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Ken M
Mountain climber
Los Angeles, Ca
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Sep 10, 2012 - 01:38pm PT
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I've shown that a dollar dedicated to healthcare will do more good in the hands of a private charitable organization than that same dollar would if spent by the government - by a factor of two or three, at least.
chaz, you haven't shown anything that remotely shows that.
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Ken M
Mountain climber
Los Angeles, Ca
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Sep 10, 2012 - 01:41pm PT
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I don't know yet, but can you NOT be in medicare if you're over 65?
You certainly can. You can if you are permanently disabled, you can if you are on kidney dialysis.
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stevep
Boulder climber
Salt Lake, UT
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Sep 10, 2012 - 02:16pm PT
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Well, then you would be potentially dual eligible, Medicare/Medicaid.
In any case though, neither program is mandatory. If you are wealthy, you are free to pay directly for your own care or use private insurance.
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Norton
Social climber
the Wastelands
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Sep 10, 2012 - 04:12pm PT
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Medicare is available for people 65 and older, if they want it.
Of course, they have to "qualify" for Medicare, as in pay into the program while working, just like you have to qualify for Social Security.
If you are disabled, Federally speaking, then you can be on Medicare at any age.
Medicaid is different, you have to be very poor with little or no income or assets, and the
"quality" of the healthcare is less than Medicare.
Almost all poor old people living in nursing homes are being funded by Medicaid, not Medicare.
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sempervirens
climber
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Sep 10, 2012 - 07:01pm PT
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I agree with Chaz about the gov. forcing us to pay tax. But shouldn't we be required to pay tax? Would anyone propose not having a tax funded gov? Would we privatize national parks, national forests, the FDA, military, etc.?
On another point, using the example of the victim of a motorcycle crash, even if the victim were sent to a private run hospital (Catholic, Shriners, or other) it still involves the gov. because somehow a decision must be made, i.e. what do we do with the freedom-loving coma patient? I don't think you'd leave that to any private organization be it Catholic Charities or United Way. Regardless of the family's decision it is still a legal matter and therefore involves the gov. unless we do away with law. If you'd rather have anarchy, well then we can move on to that debate.
The gov is inefficient when compared to private industry. But industry is only better at providing service when profit is the objective. Health care is a different type of industry unless you believe profit to be its over riding priority.
So drop the anit-gov. ideology and discuss how to best to deliver health care. That is the topic.
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Norton
Social climber
the Wastelands
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Sep 10, 2012 - 07:16pm PT
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But industry is only better at providing service when profit is the objective. Health care is a different type of industry unless you believe profit to be its over riding priority.
So drop the anit-gov. ideology and discuss how to best to deliver health care. That is the topic.
very well stated
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HighTraverse
Trad climber
Bay Area
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Sep 10, 2012 - 07:43pm PT
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....certain unalienable rights, that among these are Life, Liberty and the Pursuit of Happiness.
how to best to deliver health care. without good health care you're sure not going to enjoy Life and Happiness.
The UN Universal Declaration of Human Rights, adopted in 1948 with US voting YES states:
Article 3:
Everyone has the right to life, liberty and security of person. Not a bad translation from 18th to 20th century
and
Article 25:
(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.
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Reilly
Mountain climber
The Other Monrovia- CA
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Sep 10, 2012 - 07:56pm PT
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So drop the anit-gov. ideology and discuss how to best to deliver health care. That is the topic.
Unfortunately, dissing the government's ability to deliver healthcare is cogent
to the issue. Government does very little efficiently except collect taxes.
How else to explain the billions it/we are being bilked out of through fraudulent
Medicare payments? If private industry were in charge you can bet your
bippy they wouldn't be letting those billions fly out the window.
If we want universal coverage then efficiency will result in greater and better
coverage for all. Since it seems highly unlikely the government is or can
disband the insurance industry then wouldn't the most efficient delivery of
services be achieved through those with a vested interest in not being robbed?
And if the insurance companies all had to play by the same rules in terms of
coverage and delivery of services with a fixed profit margin set then all the
government would have to do is monitor the situation. This is what, in effect,
the IRS does. Put the IRS in charge of overseeing the insurance companies
and they would play nice!
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~kief~
Trad climber
state of Awakening
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Sep 10, 2012 - 07:59pm PT
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-
Good topic.
Yet,the treads gone anti-jody,
notice how,in major issues in the us,someone will
chime in seeking only to murky-up the waters,make folks choose sides(?)
slap a label on one they disagree with,at the same time dodging the issue.
this has become the new american dialog,or lack of it..
