National Health Insurance Now, Not Later

[addst 0]

I don't think that socialized medical care will solve all many of the problems with our current medical system. Expenses continue to rise because malpractice insurance for physicians and the cost of training physicians and other health care workers continues to rise. Malpractice drives physicians into ordering sometimes unnecessary expensive tests to protect themselves from lawsuits. However, since most malpractice insurance companies prefer to settle as court expenses would far exceed the risk and price of winning the premiums for physicians increases, sometimes exceeding $250,000/year. Moreover, most physicians start they're careers with at least $150,000-$200,000 debt and make around $40,000 for their first 3-8 years. They make between $100,000 and $300,000 upon completing their training in their mid-30's. Although, that is a large sum of money, there has to be adequate compensation to ensure that there will be doctors in the future generations. Moreover, most physicians do not have easy lifestyles. Although residents are limited to 80 hours per week of time spent in hospital duties, private physicians have no such limitation. Physicians are also almost never reimbursed the price of what they bill. Medicare pays only a certain percentage for each procedure or encounter and of that percentage they only pay 80% and expect the patient to cover the remaining 20%, which the patient usually chooses not to pay. A socialized medical system would require a decrease in physician compensation, without necessarily decreasing the cost of malpractice insurance, medical education, or increasing the number of physicians to relieve work hour burden.

Insurance companies and pharmaceutical companies are business and as such exist to make money. Pharmaceutical companies must make money in some way to continue their research into new drugs. Certainly, they do not generate enough income from selling anti-retrovirals to 3rd world countries to support this research. So, 1st world countries must bare these expenses. Insurance companies decide what they pay for and what they don't pay for using research studies. The idea being that they shouldn't have to bare the costs of treatments that aren't proven to cure or treat a disease. Hence the reason that most do not pay for experimental treatments.

Lastly, the US does have some "socialized" medical systems. The Dept of Veterns Affairs and Medicare pay for people who have either served the gov't or people who meet enrollment criteria. People who are uninsured and require treatment usually get some form of therapy. Certainly receiving a kidney transplant or elective hernia repair while being uninsured is not common, however emergent surgery for appendicitis or ruptured ulcer is. The hospitals very frequently are forced to absorb these costs (albiet they may hassel the patient for the money) and in order to prevent themselves from losing too much money they charge insurance companies more thereby increasing the cost of insurance.

In conclusion, a socialized medical system would not be feasible without malpractice/tort reform, medical education and practice reform, and establishing more federal aid for pharmaceutical research. Until such time, the prices of these will only continue to rise.

[Mr. Big Dog 10,747]

I don't think that socialized medical care will solve all many of the problems with our current medical system. Expenses continue to rise because malpractice insurance for physicians and the cost of training physicians and other health care workers continues to rise. Malpractice drives physicians into ordering sometimes unnecessary expensive tests to protect themselves from lawsuits. However, since most malpractice insurance companies prefer to settle as court expenses would far exceed the risk and price of winning the premiums for physicians increases, sometimes exceeding $250,000/year. Moreover, most physicians start they're careers with at least $150,000-$200,000 debt and make around $40,000 for their first 3-8 years. They make between $100,000 and $300,000 upon completing their training in their mid-30's. Although, that is a large sum of money, there has to be adequate compensation to ensure that there will be doctors in the future generations. Moreover, most physicians do not have easy lifestyles. Although residents are limited to 80 hours per week of time spent in hospital duties, private physicians have no such limitation. Physicians are also almost never reimbursed the price of what they bill. Medicare pays only a certain percentage for each procedure or encounter and of that percentage they only pay 80% and expect the patient to cover the remaining 20%, which the patient usually chooses not to pay. A socialized medical system would require a decrease in physician compensation, without necessarily decreasing the cost of malpractice insurance, medical education, or increasing the number of physicians to relieve work hour burden.

