American Healthcare is the Best in the World IF . . .

[BaliBabyDoc]

Medscape from WebMD

How many times in the past 20 years have you heard some American politician proclaim, "the American healthcare system is the best in the world." Too many, I fear. But let's face it. People tend to speak most fervently from their own personal experiences. Maybe those politicians, medical or otherwise, actually believed what they said. One could make the case that "the American healthcare system is the best in the world if:

1) You have full, comprehensive, in-depth health insurance coverage with low deductibles and copayments, and no exclusions for pre-existing conditions;

2) You live in a major metropolitan area;

3) You have a long-term relationship with a physician who serves your primary care needs, seeks specialist attention when needed, and finds the right specialist;

4) You speak and understand good English and so does your doctor, and you are neither sight- nor hearing-impaired;

5) You are well educated;

6) You have money and transportation capability;

7) You are white;

8) You are naturally skeptical and questioning;

9) You personally access the internet to help you take charge of your life; and, until recently

10) You are male.

Well, maybe those characteristics describe many of those politicians and explain why they may actually feel the way they do. But, woe unto all those other folks. That's my opinion. I'm Doctor George Lundberg, Editor of MedGenMed.

Readers are encouraged to respond for the editor's eye only or for consideration for publication.



George D. Lundberg, MD, Editor in Chief, Medscape General Medicine


Disclosure: George D. Lundberg, MD, is an employee of WebMD.

 

[alchemize]

I scored a perfect 100%! Awesome!

 

[BaliBabyDoc]

Originally posted by: alchemize
I scored a perfect 100%! Awesome!

Are you sure?

5) You are well educated;

In all seriousness, it's pretty hard to find a policy that does not exclude pre-existing conditions . . . except for government. Can you imagine how much Cheney's healthcare is costing the US taxpayer?

 

[RabidMongoose]

How would you propose to fix this? Would you prefer a system closer to Canada's?

 

[alchemize]

Originally posted by: BaliBabyDoc

Originally posted by: alchemize
I scored a perfect 100%! Awesome!

Are you sure?

5) You are well educated;

In all seriousness, it's pretty hard to find a policy that does not exclude pre-existing conditions . . . except for government. Can you imagine how much Cheney's healthcare is costing the US taxpayer?

Well, not as well educated as you - but I do have some letters after my name.

Feel free to educate me - but I thought HIPAA or whatever that was took care of the pre-existing condition thingy? My last 4 companies have covered pre-existing conditions, and they were pretty common plans.

 

[glenn1]

And since I do meet all those qualifiers, why would I want the government screwing around with things considering they'd almost certainly only make it worse for me?

Sorry to bust your bubble, but the majority of folks in the U.S. are employed, have health insurance and a family doctor, and are relatively satisfied with the level of medical care they get. And yes, they do have some concerns, primarily getting wiped out themselves by a catastrophic event, secondarily that there are others out there not so fortunate and don't receive the same high standard of care. But even so, the least thing those of us who are relatively satisfied want is for government to screw things up for them in the name of "improving" healthcare.

 

[BaliBabyDoc]

Purely tongue-in-cheek, alchemize. The longer I stay in the academy the more I realize a lot of dumbarses have a lot of letters. Hell our President has an MBA and no one in their right mind would trust him to run a business.

An element of HIPPA allows you to retain your previous coverage as long as you pay their rates. Further, your coverage still exists at the whims of the provider. For instance, Aetna decided they were not making enough money in small states (it's hard to squeeze much cheddar from places like RI, DE). Anyway, IIRC they dropped virtually all coverage in RI.

As healthcare expenses have continued to mount many businesses (if not most) have limited choices to providers with lower premiums. Such providers invariably have high deductibles and exclude coverage for pre-existing conditions for a period of time (6mo, 12mo, infinity). Granted, best evidence is that companies with quality healthcare coverage tend to have happier and healthier employees. Take care of your employees and they will take care of you.

 

[Zephyr106]

Well it is good to see that the system puts resources where they are needed the most. Can we all agree that some poor minority in the big city deserves healthcare? Or at least that the productive white members of our society should recieve better care.

Zephyr

 

[BaliBabyDoc]

Originally posted by: glenn1
And since I do meet all those qualifiers, why would I want the government screwing around with things considering they'd almost certainly only make it worse for me?

Sorry to bust your bubble, but the majority of folks in the U.S. are employed, have health insurance and a family doctor, and are relatively satisfied with the level of medical care they get. And yes, they do have some concerns, primarily getting wiped out themselves by a catastrophic event, secondarily that there are others out there not so fortunate and don't receive the same high standard of care. But even so, the least thing those of us who are relatively satisfied want is for government to screw things up for them in the name of "improving" healthcare.

Dude you couldn't burst my bubble with a Scottish Claymore and certainly not your understanding of our healthcare system. Spend some time in a modern ER and you will understand what I mean.

Your "self-interest" is the kind of ignorance and greed that will eventually bring the system down.

