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RE: HR 676 - Single Payer Healthcare - 12/11/2008 9:00:18 PM   
Hippiekinkster


Posts: 5512
Joined: 11/20/2007
From: Liechtenstein
Status: offline 		Older than I am, anyway. Not much, though.

"The man is old and feeble
his loving time is out.
What used to be his sex appeal
is now his waterspout.

It used to take forever
to make that thing behave
Why, every single morning
it would stand and watch him shave

But now he's gotten older
and it sure gives him the blues
to have his thing hang down
and watch him shine his shoes."



_____________________________

"We are convinced that freedom w/o Socialism is privilege and injustice, and that Socialism w/o freedom is slavery and brutality." Bakunin

“Nothing we do, however virtuous, can be accomplished alone; therefore we are saved by love.” Reinhold Ne

(in reply to Hippiekinkster)
Profile   Post #: 21
RE: HR 676 - Single Payer Healthcare - 12/11/2008 9:12:39 PM   
smartalex


Posts: 50
Joined: 5/29/2008
Status: offline 		HK, there's a huge gap between "involved" and "running the show."  I'm not sure what your familiarity is with current medical business practice, but they are already involved. Have you heard of HIPAA? Do you know how much that has changed the face of medical billing, or do you just think that ends with the privacy forms you sign and insurance portability?

Do I want the government running the show? I'll need to see a lot more evidence on how the proposed system would work before I could believe that they would do a better job of it than the private insurers. (I will grant that they can't do much worse.)

I work in a medical practice doing billing. We don't "market" to Canada (or anywhere else), but have several cases on an annual basis for hysterectomies, etc. And I'm in Ga. I have no idea why that happens, all I know is they come in and pay about three times the revenue a Medicare patient would bring to the practice. (Governmental policies only pay the provider about $.30 on the dollar.)  They pay over $3000, out of their own wallets, up front. These aren't "elective" surgeries. Patients are in pain, bleeding, with prolapsed uteruses.

Meanwhile, I'm on the phone explaining to someone's 78 year old mother that even though they have a huge family history of cervical cancer, unless they sign a form that they are willing to pay out of pocket for their pap smear, they only get one every other year. And yes, the reason why the gyn didn't listen to their breathing, do the HEENT exam is that Medicare will fine them if they do. It's not that the doctor doesn't want to take her time (or his), but the government has decided that it's fraud to do so.  Sounds like fun, doesn't it? Will this single pay system create more problems like this, or will it follow Medicare's lead? (And that's just a single example from one specialty.)

I realize that it may be uncommon to find someone who isn't squarely behind the private insurers (I think they're scum) AND who also isn't gung-ho for the government regulated set up (I'm not sure I can point to many governmental programs that are overwhelmingly successful.)  I prefer to take my time to make up my mind.  Any statements that cast me as dedicated to the private sector system, not wanting any governmental involvement (as I said, too late already). . .is a result of miscommunication. If you need me to explain that again, just let me know.

However, let's take a step back. We've already got some pretty major changes going on in medicine that are going to be huge costs to practices with the dramatic increase in diagnoses that was mandated back in August.

My private opinion is that medicine shouldn't be run solely looking at the bottom line, the way private insurers do it. The transcript you quoted makes me ill. But doctors need to eat, and so do the people who work for them. But guess what? The federal and state insurers are no better. I'm a bit attached to my paycheck, since it does let me do frivolous things like pay my mortgage, eat and put gas in the car. I work damn hard for that check, jumping through hoops so that the governmental and private insurers will do what they told the patients they would do--pay for the medical care. Neither private insurers or governmental insurers get a gold star from me.

(in reply to Hippiekinkster)
Profile   Post #: 22
RE: HR 676 - Single Payer Healthcare - 12/11/2008 9:23:27 PM   
Hippiekinkster


Posts: 5512
Joined: 11/20/2007
From: Liechtenstein
Status: offline 		I'm glad you elaborated your position.  You and I aren't that far apart. I'm not saying that going to a single-payer system is a cure-all, but, as I read the bill (the text of which is available on the link I provided), it certainly seems to be a much better way of addressing the nation's health care needs than leaving it to the actuaries.

