Is the American health care system a mess?

[Zedtom]

I'm hoping that some of you ATers up in Canada or overseas can comment.

The federal government keeps adding new layers of bureaucracy to our health care system. Many doctors are leaving their profession because of paperwork demands. I have a friend that says the nurses at the facility where she works spend more time filling out records and forms than helping the patients.

I know that in some countries where the health care system is nationalized that the taxes are high, but I'm sure that even with health insurance, medical costs are out of control here.

I don't know if there is any solution except for total reform...any ideas?

 

[Czar]

I think the medical system is a mess everywhere.

The only thing I dislike about the US system is the cost, its way to expensive. Here it only costs me about $8 to see a doctor for anything that might be wrong and that $8 is just "red tape" cost and nothing else. My mom had an operation few years ago because of kidney stones and that didnt cost her anything.

 

[ToBeMe]

I like my families health insurance. We can go where we want, it covers everything including dental and eyeglasses, prescription drugs are $10 name brand, generic $5. I've been to several countries which have "government sponsered or funded" healthcare, and to be honest, I sure as hell wouldn't want to have to have that instead of what I now have! I don't want the government messing with my insurnace coverage................any of it..........I'd rather take care of that than have the government mess it all up and try to tell me where I have to go for this or that and have less coverage than I do now................

 

[Spooner]

Did someone just watch the movie John Q. or something?

 

[Czar]

Originally posted by: ToBeMe
I like my families health insurance. We can go where we want, it covers everything including dental and eyeglasses, prescription drugs are $10 name brand, generic $5. I've been to several countries which have "government sponsered or funded" healthcare, and to be honest, I sure as hell wouldn't want to have to have that instead of what I now have! I don't want the government messing with my insurnace coverage................any of it..........I'd rather take care of that than have the government mess it all up and try to tell me where I have to go for this or that and have less coverage than I do now................

what do you mean by "and try to tell me where I have to go for this or that and have less coverage than I do now"
what do you think you would loose?

just curious

 

[Vadatajs]

It's a mess. Whether we pay for insurance, or higher taxes for government subsidization, it will end up costing us about the same.

Canada's got the right idea. The government is the only provider, so there is much less paperwork involved, therefore less bureaucracy. The increased simplicity helps keep medical costs down. A reason medical costs are so high is because of the cost and time needed in dealing with many different insurance providers and policies. Canada has everybody covered, very simple and effective. Another benefit is your medical information doesn't have to change as many hands, though government involvement may seem scary from a privacy standpoint, it is actually much better than the free-for-all that the US has in place.

The drawbacks: having to wait for serious operations. It is a bit too cost effective, somebody in serious need could possibly wait too long. However, from what I have studied these cases are rare. Also, people use and abuse. That means people will go to the ER for a common cold. It's a unfortunate that the typical lack of common sense on the part of humanity will ruin even the most perfect system.


Now we need a Canadian to explain their healthcare system.

 

[iamwiz82]

Hospitals overcharge in the US, but usually the actual price will never be paid. Most of the time they lower it. Good health insurance will cover pretty much everything with low deductibles.

 

[Zedtom]

Sorry Spooner...that's not my reason. But while we're on the subject- what a ridiculous excuse for a movie. The pent-up rage and frustration of the guy is pathetic.

 

[ToBeMe]

Originally posted by: Czar

Originally posted by: ToBeMe
I like my families health insurance. We can go where we want, it covers everything including dental and eyeglasses, prescription drugs are $10 name brand, generic $5. I've been to several countries which have "government sponsered or funded" healthcare, and to be honest, I sure as hell wouldn't want to have to have that instead of what I now have! I don't want the government messing with my insurnace coverage................any of it..........I'd rather take care of that than have the government mess it all up and try to tell me where I have to go for this or that and have less coverage than I do now................

what do you mean by "and try to tell me where I have to go for this or that and have less coverage than I do now"
what do you think you would loose?

just curious

Um Czar, to be honest, I don't know what you may have, but, i do know what has been proposed here and what a few other places have...........My family and I can go to ANY doctorat ANY time when and where we want to go. A lot of proposals here have always been structured around the "HMO" standards..............you have a "network" or "area" you belong to, as long as you go to a doctor in your network or area, it will pay............at least most of the costs BUT..........decided you have a doctor you want to see outside your network and........to bad, you'll be paying a large portion of the cost.

