Is the American health care system a mess?

[CPA]

Originally posted by: smooth1
It would be reduce if fast food corporate america care more about their food quality instead of their bottom line.

 

[CPA]

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

Not a true free market system. Get rid of the third party providers and watch health care costs plummet.

 

[vi edit]

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.

Maybe you've never heard of a little thing called Hippa.

This is costing the medical industry BILLIONS to conform to the requirements. Somebody has to eat that cost.

 

[Zedtom]

Your points are well taken, BaliBabyDoc...I think you got your facts right. I do think I'm misinformed when it comes to government paperwork. The real villain here is the health care providers. Not necessarily the private doctors, but the HMO's, medical centers, and skilled nursing facilities.

It seems that these organizations just can't get enough information gathered. Seeing as how AT is a computer technology website...it makes me wonder if these people are obsessed with databases. They want their staff to fill out endless forms so their middle management drones can sit around all day and crunch numbers to play with "what-if" scenarios.

 

[Zedtom]

OMG! vi_edit...you confirmed my suspicions!

I started this thread out wondering about the state of affairs of this country's health care system. I took all your opinions at face value, but it wasn't until vi_edit suggested that Hippa, (the Clinton administration health care reform known as Health Insurance Portability and Accountability Act); was the problem.

Hippa is going to be front page news next April. I believe the health care system will be in such chaos that the Bush administration will dismantle this program.

Is it a mess?

YES!

 

[Hayabusa Rider]

I was going to use Hippa as an example. Drat you Vi

Hippa regulations are 22 thousand pages. The cost of compliance is estimated to be 30 to 50 billion dollars, which is far more than the Y2K conversions. Yesterday, some changes were made because as it stood, your doctor would have to have gotten written consent EACH time they phoned in a prescription to a pharmacy. Also, if say, you wanted to know how your three year old was doing after surgery, the MD's would have been forbidden to tell you, or release ANY medical information about your children too you.

 

[brtspears2]

American system works for only those who can afford it and have access to it.
Centrally controled systems work for everyone, but at what cost, at what cost?

It would be great if I needed heart surgery if I was in Canada, but I'd hate to die waiting. Competition keeps doctors on their toes, its a good thing.

I still believe that even in centrally controlled systems, those with money will still always get the best coverage. Doctors can run their own private practices and treat those patients and clients better.

 

[Hayabusa Rider]

Originally posted by: brtspears2
American system works for only those who can afford it and have access to it. Centrally controled systems work for everyone, but at what cost, at what cost? It would be great if I needed heart surgery if I was in Canada, but I'd hate to die waiting. Competition keeps doctors on their toes, its a good thing. I still believe that even in centrally controlled systems, those with money will still always get the best coverage. Doctors can run their own private practices and treat those patients and clients better.

Actually, the ones with the best prescription coverage are those on medicaid. Everything here in MA is 50 cents, and even then payment is optional

 

[Pliablemoose]

American heath care is fvcked, my current rant @ the hospital I work @ is that our ER doesn't have a person in dietary assigned to bring trays down to our hold-over ER patients... so the hospital ends up paying me $30/hr to go push a cart full of food trays that should be done by a $6/hr employee.

My time should be spent taking care of patients, not pushing freaking carts full of food.

I work for a federal hospital system, you-all are going to get a real mess if you ask the government to take over managing health care

 

[Hayabusa Rider]

Originally posted by: Pliablemoose
American heath care is fvcked, my current rant @ the hospital I work @ is that our ER doesn't have a person in dietary assigned to bring trays down to our hold-over ER patients... so the hospital ends up paying me $30/hr to go push a cart full of food trays that should be done by a $6/hr employee. My time should be spent taking care of patients, not pushing freaking carts full of food. I work for a federal hospital system, you-all are going to get a real mess if you ask the government to take over managing health care

Naaa..
Not right. After all look how wonderfully airport security works now that employees are federalized

 

[tcsenter]

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

Sure, plenty of them, none that are very popular.

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.

"A reason", yes, but you're talking about an unsubstantial reason. It adds a couple pennies per dollar, this is hardly cause to nationalize a health system.

There is only one substantial reason that health care costs are rising:

- It is the ONLY product or service to which everyone has unlimited "rights" to access. This "right" is merely a feat of altruistic logic, it is not a constitutional right, nor is it in the vast majority of states a statutory one. A hospital could deny you life-saving care because you were unable to pay for it, and in most states, legally no crime would be committed, nor would they have violated your "right", so long as they didn't violate your civil rights by denying care because you were black, Catholic, a woman, etc.

However, the hospital would face a civil lawsuit, and the chances of losing that civil lawsuit are overwhelming. The award would in all likelihood surpass the costs of treating the person to begin with many times over. The consequences of this 'imaginary right' to unlimited health care are obvious and inevitable.

