Universal Healthcare in the USA

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fskimospy

Elite Member
Mar 10, 2006
88,236
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i edited at the same time you posted...

i do see your point with antibiotics and drug interactions, yes we do need prescriptions when it comes to those things, but shouldn't that be the pharmacist's job?

Pharmacists don't diagnose diseases, they specialize in understanding drug interactions and things like that. They wouldn't be qualified to determine if a patient needed a particular drug or not.

By the way I think all narcotics should be legal, but regulated.
 

glenn1

Lifer
Sep 6, 2000
25,383
1,013
126
Pharmacists don't diagnose diseases, they specialize in understanding drug interactions and things like that. They wouldn't be qualified to determine if a patient needed a particular drug or not.

By the way I think all narcotics should be legal, but regulated.

Yes, but many common medications can and should be prescribed by nurse practioners or possibly even lower trained medical professionals. Hell, for medicines which are topical or should really be available OTC a LPN would probably suffice. It's complete overkill that you need an MD to prescribe simple meds like birth control pills and bacitracin. Heck, just allowing that and the feds helping subsidize the setup of clinics staffed with LPNs could probably handle 80% or more of the typical medical needs for the uninsured.
 

Newell Steamer

Diamond Member
Jan 27, 2014
6,894
8
0
Pharmacists don't diagnose diseases, they specialize in understanding drug interactions and things like that. They wouldn't be qualified to determine if a patient needed a particular drug or not.

By the way I think all narcotics should be legal, but regulated.

In Greece, which has social medicine, you can walk into a Pharmacy, tell the person behind the counter what is wrong with you, and they will sell you what they think will cure it.

You can buy antibiotics without an Rx script.
 

xBiffx

Diamond Member
Aug 22, 2011
8,232
2
0
Yes, but many common medications can and should be prescribed by nurse practioners or possibly even lower trained medical professionals. Hell, for medicines which are topical or should really be available OTC a LPN would probably suffice. It's complete overkill that you need an MD to prescribe simple meds like birth control pills and bacitracin. Heck, just allowing that and the feds helping subsidize the setup of clinics staffed with LPNs could probably handle 80% or more of the typical medical needs for the uninsured.

My GF who is a nurse seems to know more about what's going on with her patients than the MD does most of the time. When she talks about work, it sounds more and more like the MD is just a pen in a lab coat waiting on the next tee time.
 

fskimospy

Elite Member
Mar 10, 2006
88,236
55,791
136
Yes, but many common medications can and should be prescribed by nurse practioners or possibly even lower trained medical professionals. Hell, for medicines which are topical or should really be available OTC a LPN would probably suffice. It's complete overkill that you need an MD to prescribe simple meds like birth control pills and bacitracin. Heck, just allowing that and the feds helping subsidize the setup of clinics staffed with LPNs could probably handle 80% or more of the typical medical needs for the uninsured.

Nurse practitioners can and do prescribe lots of different medications, including birth control. (I'm not familiar with bacitracin)
 

zanejohnson

Diamond Member
Nov 29, 2002
7,054
17
81
just adding for relevance: Nurse practictioners can prescribe anything schedule 3 and above in most states i believe
 
Feb 4, 2009
35,862
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Nurse practitioners can and do prescribe lots of different medications, including birth control. (I'm not familiar with bacitracin)

This is true my neighbor was one & she could prescribe antibiotics, stronger cough syrup and I believe she got a light pain killer for me after a surgery. The one the Dr prescribed made me feel sick. I've forgotten exactly what it was.
 

Spungo

Diamond Member
Jul 22, 2012
3,217
2
81
Total costs associated with lawsuits are somewhere around 2% of costs. They are not the cause of our problems. Furthermore, states that have instituted "tort reform" have not experienced noticeably lower rates of health care inflation.

