A first hand (actually second hand) interpretation of UHC

[sandorski]

Originally posted by: JohnnyGage

Originally posted by: freegeeks
I don't understand why Americans are so paranoid about the govt. running healthcare, can someone enlighten me?

There is also some great reading here. Some good interviews with experts about the different approaches to healthcare in different countries

Because if govt. is involved it quashes compitition which in turn quashes quality. But I guess you don't mind that they turn over used bed sheets in some British hospitals to save $$.

Will the French system work here? Who knows. It might, but the beaucracy created would be substancial and quality of care would plummet. It's just the way it works. We are not France, Britain or Germany--we just don't have the same views on what govt. should do. And IIRC wasn't this the place were thousands died of heat stroke in 2007? Where EMS just stopped answering the phone.

The US Insurance Industry is a bigger Beuracracy than any UHC system has.

 

[freegeeks]

Originally posted by: JohnnyGage

Originally posted by: freegeeks
I don't understand why Americans are so paranoid about the govt. running healthcare, can someone enlighten me?

There is also some great reading here. Some good interviews with experts about the different approaches to healthcare in different countries

Because if govt. is involved it quashes compitition which in turn quashes quality. But I guess you don't mind that they turn over used bed sheets in some British hospitals to save $$.

Will the French system work here? Who knows. It might, but the beaucracy created would be substancial and quality of care would plummet. It's just the way it works. We are not France, Britain or Germany--we just don't have the same views on what govt. should do. And IIRC wasn't this the place were thousands died of heat stroke in 2007? Where EMS just stopped answering the phone.

the problem is that competition doesn't seem to work because the US should have the best and cheapest healthcare in the world which it is not. I posted some links before with interviews with experts in healthcare and they all seem to agree that the US system is an expensive bureaucratic mess. In all modern UHC systems, administrative cost is FAR less then the current USA system. I read somewhere that the system with the lowest overhead in the USA is the govt. run Medicare program

 

[GTaudiophile]

I was in Germany last August and suffered a pretty bad case of food poisoning (from Turkish food). I ended up going to the famous Charité hospital in Berlin at about 3:00 AM in the morning. I needed to get some IV fluids as I was unable to keep anything down. I got there and within 5 minutes I was looked at and within 10 minutes had IV fluids flowing. I took 2-3 liters and left by around 5:00 AM.

As far as I am concerned, I received top-notch care in a clean, modern environment with no cameras (that I noticed). The staff were quite pleasant.

In the end, I was charged about 160 ? for the visit. (They sent the bill to me in DC about 5 months later.)

Had I done the same in just about any major city in the US, I would have been surrounded by God knows who at 3:00 AM and would have had to wait several hours to be seen by anyone I bet. Oh, and at least in Germany you can bet on not being surrounded by people with gunshot wounds as no one has guns! Kind of helps when it comes the ER.

 

[polarmystery]

Originally posted by: shadow9d9
Guys, it is much better to pay 10-20% of your income on health insurance without any pre-existing coverage than the evils of socialist UHC... So what if you are denied insurance by everyone because of a pre-existing condition? You should just exercise more and lose weight... Losing weight and exercising will eliminate your pre-existing conditions and you will have the choice to see all of the doctors in your limited healthcare plan.... Plus, our insurance companies(american workers) get to rake in the profits for denying us healthcare treatments! What beats that!?

Wow...really?



...wow :disgust:

 

[Schadenfroh]

Glad to hear that they found what was ailing your sister, I hope she recovers.

Personally, I would not have a problem with individual state governments establishing UHC systems if its citizens are willing to fund it. I do not think that UHC is evil, but if it does come about, the government should not nationalize existing private medical related companies. I see no problem with having a public AND private system. The main thing that concerns me is that once a massive public health care system is in place, the government might try to pass more nanny laws to reduce potential future (expensive) health problems (ie more restrictions on smoking, fatty food, drinking, etc.). Have said nanny laws materialized in most countries that transitioned from private to mix?

 

[Adn4n]

I was sent to the ER last Thursday because my doc said I might have meningitis. Took them an hour to admit me and about another hour to poke an IV into me; even the release took them hours because the damn nurses just stood there and chatted. I grew up in Germany and I can absolutely say that the service there was top-notch and my family and I never had to wait like that. I interpret on the side now in the medical field and I see this lousy service everywhere I work.

It's just so infuriating to hear all these false claims about UHC that really refer to our system here.

 

[fskimospy]

Originally posted by: QuantumPion
Oh, I think I see the $62,000 reason why the French medical care system is superior to ours, in one of those linked articles:

"Practice liability is greatly diminished by a tort-averse legal system,"

Why don't you take a minute and check out what percentage of medical expenses in the US are consumed by malpractice settlements/insurance and then come back and edit your statement?

 

[Xavier434]

Originally posted by: Schadenfroh
Glad to hear that they found what was ailing your sister, I hope she recovers.

