Republicans pushing to privatize Medicare and cut outlays again

[nonlnear]

I'm curious if you could detail for me the causation link between government paying for healthcare and a lack of specialists available to meet demand?

I didn't ever advance such a thesis. It is perfectly possible to construct a single payer system without the same supply problems as my parents face (and let's be honest, the US has some serious supply problems too, just not ones that I face living in a decent sized metropolitan area with good benefits). I was simply posting to counter the claim that the USA only has the best healthcare in the world for the super rich. I would say a pretty decent proportion of Americans have excellent health care. That is, far more than just the "super rich", but not a huge majority of the population. We also have a much larger proportion of the population that receive far worse care than they would in Canada.

The flipside of the coin to what I posted previously is this: when I came to the USA I had to learn to become desensitized to how depressingly unhealthy the poor people look here. Seeing so many missing teeth when going to Wal-Mart was otherworldly - like visiting a third world country.

 

[blankslate]

I was simply posting to counter the claim that the USA only has the best healthcare in the world for the super rich. I would say a pretty decent proportion of Americans have excellent health care.

While this is a good counter point... it's important to know that amongst all of the developed first world nations: America is really the only country where a rather significant portion of the population go without healthcare or may go broke trying to pay for it.

 

[ElFenix]

medical care

 

[werepossum]

I'm curious if you could detail for me the causation link between government paying for healthcare and a lack of specialists available to meet demand?

That's fairly easy. Our current health care system rations care in part by ability to pay. A single payer government system must ration care by availability. Therefore in our system someone with the ability to pay (whether from his own resources or through health insurance) enjoys a higher level of care than he would under a single payer system, all else (such as overall societal health care spending) being equal. One big way government health care cuts costs is by restricting access to expensive specialists and very expensive equipment, especially since much of this is defensive medicine. The vast majority of sprained ankles don't need an MRI, but doctors may order them to avoid being sued by the tiny minority who DO need them due to a complication not detectable without the MRI.

One can accept this lower standard of care as an acceptable price for universal coverage, or one can propose spending at higher levels to provide the standard level of care, or one can assume that the blinding efficiency of government will provide the standard level of care to more people. (Good luck getting THAT dog to hunt.)

One practical argument for government health care is that the harm to the people who get the reduced level of health care available under single payer is much less than the harm to the people who get the reduced level of health care available under our current system due to lack of resources. That's probably true. Take my own case when I had thyroid cancer; the treatment after surgical removal is to starve your body of iodine, then give you a pill of radioactive iodine which is taken up by any remaining thyroid cells, killing them. In America, this calls for a week or so in radiation isolation - VERY expensive. In Canada, they can't afford to pay for a week in radiation isolation, so they give you the same radioactive iodine pill and send you home with the instructions to avoid sex, avoid physical contact, don't share a bed, linens or eating utensils, and don't be in the same room as children or pregnant women. I'd imagine the incidence of cancer, birth defects, or other radiation-based problems from that course of action is vanishingly small and considered a good trade-off, but it isn't considered an acceptable risk in our more pampered and much more litigious society.

 

[nobodyknows]

I didn't ever advance such a thesis. It is perfectly possible to construct a single payer system without the same supply problems as my parents face (and let's be honest, the US has some serious supply problems too, just not ones that I face living in a decent sized metropolitan area with good benefits). I was simply posting to counter the claim that the USA only has the best healthcare in the world for the super rich. I would say a pretty decent proportion of Americans have excellent health care. That is, far more than just the "super rich", but not a huge majority of the population. We also have a much larger proportion of the population that receive far worse care than they would in Canada.

The flipside of the coin to what I posted previously is this: when I came to the USA I had to learn to become desensitized to how depressingly unhealthy the poor people look here. Seeing so many missing teeth when going to Wal-Mart was otherworldly - like visiting a third world country.

First, I never said "super rich", I said the rich and privileged. I guess when you get sick and they fire you and you eventuzlly lose your health insurance you can always go back to Canada. Most of us here don't have that option.

 

[nonlnear]

First, I never said "super rich", I said the rich and privileged. I guess when you get sick and they fire you and you eventuzlly lose your health insurance you can always go back to Canada. Most of us here don't have that option.

I'm naturalized. You would have to pay me quite a lot to go back. Also I have lost my job before, for more than a few weeks. COBRA was pricey but well worth it.

 

[nobodyknows]

I'm naturalized. You would have to pay me quite a lot to go back. Also I have lost my job before, for more than a few weeks. COBRA was pricey but well worth it.