Let us suppose there was similarly an "imaginary right" for me to have as many automobiles as I want on demand, and automobile dealers HAD to give me the car whether or not I could pay for it. Technically, I would still be liable for the cost of the vehicle, but I could drive the car off the lot without paying for it. The dealer HAD to let me take possession of the vehicle, he couldn't demand payment as a condition to receive the vehicle.

Further, let us suppose he couldn't repossess the vehicle if I didn't pay. No matter what, that car is mine and nobody can take it away.

Guess how many cars I would have? Oh, I'm guessing, about 500 by now, and I wouldn't have paid a penny for them. The bill collectors can just kiss my ass, I've got better things to spend my money on, like MTV, Burger King, going to the movies, cellular phones, keeping my self in the latest 'fashions', and abusing my cars so I can get another.

But wait, there's more!

Let us further suppose that my "imaginary right" extends beyond used cars. In fact, my "imaginary right" actually forbids car dealers to provide me with older, used cars, that aren't every bit as good or 'desirable' as new cars. Of course, nobody wants old cars, they want new cars that feature the latest technology - very expensive technology.

But wait, there's more!

Let us still further suppose that I went to the dealer for a car and he 'sells' me a Chevy. I drive it home and notice that my neighbor has been provided with a Mercedes by the same dealer. I stroll over and ask "How come you got a Mercedes and I got a Chevy?" My neighbor responds, "I don't know, maybe because I had the money for a Mercedes up front?"

Now I can sue my dealer for failing to provide me with the latest and greatest automobile that he is providing to others, merely because they can pay for them up front and I cannot. I could go on, but you get the idea.

It does not take an economist to see that the natural and logical consequence of everyone having such an imaginary right would be the ultimate collapse of the automobile industry. There wouldn't be a car manufacturer or dealer in existance very long, unless...

Unless the government subsidized the losses suffered by the automobile industry, compensating it for what it lost to those who either "couldn't" pay for their cars, but more likely just decided not to because nobody can force them to. However, the government doesn't cover all of the costs, the subsidy is only intended to reduce the burden on auto manufacturers and dealers, not to eliminate it.

On a $100,000 Mercedes, the government will only reimburse $60,000. The automotive industry must still 'absorb' $40,000 of this loss, which means shifting it to other "paying" customers. After 20 years under such a system, that $100,000 Mercedes will now cost $300,000, much of the increase attributed to this cost-shifting.

What is the cure? There is no cure! If you continue to enforce an "imaginary right" to automobiles or health care in this manner, the result is the same - collapse of the system - only by subsidizing it, you've postponed this inevitable result.

The difference is one of death by gun or smoking, although one takes 50 years longer, the end result is identical, except dying from lung cancer will prove to be the more painful fate.

For those who live in countries that are ALREADY subsidizing their national health care with 50+ percent income tax rates, things may look superior by comparison. Wait until that 50% income tax rate becomes 65%, then becomes 75%, then 85%, and if you believe that won't happen, you're a fool.

 

[eplebnista]

Is the American health care system a mess?

Yes.

 

[sandorski]

tscenter said:

For those who live in countries that are ALREADY subsidizing their national health care with 50+ percent income tax rates, things may look superior by comparison. Wait until that 50% income tax rate becomes 65%, then becomes 75%, then 85%, and if you believe that won't happen, you're a fool.




You've made a few incorrect assumptions here:

1) Canadian's don't pay 50% taxes for healthcare. Canadian's pay hightaxes for a number of reasons which includes Healthcare

2) Taxes are going down, not up

 

[Freejack2]

Let me put it to you this way about the American health care system...
What health care system?

 

[tcsenter]

You've made a few incorrect assumptions here:

1) Canadian's don't pay 50% taxes for healthcare. Canadian's pay hightaxes for a number of reasons which includes Healthcare

Actually you've made the incorrect assumption, where did I mention the word "Canada"?

Sure, some of your taxes go to other things...I never implied 100% of Canada's budget is for health care.

2) Taxes are going down, not up

Short term trend, not long term. Actually, the better term would be 'short term political expediency'.

Canada can only reduce its tax burden to the extent that it rations or places more restrictive controls on its national health care system, causing thousands of doctors and nurses to bail across the border, as well as an increasing number of patients.

Regardless of short term trends, a system like the one I described, which, though it was a far-fetched analogy, does capture the essence of the problem with an imaginary 'right' to health care exceedingly well, a system like that cannot result in any other outcome, unless you continually ration and decrease services.

There isn't much difference between the Canadian and US systems, in that nobody is denied necessary medical care in either country. If you cannot afford it, tax-payers pick up the bill, ultimately. It matters not whether the reimbursement structure is back-ended or front-ended, tax payers are still picking up the bill.

