking in order to acheve a profit? How do you assess a high achieving doctor? A doctor is a part of a health team and the success of a health team comes out in patient statistics. You can have all the high achieving doctors you want but if the overall patient statistics remain mediocre as in the US, high achievement is meaningless and since the Japanese health system show better results than the US, it seems the Japanese have got the balance better.

SugarMyChurro -> RE: Health Care: One way to do it right... (5/6/2008 3:01:40 AM)
Two things: Something doesn't smell right about a few details in the story - everything is privately owned, and yet there appears to be no incentive to own as the profits are minimal. Someone is lying. And with obvious motive. My guess is that the books are well cooked in various ways. But let's accept that doctors and other health care pros aren't paid enough. Fine. Then let them negotiate a higher rate for goods and services with the Health Ministry. There's your fix. Problem solved. I'm not an insider in Japan, but there are dozens of ways to improve things profit-wise. IIRC, in England doctors are allowed to charge people to allow them to leap ahead in line - so if you want to be seen right away, pay up. Otherwise, be satisfied with the queue. What I didn't hear was that Japan was losing doctors because the pay was so poor. But maybe there's an article out there somewhere making that very claim. Overall, that everyone is covered is a good thing. I'd prefer a system in which there were no insurers (profit-seeking middlemen) and no involvement with private businesses to cover employees. Streamline the whole deal.

meatcleaver -> RE: Health Care: One way to do it right... (5/6/2008 3:46:15 AM)
quote: ORIGINAL: SugarMyChurro What I didn't hear was that Japan was losing doctors because the pay was so poor. But maybe there's an article out there somewhere making that very claim. I know Japan is very complex and you are right, the facts in the article about a doctor's earnings don't seem to add up but there is a very strong social ethic and a very strong sense of duty in Japan and pursuing excellence for the sake of excellence and not just monetary reward is very strong. Like many far eastern countries, keeping face in Japan is far more important than personal gain. My younger daughter's mother is Japanese and has a small design company (I mean small) and she would prefer to make a loss than be thought to be overcharging one of her clients.

popeye1250 -> RE: Health Care: One way to do it right... (5/6/2008 8:45:16 AM)
quote: ORIGINAL: SugarMyChurro Two things: Something doesn't smell right about a few details in the story - everything is privately owned, and yet there appears to be no incentive to own as the profits are minimal. Someone is lying. And with obvious motive. My guess is that the books are well cooked in various ways. But let's accept that doctors and other health care pros aren't paid enough. Fine. Then let them negotiate a higher rate for goods and services with the Health Ministry. There's your fix. Problem solved. I'm not an insider in Japan, but there are dozens of ways to improve things profit-wise. IIRC, in England doctors are allowed to charge people to allow them to leap ahead in line - so if you want to be seen right away, pay up. Otherwise, be satisfied with the queue. What I didn't hear was that Japan was losing doctors because the pay was so poor. But maybe there's an article out there somewhere making that very claim. Overall, that everyone is covered is a good thing. I'd prefer a system in which there were no insurers (profit-seeking middlemen) and no involvement with private businesses to cover employees. Streamline the whole deal. Churro, agreed, anything is better than what we're dealing with now and with 47million uninsured in the U.S. Another thing we need to do is make medical school and nursing school free so that Drs won't have to make $400k a year to pay off a half million in school debt. Right now the Insurance and Drug companies (middle men) make the lion's share of profits. And our govt. builds hospitals in foreign countries paid for with some of the tax money of the 47 million un-insured! If we ended "foreign aid", cut the State Dept in half and brought Troops home from Iraq, S. Korea and Japan where they don't want us anyway everyone would or could have "free" healthcare! You should start a thread about the corrupt "foreign aid" system!

SugarMyChurro -> RE: Health Care: One way to do it right... (5/6/2008 1:03:30 PM)
Yeah, good point about school loans. I believe in free, merit-based education to as high a level as someone can achieve. Can't make the grade? Wal-Mart has dead-end jobs for you! ----- "Foreign aid," given our military presence in the world, is really just shotgun diplomacy. Forced trade agreements. According to some SCOTUS rulings, the jurisdiction of the U.S. now extends over the whole of the planet. Does no one else find that interesting?

