Federal Healthcare

Discussion in 'Politics, Religion, Social Issues' started by Desertrat, Jun 11, 2009.

  1. Desertrat macrumors newbie

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    #1
    Many here have long touted the benefits of a public system to deal with healthcare costs. Obama and Congress have made a start at a drastic remake of the entire U.S. system.

    Regardless of the benefits of such a system, the Devil is in the How-to. CNN has an analysis of what's been proposed, and it doesn't look good:

    http://money.cnn.com/2009/06/11/new...an_no_bargain.fortune/?postversion=2009061104

    "The crucial question about Obama's agenda has always been whether it really will slow the disastrous rise in health-care spending, or actually increase it while hiding the real costs of the new system. On analyzing the bills, the conclusion is inescapable: Obama promises Americans what appears to be a bargain by heavily subsidizing their premiums. But the only way to pay for what's really outrageously expensive coverage will be huge tax increases, especially on the same middle class that's being wooed as the chief beneficiary of reform."

    As a nation, we are already over-extended with our commitments to Social Security, Medicare and Medicaid. The anticipated cost of this new program, expected to reach $200 billion per year by 2019 (which is probably another bit of optimism in a long string of under-estimated costs) will merely add to the uncontrollable deficits.

    'Rat
     
  2. edesignuk Moderator emeritus

    edesignuk

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    #2
    That seems low. The NHS costs the UK over £100bn already. edit: Actually, that's £100bn just for England, apparently.

    [​IMG]
     
  3. leekohler macrumors G5

    leekohler

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    #3
    I have yet to hear a viable solution from the "privatize everything" crowd. Our healthcare system is severely broken and pathetic. The free market works for many things, but health care isn't one of them. That should be glaringly apparent by now. The rest of the civilized world (and for god's sake, even Cuba) makes universal health care work. Why does everyone think the US can't make it work? Are we not smart enough or something?
     
  4. iGary Guest

    iGary

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    #4
    No easy answer for this one, but it's pathetic that we, as a nation, allow the hospitals to bankrupt people for getting sick.
     
  5. nick9191 macrumors 68040

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    #5
    Many reports have shown that higher taxes is cheaper than lower taxes plus insurance.

    Every human being, regardless of income is entitled to healthcare, it is not a luxury, this is not arguable.
     
  6. edesignuk Moderator emeritus

    edesignuk

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    #6
    I don't live and never have lived in the US. I do hear from my wife, and the American members here though.

    The insane life destroying bills that people can be hit with, perhaps through nothing more than bad timing (between jobs etc), absolutely amazes me.

    The NHS certainly has its faults, but if I have a heart attack, chop my foot off, or need an organ transplant, I know it will be paid for, and I won't be sitting on a debt the size of a second mortgage for the privilege of still being alive.
     
  7. gibbz macrumors 68030

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    #7
    Amen.

    Our country is often extremely hypocritical. We are supposedly a Christian nation (if you don't believe me, ask most of the GOP). Yet this same supposedly morally upstanding public (politicians especially) would rather let someone die than receive health care funded by the citizens of the country.

    They take (or fed by the fear tactics of the powers that be) this position with the guise of preventing governmental control over personal freedoms. The truth is that the majority of these people look at having insurance as a class separator and some indicator to their success. We've all heard someone say negative comments about those without health insurance. It is sad we would let our own suffer out of fear that a person might receive care beyond their current means.

    My fiancee is just starting her 3rd year in medical school this summer and has volunteered at free clinics for the past two. She has told me stories of regular working (and often normal middle-class) patients who for whatever circumstances don't have or can't afford insurance. There was one story that really stood out in which a guy had a broken arm, but since the clinic could only afford to be open 1 day a week, was forced to wait 6 days to get it treated. Can you imagine being so worried about affording care that you would suffer through a broken limb for a damn week? I always hear opponents to nationalized health care say "well there are free clinics." Yeah, these "free" clinics rely on donations from churches and sample medication supplies and donated time from doctors ... and due to these tight supplies can often only treat a maximum of 30 patients a week.