Many studies have credibly argued that US tax payers are getting more bang for their buck because our climate of competition is more robust and the system is not a centralized bureaucracy, but even so, this cannot avoid the logical and inevitable consequences of a system where unlimited demand for a product or service is coupled with unlimited access.

Unlimited demand for a product or service cannot be compatible with unlimited access unless an extremely high percentage of the people incurring costs not only have the ability to pay, but are paying, their own bills, and fewer people will inevitably have the ability to pay their own bills when cost-shifting causes prices to increase at a rate which far out-paces inflation and wages, by an order of magnitude.

This isn't a foreign or difficult concept, we've seen the same fundamental problem play out numerous times on a different stage: the failure of the welfare state.

When too many people are suckling from the public money tit, or too many people are taking far more than they are contributing, the tit runs dry! Woah, this isn't quantum physics here!

Many states were going broke trying to maintain and build a voter base for Democrats by cutting government checks to anyone and everyone who had some sad story. Because there will always be unlimited demand for free money without condition, access had to be substantially restricted because people were shamelessly bleeding the system dry.

This problem is only going to get worse, far worse, until we eliminate this 'imaginary' right to unrestricted access to very expensive products and services that are only going to get more expensive as technology enables us to diagnose and treat more illnesses. In case you haven't noticed, there are very few 'freebies' in the way of medical advancements anymore. Nobody is discovering a revolutionary new treatment for disease by accidentally spilling mold in a petrie dish.

New advancements will come with a hefty R&D price tag. If everyone has an imaginary right to access the most expensive medical care available, yet not all of them can pay for it, increasingly more tax dollars will be needed to compensate providers for care they give but are uncompensated for...until every last dollar of tax revenue is being eaten up in health care expenditures. It is inevitable.

No discussion about rising heath care costs can possibly lead to any productive solutions other than palliative measures which are in effect a band-aid that masque the symptoms of a greater underlying problem, unless that discussion addresses the REAL problem.

 

[CPA]

Originally posted by: Pliablemoose
American heath care is fvcked, my current rant @ the hospital I work @ is that our ER doesn't have a person in dietary assigned to bring trays down to our hold-over ER patients... so the hospital ends up paying me $30/hr to go push a cart full of food trays that should be done by a $6/hr employee.

My time should be spent taking care of patients, not pushing freaking carts full of food.

I work for a federal hospital system, you-all are going to get a real mess if you ask the government to take over managing health care

Straight from the Moose's mouth.

I dare anyone to find one federal program that is not a mess.

 

[sandorski]

tscenter: I mentioned Canada for 2 reasons: 1) you likely would incliude it in your group of single payer/government run medical system list, so it seemed appropriate; 2) I am Canadian, so I have some knowledge of the Canadian system

As for your contention that tax breaks(in Canada)are just a short term trend, I'll be as bold to make this claim: Canada's tax cutting will outlast the tax cutting of the US. Canada continues to run budgetary surpluses, and it still has the highest GDP growth in the industrialized world. Remember Bush Sr.'s, "No new taxes!"? Be prepared for the premature end of tax cuts by Bush Jr.

 

[laFiera]

i just want to know why prisoners in the usa get free medical care...
i work in the health professions myself, and have dealt with immates that swallow metals, glass etc just to get a trip to the hospital;
what i love the most is when they demand their pain killers and then yell at you for being treated like shit!
gotta love it!
oh, and the best one...
45 year old male in austin, tx was drunk and ran into another vehicle killing the driver of that vehicle; the intoxicated driver tested positive for amphetamines and had twice the legal amount of alcohol in his blood; cops didnt arrest him yet cause they dont want to take him as an immate and pay the bill; so the man now is demanding rehab knowing that will keep him free indefinetely...
in the meantime, he gets demerol 50 mg iv/im q 3-4 hr for the neck pain he suffered from his unfortunate accident...
gotta love the system!!!!

 

[charrison]

Originally posted by: sandorski
tscenter: I mentioned Canada for 2 reasons: 1) you likely would incliude it in your group of single payer/government run medical system list, so it seemed appropriate; 2) I am Canadian, so I have some knowledge of the Canadian system

As for your contention that tax breaks(in Canada)are just a short term trend, I'll be as bold to make this claim: Canada's tax cutting will outlast the tax cutting of the US. Canada continues to run budgetary surpluses, and it still has the highest GDP growth in the industrialized world. Remember Bush Sr.'s, "No new taxes!"? Be prepared for the premature end of tax cuts by Bush Jr.

Canada has significantly highers income and sales tax. If your govt is running a surplus you are overtaxed.

Do not assume the sins of the father will be the sins of the son.

I would also assume Canadian GDP growth mirrors what is happening in the US.

 

[BaliBabyDoc]

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.

I know . . . the GOP glory days before the party was hijacked by the zealots.