popeye1250 -> RE: Health Care: One way to do it right... (5/6/2008 2:52:29 PM)
quote: ORIGINAL: toservez The problem is there is no motivation to control a single cost in the whole greedy triangle. Between the medical profession (hospitals, drug companies and so on), insurance companies and the lawyers none of them have it much in their interest to really care about costs. Hospital gets sued, insurance company settles and raises their premiums to the hospital, hospital raises their fees to the insurance company and the insurance company passes those on to the people who pay them. Of course these places have “losses” because they hand out blank checks and when they add them up go whoops we need more money. Look at it this way say you own a company and it made $10,000 last year. You would give yourself a bonus for some of that. Next year you still made $10,000 you would probably give yourself a similar bonus. If you were a hospital you would just assume what bonus you would like and make that part of your regular salary with no concern or thought if you have that money or not. In the hospital industry they are basically paying out huge salaries instead of profit sharing or bonus plans that are not based on any financial point. We need a certain amount of doctors, nurses and on and on and since there is more demand then supply the medical profession writes blank checks and then holds their hands out. Take me for example; I had only mentioned I was thinking about working part time once I was married. That somehow got back to administration and they sought me out to offer me immediately reduced work load roughly 33% with all the same benefits and a marginal reduction in total pay. We have nurses working at our hospital that just graduated nursing school taking jobs that they only work two shifts (24 hours a week) and are getting paid $45,000 with benefits all because they are willing to work on a floor or department that few want to. Free market system does not work when our morality demands (or at least should) that everyone should be entitled to quality care without destroying their lives financially. About all the doom and gloom losses the health industry love to promote my Master will comment “I will start to be concerned about that when I see my doctor shopping the used car lots and playing on the municipal golf courses.” Editd to add the last paragraph. Toservez, I certainly wouldn't begrudge Nurses a good weeks pay! For what they do, Nurses and Teachers are underpaid anyway.

popeye1250 -> RE: Health Care: One way to do it right... (5/6/2008 2:59:36 PM)
quote: ORIGINAL: SugarMyChurro Yeah, good point about school loans. I believe in free, merit-based education to as high a level as someone can achieve. Can't make the grade? Wal-Mart has dead-end jobs for you! ----- "Foreign aid," given our military presence in the world, is really just shotgun diplomacy. Forced trade agreements. According to some SCOTUS rulings, the jurisdiction of the U.S. now extends over the whole of the planet. Does no one else find that interesting? Churro, yeah, I find that interesting! And not in a "good" way! Funny, all the people who say that we can't have a National Healthcare Program because, "the government would mess it up" say that we (can) have an extensive foreign policy program but somehow, (that)...wouldn't get messed up! You see, to the State Dept and other buearocrats it's not "the Taxpayers money" it's "their money."

SugarMyChurro -> RE: Health Care: One way to do it right... (5/6/2008 7:19:24 PM)
All I have ever argued is this: If we have the money for a military presence all over the world, extravagant private interest wars like Iraq and Afghanistan, endless funds for crisis victims the world over, etc - then... Goddamn it, I want universal healthcare. In fact, I want universal healthcare first and then we can talk about the rest of it. Where are the peoples' priorities? It's somehow better to deal in death and destruction and forced trade all over the world for the benefit of a very few than it is to make sure grandma or junior have adequate healthcare? Why?

Irishknight -> RE: Health Care: One way to do it right... (5/7/2008 6:29:15 PM)
If I remember what I was reading last year, there are quite a few VA hospitals that have closed down over the last decade. Why not reopen tem as government funded hospitals for the public? Use some of what we've pissed away for something good. We don't need some government run insurance, we need a place to go thats affordable. Grant that free doctor's education to anyone who will treat patients at a government hospital for 5 years. I was charged 2500 for a test at a university hospital. I got the same test at the VA 3 months later because the University screwed it up and it cost me 50. When I got the test at the University hospital, it made me so sick I couldn't eat for 2 days. The VA made me a little queasy for about 2 hours. The cost of the meds was also reasonable from the VA. We have the system design we need right there. Lets use it.

Lynnxz -> RE: Health Care: One way to do it right... (5/7/2008 6:37:25 PM)
I dunno about VA hospitals... last time I was there they perscribed me coughdrops for a broken leg.... True story! Anyway, I'm not so sure about public hospitals. Grady, the only public hospital in Atlanta is struggling right now because the people that go won't even pay what little they are charged, which in turn forces the prices up... which no one pays... and last I heard, the hospital was in danger of closing. People that work the system will aways be the downfall of public healthcare I think. The hypochondriacs, the people that go to the ER for a broken toe and stuffy nose, and the lonely old ladies that see a Ambulance ride as their only way of getting some human interaction take a huge toll on hospitals. When I was in the military, I knew several people who, in order to fake their way out of the Army, went to the ER and sick call countless times, the doctors ran countless tests on them- X-rays and MRI's all over the place, and after what should of been hundreds of thousands of dollars and medical expenses, they were eventually kicked out of the Army. Because we were technically still in training, they were never charged a penny.

Irishknight -> RE: Health Care: One way to do it right... (5/7/2008 6:40:09 PM)
I knew people like that. One of them wanted out so bad that I talked him into going into sick call in a maternity uniform and asking for a pregnancy test. He didn't get the test or a discharge but I got a good laugh. Just wish I had pictures.

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