    If we are such a great country that we claim, it is time to care for our own. We are guaranteed Life, Liberty, and the Pursuit of Happiness. None of which are feasible when sick, bogged in medical bills, or dead from our health care system.
     
  8. racers macrumors regular

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    Mar 24, 2009
    #8
    All I know is we need to do something.
    Our current system is a joke for how much we pay
     
  9. iGary Guest

    iGary

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    #9
    Well Medicaid will usually pick up and pay the bill when someone cannot pay, but you're term "life-destroying bills" is spot on.
     
  10. mactastic macrumors 68040

    mactastic

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    #10
    Hey, greed is good, right? Doctors take that advice just the same as everyone else.
     
  11. Ugg macrumors 68000

    Ugg

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    #11
    It's funny how there's been no viable alternative from the right. Bush simply provided big pharma with the largest corporate welfare scheme since the end of WWII. The Drug Benefit of Medicare Part D increased medical costs by a huge amount.

    Obama has it right to a certain extent, the need to eradicate waste and fraud by medical practitioners. But, and this doesn't just apply to the US but all countries where age related illnesses are bankrupting the systems.

    It's time to take a serious look at end of life issues. The majority of Medicare spending takes place during the final year of a patient's life. Is it worth it?

    If a viable solution isn't found, health care rationing will take effect for all but the wealthiest Americans. We can choose our poison or we can have it forced upon us.
     
  12. Desertrat thread starter macrumors newbie

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    #12
    One thing I do not see in the various discussions of the problems for our health care system is any analysis of the reasons that various things are priced so high.

    One thing I discovered when I got involved in establishing a little primary care clininc here: Government policy seems to be backwards. Grant money is available for brand-new equipment. No grant money is available for operating expenses.

    We could have gotten tons of "good used" equipment, up to and including an X-Ray machine for FREE. We didn't need brand new bedpans and desks and gurneys and examination tables. But grant money was available to buy the new stuff.

    In a poor community, loose money is just not available from donations and local taxes in an amount large enough to hire a doctor, nurses, and clerical people. We had a doctor who was willing to work for a relatively low salary, mostly from personal interest in the Border area--a base of operations for his personal research.

    But we tried to do the deal. Incorporated, Board of Directors, all that stuff. Renovated a local building. Got grants for equipment. Found a competent PA, a couple of nurses and a secretary.

    Within a few months, it was determined from the usage of the clinic that the price of an office visit to see the PA had to be $50 in order to keep the doors open. Economics 101 blew that out, with a reduced usage. Remember, it's 80 miles up the highway to other medical help, so avoidance of the clinic was not a lightly-taken decision on the part of a person with a health problem.

    So there's just one example among many about costs: Federal policy on grants.

    'Rat
     
  13. dukebound85 macrumors P6

    dukebound85

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    #13
    you know....how about we solve our current budget deficits before we add huge programs such as this

    health care reform wont mean anything one our country is broke...which it will be at the rate we are going.

    im so frustrated with BO. his intentions are good but he needs to realize the priorities
     
  14. leekohler macrumors G5

    leekohler

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    #14
    Meanwhile, the list of uninsured Americans continues to grow... and I'm still waiting for viable solutions from the right.

    And California better not get money from the fed, dammit- especially if they aren't willing to fix their own problems.
     
  15. mactastic macrumors 68040

    mactastic

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    #15
    Perhaps looking around might help?
     
  16. dukebound85 macrumors P6

    dukebound85

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    #16
    and then we have our economy is shrinking and people are getting laid off left and tight. this is part of the factors of th uninsured list growing as people that had hc through their company no longer do as they are no longer with them

    however, to increase taxes on people at the same time as many people are getting laid off is not a wise move either

    this type of legislation needs to be done when the economy is not on the brink of ruin
     
  17. iGary Guest

    iGary

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    #17
    I have a question for the Brits (or anyone from a country with socialized medicine).

    So an average income for a neurosurgeon here in my area (Annapolis, MD) is about $500,000 a year.

    I assume that doctors don't make there what they make here?
     
  18. Cursor macrumors 6502

    Cursor

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    #18
    I'm curious to know how the system was in the 20s, 30s, 40s, and 50s. Can't we just go back to the way it was?