>>>>health care in the US has become a world wide laughing stock.
remember michael moores sicko?
remember how P.O-ed you were?
I will never understand how helping the sick and dying,for profit
was,is, has become accepted as right,just,or even smart.
I guess,unless you're the one making the profit.and they are..
-how do we fix it?
fire all those F*ckers.
nationalize it.
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The Wedge
Boulder climber
Santa Rosa & Bishop, CA
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Sep 10, 2012 - 09:45pm PT
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The IOM (institute of medicine...an arm of the national academy of science)has put out a number of reports about our health care system one in 1999 titled "to err is human: building a safer health care system" and another in March 2001 call "crossing the quality chasm; a new health system for the 21st century. They tell you what is wrong and suggestions on how to fix it. Both are about 6-7 pages. Im sure you can find it on the internet. Check it out.
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climbski2
Mountain climber
Anchorage AK, Reno NV
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Sep 10, 2012 - 10:09pm PT
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I wonder how much our Car insurance would go down if Healthcare costs did not have to be covered?
I wonder how much business would save if they didn't have to pay for healthcare? I think GM said about 1K of their cost for building a car was due to healthcare costs.
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stevep
Boulder climber
Salt Lake, UT
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Sep 10, 2012 - 10:23pm PT
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The government isn't always worse at things, even healthcare. There are a fair number of studies/opinions that make a decent case that the best health care system in a number of ways is the VA.
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sempervirens
climber
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Sep 11, 2012 - 12:32am PT
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And if the insurance companies all had to play by the same rules in terms of
coverage and delivery of services with a fixed profit margin set then all the
government would have to do is monitor the situation.
Reilly,
You present a potential solution that needs to be explored, IMO. It depends upon the government to regulate the industry. That's why I'm saying to cut the anti-gov ideology rhetoric- force and coercion, etc. The gov. already regulates the industry but does so in a way that gives us this inefficient system.
Ken M brings up a good point too. I searched Dr Ezekial Emanuel and his background and affiliations don't bring up any conflicts of interest. But the same is not true, IMO, about Obama. I don't trust Obama to put in place the best system for the country.
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Ken M
Mountain climber
Los Angeles, Ca
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Sep 11, 2012 - 12:54am PT
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Unfortunately, dissing the government's ability to deliver healthcare is cogent
to the issue. Government does very little efficiently except collect taxes.
How else to explain the billions it/we are being bilked out of through fraudulent
Medicare payments? If private industry were in charge you can bet your
bippy they wouldn't be letting those billions fly out the window.
Uhhhh...nice try, but WRONG! Medicare is administered under contract CURRENTLY by fiscal intermediaries...which are INSURANCE COMPANIES.
Your friends don't seem to have any trouble letting the fraud through....
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Reilly
Mountain climber
The Other Monrovia- CA
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Sep 11, 2012 - 01:01am PT
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Ken M, but it isn't their money, hence, no vested interest. Plus the government
is still failing in its oversight. Plus, pardon the thread drift, we both
know the absurdity of the coding system. You can't have a system that is
half guvmint and half private; that is half-assed.
Somebody said something in praise of the VA. I thank my stars I've not seen
the inside of one since the 70's, period. Not a pretty sight. They've got
to be better these days as they couldn't be worse.
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Chaz
Trad climber
greater Boss Angeles area
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Sep 11, 2012 - 01:06am PT
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Dr Hartouni writes:
"certainly an evolved system, not a designed one..."
True that.
What's been proven to work better? Evolution? Or intelligent design?
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Ken M
Mountain climber
Los Angeles, Ca
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Sep 11, 2012 - 01:15am PT
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I've posted this before, but it is still the best I've seen.
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/view/
In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies -- the United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and their failures.
Reid's first stop is the U.K., where the government-run National Health Service (NHS) is funded through taxes. "Every single person who's born in the U.K. will use the NHS," says Whittington Hospital CEO David Sloman, "and none of them will be presented a bill at any point during that time." Often dismissed in America as "socialized medicine," the NHS is now trying some free-market tactics like "pay-for-performance," where doctors are paid more if they get good results controlling chronic diseases like diabetes. And now patients can choose where they go for medical procedures, forcing hospitals to compete head to head.
While such initiatives have helped reduce waiting times for elective surgeries, Times of London health editor Nigel Hawkes thinks the NHS hasn't made enough progress. "We're now in a world in which people are much more demanding, and I think that the NHS is not very effective at delivering in that modern, market-orientated world."