I'm in GA too, and it's a bit late, but I do want to revisit your post. In the meantime,
Mythbusting Canadian Health Care:
http://www.ourfuture.org/blog-entry/mythbusting-canadian-health-care-part-i

_____________________________

"We are convinced that freedom w/o Socialism is privilege and injustice, and that Socialism w/o freedom is slavery and brutality." Bakunin

“Nothing we do, however virtuous, can be accomplished alone; therefore we are saved by love.” Reinhold Ne

(in reply to smartalex)
Profile   Post #: 23
RE: HR 676 - Single Payer Healthcare - 12/11/2008 10:48:04 PM   
awmslave


Posts: 599
Joined: 3/31/2006
Status: offline 		As I understand it (based on original post) US government would take a position of health insuarance provider.  Medical lobby will stop it in Congress if they feel their profits in any danger of being reduced. Massive fraud will be a problem. Fraud is big part of the Medicare today. Hospitals and doctors may like it as they would get HMO-s off their back. In general, it will certainly cost overall more than the current system. But the benefit may be spreading the cost better and subsidizing poor. If it frees businesses from misery being forced to provide health benefits it may not be bad.

(in reply to Hippiekinkster)
Profile   Post #: 24
RE: HR 676 - Single Payer Healthcare - 12/11/2008 11:27:37 PM   
Evility


Posts: 915
Joined: 12/19/2007
Status: offline
quote:

ORIGINAL: corysub
I guess you never heard of the influx of Canadians coming into America for treatment.  There are estimates that almost one million Canadians are on waiting lists for referrals to specialists.  Ten percent of patients at the Cleveland Clinic for hip replacements are Canadians, ..if they have the money and need treatment..they come to America.
Try getting a high quality doctor or dentist in Germany on the public dole!  The good ones DON'T participate in the government programs and only accept cash...and this we know from personal experience.

Most importantly, where the heck do people come up with the idea that the United States healthcare system is "malfunctioning".  My family has had nothing but the best of timely and professional care in problems from tonsils to lung cancer and have no complaint but only praise for the services rendered. 
15% of the population does not have healthcare according to estimates.  Well..the government should help them with better clinics but leave the system alone. Beating up on the drug companies that develop most of the life saving drugs used around the world were developed by the research of American companies and scientists.  Our biotech industry is the envy of the world.... 
Universal Healthcare in this country should be put on the garbage heap along with Global Warming insanity.


Careful. Facts upend these discussion with alarming speed.

(in reply to corysub)
Profile   Post #: 25
RE: HR 676 - Single Payer Healthcare - 12/12/2008 12:03:18 AM   
Hippiekinkster


Posts: 5512
Joined: 11/20/2007
From: Liechtenstein
Status: offline
quote:

ORIGINAL: Evility

quote:

ORIGINAL: corysub
I guess you never heard of the influx of Canadians coming into America for treatment.  There are estimates that almost one million Canadians are on waiting lists for referrals to specialists.  Ten percent of patients at the Cleveland Clinic for hip replacements are Canadians, ..if they have the money and need treatment..they come to America.
Try getting a high quality doctor or dentist in Germany on the public dole!  The good ones DON'T participate in the government programs and only accept cash...and this we know from personal experience.

Most importantly, where the heck do people come up with the idea that the United States healthcare system is "malfunctioning".  My family has had nothing but the best of timely and professional care in problems from tonsils to lung cancer and have no complaint but only praise for the services rendered. 
15% of the population does not have healthcare according to estimates.  Well..the government should help them with better clinics but leave the system alone. Beating up on the drug companies that develop most of the life saving drugs used around the world were developed by the research of American companies and scientists.  Our biotech industry is the envy of the world.... 
Universal Healthcare in this country should be put on the garbage heap along with Global Warming insanity.


Careful. Facts upend these discussion with alarming speed.

And what facts would those be? All I have read are some assertions without any source materiel whatsoever.

You do know the difference between a fact and an assertion, right?