Try being unemployed and uninsurable, or your cobra runs out. Or even self employed and being dropped by your insurance company because of an illness and being unable to get insurance at any price. I've seen examples of both.

It's my opinion that if we can't take care of the basic health needs of everyone we can't be considered a civilized society.

 

[nonlnear]

Try being unemployed and uninsurable, or your cobra runs out. Or even self employed and being dropped by your insurance company because of an illness and being unable to get insurance at any price. I've seen examples of both.

I don't believe I ever said this system is great. It's very very broken in a lot of different ways. However, for those who have the means to pay for it (either through an employer or from their own pocket), the US has excellent medical services.

It's my opinion that if we can't take care of the basic health needs of everyone we can't be considered a civilized society.

I also agree with you about the bottom being a very harsh landing in the US. This is a very big problem, and one that is a real black eye to American dignity - whether some want to admit it or not. I would like to see medicare made available to all, but scaled back to only cover drugs whose patents have expired, and a few other niceties trimmed out.

 

[nobodyknows]

I also agree with you about the bottom being a very harsh landing in the US. This is a very big problem, and one that is a real black eye to American dignity - whether some want to admit it or not. I would like to see medicare made available to all, but scaled back to only cover drugs whose patents have expired, and a few other niceties trimmed out.

In other words, you favor death panels?

We had a cliché back in the 60's/70's to describe your view. You feel for us but you can't quite reach us.

 

[nonlnear]

in other words, you favor death panels?

lolwut?

 

[nobodyknows]

lolwut?

You favor cutting out drugs that aren't generic. That means many people would not be able to afford their life saving drugs.

Damn, I don't believe I had to point out my meaning to you.

 

[nonlnear]

You favor cutting out drugs that aren't generic. That means many people would not be able to afford their life saving drugs.

That's not strictly true. Not all drugs have generics that hit the market upon expiry of their patents. Anyways, patents don't last all that long. You know what people did 15 years ago without the drugs currently under patent? They didn't do all that badly.

There are always going to be new treatments out that not everybody can get. I happen to favor a system where the best that medicine had to offer 15 years ago is available for free to all and if you want more than that you can go purchase it yourself. 15 year old medicine isn't really all that bad.

Damn, I don't believe I had to point out my meaning to you.

Your meaning was cloaked in rather acerbic hyperbole. Forgive me if I don't jump to the most charitable meaning. What does that have to do with "death panels"anyways? Every system rations in some manner or another. I happen to believe that the basic standard of universal care should be basic, but freely available to everybody.

 

[nobodyknows]

That's not strictly true. Not all drugs have generics that hit the market upon expiry of their patents. Anyways, patents don't last all that long. You know what people did 15 years ago without the drugs currently under patent? They didn't do all that badly.

There are always going to be new treatments out that not everybody can get. I happen to favor a system where the best that medicine had to offer 15 years ago is available for free to all and if you want more than that you can go purchase it yourself. 15 year old medicine isn't really all that bad.

What's the point of having a society if the scientific discovers made are only available to the work force and not the retired/disabled? 15 year old drugs may not be that bad, unless you have cancer or some other ailment that has only recently had beakthroughs in medical science to cure or xlow up said ailments.

Your meaning was cloaked in rather acerbic hyperbole. Forgive me if I don't jump to the most charitable meaning. What does that have to do with "death panels"anyways? Every system rations in some manner or another. I happen to believe that the basic standard of universal care should be basic, but freely available to everybody.

It's obvious to me that you would support death panels as long as you thought it would benifit you. that's why you feel guilty and don't discuss medical issues with your parents/family back in Canada.

 

[nonlnear]

What's the point of having a society if the scientific discovers made are only available to the work force and not the retired/disabled?

There are always new and expensive treatments that are unavailable to a lot of people - even people with good insurance. That's life. Every standard of care carries with it, well, a standard. Pretending that we can make everything available to everyone is hardly the basis for a sensible medical system. It's not even a basis for a conversation with a person beyond elementary school.

15 year old drugs may not be that bad, unless you have cancer or some other ailment that has only recently had beakthroughs in medical science to cure or xlow up said ailments.

There is always a cohort of patients who just miss the next breakthrough. I understand that. I am actually okay with an expedited channel for some patented drugs to be covered, but only for otherwise terminal or permanently debilitating cases. For more mundane things, not so much. Buy some additional coverage.

It's obvious to me that you would support death panels as long as you thought it would benifit you. that's why you feel guilty and don't discuss medical issues with your parents/family back in Canada.