A note on HIPAA . . . Clinton certainly signed it but that document came from a Republican House, Republican Senate, and subsequent Republican-dominated conference. They deserve credit as well. Furthermore, the Bush admin 'revisions' go too far when it comes to patient records. The HIPAA requirements definitely need to be properly tuned but the current proposal is just short of putting your medical records on the Web.

Part of HIPAA that might go down for the count if the admin gets its way . . .
1. Standardization of electronic patient health, administrative and financial data
2. Unique health identifiers for individuals, employers, health plans and health care providers
3. Security standards protecting the confidentiality and integrity of "individually identifiable health information," past, present or future.

The problem is good ideas become bad law (b/c most legislators do not have any expertise and their advisors always have an angle) and even worse policy (few people outside of government agencies have the ability to take bad laws and make them look worse than intended.

 

[BL0RT]

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.

holy crap it's time to go back to the motherland where i'll be considered tier one. suckas!

 

[shifrbv]

I think the biggest problem we have is government involvement with healthcare in the US. Since they entered the scene with Medicare/Medicaid things have been going downhill. Free market approaches would be best.

For one, take the phenomenal labor costs in the healthcare industry. We always hear about shortages of skilled professionals in these areas which allow those in the profession to command top dollar. Why is this? Because the government controls which institutions can grant degrees and how many students can be enrolled. If there were free market approaches in place, I would open my own school up tomorrow to train as many doctors and nurses as possible. I would bring them up from Mexico by the busloads to work here and provide affordable care to the 40 million without insurance. I'm sure there are alot of them that would love to make $15 an hour to provide basic care. I'm sure alot of unemployed would like to get an affordable education and another career option. But I can't do that because the state says who can do what and where. There is only one school in my state that has a state approved program for pharmacy and there is a 6 year wait to get in the program. That is just not right.

Government is in every facet of the healthcare system driving up costs at every angle. Take another example, hospitals are required to have certain very expensive drugs on hand whether they need them or not. It's federally mandated. So they have storerooms filled with expensive medications that they somehow have to find a way to pay for.

Whenever government gets involved, there's always a bottleneck in the system and inefficiencies abound. What's worse, is that now comapanies are starting to realize that they can't provide the benefits that they once could. Costs keep rising and employees are being forced to pay more and more. When this breaks down, which it will as it's only a matter of time, there are going to be alot of unhappy people. Unfortunatley, the way the system is rigged, we'll see more government involvement instead of less. People will demand government subsidies (via some new plan) instead of looking to themselves for the answers. Oh well, I guess people get the government they deserve.

 

[tcsenter]

As for your contention that tax breaks(in Canada)are just a short term trend, I'll be as bold to make this claim: Canada's tax cutting will outlast the tax cutting of the US. Canada continues to run budgetary surpluses, and it still has the highest GDP growth in the industrialized world. Remember Bush Sr.'s, "No new taxes!"? Be prepared for the premature end of tax cuts by Bush Jr.

That is a rather dishonest statement, considering that Canada's relationship with the US is such that every dollar the US spends means a nickel that Canada doesn't have to. The US takes all the risks in foreign affairs, international trade, defense, among other things, and Canada benefits directly by playing the neighborhood suck-up ala Eddie Haskell, not to speak of the billions of dollars Canada is able to save because US consumers subsidize Canada's federal purchasing contracts with drug manufacturers.

Canada is able to negotiate such great deals on drugs over there because manufacturer's are able make up the difference over here. This is pretty much true of most R&D intensive markets which the US outspends Canada on by an order of magnitude.

And need I mention Sept. 11? I realize Canada sent a couple rescue dogs, and we really appreciate it, but that is far from the billions Canada would surely have received from the US had the shoe been on the other foot!

Again, Canada can only reduce its tax burden to the extent that it rations or places more restrictive controls on its national health care system, causing thousands of doctors and nurses to bail across the border, as well as an increasing number of patients.

 

[sandorski]

The closest enemy Canada has had was Spain 6 or so years ago during the "Turbot War". Canadians don't feel threatened, so defense spending isn't a top priority. No the US doesn't subsidize us by defending us, in fact, our association with the US puts us at more risk.

We did more than you seem aware of after 9/11, perhaps you should do some research on it. I also highly doubt that the US would have given us $billions if it had happened to us, in fact the US probably wouldn't even have agreed to join us in a War on Terrorism.

 

[tcsenter]

No the US doesn't subsidize us by defending us, in fact, our association with the US puts us at more risk.

Where did you get your country's premier fighter aircraft, the F-18 Hornet? Or your C-130 Hercules? Your CH-146 Griffon? Or past RCAF aircraft such as the P-51 Mustang? The Aegis and Phalanx weapons systems which your Navy relies on?

You think you paid part of the development costs on these babies or just the "copy" price? You don't fear anyone because you don't need to, we take all the risks, and you benefit. Its ok, though, we don't mind. A little appreciation would be nice.