Personally, I would not have a problem with individual state governments establishing UHC systems if its citizens are willing to fund it. I do not think that UHC is evil, but if it does come about, the government should not nationalize existing private medical related companies. I see no problem with having a public AND private system. The main thing that concerns me is that once a massive public health care system is in place, the government might try to pass more nanny laws to reduce potential future (expensive) health problems (ie more restrictions on smoking, fatty food, drinking, etc.). Have said nanny laws materialized in most countries that transitioned from private to mix?

Just remember that the fear of future additions, deletions, and amendments for any government system or law is always present no matter what happens. Therefore, there is little reason to take it into consideration beyond formulating the detailed verbage in whatever is presented before legislation. Good wording can help prevent some of that kind of stuff to a degree, but there is only so much we can do. We have no choice but to rely on them to do the right thing and maintain.

 

[Atreus21]

I wonder if any math-heads here could do an analysis of how much we could be taxed for UHC before it became more expensive per capita than the existing system.

 

[fskimospy]

As big a supporter of UHC as I am, anecdotal evidence isn't really very useful. Late last year I had some strange swelling in my face and neck and so I went to my doctor, who proceeded to give me all the quick and cheap checks. He gave me some allergy tests, and they did nothing. Then he said it was an infection and gave me some antibiotics... that did nothing. Then I was sent to get an ultrasound to check my thyroid, which did nothing. When it finally got bad enough I decided to go to the emergency room and not leave until they figured out what was wrong with me, and after waiting for about six hours it turned out that I have cancer. I sat around with cancer for the better part of a month because people here wanted to try the cheap solution first. How shitty is that?

Even that having been said though, my experience really doesn't impugn the quality of US health care, which in general is quite good. The problem with the US system is its absurd cost/benefit ratio. People should support UHC because it saves us all money and still provides equivalent quality, not because they had some good experience or bad experience somewhere.

 

[Atreus21]

Originally posted by: eskimospy
As big a supporter of UHC as I am, anecdotal evidence isn't really very useful. Late last year I had some strange swelling in my face and neck and so I went to my doctor, who proceeded to give me all the quick and cheap checks. He gave me some allergy tests, and they did nothing. Then he said it was an infection and gave me some antibiotics... that did nothing. Then I was sent to get an ultrasound to check my thyroid, which did nothing. When it finally got bad enough I decided to go to the emergency room and not leave until they figured out what was wrong with me, and after waiting for about six hours it turned out that I have cancer. I sat around with cancer for the better part of a month because people here wanted to try the cheap solution first. How shitty is that?

Even that having been said though, my experience really doesn't impugn the quality of US health care, which in general is quite good. The problem with the US system is its absurd cost/benefit ratio. People should support UHC because it saves us all money and still provides equivalent quality, not because they had some good experience or bad experience somewhere.

Sure. I was just giving some evidence on a personal scale, and using it as an excuse to illustrate the uncertainty of my position on this issue.

 

[vi edit]

US population ~300+ million.
France ~60 million:

We aready have about 40 some odd million under medicare and that accounts for almost 25% of the federal budget.

Do the math on that.

 

[fskimospy]

Originally posted by: vi edit
US population ~300+ million.
France ~60 million:

We aready have about 40 some odd million under medicare and that accounts for almost 25% of the federal budget.

Do the math on that.

Population size doesn't matter, and Medicare merely acts as a band-aid for the elderly slapped on to our already horrible health care system. It has very little to do with a UHC system, other than the fact that both would be government run.

On an interesting side note however, the overhead costs for Medicare are sharply lower than private HMOs.

 

[JS80]

Do you guys have magic beans laying around that's all of a sudden going to increase the number of doctors, nurses, and medical facilities to support the newly insured?

 

[vi edit]

Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

 

[freegeeks]

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

it works in Japan, not exactly a small country so I don't see why it couldn't work in the USA. If it works for countries with a population of 60 million (France), 82 million (Germany) and 120 million (Japan) there should be absolutely no reason why it wouldn't work in a country with 300 million

 

[fskimospy]

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

Of course the whole system would have to be changed, but there is nothing in the European model that precludes it from being used in a larger country such as ours.

Our system is totally fucked from the ground up. We're simply too arrogant and ideological to change it, despite the evidence staring us in the face from every corner of the western world. Sooner or later we WILL change when we no longer have any choice, it's just a question of how much pain and misery we are willing to absorb until that day comes.

 

[freegeeks]

Originally posted by: eskimospy

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

Of course the whole system would have to be changed, but there is nothing in the European model that precludes it from being used in a larger country such as ours.

Our system is totally fucked from the ground up. We're simply too arrogant and ideological to change it, despite the evidence staring us in the face from every corner of the western world. Sooner or later we WILL change when we no longer have any choice, it's just a question of how much pain and misery we are willing to absorb until that day comes.

If a country like France already has a huge leverage to negotiate with pharma companies, imagine the leverage a country like the US would have

 

[fskimospy]

Originally posted by: JS80
Do you guys have magic beans laying around that's all of a sudden going to increase the number of doctors, nurses, and medical facilities to support the newly insured?