_____________________________

"We are convinced that freedom w/o Socialism is privilege and injustice, and that Socialism w/o freedom is slavery and brutality." Bakunin

“Nothing we do, however virtuous, can be accomplished alone; therefore we are saved by love.” Reinhold Ne

(in reply to Evility)
Profile   Post #: 26
RE: HR 676 - Single Payer Healthcare - 12/12/2008 1:54:29 AM   
corysub


Posts: 1492
Joined: 1/1/2004
Status: offline
quote:

ORIGINAL: Hippiekinkster

quote:

ORIGINAL: Evility

quote:

ORIGINAL: corysub
I guess you never heard of the influx of Canadians coming into America for treatment.  There are estimates that almost one million Canadians are on waiting lists for referrals to specialists.  Ten percent of patients at the Cleveland Clinic for hip replacements are Canadians, ..if they have the money and need treatment..they come to America.
Try getting a high quality doctor or dentist in Germany on the public dole!  The good ones DON'T participate in the government programs and only accept cash...and this we know from personal experience.

Most importantly, where the heck do people come up with the idea that the United States healthcare system is "malfunctioning".  My family has had nothing but the best of timely and professional care in problems from tonsils to lung cancer and have no complaint but only praise for the services rendered. 
15% of the population does not have healthcare according to estimates.  Well..the government should help them with better clinics but leave the system alone. Beating up on the drug companies that develop most of the life saving drugs used around the world were developed by the research of American companies and scientists.  Our biotech industry is the envy of the world.... 
Universal Healthcare in this country should be put on the garbage heap along with Global Warming insanity.


Careful. Facts upend these discussion with alarming speed.

And what facts would those be? All I have read are some assertions without any source materiel whatsoever.

You do know the difference between a fact and an assertion, right?


You do know the difference between "facts" and politcal spin?   ...and from Conyers no less...LOL

I would suggest you try an interesting search engine called Google.
You can bring up all sorts of really interesting articles, commentary and studies on a wide variety of subjects.  I thought the article below was kinda interesting in that it is not a U.S. citizen discussing how bad our healthcare is but  Canadians discussing the problems in their healthcare system, as well as some mention of the cancelled specialist visits in the U.K. and the wait period for specialist services.  The Tornoto Sun also has some interesting articles on Canadian National Healthcare, the closing a number of maternity hospitals to cut costs and in response to the outcry suggesting that a woman would not have to drive longer than an hour in labor to reach a maternity facility.  Obiously, written by someone who has never been preggy and in labor.
-----------------------------------------------------------------------------------------------------
http://www.chmonline.ca/news/article.jsp?content=20081128_153428_11964

Dr. Richard Lessard, Director of Public Health in Montreal said that it has been known for a long time that people with lower socio-economic status experience significantly worse health than those with higher socio-economic status, "Yet the lives of far too many Canadians continue to be burdened by preventable poor health. This is not acceptable."
--------------------------------------------------------------------------------------------
http://www.city-journal.org/html/17_3_canadian_healthcare.htm


--------------------------------------------------------------------------------------

http://www.chmonline.ca/news/article.jsp?content=20081015_191224_20248
Canada ranks 17th out of 18 countries on public spending on pharmaceuticals.
  • In a comparison of 36 new drugs evaluated for public drug plan reimbursement by all countries, Canada’s public drug plans ranked 16th out of 18, providing less coverage than all countries except Australia and New Zealand.
  • In an analysis of 36 new drugs common to all jurisdictions studied, Canada’s Common Drug Review (CDR) recommended only 61% of drugs for public drug plan reimbursement, far less than the averages of the European Union (91%) and United States (88%). Provincial formulary decisions further reduce the Canadian drug listing average.
  • Of 78 recommendations issued from the inception of the CDR in 2003 to the end of 2007, it has given positive recommendations only 46% of the time, even lower than the percentage quoted in the study.
  • Wait times for approval of priority review and orphan drugs to treat rare disorders are longer in Canada than in the U.S. or E.U.
  • The U.S. medicare plan extends catastrophic drug coverage for seniors to a far greater extent than is available to Canadian patients.