Insurance companies and pharmaceutical companies are business and as such exist to make money. Pharmaceutical companies must make money in some way to continue their research into new drugs. Certainly, they do not generate enough income from selling anti-retrovirals to 3rd world countries to support this research. So, 1st world countries must bare these expenses. Insurance companies decide what they pay for and what they don't pay for using research studies. The idea being that they shouldn't have to bare the costs of treatments that aren't proven to cure or treat a disease. Hence the reason that most do not pay for experimental treatments.

Lastly, the US does have some "socialized" medical systems. The Dept of Veterns Affairs and Medicare pay for people who have either served the gov't or people who meet enrollment criteria. People who are uninsured and require treatment usually get some form of therapy. Certainly receiving a kidney transplant or elective hernia repair while being uninsured is not common, however emergent surgery for appendicitis or ruptured ulcer is. The hospitals very frequently are forced to absorb these costs (albiet they may hassel the patient for the money) and in order to prevent themselves from losing too much money they charge insurance companies more thereby increasing the cost of insurance.

In conclusion, a socialized medical system would not be feasible without malpractice/tort reform, medical education and practice reform, and establishing more federal aid for pharmaceutical research. Until such time, the prices of these will only continue to rise.

The propaganda of those profitting handsomely from this broken system of ours on the backs of millions of un- and underinsured has certainly worked very well on you.

Fact: No healthcare system in the industrialized world is as inefficient and expensive as the one we have in the US. Not one. All the systems run by government, including those in the US, outperform the private US system in efficiency and cost control. Ever wonder why that is?

[beameup 0]

Under Democrat (Liberal) control of Congress for 40 years the "Legal Profession" has flourished in the U.S.

Until this infrastructure of circling sharks filing frivolous lawsuits is reigned in, the healthcare industry will be crippled and very, very expensive. Until this atrocity that the Democrats have created is addressed, the TAXPAYER will be footing the bill regardless of what type of "insurance" is provided. Besides, whatever happened to the Economic principle of COMPETITION.

I discuss this at length with my Philippine Cardiologist and we agree that American Medicine is way overpriced - out of control.

Then I pay her my 200 Pesos for the office visit and leave. (that's about $4 U.S. Dollars).

[Trumplestiltskin 5,791]

From what I see, the so-called 'frivolous' lawsuits are the inevitable result of a general lack of consumer protections.

[DeadPoolX 9]

From what I see, the so-called 'frivolous' lawsuits are the inevitable result of a general lack of consumer protections.

Did you -- or anyone else here -- even read what Addst wrote in its entirety or did you just stop after the first few sentences? Physicians are forced to order expensive tests to cover their own asses. If they don't, and something goes awry or they miss something, they get sued. Malpractice insurance is already unbelievably high and it only gets worse when a doctor is the subject of a lawsuit.

Another reason why these lawsuits are generally frivolous is because patients will sue over the most ridiculous things. For instance, say a patient gets a small temporary rash from a medication, but it clears up whatever her symptoms were. She might very well sue for that. I've seen that happen before. Usually a case like that is "thrown out of court" by the judge, since the medication and the doctor did their respective jobs; however, the doctor lost time and money due to some completely idiotic court case.

If anything, I think there is a general lack of physician protections; not patient protections. There are plenty of lawyers out there just chomping at the bit to sue a doctor over the smallest thing -- a doctor needs protection against sue-happy patients. This sort of protection might also drive down costs, as the physician wouldn't necessarily need to order so many tests unless necessary.

So yeah...I think malpractice/tort reform is one of the greatest obstacles in the way of getting a better healthcare system. Socialized medicine? It'll never happen. The United States just won't do it. But we can drive down costs by reforming the way things work now, which is better than nothing.

[Heracles 417]

Now he's trying to get insured and finds that the drugs the doctor have put him on (cholesterol lowering Lipitor) is a huge red flag for the insurance companies who are now quoting him huge monthly premiums. It's hardly a humane system that screws you over the moment you really need it.