This is a right wing totem.
That stat may be correct, but consider what the stat actually means. The cost of medical care is extremely inflated because doctors and hospitals don't want to be sued. Today, 1/3 of all child births involve surgery. link. The reason for this is very simple. Natural birth is risky for the baby. C-sections are risky for the mother. If the mother gets a post-surgery infection, nobody really cares. If a baby suffers an injury during birth that leads to a long term disability, an army of lawyers swarm the hospital like locusts. You'd be amazed how many things can go wrong during natural child birth. All it takes is one complication and you get a child that is mentally or physically handicapped for life. Although rare, those types of lawsuits cost tens of millions of dollars when they happen, so doctors and hospitals end up doing surgery when it really isn't needed. Come on, do surgeries really need to be done in 1/3 of all births?
Think of it like this. How much should child birth cost? Midwives are not doctors, so their labor is maybe comparable to that of a mechanic or a plumber. $1000-$2000 seems like a reasonable price. Actual cost: $18k for normal childbirth, $28k for surgery. wtf? That's the cost of covering your ass.


This is already being done.
This is like saying America is moving toward electric cars. Having 1 nurse practitioner in a country with 1/3 of a billion people is a start, but I don't expect it to take off. It'll be banned as soon as it starts showing signs of success.


Drugs should definitely require prescriptions. Perhaps some drugs that are currently prescription only should not be, but overall prescriptions are an absolutely vital part of any well-functioning health system. Removing them would be a catastrophe.
If people want to kill themselves by mixing random drugs, I say go for it. I'm strongly pro-suicide.

It's not like having doctors involved in the process helps. Look at some of the cocktails doctors give to children. A kid will be given amphetamine to treat his attention problems (boredom), the amphetamine causes amphetamine psychosis, so the doctor gives him quetiapine to reduce the psychosis, but the quetiapine makes the kid tired, so the kid is also given modafinil, but that causes...etc... and the kid ends up being on 10 drugs at the same time. The only reason parents go along with it is because they trust that doctors are not being bribed by drug companies. They never stop and think "hey, maybe taking 10 drugs in large amounts is the reason my son's mental health is rapidly deteriorating." I know you're thinking there's no way people are that sheep-like, but they are. If something given by a doctor causes extremely negative side effects, many people will continue taking it. They only keep taking it because they blindly listen to doctors.


We already have legal marijuana in some places and it's only expanding. Hopefully that expands to all drugs someday. Where have you been?
America. 47% of the country voted for Romney He was asked about medical marijuana by a person in a wheelchair, and his response was cold blooded. That guy simply doesn't care about humans because humans are too "worldly", and 47% of the country agreed with him. All it takes is 51% and we put the car in reverse. Marijuana becomes illegal, gay marriage becomes or remains illegal. I remember an episode of Dr Phil (yeah I know..) where he said he wished cough medicine required a prescription so kids couldn't abuse it. That's not just some crazy asshole on TV. Millions of people agree with him. Those people will eventually control the congress and senate.... sort of like right now... and they'll make life suck for everyone.


So you think that people should be able to take antibiotics whenever they want?
They do that anyway. It might even be worse when doctors are the ones giving out antibiotics. I want you to do a test for me. Ask someone about the dangers of taking antibiotics. It could be a coworker, a family member, a friend. I'll bet my lunch money that none of the people you talk to are aware of how dangerous antibiotics are. They go in the same category as chemotherapy when it comes to scorched earth medicine. You're basically attacking all bacteria and hoping your bacteria survive longer than the invading bacteria. People are not aware of this because doctors never mention it. The pharmacist never says anything because they assume the doctor already said something. There's no warning on the box saying that you're setting off a nuclear bomb in your immune system.

Many drugs can have harmful or even fatal interactions with other drugs and those interactions are not at all obvious to patients. Say hello to lots of additional deaths from unintended drug interactions.
Put a warning on the box and include the contraindication list. "Consult with pharmacist if you are taking other medications."
 

dmcowen674

No Lifer
Oct 13, 1999
54,889
47
91
www.alienbabeltech.com
Healthcare in the USA

So my question is really, does anyone here, after all the talk about Obamacare really oppose universal healthcare?

What's stopping us from getting it?

How do we get the insurance companies out of the equation?

In the movie they said that if they tried to take the national healthcare system away from the British there would be a revolution. It's that important to them.

Why is it not important enough for us to stand up and demand it NOW?

It's all about the bass (er money) no treble
It's all about the bass (er money) no treble
It's all about the bass (er money) no treble

It's similar situation to Gasoline.

Americans are too lazy to stand up against the Healthcare Thugs just like they are too lazy to stand up against the Oil Thugs.