The time and resources necessary to issue preventative care is orders of magnitude lower than is required for corrective care. By the most recent data, we have 2.4 doctors per 100,000 in the US compared to 2.9 doctors per 100,000 in other western UHC countries. This means about a 17% difference. With nurses, we have approximately 4% fewer per 100,000. (7.9 vs. 8.2) The nurse numbers are nearly insignificant, and the doctor number is hardly impossible to rectify through immigration incentives, reform of medical schools, etc.

So I guess the question really is why you think that 0.5 doctors per 100,000 population is some insurmountable obstacle to UHC?

 

[vi edit]

Originally posted by: freegeeks

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

it works in Japan, not exactly a small country so I don't see why it couldn't work in the USA. If it works for countries with a population of 60 million (France), 82 million (Germany) and 120 million (Japan) there should be absolutely no reason why it wouldn't work in a country with 300 million

I ask because I simply don't know....

But do either of these countries have illegals/undocumented flowing in by the millions and using care that they have paid a dime into?

 

[Slew Foot]

Originally posted by: vi edit

Originally posted by: freegeeks

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

it works in Japan, not exactly a small country so I don't see why it couldn't work in the USA. If it works for countries with a population of 60 million (France), 82 million (Germany) and 120 million (Japan) there should be absolutely no reason why it wouldn't work in a country with 300 million

I ask because I simply don't know....

But do either of these countries have illegals/undocumented flowing in by the millions and using care that they have paid a dime into?

Most of those countries dont flog Grandma for 6 months in the ICU before she dies.

 

[freegeeks]

Originally posted by: vi edit

Originally posted by: freegeeks

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

it works in Japan, not exactly a small country so I don't see why it couldn't work in the USA. If it works for countries with a population of 60 million (France), 82 million (Germany) and 120 million (Japan) there should be absolutely no reason why it wouldn't work in a country with 300 million

I ask because I simply don't know....

But do either of these countries have illegals/undocumented flowing in by the millions and using care that they have paid a dime into?

latest estimates say that there are 8 millions illegals in the EU and there are 500.000 new illegals entering the EU annually. Illegal migration is not only an USA problem and just like in the US, illegals end up in hospitals needing care that has to be paid by someone

 

[vi edit]

Originally posted by: Slew Foot

Originally posted by: vi edit

Originally posted by: freegeeks

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

it works in Japan, not exactly a small country so I don't see why it couldn't work in the USA. If it works for countries with a population of 60 million (France), 82 million (Germany) and 120 million (Japan) there should be absolutely no reason why it wouldn't work in a country with 300 million

I ask because I simply don't know....

But do either of these countries have illegals/undocumented flowing in by the millions and using care that they have paid a dime into?

Most of those countries dont flog Grandma for 6 months in the ICU before she dies.

Yeh. That's what I was referring to when I said it would take a dramatic change in expectations. My wife is a staff pharmacist working a 25 bed ICU unit. She's just sickened by the excesses that go on there. Whether it's to convenience the family members so that Mom/Dad/Grandma/ect can stick around until after Christmas time, or because some cardiovascular surgeon sucks at patient management. There's just thousands of people living off a machine that *somebody* won't let go.

 

[JS80]

Originally posted by: eskimospy

Originally posted by: JS80
Do you guys have magic beans laying around that's all of a sudden going to increase the number of doctors, nurses, and medical facilities to support the newly insured?

The time and resources necessary to issue preventative care is orders of magnitude lower than is required for corrective care. By the most recent data, we have 2.4 doctors per 100,000 in the US compared to 2.9 doctors per 100,000 in other western UHC countries. This means about a 17% difference. With nurses, we have approximately 4% fewer per 100,000. (7.9 vs. 8.2) The nurse numbers are nearly insignificant, and the doctor number is hardly impossible to rectify through immigration incentives, reform of medical schools, etc.

So I guess the question really is why you think that 0.5 doctors per 100,000 population is some insurmountable obstacle to UHC?

You're assuming all we need to do is increase the supply of doctors by 17% (which will be a near impossible feat in itself) to achieve equal price parity. Who's going to pay for new medical facilities? Will they be financially sustainable?

Good luck trying to break the medical association/lobby.

 

[fskimospy]

Originally posted by: vi edit

Originally posted by: freegeeks

Originally posted by: vi edit
Population size absolutely does matter. We've got 6x the possible number of people sucking up incredibly expensive, end of life care. These costs are exponential in nature and don't follow a linear trend of costs paid in by subscriber.

The only way it would work would be both a radical revision in both administration of healthcare AND the expectations (or lack their of) by us as citizens in what we'll be entitled to as we age.

it works in Japan, not exactly a small country so I don't see why it couldn't work in the USA. If it works for countries with a population of 60 million (France), 82 million (Germany) and 120 million (Japan) there should be absolutely no reason why it wouldn't work in a country with 300 million

I ask because I simply don't know....

But do either of these countries have illegals/undocumented flowing in by the millions and using care that they have paid a dime into?

According to a RAND corporation study, illegal immigrants comprise a small fraction of health care spending. In the example they use, illegal immigrants consume 6% of health care spending in LA county despite comprising 12% of the population. Considering they are a significantly smaller fraction of the population nationwide, this cannot account for anywhere close to the disparity in spending between the US and Japan.