Healthcare Dilema

Discussion in 'Current Events' started by wdlove, Jan 15, 2004.

  1. wdlove macrumors P6

    wdlove

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    #1
    We need to have a national debate about healthcare. I am against a government run system. With the knowledge base that we have in the country, I'm confident that an equitable solution can be found. Profit is not a dirty word, but curently medical price increases are outrageous. Increases much greater than inflation are suspect.

    Retirees are facing big increases for healthcare and in some instances loosing coverage.

    http://www.boston.com/news/nation/articles/2004/01/15/retirees_face_pinch_on_benefits/

    A panel of scholars is calling for healthcare coverage for all Americans by 2010. They have set standard, but don't back any certain resolution of the problem.

    http://www.boston.com/news/nation/washington/articles/2004/01/15/universal_health_care_sought/
     
  2. mactastic macrumors 68040

    mactastic

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    #2
    Uh oh, you're opening up the health care can of worms outside the politics section. This will get ugly faster than an HMO CEO can say 'profits'.

    There's a 4 pager going on it in politics already, it's just mislabeled under 'Space Exploration'. ;)
     
  3. wdlove thread starter macrumors P6

    wdlove

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    #3
    My hope and prayer is that we will have a national discussion of the issue. That we can discuss all options openly. This is too vital of an issue to play politics. Hopefully during the 2004 election options can be debated. Then after the election actual debate in Congress can go forward. Something needs to be done before it is a real crisis.
     
  4. Frohickey macrumors 6502a

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    #4
    Cool. I like healthy discussions.

    We are so far away from the days of the country doctor. Seems that what the doctor/dentist is really these days is a general contractor. They send off lots of work to the labs, which do the work, but do not look at patients. These are the subcontractors, if you will.

    So, is it really that we have lots and lots of middlemen that we ended up paying more, or is it because that we get more as well, more expertise from the lab workers, that we pay for as well.

    When you get more middlemen, you also get more papershufflers. I think that tacks on some costs as well. We don't have large conglomeration of health care facilities anymore, or do we?
     
  5. Raid macrumors 68020

    Raid

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    #5
    Re: Healthcare Dilema

    I support socialized healthcare, the health of the citizens directly reflects on the health of a country. I'm not here to say Canada has done it right. In fact I know there are a few things wrong. But I don't think introducing a profit margin would help Canadians, nor do I think it helps Americans. I once suggested to a conservative that if he wanted private hospitals then salaries and profits of the hospital should be capped. It didn't go well from there he accused me of being a tree-hugging hippe, and I accused him of wanting a $100,000 hospital administrator salary. :p

    Insurance/Health costs are a big issue both in Canada and the United States, largely due to the fact that we have private corporations looking to keep their bottom line growing, and the wallets of a sellect few grow fatter.

    I just hope someone finds the right answer for this problem.
     
  6. wdlove thread starter macrumors P6

    wdlove

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    #6
    Raid is it true that you have 2 healthcare systems? One run by the government where you can wait months for treatment. That is what I've heard. If that is the case it's very similar to our Veterans Administration Health Care System. A private system where you pay out of pocket and get personal care?

    The problem with socialized care is the government control. The pay of doctors and nurses would be artificially low. There would be no incentive to provide better care.
     
  7. Frohickey macrumors 6502a

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    #7
    But...but...

    you mean to tell me that it is not right to put doctors and nurses into a state of slavery? But its for the public good. ;)
     
  8. virividox macrumors 601

    virividox

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    #8
    well doctors and nurses need to make a living, if their pay is too low, then no one will enter the proffession and soon there will be a shortage (there is currently a shortage of nurses). so we have to find a balance, i know its easier said than done. but at least a debate will clear up some of the smoke and magic
     
  9. wdlove thread starter macrumors P6

    wdlove

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    #9
    Yes, there is a crisis with the current shortage of nurses. It is only going to get worse and with your parents aging they will require increased care. This is where the government can encourage more young men and women to enter nursing. They are already doing it with teachers.

    Americans still want to be free. I think that having a govenment entity deciding where a student will go to school, what specialty they enter, and where they practice will no be tolerted. Also patients being told what doctor they will see and what clinic they recieve care is not the America I grew up into. Freedom of choice needs to be at the core. The biggest obstacle to solve will be price increases greater than inflation.
     
  10. Frohickey macrumors 6502a

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    #10
    Uh...oh.

    Now you have opened up another can of worms bringing price increases and inflation into the mix.

    How about fixing/tying monetary value to a scarce resource again... like gold or precious metals. That would go a long way to keep the value of money from fluctuating.

    I agree with you that you want to preserve the freedom to choose and decide for yourself. Freedom is worth more, IMO. Worth more than having a government-guaranteed healthcare, old age retirement and all of the other socialist boondoggles.
     
