Wyden's vision for health care reform begins with making sure everyone is covered

[one...two...tree 2,762]

In March 2008, Lord Mancroft, a Tory peer who has held responsible positions in the public health area, claimed it was a miracle he was still alive after a stay in a filthy British public hospital with uncollected infected waste in the wards and dirty, drunken and sluttish nurses.

almaty, road trip!

Take a lifejacket.

You manage those costs by insuring everyone, first and foremost.

If you insure everyone but screw them on coverage, then that's not change we can believe in

You're defining how costs would be managed. Who currently governs or oversees what insurance companies should cover? Should breast augmentation be covered? Liposuction? Managing healthcare is not a clear cut and dry process that you seem to imagine it to be.

[w¡n9Nµ7 §£@¥€r 123]

Managing healthcare is not a clear cut and dry process that you seem to imagine it to be.

You're in my head now?

All I'm saying, and this is pretty simple so it's mind-boggling to me that you're not getting this, is that if healthcare reform occurs, the primary goal must be to maximize patient outcomes. Not to save money.

[I AM NOT THAT GUY 5,715]

When it comes to healthcare, the U.S., Britain and Canada are hurting

(abstracted)

Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more. One of the ways the British and Canadians save money is to punt elective surgeries to a lower priority level. A 2001 survey by the policy journal "Health Affairs" found that 38% of Britons and 27% of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5%. Score one of us!

Well, sort of. American healthcare controls costs in another way. Rather than deciding as a society how much will be spent in the coming year and then figuring out how best to spend it, we abdicate collective responsibility and let individuals fend for themselves. So although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of those who can't afford care simply won't get it.

Just last week, House Republicans expressed their preference for the latter. Their long-awaited budget document was admirably specific about changes to Medicare. They call for "a new Medicare program" in which enrollees are given a check "equal to 100% of the Medicare benefit," which they can then take to the private market to purchase their own care.

This proposal has a purpose beyond dismantling a popular government entitlement program. Currently, Medicare does not abide by a budget. It is not run like the Canadian or British healthcare systems. Instead, it pays whatever is deemed "reasonable and necessary." Because of that, costs are shooting through the roof: The Congressional Budget Office estimates that Medicare spending will more than triple by 2050.

The Republican plan gives Medicare a budget. Costs grow only as fast as the check grows. And because the check grows more slowly than health spending does, the program saves money. But this is, in effect, almost precisely the strategy of Britain and Canada: It is the government imposing an arbitrary budget on its healthcare spending.

The difference is that the British and Canadian governments try to apportion that health spending so that the whole population gets care. That can mean, alongside other cost-saving measures, longer waits for services. The Republican budget simply would give individuals a fixed check. That will mean that patients who exceed that sum and don't have money of their own go without needed care.

So Americans will continue to brag that no one waits, and Canadians and Britons will continue to brag that no one goes without. And somewhere, the French and the Germans and the Japanese and the Swiss and many others will wonder why we insist on choosing between such awful extremes.

http://www.latimes.com/news/opinion/la-oe-...0,3092824.story

[Trumplestiltskin 5,791]

As I say its easy to find horror stories to justify what you want to believe.

[one...two...tree 2,762]

Managing healthcare is not a clear cut and dry process that you seem to imagine it to be.

You're in my head now?

All I'm saying, and this is pretty simple so it's mind-boggling to me that you're not getting this, is that if healthcare reform occurs, the primary goal must be to maximize patient outcomes. Not to save money.

It depends on the situation. If you had skin cancer, for example, and there were 4 available and effective treatments, including one that is experimental but also very expensive, would you think that because you private insurance company won't cover the experimental treatment, that they aren't making your health a priority? If they only cover 2 of the 4 available treatments, are they compromising your care? IMO, the decision should be made by the doctor...if he believes one treatment is the better one for you, then the insurance company should make an exception, which they sometimes do. But if your doctor found the 2 form of treatment that are covered, acceptable, then there is no compromise on your quality of care.

[Trumplestiltskin 5,791]

I think that is one of the worst things about our current system - bureaucrats without medical training or case history overriding the treatment recommendation of doctors.

My FIL was almost killed by someone doing that.

[one...two...tree 2,762]

I think that is one of the worst things about our current system - bureaucrats without medical training or case history overriding the treatment recommendation of doctors.

My FIL was almost killed by someone doing that.

Yep. I think your doctor should have the final say, but if the insurance company wants a second or third opinion, they should be able to require that.

[Trumplestiltskin 5,791]

I also think that the stress of dealing with the system intimidates a lot of people.

When I had to have surgery for a lymphoma biopsy people at my old work were looking at me like I was crazy to consider it an option.

A friend of ours had a mild stroke a couple of years back and actually checked himself out of hospital, rather than let the hospital doctors run all their tests to see if was ok.

Really terrible attitude for people to take to their own health...

[AlHayatZween 2]

i just feel like no matter what, the people in the middle are gonna get hit.

For example, if you are freelancer and you make enough to get by, but you don't make enough to pay $500 or so a month in health insurance, what do you do?

If you're dirt poor, you are covered... if you are well-off and secure in your job, you're covered... what about the middle?