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Lituya
Mountain climber
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Nov 19, 2018 - 10:12pm PT
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The republicans want 100% of their wish list approved which translates to no universal health care but let's all pretend they want to fix the problem...
...and Democrats want 100% of their wish list approved or any movement toward a fix to represent movement toward single-payer. But let's all pretend they actually want to fix the problem...
See how it works?
Yuri, thanks for clarifying Canadian healthcare. I've heard good and bad. A doctor friend of mine treats dozens of Canadian citizens who can't get prompt care in Vancouver.
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Lituya
Mountain climber
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Nov 19, 2018 - 10:17pm PT
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Last I read Medicare overhead was 3% bro.
And yea, MD class of 2006 UC Davis. Look it up, I give no more shits.
If you say so. Your temperament is far beneath that of any doctor I know.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Nov 19, 2018 - 10:18pm PT
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So what direction do you think the American healthcare system should take, Lituya?
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Lituya
Mountain climber
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Nov 19, 2018 - 10:31pm PT
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Full implementation of the ACA--including the parts Obama himself refused to implement. And, maybe, a phased lowering of the Medicare age. A raising of federal taxes to pay for it in the form of additional Medicare payroll tax for every citizen.
But always, no matter what, a private-sector option.
Just ideas. None of us really know how to fix this.
Your thoughts and/or ideas?
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Nov 19, 2018 - 11:14pm PT
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Damn, Lituya...your vision sounds almost liberal.
I think we need a system where every tax-paying citizen has a baseline level of healthcare. That basic level should be very basic, but enough to provide preventative care, and basic emergency care when it's needed. Preventative care may be a bit delayed, but not unreasonably so. The insurance industry should have little or nothing to do with this baseline healthcare system.
If citizens want better care...more immediate care...there should be a means by which they can obtain it, if they can pay for it themselves, without subsidies. This might involve the insurance industry (not sure how that could be avoided).
A major problem with all of this...that I have no idea how to solve...is that healthcare costs are so twisted up with insurance reimbursement rates and negotiations...that it's really hard to get a sense for what the actual cost of the treatments and therapies.
Though I appreciated Obama's efforts at changing our current system, even if it had been fully implemented, it still relies on a profit-driven insurance system, regardless of what level of healthcare one seeks. The idea that the ACA was going to be a baby step towards a complete revision of the system was pie in the sky.
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Lituya
Mountain climber
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Nov 19, 2018 - 11:19pm PT
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Not liberal at all--it's just that the current healthcare system isn't really free market--so I won;t defend it like I will capitalism generally.
Hell, even Medicare requires paid supplements now to make ends meet. My dad just received a bill for $175 from his doctor--because he asked a question that wasn't covered under Medicare guidelines.
Medicare For All might end up eventually meaning more of the same.
A major problem with all of this...that I have no idea how to solve...is that healthcare costs are so twisted up with insurance reimbursement rates and negotiations...that it's really hard to get a sense for what the actual cost of the treatments and therapies.
Man, I could tell you a story...
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Yury
Mountain climber
T.O.
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Nov 20, 2018 - 04:30am PT
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apogee:
Yury, there's a difference between quality of healthcare, and access to it. The quality of American healthcare is the highest in the world...if you can get access to it. apogee, for majority of Americans your health care system is better than Canadian one from quality and access point of view.
Have you ever heard about waiting times?
Just google for "waiting times" and add the name of any Canadian province.
There are some segments of American population (like independent contractors without corporate insurance) with access issues, but for more than 51% of people American system is better than Canadian one.
I think we need a system where every tax-paying citizen has a baseline level of healthcare. apogee, I did not know that you were a conservative. ;)
What about tax-paying non-citizens?
What about not so basic heart attack, stroke or cancer?
Should they be covered?
Again, Obamacare is a monstrocity designed to please health insurance companies.
It's possible to design a single payer system with private providers of services and mixed (depending on a state) private/public administration of services that can be supported by majority of American voters and majority of American politicians.
Again, some people like young single healthy males and healthcare executive would not like it.
Again, it should not be a monopoly and should coexist with private insurance to cover better services.
Do you understand why Obama has not even tried to develop such option?
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Nov 20, 2018 - 06:24am PT
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As a physician for 20+ years, I have seen it all in terms of the American health care system.
We have to get capitalism out of health care. The privatization of health care has been an unqualified disaster. Capitalism in health care establishes a vast realm of unintended consequences and counter-productive incentives that are not consistent with providing quality health care. Costs have risen out of control, access has declined, and private insurance companies are practicing medicine for monetary gain at the expense of people's health and lives. Every day, we see more and more hoardes of people for whom health care insurance is out of reach. No where else in the world but the USA are people going into bankruptcy from health care expenses. People are dying from treatable illnesses so that CEOs and lawyers can buy more yachts.
We have to move to universal health care that does not involve private for-profit corporations.
Obamacare is a monstrocity designed to please health insurance companies.
Obamacare is a disaster because the Republicans had to get their fingers in the works. The original idea of Obamacare was perverted by the Republicans into an bastard system.
We need to get capitalism, profit, and Republicans out of health care.
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rottingjohnny
Sport climber
Sands Motel , Las Vegas
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Nov 20, 2018 - 06:33am PT
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Lituya...No waiting lines in America's system...Bull sh#t...!!!!!
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rottingjohnny
Sport climber
Sands Motel , Las Vegas
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Nov 20, 2018 - 06:36am PT
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And then wait some more to see if the insurance company denies your claim.....who do you think you're kidding with the smooth Mitch Mcconnel delivery...Take another shot at it liar....
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Nov 20, 2018 - 06:40am PT
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No waiting lines in America's health care system?