    [Mod Note:  image removed]


    < Message edited by ModeratorEleven -- 12/12/2008 7:13:28 AM >

    (in reply to Hippiekinkster)
    • Profile   Post #: 27
    RE: HR 676 - Single Payer Healthcare - 12/12/2008 8:42:24 AM   
    samboct


    Posts: 1817
    Joined: 1/17/2007
    Status: offline     		"Then, of course, we have the persistent myth of medical malpractice insurance being the driver of higher and higher medical costs. Uh-huh.
    " After all, including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-half of 1 percent of health-care spending. If anything, there are fewer lawsuits than would be expected, and far more injuries than we usually imagine."
    ONE-HALF OF ONE PERCENT.
    There's more interesting data about "frivolous" lawsuits.
    http://www.slate.com/id/2145400/ "

    Umm- no.

    The fear of lawsuit has multiple costs- never mind the direct costs of paying out the lawsuit.  These costs include defensive medicine such as:
    1)  unnecessary tests: Lawyer- how come you didn't order the Barr-Mannheim smear when you knew there was at least a one in a thousand chance that my client suffered from this malady????
    2) Unnecessary scans:  How come you didn't take the MRI of my knee which hurts?  When I had another doctor take a look, it showed that there was a tear in the meniscus.  Answer: your knee hurts because you have arthritis and the tear in the meniscus is because of that disease.  It's not useful in deciding whether or not to do surgery.
    3)  Unnecessary visits: How come the first doctor didn't tell me I was ugly?  Ans- he didn't want to be sued.  Reality- since doctors are afraid of being sued, they won't admit to making a human error.  If you can't admit to making a mistake- how do you tell your patient that the first treatment failed?
    4)  Best practitioners retiring: My folks are docs, so I know a few others.  A common theme is that docs who do high risk medicine get sued and they get aggravated and retire.  Their replacements are not as well trained or don't have their experience.  First hand example- my primary care doc hung it up after the group he was in had insurance rates go through the roof.  Some of their patients were in a poor urban neighborhood- and they were looking at a lawsuit a year.
    5)  In Hartford Hospital- a well respected hospital in the area- of the dozen or so orthopaedic surgeons- each of them has either had a lawsuit or has one pending in the past 10 years.

    In short- the costs of malpractice are real, but the payouts in the lawsuits may be a red herring- it'e irrelevant.  The costs of defensive medicine and the costs of malpractice insurance are real, and easily account for over 50% of medical costs in this country- if not higher.  It's just hard to measure.

    Alex

    I'm getting tired of the gov't getting blamed for incompetence.  In a democracy- we the people are the gov't.  If we're incompetent- so be it.  But I like to think I'm actually pretty competent about what we do- and if we set the bar high enough, our government will be as well.  Our government managed to put a man on the moon and developed the internet- that doesn't smack of incompetence to me.  Of course, the last few administrations haven't exactly been stellar, but it's a democracy- and that can change.  It better, or we're all going to be on the street.

    Sam

    (in reply to corysub)
    Profile   Post #: 28
    RE: HR 676 - Single Payer Healthcare - 12/12/2008 4:27:23 PM   
    smartalex


    Posts: 50
    Joined: 5/29/2008
    Status: offline     		Cory,

    I agree with you in theory, but most voters don't research, don't look any deeper than the articles on their home page or the 30 seconds major stories are given on the evening news. Get your message out there, get it spun right. . .and you can rule the world. I think that is part of the problem with the past few administrations. I'm fully willing to shoulder my share of responsibility for changing what I think is wrong with gov't. (I just find it easier to do at the city/state level rather than national.) Also I don't want you to think that I believe that the private insurance sector isn't incompetent. (They are. . .and it's worse, because they're perhaps purposely so.)

    I am in favor of a smaller federal government. If I were in charge, there would be more personal responsibility. But there might be other changes I'd regret, so I'll just be in charge of my little corner of the universe.

    a

    (in reply to samboct)
    Profile   Post #: 29
    RE: HR 676 - Single Payer Healthcare - 12/12/2008 6:04:32 PM   
    HunterS


    Posts: 553
    Joined: 10/21/2008
    Status: offline
    quote:

    I guess you never heard of the influx of Canadians coming into America for treatment.  There are estimates that almost one million Canadians are on waiting lists for referrals to specialists. 