  11. voicegy macrumors 65816

    voicegy

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    Sandy Eggo - MacRumors Member since 1-1-2002
    #11
    National Healthcare, Socialized Medicine...whatever we call it, it has to happen. The haves and the have-not gap is widening every year between the classes, and in health care this is most evident.

    I currently pay nothing for full medical and dental and vision under San Diego City Schools. I realize now that that is a rare privilige, and given California's current budget status, that may come under fire in the not too distant future.

    As with many things, I'm sorry to say, lawyers are to blame in my opinion. We live in a litigious society, and the outrageous cost of malpractice insurance is one of the driving forces behind out of control health care costs.
     
  12. wdlove thread starter macrumors P6

    wdlove

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    #12
    You are indeed very fortunate voicegy. I have never had the privilege of free health, dental, and vision. Are you willing to pay for it like the rest of us? Do you have a copay?

    The big obstacle to overcome is the lawyers, drug companies, and insurance willing to decrease profits. The government is not the answer. So far the American people have not come together to force a change. Just a small example of the power of the American consumer is that the Reagan program on CBS was cancelled.
     
  13. Raid macrumors 68020

    Raid

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    #13
    Well the unfortunate reality is that there are private clinics and testing labratories, and recently in Brampton (just north west of Toronto) a hospital is underconstruction with private funding. They had a contract for the construction was approved by the former conservative government. While nobody will say there is a two tier system (because usually everything is still covered by the government) people are worried that it's creeping up on us. There are concerns about waiting lists, but there is triage and the truly critical patients get priority. I don't know what you've heard but I don't think the delays are that long.

    On the matter of compensation for doctors, a balance must be struck between keeping doctors in the country and keeping costs low. Since this is the area I do have some expertise in (well not medical... but the principles are the same).

    A simple run down would go like this:
    In a private system you have a division of classes, the richer hospitals will pay more for better doctors to attract more clients, gain a reputation, and strengthen the business. As such their costs go up and only affluent individuals can afford the costs of treatment. But they're rich and can afford it, the hospital is doing quality work and making a profit so everythings fine right? Well people in certain tax brackets will answer differently and here's why. Competition would keep upward pressure on doctor salaries as such poorer hospitals would continualy loose thier better doctors to higher paying positions they can't afford. The poorer hospital would be under increasing pressure to cut costs to keep doctors who can at least handle the work load. Now this poorer hospital is in survival mode which means cost cutting and the quality of care decreases, but that's ok because the poor people who can only afford this kind of hospital don't deserve the best treatment anyway right?... Now this is a pretty simplified arguement but the mechanics of profit and corporate thinking are tried, tested, and true.

    The nature of hospital service means that the demand is pretty inelastic. In other words you are willing to pay regardless of price because... well if you don't get better you're going to die! Company's drool over this type of business because they can keep jacking up the price and the consumer will keep demanding the service. I'm sure you all heard stories about people so far in debt from medical expenses that they couldn't possibly pay it back in thier lifetime... and that is one cruel irony.

    While do believe that competition and a capitalist system is a healthy and works in many industries; I strongly believe that the government should control markets where inelastic demand could mean profit taking to the detriment of the public.
     
  14. voicegy macrumors 65816

    voicegy

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    #14
    No copay for medical (just 5 bucks a shot for prescriptions, if any are needed.) That's with Kaiser. I have perfect vision, so I don't know the details about the vision coverage. Dental pays everything except about every 4th visit, which is a modest copay. Since working for a school district is like a government job, I assume most government jobs are similar in thier coverage.

    Since I've had that for so many years, it would be a shock to start paying for it. If it meant that paying for it would move us towards a more equitable system for all, I'd be willing to shell out. As it stands now, such a move isn't on the table yet. But if our economy continues to get worse before it gets better, that item will come to the front burner for at least discussion.

    I just got my new position approved by the Board after a 17 month long process...sure would be disheartening to have that raise skewered by having to pay for coverage. Ah, the Lord giveth and taketh away, eh?;) But we'll cross that bridge when we come to it, if ever.

    wdlove, I'm surprised that you have to pay something for medical coverage considering you're in the business itself! How does that work?
     
  15. mactastic macrumors 68040

    mactastic

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    #15
    Doctor's pay is low now and had been trending lower for years. Nurses get paid squat too. And this is with the private system without government involvement. Doctors have incentives to provide poor service already, they can order expensive tests that don't provide much benefit just to collect from HMO's. They get everything from gifts to kickbacks from drug compaines to prescribe certain drugs over others no matter the cost.

    The problem with the 'let's keep the gov't out of it argument' is that that's how it is now and the system sucks.

    Being a doctor used to be a ticket to a well paying job. Now its years and years of expensive medical school, debt to the eyeballs, and untold suffering through the program just to get a mediocre-paying job. If you want to make money as a doctor you become a shill for the drug companies, or for the managed-care organizations.