As for less coverage............number one, all the proposals which have ever been considered here have said that dental and eyecare coverage would be to expensive and would not be part of the plan so I'd still have to take out a policy seperately for those which would likely be higher for each since it is not a part of a "package" as it is with my present insurance. Also, co-pays...........let's just say this, I, or any of my family now pays $5 for an office visit, that wouls almost certainly be higher. Also, I have been in the hospital several times in the past few years with back surgery..............my "out of pocket expense".................$0.00!!! When our last child was born under this policy we have.........our out of pocket expense was.........$0.00!!! I've already covered the cost of our prescription drug program so................tell me..........does anyone actually think the government is going to supply me with similar coverages and the freedom to see ANY doctor we want????? Not bloody likely and what they would provide would in all likelyhood cost me more in taxes than I am paying for the coverage I have now!

 

[LostHiWay]

Health insurance rates are just way too much. Since I have to pay my own it really pisses me off. In a few years it's going to be cheaper just to pay the doctors and hospitals yourself out of pocket unless you have something major like cancer.

I've been paying for my health insurance for 3 years and I've been to the doctor ONCE!! Sometimes I wish I would get sick just so I get my money's worth.

 

[Czar]

ToBeMe,
About the Doctor thing, here I can go to any doctor I want and pay only $8 for each apointment unless its a speciality doctor then its more (not sure by how much since I never had to go to one).

This system does not apply to dental and I think eyecare also but its not that expensive to go to a dentist, I pay about $40 twice a year for that. And not sure about eyecare because I dont use glasses.
My friend had a few back surgeries few months ago also and he didnt have to pay anything.

I think the system Europe, Canada and other places have is very good in a way and I think that the system the US has is very good in another way.
Just have to find a way to combine the two to make a perfect system

 

[Scouzer]

I'm really tired but I'll my word on the Canadian system. Its great, but if you hit bad luck, your fvcked. For example, in a city of 35,000 (at the time) in Ft. Mcmurray, Alberta, there is a 7 story hospital. My father decides he needs to the ER (it wasn't extremely urgent thank god but thats not the point), guess how long he sits there before he's seen by a doctor? Eight hours. Thats right, eight hours. Want to know why? Some drunk driver hit a pole and needed desperate care and stabilization before being able to be transfered onto an ambulance, to the airport, then a Medevac to Edmonton. Eight hours. What if my father had been dying? He would of sat in a hospital bed with a nurse watching him with nothing he/she could do. Thats not right.

Not that the US system this doesn't happen.

Normally if you need a regular doctor's appointment (I.E. you don't need to goto the ER) you can expect a 1 or 2 week wait. Specialty doctors often far greater times.

The crucial surgeries are almost always done in plenty of time. But the big diagnoses equipment like MRI's you can expect a massive wait. 2-3 months is common...elective surgeries (which doesn't matter) can expect an 8 month wait. Stuff can be really backed up, but chances are pretty good if you need attention badly, you will get it, costing you no more than a penny out of your pocket directly.


Oh, the expense is my mother who gets paid $65,000 a year gets 49% taxes, plus 7% G.S.T. on everything new we buy. We're the only province without P.S.T. which is usually 7 or 8%.. so a total of 15%ish more on new goods. Thats crazy high taxes.

 

[ViRGE]

Scouzer, you probably haven't been in to a hospital lately. Was in the ER 3 months ago, it was a 3 hour wait.

 

[43st]

Managed health in the US is a failer. Everyone wants:

1. access to all doctors.
2. to pay nothing.
3. access to best doctors.
4. to pay nothing.

It's a system that can't survive. In St. Paul health costs have gone up 50% in the past 3 years (from an article I read). It's going to be like that everwhere.

The problem is that people want the best service and they don't want to pay one cent. It's BS.