Reid reports next from Japan, which boasts the second largest economy and the best health statistics in the world. The Japanese go to the doctor three times as often as Americans, have more than twice as many MRI scans, use more drugs, and spend more days in the hospital. Yet Japan spends about half as much on health care per capita as the United States.
One secret to Japan's success? By law, everyone must buy health insurance -- either through an employer or a community plan -- and, unlike in the U.S., insurers cannot turn down a patient for a pre-existing illness, nor are they allowed to make a profit.
Reid's journey then takes him to Germany, the country that invented the concept of a national health care system. For its 80 million people, Germany offers universal health care, including medical, dental, mental health, homeopathy and spa treatment. Professor Karl Lauterbach, a member of the German parliament, describes it as "a system where the rich pay for the poor and where the ill are covered by the healthy." As they do in Japan, medical providers must charge standard prices. This keeps costs down, but it also means physicians in Germany earn between half and two-thirds as much as their U.S. counterparts.
In the 1990s, Taiwan researched many health care systems before settling on one where the government collects the money and pays providers. But the delivery of health care is left to the market. Every person in Taiwan has a "smart card" containing all of his or her relevant health information, and bills are paid automatically. But the Taiwanese are spending too little to sustain their health care system, according to Princeton's Tsung-mei Cheng, who advised the Taiwanese government. "As we speak, the government is borrowing from banks to pay what there isn't enough to pay the providers," she told FRONTLINE.
Reid's last stop is Switzerland, a country which, like Taiwan, set out to reform a system that did not cover all its citizens. In 1994, a national referendum approved a law called LAMal ("the sickness"), which set up a universal health care system that, among other things, restricted insurance companies from making a profit on basic medical care. The Swiss example shows health care reform is possible, even in a highly capitalist country with powerful insurance and pharmaceutical companies.
Today, Swiss politicians from the right and left enthusiastically support universal health care. "Everybody has a right to health care," says Pascal Couchepin, the current president of Switzerland. "It is a profound need for people to be sure that if they are struck by destiny ... they can have a good health system."
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Ed Hartouni
Trad climber
Livermore, CA
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Sep 11, 2012 - 11:07am PT
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What's been proven to work better? Evolution? Or intelligent design?
we haven't tried intelligent design, yet...
what is interesting is that there can be large changes in the "fitness landscape" when evolution is at work, and I have to say we will have evolution...
the extinction event of interest in this case is the independent physician, the very ideal that the AMA fought so vigorously to preserve in its staunch opposition to federal healthcare insurance. This is interesting because the economics of the private insurance health care eventually overwhelmed the docs. In the end, their fate was the one they most feared, the fate of having health care decisions made by non-physicians.
this is gleaned from that SSA sponsored history of Medicare, which is a very interesting read if any of you are of the mind that the debate is new... or that the tone of the debate is any different from the past.
in the end, we will evolve a system, no doubt.
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BASE104
Social climber
An Oil Field
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Sep 11, 2012 - 01:01pm PT
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Ken M,
Everyone should hit Netflix or perhaps PBS online to watch that Frontline episode you mentioned:
Sick Around The World
Since every developed nation on the planet has government run or influenced healthcare laws, it really shines a light on the systems that work great like Switzerland and Japan (particularly Switzerland).
Some of the older systems aren't that great, but the nations who studied it well and used the efficient methods vs the ones that suck, have a really good record.
Switzerland is probably the best, but Japan is really innovative. Both have pretty much zero wait.
I wonder why nobody caught on to my previous post about my recent knee surgery cost. The hospital and docs billed around 100 grand, but the insurance company wrote off over half of it. Way over half. Then I paid my percentage.
Without that provider write off it would cost an uninsured person triple what my insurance company paid. Now that is fuc&ed up.
The whole notion that in America you can get in to see a specialist right away, or get an MRI right away is bogus. I have to get pre-approval for everything. It took me 6 weeks to get in for my first appointment with the ortho surgeon. I have been back three times for 10 minute look sees, and have only seen a PA once and a nurse the other 2 times.
So three follow up appointments that were ten minutes each, not seeing the doctor, and they bill me 210 dollars for each appointment. Now I have met my deductable, so it is cheap, but if I didn't have insurance I would be screwed.
No provider write off if you have no insurance. It would cost over triple what the insurance company pays. People, I have been watching my bills and it is very enlightening.
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