Medicare covers about 250,000 Americans of all ages who suffer from permanent kidney failure. This end-stage renal disease (ESRD) program has been in operation since 1973. It pays for the treatment of more than 90 percent of the population that suffers from this disease, which is usually caused by diabetes, hypertension, or a nonchronic kidney condition and is treated by dialysis. This program has undeniably improved quality of life and prevented deaths, though at considerable cost: 5 percent of overall Medicare spending is devoted to paying for ESRD, though its beneficiaries make up only around 0.5 percent of all Medicare beneficiaries.

The law requires that an ER provide care for people in crisis but health maintenance would dramatically reduce the costs (and morbidity) of these people. Trust me I want to keep people out of the hospital b/c anyone hooked up to the dialysis machine isn't working and paying taxes.

The majority of folks in America are employed but the lowest % in decades receives their healthcare from their employer. The majority of the uninsured (total 44m) are employed or children of the employed. When these people have minor issues they ignore them. When they become major they miss work and spend an afternoon (or day) in the ER waiting for care at the most expensive (and inefficient entry portal). Medicare alone cares for over 5 million non-elderly people with permanent disability . . . many of which were preventable.

Other unsustainable patterns . . .

Medicare is the biggest single source of income for most providers of medical services.43 Medicare provides almost all of the revenue received by home health care agencies, hospices, and kidney dialysis facilities. It represents between 25 percent and 75 percent of the revenue of clinics, laboratories, and ambulance services. And it accounts for almost 40 percent of total hospital revenues, including payments for patient care, capital costs, and the education of medical students and other personnel.44 (See Figure 5.)

This haphazard system makes no sense whatsoever. Do I trust Democrats or Republicans to produce a better system? Hell no. Do I trust Big Pharma, hospitals, doctors, or insurance companies? Hell no . . . they are the primary reason the system is so messed up!

Century Foundation

Trial lawyers are a hemorrhoid on the healthcare system but all of the attention devoted to them has meant real reforms have fallen to the wayside. Granted, the primary reason no one is addressing the system's deficiencies is the lack of political will to tell the truth. Think about it. Republicans claimed the system was horribly expensive and inefficient . . . then passed legislation making it more expensive and more inefficient!! Sadly, I will live long enough to see the fruits of our labor.

 

[glenn1]

Dude you couldn't burst my bubble with a Scottish Claymore and certainly not your understanding of our healthcare system. Spend some time in a modern ER and you will understand what I mean.

Your "self-interest" is the kind of ignorance and greed that will eventually bring the system down.

Excuse me, my "ignorance and greed" along with my insurance premiums, checkbook, and tax dollars are what pay you. As the patient, you're my employee, just like any other service provider, and I can fire your ass just like I would a stockbroker or architect who wasn't meeting my expectations. You might want to get off your high horse and start paying attention to what your paying customers want, rather than what you think is best for them.

 

[CrazyHelloDeli]

Yes, the American Health Care system is on the brink of collapse. If you arent a white male billionare who speaks perfect english and has 20/15 vision, the next time you get a paper cut YOU WILL DIE! Sorry, thats just the way the system works. In time you will be another rotting corpse piling up in the ally behind the hospital.

 

[BaliBabyDoc]

Originally posted by: glenn1

Dude you couldn't burst my bubble with a Scottish Claymore and certainly not your understanding of our healthcare system. Spend some time in a modern ER and you will understand what I mean.

Your "self-interest" is the kind of ignorance and greed that will eventually bring the system down.

Excuse me, my "ignorance and greed" along with my insurance premiums, checkbook, and tax dollars are what pay you. As the patient, you're my employee, just like any other service provider, and I can fire your ass just like I would a stockbroker or architect who wasn't meeting my expectations. You might want to get off your high horse and start paying attention to what your paying customers want, rather than what you think is best for them.

There you go again . . . it's one of the major fallacies of healthcare is this notion that it's just another commodity. It's certainly true that healthcare fills a lot of wallets . . . but it's also emptying out the Treasury and the wallets of every American.

I will never be "employed" by anyone. But I love to "serve" the best interests of my patients. It is FAR more common that people like yourself fail to meet MY expectations rather than the other way around. Fortunately, I no longer see adults so now all I have to deal with are parents that fail to meet my expectations.

By definition my education and experience will determine what I would "recommend" as the best course of action for patients and research participants. It's always a patient's (or parents') decision whether or not they follow our "options" but no child will remain in our care for long if their parent refuses to act in the child's best interest.

Unlike your stockbroker or architect (although I doubt you've ever used one) your ability to pay doesn't matter. Why? Because I believe in what I do. I want to change the world for every single child I have contact with from the incredibly wealthy family with a teen with schizophrenia to the extremely poor family with a teen with schizophrenia. It's not uncommon for us to drive to kid's homes to pick them up and bring them to appointments. Although both of the previously mentioned kids are very sick, one has a fighting chance the other will likely be permanently disabled and possibly stumble into the criminal justice system.