 

[Garet Jax]

I think I can comment on both systems. I lived in Canada for the first 27 years of my life and have lived in the States for the last 3 1/2 years.

Both systems have problems, both systems have their advantages. The problem with Canada is that the government is in charge of the health care system. This would be the same as having one HMO in the States who controlled the system for the entire country. They would drive costs down and they would force every DR to be part of their system. This means a lot of the really good DRs would leave to find a better place to work. In addition, since DRs are leaving and the costs are bring driven down, the availability of the services would decrease. This unfortunately is something that Canada suffers from. A lot of the services in Canada have a very long waiting list: the only way to get bumped to the front is to be one of the worst cases (ie. closest to death ). In addition, a lot of the good, young, promising DRs are leaving for the States because Canada controls the costs so closely that it is impossible to make the money they can make in the States.

On the positive side though, everyone has basic health care in Canada. This allows people to go and see DRs when they want at no cost to them. They do not have to be employed or pay an exhorbitant amount of money just to get basic health care. In addition, the paper work and complexity is hidden from the end user. It is a pleasant experience for the patient. Also, the DRs are guaranteed they are going to get paid (because it is the government paying) so they can concern themselves with what is important (healing the patient). It is very frustrating for me to go into a DR's office with a broken bone and to have to sit, fill out a whack of paper work, then provide proof of insurance and have to sign a form saying that I will pay my bills if my insurance company chooses not to pay all before I get a chance to see a DR.

 

[ToBeMe]

Originally posted by: Czar
ToBeMe,
About the Doctor thing, here I can go to any doctor I want and pay only $8 for each apointment unless its a speciality doctor then its more (not sure by how much since I never had to go to one).

This system does not apply to dental and I think eyecare also but its not that expensive to go to a dentist, I pay about $40 twice a year for that. And not sure about eyecare because I dont use glasses.
My friend had a few back surgeries few months ago also and he didnt have to pay anything.

I think the system Europe, Canada and other places have is very good in a way and I think that the system the US has is very good in another way.
Just have to find a way to combine the two to make a perfect system

I suppose a good idea for the US then may be to provide basic healthcare for everyone but leave any extra coverage to the person/family. You'd think they could come up with a way to provide that without making a huge mess of it.........but............it is the government so............... I wouldn't mind that I suppose as long as I was still free to see any doctor I choose anyplace I/we happen to be. I could then take out my own policy to supplement my other healthcare needs such as ental, Eyecare, Prescription, Major Medical, etc.. They would simply provide the basic doctor visits and emergency care............LOL! God I'd like to think that they could acheive that without to much hassle or cost and without making a mess of it, but sadly, I'm not so sure..............

I just personally believe I am much better off paying for what I have..............if I want to pay for zero cost and the ability to see any doctor I want.............by god it ought to be my perogative to do so!

 

[rahvin]

Originally posted by: Zedtom
I'm hoping that some of you ATers up in Canada or overseas can comment.

The federal government keeps adding new layers of bureaucracy to our health care system. Many doctors are leaving their profession because of paperwork demands. I have a friend that says the nurses at the facility where she works spend more time filling out records and forms than helping the patients.

I know that in some countries where the health care system is nationalized that the taxes are high, but I'm sure that even with health insurance, medical costs are out of control here.

I don't know if there is any solution except for total reform...any ideas?

The federal government is NOT adding layers of beuraucracy to our health care system. The ONLY government paperwork that has to be filled out is if the person is on medicaid or died or has a gunshot or suspicious injury. All the paper work nurses and doctors fill out is related to PRIVATE insurance.

You wanna know why healthcare in the US is so expensive? Malpractice lawsuits. It's not the paper work, it's not the insurance its not even the people that can't pay. It's the people that sue doctors and get awarded 300 million dollars. If you wanna lower the health care costs in the US you need to call your congressman and tell him you support medical malpractice TORT reform. Only by stopping rampant lawsuits can we lower healthcare costs.

It's all pretty simply really, it just means if you want cheaper healthcare you gotta give up your right to sue doctors for making mistakes.