Thank you for that internet therapy session. Your insights have improved my life. I feel better now. P.S. I don't feel guilty. Not about anything at all. The self-consciousness comes from making explicit the awareness of our very different situations. At times in my life when my situation was markedly worse than other family members, I would hesitate to get into the details for the very same reason. It detracted from the ease of the moment to accentuate differences rather than just being together.

And what's up with you saying death panels all the time? It really doesn't play well at all.

 

[ericlp]

My only problem with medicare/medicade is that if your a millionaire your still qualified to get it if you reach that magic number in age.

 

[mcmilljb]

I am pretty far from rich even by Democrat standards but I have a job with decent benefits. I have a MUCH higher level of health care than my family in Canada. They have to wait often for months to see specialists, and any remotely unusual procedure seems to take forever to actually get done. It's gotten to the point where I don't tell my parents about medical stuff because the contrast in our levels of service makes me feel self-conscious.

People in America wait for specialists and uncommon procedures too! That's a ridiculous argument to make. Try getting into a specialist's office without a referral LOL. That increases the wait time. They try to put off the least profitable patients because they want to keep the most profitable coming in sooner. Unless you're an urgent patient, you're last in line and can keep getting pushed back.

 

[mcmilljb]

My only problem with medicare/medicade is that if your a millionaire your still qualified to get it if you reach that magic number in age.

You need to remove medicaid from that statement because it's inaccurate.

http://en.wikipedia.org/wiki/Medicaid

I have no problem with a millionaire getting medicare though. He should pay a higher premiums, deductibles, and coinsurance though. This is called means testing.

 

[nonlnear]

People in America wait for specialists and uncommon procedures too! That's a ridiculous argument to make. Try getting into a specialist's office without a referral LOL. That increases the wait time. They try to put off the least profitable patients because they want to keep the most profitable coming in sooner. Unless you're an urgent patient, you're last in line and can keep getting pushed back.

I don't get pushed back, and I don't have trouble getting in to see a specialist, even without a referral.

And when I say wait times I don't just mean that when you call to schedule it might be a month or two off. I mean it'll be that far off, but when their appointment comes they often get bumped. That's far worse - especially when you are trying to coordinate care between specialists. Here, even if I can't get in in a week or two, I never get bumped when I have an appointment. Up there my parents can have an appointment bumped two or three times (at an additional 3-8 weeks a pop) because the schedule had to be shuffled due to patient prioritizing. And don't get me started on how long it can take to have a (yes, medically required) operation. It took over a year to get a thyroid tumor removed because it happened not to be cancerous. It was still wreaking all kinds of metabolic havoc though, and it's not like the symptoms were being effectively managed in the interim.

My parents' wealthier acquaintances regularly come to the US for medical procedures. Even ones that are covered in Canada because sometimes the waits are completely unbearable.

 

[mcmilljb]

I don't get pushed back, and I don't have trouble getting in to see a specialist, even without a referral.

And when I say wait times I don't just mean that when you call to schedule it might be a month or two off. I mean it'll be that far off, but when their appointment comes they often get bumped. That's far worse - especially when you are trying to coordinate care between specialists. Here, even if I can't get in in a week or two, I never get bumped when I have an appointment. Up there my parents can have an appointment bumped two or three times (at an additional 3-8 weeks a pop) because the schedule had to be shuffled due to patient prioritizing. And don't get me started on how long it can take to have a (yes, medically required) operation. It took over a year to get a thyroid tumor removed because it happened not to be cancerous. It was still wreaking all kinds of metabolic havoc though, and it's not like the symptoms were being effectively managed in the interim.

My parents' wealthier acquaintances regularly come to the US for medical procedures. Even ones that are covered in Canada because sometimes the waits are completely unbearable.

What specialist have you seen without a referral? You might be able to see a dermatogolist or podiatrist without a referral, but you're not going to someone like a neurologist or orthopedist without one. Specialists do not like seeing one without information coming directly from a doctor.

Getting bumped is not uncommon although generally it happens more often if you don't speak up when setting the appointment. I hear about getting month or longer here. Shit it used to happen at my rheumatologist. If you're near or can afford better practices, you're less likely to avoid delays and getting bumped.

I can't help Canadians have longer wait times. Probably because their doctors like coming down here to work since they can make more money off our system. I'm glad patients can afford to come down. Yay for border states? It still doesn't change that fact that Americans have to wait too, and we'll probably see more wait times. Our wait times will be because people won't be able to afford it until they have to go to the ER.