    Since Canada is only about thirty million people a million is a pretty significant fraction.  Are you sure about those numbers or are these "estimates" the product of someone's imagination?
     
    H.

    (in reply to corysub)
    Profile   Post #: 30
    RE: HR 676 - Single Payer Healthcare - 12/12/2008 7:20:17 PM   
    Hippiekinkster


    Posts: 5512
    Joined: 11/20/2007
    From: Liechtenstein
    Status: offline
    quote:

    ORIGINAL: corysub

    You do know the difference between "facts" and politcal spin?   ...and from Conyers no less...LOL
    This is an example of
    9. DAMNING THE SOURCE: (ad hominem, sometimes called the genetic fallacy) attempts to refute an argument by indicting the source of the argument, rather than the substance of the argument itself.
    example: There is no reason to listen to the arguments of those who oppose school prayer, for they are the arguments of atheists!example: The American Trial Lawyers Association favors of this piece of legislation, so you know it has to be bad for ordinary citizens.

    quote:

    I would suggest you try an interesting search engine called     Google.
    You can bring up all sorts of really interesting articles, commentary and studies on a wide variety of subjects.  I thought the article below was kinda interesting in that it is not a U.S. citizen discussing how bad our healthcare is but  Canadians discussing the problems in their healthcare system, as well as some mention of the cancelled specialist visits in the U.K. and the wait period for specialist services.  The Tornoto Sun also has some interesting articles on Canadian National Healthcare, the closing a number of maternity hospitals to cut costs and in response to the outcry suggesting that a woman would not have to drive longer than an hour in labor to reach a maternity facility.  Obiously, written by someone who has never been preggy and in labor.
    Perhaps you should look at a map of Canada.  The majority of it is sparsely populated, as opposed to the US, where there is a town every few miles or so.
    quote:


    http://www.chmonline.ca/news/article.jsp?content=20081128_153428_11964

    Dr. Richard Lessard, Director of Public Health in Montreal said that it has been known for a long time that people with lower socio-economic status experience significantly worse health than those with higher socio-economic status, "Yet the lives of far too many Canadians continue to be burdened by preventable poor health. This is not acceptable."
    And yet the life expectancy for Canadians is higher than for Americans. Fancy that.
    http://en.wikipedia.org/wiki/Life_expectancy
    quote:


    http://www.chmonline.ca/news/article.jsp?content=20081015_191224_20248
    Canada ranks 17th out of 18 countries on public spending on pharmaceuticals.
  • In a comparison of 36 new drugs evaluated for public drug plan reimbursement by all countries, Canada’s public drug plans ranked 16th out of 18, providing less coverage than all countries except Australia and New Zealand.
  • In an analysis of 36 new drugs common to all jurisdictions studied, Canada’s Common Drug Review (CDR) recommended only 61% of drugs for public drug plan reimbursement, far less than the averages of the European Union (91%) and United States (88%). Provincial formulary decisions further reduce the Canadian drug listing average.
  • Of 78 recommendations issued from the inception of the CDR in 2003 to the end of 2007, it has given positive recommendations only 46% of the time, even lower than the percentage quoted in the study.
  • Wait times for approval of priority review and orphan drugs to treat rare disorders are longer in Canada than in the U.S. or E.U.
  • The U.S. medicare plan extends catastrophic drug coverage for seniors to a far greater extent than is available to Canadian patients. 

    •  

    The argument seems to be that if the US adopts a single payer health plan, the US will experience the same sort of problems getting drugs approved and to market that Canada has thus far had. There is absolutely no evidence that this will be the case. A complete red herring.


    < Message edited by Hippiekinkster -- 12/12/2008 7:28:21 PM >

    _____________________________

    "We are convinced that freedom w/o Socialism is privilege and injustice, and that Socialism w/o freedom is slavery and brutality." Bakunin

    “Nothing we do, however virtuous, can be accomplished alone; therefore we are saved by love.” Reinhold Ne

    (in reply to corysub)
    Profile   Post #: 31
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