 

[StageLeft]

Lived in Canada for a long time and been in the US for just over a year. We've got bluecross health coverage through work. Mrs. skoorb had to go to the hospital a few times last august for some weird virus or something (don't really know).

Our experience was that there was a lot more paperwork than in Canada - first thing she did when she went in was do health forms and paper work. In canada you show you're card and you're ready to go - assuming anybody can see you. I think wait times in Canada are probably higher. We went to the out patient "ER" last year in Huntsville, AL. The wait time was a few hours two of the times but one of the times she complained of having trouble breathing and I think she was in in like 10 minutes no problem.

Someone we know in Canada who is in otherwise great health recently was found to have a very very high diastolic <SP> blood pressure recently. He wants to see a specialist - the soonest that he can get an appointment is next January of 2003. that's 5 frigging months for a guy who's blood pressure is in the stroke range. Now if he thought he was going to die I'm sure he could get a bump on things but a D blood pressure of 110 apparently is not something minor.

Also in Canada in some cases people can't get doctors because there are not enough of them so if you have some sort of problem you go to the outpatients and see whomever because you don't have your own doctor.

People say medical coverage in the US is high but then that's because we aren't paying really high taxes to cover health care which people in Canada have to do. Wages are also low in Canada which does to some extent affect the desire of a health professional to stay there.

On the other hand in Canada you won't have what happened in John q which is simply the inability to pay for a major treatment if your health insurance doesn't want to pay it...but then because of wait lists in canada you may be dead before you're treated as well

Personally I can't easily say which one is better. If you have health coverage in the US it's really not that bad - but for those without it you're in a very bad spot and that's probably why typically most would say that Canada has a better health care systerm than the US (like those organizations - maybe the UN or whatever - that rank the countries in order of best to live in).

 

[Linflas]

Originally posted by: rahvin

Originally posted by: Zedtom
I'm hoping that some of you ATers up in Canada or overseas can comment.

The federal government keeps adding new layers of bureaucracy to our health care system. Many doctors are leaving their profession because of paperwork demands. I have a friend that says the nurses at the facility where she works spend more time filling out records and forms than helping the patients.

I know that in some countries where the health care system is nationalized that the taxes are high, but I'm sure that even with health insurance, medical costs are out of control here.

I don't know if there is any solution except for total reform...any ideas?

The federal government is NOT adding layers of beuraucracy to our health care system. The ONLY government paperwork that has to be filled out is if the person is on medicaid or died or has a gunshot or suspicious injury. All the paper work nurses and doctors fill out is related to PRIVATE insurance.

You wanna know why healthcare in the US is so expensive? Malpractice lawsuits. It's not the paper work, it's not the insurance its not even the people that can't pay. It's the people that sue doctors and get awarded 300 million dollars. If you wanna lower the health care costs in the US you need to call your congressman and tell him you support medical malpractice TORT reform. Only by stopping rampant lawsuits can we lower healthcare costs.

It's all pretty simply really, it just means if you want cheaper healthcare you gotta give up your right to sue doctors for making mistakes.

Agreed 100%. I also am not a big fan of HMOs and have alway choosen to go with the PPO option. It costs me a bit more for the premium but I get to go to the doctor of my choosing rather than whoever is next on the list at some HMO.

 

[gotsmack]

don't kid yourself, the american free market medical system is the best, if you can afford it.

 

[dexvx]

US healthcare is the best healthcare that money can buy (if you have lots of it). But for most middle class people, that is out of reach.

The reason the health care costs are up so much is because of malpractice suits that bankrupt hospitals/scare doctors. Doctors also get paid exorbitant amounts (not the surgeons, but the regular doctors, physician) because for some reason you need to go through 10 years of school to become a doctor. Generally in the US, tier1 students become doctors, while tier2 students become engineers. In most of Asia for example, tier1 students become engineers, and tier2 students become doctors. That alone helps drive costs way up.

Another reason is that the US Government decided to cover childbirth as standard (due to some feminists). Since the government mandated childbirth as part of the coverage, the rates seem to have skyrocketted. Is it an exact cause-effect? I dont know. Is it a correlation? Definitely.