 

[J-Money]

I am pretty far from rich even by Democrat standards but I have a job with decent benefits. I have a MUCH higher level of health care than my family in Canada. They have to wait often for months to see specialists, and any remotely unusual procedure seems to take forever to actually get done. It's gotten to the point where I don't tell my parents about medical stuff because the contrast in our levels of service makes me feel self-conscious.

Your parents must live in some shitty part of Canada.

I currently live in Canada and my parents, both of which have been to specialists very recently for different things, have not waited months at all. Maybe a couple weeks if it's not an emergency. My step-mother has seen about 8 specialists in the last year about her back issue. You make it sound like you could maybe get one appointment per year.

I have some moles on my back I had to checked for skin cancer, I went to my doctor, got the referal, went next door to the skin specialist and she took a biopsy that day.

My Dad had surgery to remove potential skin cancer from his nose, where they cut out the portion then stretched cheek skin over it, and it also didn't take forever to get done. Again MAYBE a month from when it was figured it should be done, and that was more for when it was convenient for my Dad since it wasn't an emergency.

It always seems to be that the justification for Americans healthcare is that Canada's takes months or years for stuff through anecdotal evidence when actual Canadians wouldn't trade there healthcare for the US one in a lifetime. It's always "this guy I know", "my friends over there", "I know people in Canada".

Not to mention if you are willing to pay here for faster care, you can do that too. In Canada you get the choice at least and regardless everyone is taken care of.

 

[nonlnear]

Your parents must live in some shitty part of Canada.

It's one of the nicer areas (interior of BC), but it doesn't have the best medical services. Land values are kept high by vacationers and the local economy is fairly depressed.

Not to mention if you are willing to pay here for faster care, you can do that too. In Canada you get the choice at least and regardless everyone is taken care of.

For its size, the medical services available to the wealthy in Canada are pretty good.There si still a lot more choice in the US, and the best here is generally better than the best up there. Also it's easier (at least in my career path) to become wealthy enough to afford good care here in the US than in Canada. My disinclination to go back to Canada isn't primarily driven by health care differences. I readily acknowledge that the poor in Canada have it MUCH better than the poor here, and that is a plus for the fabric of society. My disinclination to go back is due to the relative lack of economic diversity.

 

[nobodyknows]

There are always new and expensive treatments that are unavailable to a lot of people - even people with good insurance. That's life. Every standard of care carries with it, well, a standard. Pretending that we can make everything available to everyone is hardly the basis for a sensible medical system. It's not even a basis for a conversation with a person beyond elementary school.
There is always a cohort of patients who just miss the next breakthrough. I understand that. I am actually okay with an expedited channel for some patented drugs to be covered, but only for otherwise terminal or permanently debilitating cases. For more mundane things, not so much. Buy some additional coverage.

Thank you for that internet therapy session. Your insights have improved my life. I feel better now. P.S. I don't feel guilty. Not about anything at all. The self-consciousness comes from making explicit the awareness of our very different situations. At times in my life when my situation was markedly worse than other family members, I would hesitate to get into the details for the very same reason. It detracted from the ease of the moment to accentuate differences rather than just being together.

And what's up with you saying death panels all the time? It really doesn't play well at all.

Your just full of rationalization of your beliefs and aren't worth my "elementary scholl education" time to nitpick with.

You pulled this stupid idea out of your ass of only having generic drugs available for people on medicare and now can't defend it so take your double talk and shove it up where your ideas come from.

 

[blackangst1]

Is this going to be a winning strategy during an election year? Brb after forwarding this to my hardline Republican parents who LOVE their Medicare...LMFAO.

http://nbcpolitics.msnbc.msn.com/_n...-move-republicans-offer-medicare-alternatives

Did you tell them this was originally an idea out the Dem's camp? Hopefully they read the entire article:

Paul thanked Sen. John Kerry, D-Mass., for letting the group “borrow” the idea. Paul said the plan was part of Kerry’s campaign platform in 2004.

Also, Im sure youre in favor of Obamacare? If so you should love this proposal. Its Obamacare for medicare.

enrollment of seniors in the Federal Employees Health Benefits Plan (FEHBP) which offers an array of privately-run health insurance plans.

 

[ky54]

Ky probably thinks he can stroll into any hospital and obtain "the highest level of health care in the world" at any time.

Or maybe you could answer my question - show me how single payer health care will reduce the overall cost of health care?

 

[Ausm]

Did you tell them this was originally an idea out the Dem's camp? Hopefully they read the entire article:



.

Not any camp that I am privy to or would back.