Now that is up to the government to regulate. Be it the responsibility of State or Federal government. In certain situations, such as this, the free market fails and needs government intervention to ensure fairness..

Its the same thing with HIV tests - some insurance applications ask you to declare if you've ever had one (on the assumption that you live a risky life) and factor that into the cost of your premium.

The free market works when consumers have choices and the companies are not collaborating with each other. I actually aced this class in school. The invisible hand, as they call it, can fail and when it does it is up to the government to ensure the market is not abused by companies, especially in a monopoly situation.. Once consumer does not have the market power to make a difference and the insurance company's executives know this..

My wife's cousin has MS and all of the insurance companies refuse to cover him. They had to raise $80,000 for surgery needed to save his life. That is ridiculous and a clear sign of the insurance companies abusing the market.

[Caladan 19]

It is important to consider how much of a total percentage of the cost of care malpractice constitutes; I'll look up a cite later, but it's very low given the amount of attention it gets.

[Heracles 417]

Under Democrat (Liberal) control of Congress for 40 years the "Legal Profession" has flourished in the U.S.

Until this infrastructure of circling sharks filing frivolous lawsuits is reigned in, the healthcare industry will be crippled and very, very expensive. Until this atrocity that the Democrats have created is addressed, the TAXPAYER will be footing the bill regardless of what type of "insurance" is provided. Besides, whatever happened to the Economic principle of COMPETITION.

I discuss this at length with my Philippine Cardiologist and we agree that American Medicine is way overpriced - out of control.

Then I pay her my 200 Pesos for the office visit and leave. (that's about $4 U.S. Dollars).

Very interesting point..

From what I see, the so-called 'frivolous' lawsuits are the inevitable result of a general lack of consumer protections.

Insurance companies and hospitals need be protected from frivolous lawsuits.. Well said by beameup as the abuse of the US legal system by liberal lawyers has a reputation of being a joke in every single country I have visited. It is stuff like this that has made the US the laughing stock of the world, while Liberal lawyers make millions behind the doors of the court rooms.

The medical system needs to regulated by the government but at the same time I agree 110% it needs to be protected from frivolous lawsuits by money hungry liberal lawyers, who are there for the people of course.. NOT!!

In know Australia recently implemented both measures.. You cannot have one measure without the other..

Edited February 21, 2007 by Infidel

[Mr. Big Dog 10,747]

The patients and the lawyers and the malpractice suits are responsible for the health care crisis. That old hat. Interstingly, neither the GAO nor the CBO buy into this nonsense. The CBO found that there's "no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts".

Even if you were to settle for the inflated effects of malpractice lawsuits and go with the inflated savings the system could achieve by limiting the awards, this would, per HHS only get 2.4 - 4.3 million addt'l Americans access to health insurance. That's anywhere betyween 5 and less than 10% of today's uninsured. Surely that ain't the solution that's needed.

[Trumplestiltskin 5,791]

The problem as I see it, is and continues to be the middlemen. The wife of a friend of ours had to go in for a neurological scan. The doctor told them specifically what they needed, a high-res multi-pass MRI but that the insurance companies frequently over-ruled him and insisted upon the lower res – single pass test. So after several phone calls and letters to the insurance company to specifically request the hi-res scan, they have the test done – only to find out later that it was the ‘single-pass’ test, which for all intents and purposes was useless and a complete waste of everyone’s money.

I’ve also mentioned (several times) my FIL’s near heart attack, resulting directly from his insurer refusing to accommodate his cardiological exams. Frivolous?

[DeadPoolX 9]

The problem as I see it, is and continues to be the middlemen. The wife of a friend of ours had to go in for a neurological scan. The doctor told them specifically what they needed, a high-res multi-pass MRI but that the insurance companies frequently over-ruled him and insisted upon the lower res – single pass test. So after several phone calls and letters to the insurance company to specifically request the hi-res scan, they have the test done – only to find out later that it was the ‘single-pass’ test, which for all intents and purposes was useless and a complete waste of everyone’s money.