I'm a physician. My knee went bad from an old running injury, and I was having a lot of trouble walking. I could walk 100 yards at the most. My knee MRI showed major abnormalities of the bones around the joint, blood in the joint, and a shredded meniscus.
I saw an orthopedic surgeon who recommend surgery. The insurance company denied my medical care as an "elective" procedure. Four months of appeals, denials, appeals, and more denials. My pain became intolerable and I had to stop working. I could watch my quadriceps muscles wasting away. My surgeon recommended that I just pay $20,000 cash for the surgery rather than let my health deteriorate any further. When I said that I would pay, I had the surgery within 36 hours and I am working again.
Imagine what life is like for people who are less educated and have fewer resources.
Yeah. "No waiting lines for health care in America."
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rottingjohnny
Sport climber
Sands Motel , Las Vegas
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Nov 20, 2018 - 06:47am PT
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And how bout the Republicans pre-existing condition scam...?
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Nov 20, 2018 - 06:53am PT
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And how bout the Republicans pre-existing condition scam...?
Hey - CEOs and lawyers need more yachts! If insurance companies actually had to pay for health care, how could they afford another yacht?
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perswig
climber
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Nov 20, 2018 - 08:17am PT
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SLR, any of that through the VA or all general public service/providers?
Dale
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Nov 20, 2018 - 08:26am PT
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SLR, any of that through the VA or all general public service/providers? Yes, the VA, but I am under contract to not disclose any dirty laundry at the VA per a legal agreement
DO NOT confuse the VA system with a single-payer system. VA patients are generally poorly educated, dysfunctional, and their sense of entitlement knows no bounds. The VA patient population is vastly different from the general population at large.
The vast majority of veterans, most of whom are solid citizens, do not use the VA because they have a job and private health insurance, or they work for a living therefore don't qualify for VA care.
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apogee
climber
Technically expert, safe belayer, can lead if easy
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Nov 20, 2018 - 08:49am PT
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"Again, Obamacare is a monstrocity designed to please health insurance companies.
It's possible to design a single payer system with private providers of services and mixed (depending on a state) private/public administration of services that can be supported by majority of American voters and majority of American politicians.
Again, some people like young single healthy males and healthcare executive would not like it.
Again, it should not be a monopoly and should coexist with private insurance to cover better services."
Yury, I find myself more in agreement with you than not. Yes, I've heard of the waiting periods that exist in the Canadian system, and they sound awful and unacceptable. While I think a baseline level of care (however it is managed, single payer or some variation) should provide basic coverage (where to draw the line would be the challenge), it wouldn't be 'Gold' or 'Platinum' care...more like Bronze. Reasonable waiting times might be a part of such baseline care...if you want better care (including short wait times), you need to pay for it yourself.
And, importantly, somehow, some way, insurance company reimbursements and negotiations need to be extricated from the whole damn process. It's impossible to get a sense for the actual cost of healthcare due to the 'middle man' of the insurance industry.
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Sierra Ledge Rat
Mountain climber
Old and Broken Down in Appalachia
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Nov 20, 2018 - 09:11am PT
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Again, it should not be a monopoly and should coexist with private insurance to cover better services. That's exactly the kind of perverted thinking that got us into the current situation.
Universal single-payer health care is the only way to go. All capitalism and private enterprise has to be eliminated from health care. We can no longer permit a tiered system where being rich enables you to get good care, while being poor means you die in the gutter from treatable diseases.
Period.
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the Fet
climber
Tu-Tok-A-Nu-La
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Nov 20, 2018 - 09:28am PT
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A Canadian friend (with dual citizenship) back in the 90s told me his the total of his taxes (national, province, etc) were like 50% of his pay in Canada vs. 35% in the US. But it was worth it to not have to worry about health care. I have no idea if those figures are accurate, or for whom, but that is the choice we'd have to make.
If you add up co-pays, prescriptions, office visits, etc. in the US that also takes up a good chunk of income. Pay may also be higher since the employer is not providing health care.
Our system is so entrenched it would be extremely difficult to change, even without the lobbying of the insurance co.s etc.
It would be nice if there was some type of hybrid system. Where access to healthcare was universal but we could make choices of who our provider was to keep competition and innovation in the system. I have and like Kaiser. It seems way smarter to have the "insurance" and care from the same company, so the insurer is more interested in doing what's best for your long term health. Lot's of preventative stuff is free. I went to free classes for shoulder impingement and patello femoral syndrome. Way smarter to offer a free class that teaches PT, than have someone need surgery later.
I used to think access to health care wasn't a right, until I though about prisoners. If prisoners are denied health care and they die they've been denied a right the same as food or safety. I don't know about giving everyone free health care if they do nothing to contribute, but definitely everyone should have access. Obamacare really helped in that regard.
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the Fet
climber
Tu-Tok-A-Nu-La
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Nov 20, 2018 - 09:40am PT
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America pays twice as much for health care as other countries. The biggest factor is so many things are overpriced, from prescriptions to surgeries. The copay I pay for things in the US can be what people in other countries may pay for the whole visit. A lot of that is due to sand bagging the insurance companies.
I feel like we should have universal healthcare (govt. insurance) but everyone goes to private providers and has a 1-40% copay. If everyone has skin in the game they will shop for the best deal and prices would come down. If everyone is involved it would work much better than some bureaucrat trying to set prices and keep up with millions of transactions.
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Gary
Social climber
Desolation Basin, Calif.
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Nov 20, 2018 - 10:14am PT
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it's just that the current healthcare system isn't really free market
Y'know, I've never understood why the free market is supposed to be part of healthcare.
In the depression people in the cities were dying of malnutrition while farmers were plowing their crops under because they had no market for their crops. That's the magic of the free market at work? No thanks.
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