    When did this healthcare problem in the US spiral out of control? Is it all due to malpractice suits and insurance companies?

    It seems odd to me that we have insurance only for emergency situations when we drive, own a home or apartment, or die. But when it comes to healthcare, we need insurance for even the smallest of doctors visits. Should healthcare insurance just be used for costly emergencies, like bad breaks, cancer, strokes, heart attacks, etc.?
     
  19. dukebound85 macrumors P6

    dukebound85

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    #19
    oh how i would love if i could get my car maintained for free if i just had car insurance. thatd be great!

    you bring up a good point
     
  20. miloblithe macrumors 68020

    miloblithe

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    #20
    Definitely truth to this. There's some wisdom in buying new in that it is predictable. You know how much something will cost and are more sure that it won't break down--and if it does it's likely covered by a warranty. In project management, predictability is handy. On the other hand, aggregated all together, you're right that this is essentially a huge waste of money.

    With USAID money, we're not allowed to buy used, then we have to "dispose" of the equipment once the (usually 3-5 year project) has ended, which usually means trying to donate it to a local entity that often doesn't want the financial liability of taking over the maintenance of older (or even broken) equipment. In some cases, the equipment is returned to USAID who is then very inefficient to giving it out again to new projects.
     
  21. leekohler macrumors G5

    leekohler

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    #21
    I disagree. This is when we need it most. The reasons should be obvious.
     
  22. SLC Flyfishing Suspended

    SLC Flyfishing

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    #22
    I said it in another similar thread earlier this week, but one of the reasons that health care costs so much is because of the way the drug system is set up. With drug companies having virtually no time to make back the billions and billions of dollars that they had to invest to bring a drug to market. The single largest reason that I can see as to why some people have to pay so much to fill their prescriptions is because the drug company is scrambling to break even before their patent expires and the generics are released. If that means that it takes $250 for a weeks supply of medication then so be it.

    I did some shadowing with an Anesthesiologist 3 years ago, I spent a full day in the OR with him watching him work and interviewing him about his chosen field of practice. At one point he lifted a small vial of some opioid analgesic (probably fentanyl) and he casually mentioned how potent it was. He said that it would probably go for $15,000 on the streets (just a guess I'm sure) but that in actuality it only costs the hospital about $0.45 per vial. Knowing that, I don't think it's unreasonable to imagine that many prescriptions are probably not so expensive to produce per se, but rather mind boggingly expensive to develop.

    My #1 suggestion right now would be rather than looking into nationalized health care, looking at government subsidy of the R&D costs of some drugs. It just strikes me as morally wrong to be trying to turn a profit off a drug that someone requires to live. I think the government should be doing something to help keep the costs of prescription drugs low.

    I also think that they should be looking into granting pathology, radiology and other diagnostic facilities for providing cheaper and/or free tests when those tests are deemed to be a medical necessity. In speaking with some of the med students and physicians I associate with on a daily basis, most of them seem convinced that a large part of the skyrocketing cost of health care is all the tests that are ordered.

    I also think we might benefit from backing off on the need for constant upgrade to our technology. There's no reason for a hospital to have 5 or 6 MRI machines or CT scanners, and if there is, do they all have to be replaced every time something new hits the market? I live next to the main Trauma center for the Utah, Idaho, Northern Nevada, Northern Arizona, Wyoming region of our country. There are a ton of MRI and CT scanners along with a lot of other high end Radiology equipment. I used to work there and I was in and out of those areas constantly. I don't think I ever saw any of the Machines being used simultaneously.

    SLC
     
  23. xUKHCx Administrator emeritus

    xUKHCx

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    #23
    http://www.nhscareers.nhs.uk/details/Default.aspx?Id=553


    The figures can vary quite a bit after all there were reports that GPs were on average £110,000 back in Oct 2007.
     
  24. Peterkro macrumors 68020

    Peterkro

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    #24
    ^^ It's as well to keep in mind that many Consultants practice privately as well as being employed by the NHS.
     
  25. leekohler macrumors G5

    leekohler

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    #25

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