I’ve also mentioned (several times) my FIL’s near heart attack, resulting directly from his insurer refusing to accommodate his cardiological exams. Frivolous?

We're talking about two different things here, I think.

You're talking about how insurance companies often refuse the proper care patients need. If that's the case (and something occurs because of that) then yes, a lawsuit is justified. However, I don't see where suing the physician comes into play as many do today (which is what I'm talking about). The physician wants to have these tests done. Doctors often suggest what is needed, but as you said, the insurance companies will over-rule them. Many times doctors will spend a good portion of their day fighting with insurance companies, over many details -- whether it's a patient's needs or something financial.

I agree, there needs to be less control in the hands of the insurance companies. However, I don't see giving full control over to the government as the answer. The U.S. government can barely tie it's own shoes without tripping over them. I don't see how that sort of system could handle healthcare.

[Heracles 417]

You know what sort of payouts the US courts make in these cases.. All it takes is 100 people to score $20 million dollar payouts and that is a $2 billion dollar loss for insurance companies. Guess who ends up paying for that, the people.

[Heracles 417]

The problem as I see it, is and continues to be the middlemen. The wife of a friend of ours had to go in for a neurological scan. The doctor told them specifically what they needed, a high-res multi-pass MRI but that the insurance companies frequently over-ruled him and insisted upon the lower res – single pass test. So after several phone calls and letters to the insurance company to specifically request the hi-res scan, they have the test done – only to find out later that it was the ‘single-pass’ test, which for all intents and purposes was useless and a complete waste of everyone’s money.

I’ve also mentioned (several times) my FIL’s near heart attack, resulting directly from his insurer refusing to accommodate his cardiological exams. Frivolous?

On that example I have to agree that under a state or federal run medical system, that would not occur. Yet it is not justified for that person to sue and score a $20 million dollar payout. Even with a government funded health care system in Australia, we still have to pay for stuff like that out of our pocket. As we do with any medication.

Prescriptions is another problem here. The current system allows for abuse by pharmacies, which ends up costing the consumer.

There is just too much abuse by pharmacies, doctors and hospitals. Have a look at some of the things hospitals charge like a 'hygiene' cloth, aka tissue, for $55. Guess who ends up paying for that, the consumer..

Edited February 21, 2007 by Infidel

[beameup 0]

One more piece of the puzzle is the "Third Party Provider" - the INSURANCE COMPANY.

When you have a third party involved it complicates the consumer-provider relationship. The rules of economics get screwed up and don't work properly.

In my particular case, I do my own medical research constantly on the web. Then I go to the lab, for example, and tell them what blood tests I need. Also, after research, I go to the pharmacy and tell them what drugs I need for my particular ailment. I also have several excellent doctors that I consult as well. It's called PERSONAL RESPONSIBILITY. I can do this because I'm in the Philippines. I don't even bother to submit claims to my U.S. insurance company because the costs are so low (only for prescription medications). The blood testing I get costs about $40 - the VERY SAME TESTS cost a couple of hundred dollars in the U.S.

Personally, I don't want a BIG BROTHER type GOVERNMENT telling me what I can and can't do, what medical tests I can and can't get and what doctor I can and can't go to.

[Trumplestiltskin 5,791]

You should definitely receive financial compensation if your insurer damages your health as a result of interfering in your care against the advice of the doctor – and certainly if you suffer as a result of it. At the very least, you should not have to pay for subsequent care resulting from any hospitalizations or procedures required (like having the paramedics come over to your house, because you’re in the throes of an angina attack).

As far as that goes – there should, at the very least, be some sort of watchdog body to regulate this kind of activity – because it really undermines any sort of humanitarian healthcare philosophy.

If I understood the above right, I’m not sure I agree that its my responsibility to “self-medicate”. I’m not qualified to tell which drugs are better for me than others, or insist that I be prescribed something, for example, on the basis of a TV ad. Speaking of which, those drug commercials really should be illegal.