    And the burnout rates for nurses are so high you have a hard time retaining the best people. Nurses are the 'get no respect' crowd that keeps you alive and does most of the heavy lifting at the doc's office and hospital, they work all the late nights and holidays that the rest of us get to enjoy (much like cops and firefighters incidentally) but get paid at a rate that virtually guarantees that a single nurse can't afford to buy a house near a metropolitan hospital in a major city. I fail to see how getting the government further out of the health care industry than it already is will produce incentives to pay doctors and nurses more. Private industry (HMOs) were the ones who have caused the downward trend in doctor's pay as it is.

    Yes cutting out the middle man would go a long way towards lowering costs as would reasonable tort reform that can guard against frivolous lawsuits while still guaranteeing a damaged party's rights to compensation for malpractice. But ultimately a private for-profit system that can refuse service to those who cut into its profits can't be allowed to cherry-pick it's clientele, and it can't be allowed to make life-or-death decisions based on the bottom line. That decision needs to be between an informed doctor and an informed patient. And since I can't ask a private for-profit organization to willingly do things that could cause it to lose money, it needs to be backed by the govenrment.
     
  16. crazytom macrumors 6502a

    crazytom

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    #16
    Frivolous lawsuits and drug companies need to be put in check. Those two things, IMO, cost people the most.

    But here's my controversial solution: legalize all drugs (marajuana, opium, cocaine, crack, etc). Have the government produce these substances 'safely' (safer than your neighbors basement!) and cheaply and use the profits (which would be HUGE!!!) to fund healthcare. Not only would there be huge profits from that, but just think of all the money spent on the 50+ year old "war on drugs" that would be freed up.
     
  17. wdlove thread starter macrumors P6

    wdlove

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    #17
    I'm not a doctor. It used to be that a physican would take care of another physician or family at no charge. Now with increased costs, it is more likely that in the same situation they would just take the insurance money. There would be no discount with drugs or the hospital. It would be according to your insurance coverage.

    My wife & I have always had to pay for health insurance. I have a govenment paid insurance, it's Blue Cross Blue Shield. Don't really have much of a choice. I pay 20% which is >$100 per month. I pay $15 per doctor visit. Medications I pay 20% of the cost.
     
  18. Dros macrumors 6502

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    #18
    I don't think doctors have mediocre-paying jobs. Even a non-specialist makes over $100,000, a specialist more than $200,000. So they have more than $100,000 in loans... a high percentage of that salary is disposable income unless they feel they need to buy a huge house right off the bat.

    If you want to attract better people to the medical profession, reducing the amount of paperwork would go a long way. Who wants to deal interacting with insurance companies and HMOs and documenting everything six different ways?

    I would love if we could trade massive malpractice for universal insurance coverage. The doctors would win out... right now the insurance premiums do take a significant portion of income. And they wouldn't feel compelled to practice defensive medicine which increases costs just to cover their rears if something goes wrong. The populace would win out... so many people have no coverage. The small percentage of the population that suffers from poor care wouldn't be compensated to the extent they are now, but any "punishment award" should go to paying the universal care rather than the victim. And lawyers would lose out since they take a good portion of any large awards anyway.
     
  19. jayb2000 macrumors 6502a

    jayb2000

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    #19
    Profit

    I don't have a problem with profit, and I hope to make some on my own.
    However, looking at healthcare and the costs associated with it, it seems too great a percent of the costs go to overhead and not the patients and caregivers.

    During the recent debate (all 12 hours of it) on the GOP medicare bill, one of the opponents of the privatization section of the act showed the industry statistics that showed most HMOs have overhead of 15%. The need to pay for advertising, design costs, etc. Medicare has a 3% overhead. So, on a multi-billion dollar industry, we could save hundreds of millions in the overhead costs. If we took those costs and used them to lower costs or cover the rest of the country, we would be much better off.

    The average American costs 5400 dollars to insure and not everyone gets full coverage. Britain and Canaca cost less and all get full coverage.

    I know goverment is not perfect, but neither is business. We need to look at very different solutions than what we have now.
     
  20. Frohickey macrumors 6502a

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    #20
    There is already a solution for this. Its called the contract.

    Government has the power to enforce contracts between private parties. This would go along laws against fraud.

    The contract says you have to provide such and such a service in exchange for such and such a sum, etc.

    So, are you saying that you support the increase in size of government because they failed to do their job about enforcing contracts in the first place?
     
  21. Frohickey macrumors 6502a

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    #21
    Re: Profit

    Yes, but you forget.

    Government is a monopoly.
    Business could be a monopoly, or it could be competitive.

    A business that has 15% overhead cannot compete with another that has 10% overhead. So, the trend would be for lower overhead in order to maximize profits. Also, various HMOs have wellness programs where they recommend preventative visits to forestall/eliminate complicated health problems.
     
  22. mactastic macrumors 68040

    mactastic

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    #22
    No.
     

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