 

[BaliBabyDoc]

You wanna know why healthcare in the US is so expensive? Malpractice lawsuits. It's not the paper work, it's not the insurance its not even the people that can't pay. It's the people that sue doctors and get awarded 300 million dollars. If you wanna lower the health care costs in the US you need to call your congressman and tell him you support medical malpractice TORT reform. Only by stopping rampant lawsuits can we lower healthcare costs.

The system is expensive b/c . . .

1) it is a patchwork of modalities that were never conceived as a uniform whole which makes it extremely inefficient

2) price inflation started in earnest when the paradigm of conservativism and market capitalism, Richard M. Nixon signed Medicare into law . . . so grandma and grandpa could get regular health care . . . market forces quickly took hold as hospitals and various other private/for-profit organizations rushed to fill the need.

3) our great medical technology has an insidious secret . . . it's damn expensive. Plain film X-ray $60, Ultrasound $200, CAT scan $600, MRI $2000, and PET scan $4000 . . . and those are low ball prices . . .

4) Medications are eating federal, state, and HMO budgets alive. 15-20% inflation per annum over the past few years as more expensive drugs are used more often. Some truly meet new needs but most are extended release formulations intended to protect BigPharma from patent expirations. Physicians are partly responsible for prescribing new medications when old ones work just as well if not better but drug reps keep the closet stocked with samples of the next best thing so it's difficult not to give patients new medications to start. Then again BigPharma has brainwashed the public into requesting particular drugs from docs.

5) Defensive medicine has been shown to have a minimal effect on the cost of health care; nothing compared to the influence of 1-4. Now malpractice insurance is a different story. Awards have not increased significantly and contrary to folklore only a tiny fraction involve huge judgments. Many companies lowballed premiums to gain market share. They could get away with it when they were making fat money in the stock market (few insurance companies make big money off of premiums). But when the market tanked they were SOL so they started jacking premiums on a captive audience. I know an obstetrician that saw his premiums increase from $20,000 per year in 1996 to $100,000 this year. Companies that couldn't jack premiums fast enough (or not have doctors switch) have gone out business hence reducing competition and allowing the remaining vultures to hike prices even more.

 

[BaliBabyDoc]

Another reason is that the US Government decided to cover childbirth as standard (due to some feminists). Since the government mandated childbirth as part of the coverage, the rates seem to have skyrocketted. Is it an exact cause-effect? I dont know. Is it a correlation? Definitely.

I never thought the day would come . . . I've got to say it . . . you sir are a moron. The government covers childbirth (through Medicaid) and mandates it for private insurers b/c having women go out in the woods to squat, drop, clip, and carry is not good public health. And yes coverage for it and costs are correlated, along with Bush's age, gross movie receipts, and gross vehicle weights but it is not causative. Private insurers are reimbursing about $1500 per child for ALL prenatal care. Every test, ultrasound, and examination for 9 months plus delivery (circumcision is extra). As for the 36 hours moms spend in the hospital afterwards . . . how about YOU try childbirth and see how long you would BEG to stay in the hospital. That time also allows mom to focus on the child and for medical staff to identify and treat postpartum complications.

The current treatment for toenail fungus costs almost as much as 9 months of prenatal care and delivery of a healthy baby. $1500 doesn't cover 1 day in the Neonatal Intensive Care Unit which is too commonly the destination for children who receive no prenatal care.

 

[Linflas]

2) price inflation started in earnest when the paradigm of conservativism and market capitalism, Richard M. Nixon signed Medicare into law . . . so grandma and grandpa could get regular health care . . . market forces quickly took hold as hospitals and various other private/for-profit organizations rushed to fill the need.

This would be the Wage and Price Controls Phase 1 and 2 Richard Nixon? I don't believe free market conservatives ever claimed him as one of their own. Nixon by todays Conservative/Liberal barometer would actually look quite liberal and quite in line with the Rockefeller Republican tradition. Otherwise you make some very good points.

 

[smooth1]

It would be reduce if fast food corporate america care more about their food quality instead of their bottom line.