The Corporate Thugs own the U.S.

There will be an American Revolution eventually against the Corporations.

Hard to tell when and what will be the tipping point.

Food prices going up to the point hard working people have to chose between paying bills for a roof overhead Vs going hungry I suspect will be the Catalyst for Revolution starting.

It's getting there pretty quickly.
 

fskimospy

Elite Member
Mar 10, 2006
88,236
55,791
136
That stat may be correct, but consider what the stat actually means. The cost of medical care is extremely inflated because doctors and hospitals don't want to be sued. Today, 1/3 of all child births involve surgery. link. The reason for this is very simple. Natural birth is risky for the baby. C-sections are risky for the mother. If the mother gets a post-surgery infection, nobody really cares. If a baby suffers an injury during birth that leads to a long term disability, an army of lawyers swarm the hospital like locusts. You'd be amazed how many things can go wrong during natural child birth. All it takes is one complication and you get a child that is mentally or physically handicapped for life. Although rare, those types of lawsuits cost tens of millions of dollars when they happen, so doctors and hospitals end up doing surgery when it really isn't needed. Come on, do surgeries really need to be done in 1/3 of all births?
Think of it like this. How much should child birth cost? Midwives are not doctors, so their labor is maybe comparable to that of a mechanic or a plumber. $1000-$2000 seems like a reasonable price. Actual cost: $18k for normal childbirth, $28k for surgery. wtf? That's the cost of covering your ass.

Nope. Studies have been done on defensive medicine. Still not driving our costs.

This is like saying America is moving toward electric cars. Having 1 nurse practitioner in a country with 1/3 of a billion people is a start, but I don't expect it to take off. It'll be banned as soon as it starts showing signs of success.

There are somewhere around 200,000 nurse practitioners in the US. Total, there are only about 400,000 doctors.

If people want to kill themselves by mixing random drugs, I say go for it. I'm strongly pro-suicide.

It's not like having doctors involved in the process helps. Look at some of the cocktails doctors give to children. A kid will be given amphetamine to treat his attention problems (boredom), the amphetamine causes amphetamine psychosis, so the doctor gives him quetiapine to reduce the psychosis, but the quetiapine makes the kid tired, so the kid is also given modafinil, but that causes...etc... and the kid ends up being on 10 drugs at the same time. The only reason parents go along with it is because they trust that doctors are not being bribed by drug companies. They never stop and think "hey, maybe taking 10 drugs in large amounts is the reason my son's mental health is rapidly deteriorating." I know you're thinking there's no way people are that sheep-like, but they are. If something given by a doctor causes extremely negative side effects, many people will continue taking it. They only keep taking it because they blindly listen to doctors.

Okay, so now you're arguing against the concept of doctors.

America. 47% of the country voted for Romney He was asked about medical marijuana by a person in a wheelchair, and his response was cold blooded. That guy simply doesn't care about humans because humans are too "worldly", and 47% of the country agreed with him. All it takes is 51% and we put the car in reverse. Marijuana becomes illegal, gay marriage becomes or remains illegal. I remember an episode of Dr Phil (yeah I know..) where he said he wished cough medicine required a prescription so kids couldn't abuse it. That's not just some crazy asshole on TV. Millions of people agree with him. Those people will eventually control the congress and senate.... sort of like right now... and they'll make life suck for everyone.

This is a lot of dancing to avoid admitting that what you said about marijuana was wrong.

They do that anyway. It might even be worse when doctors are the ones giving out antibiotics. I want you to do a test for me. Ask someone about the dangers of taking antibiotics. It could be a coworker, a family member, a friend. I'll bet my lunch money that none of the people you talk to are aware of how dangerous antibiotics are. They go in the same category as chemotherapy when it comes to scorched earth medicine. You're basically attacking all bacteria and hoping your bacteria survive longer than the invading bacteria. People are not aware of this because doctors never mention it. The pharmacist never says anything because they assume the doctor already said something. There's no warning on the box saying that you're setting off a nuclear bomb in your immune system.

This is downright quackery. I doubt you have much of an understanding of chemo either.

Put a warning on the box and include the contraindication list. "Consult with pharmacist if you are taking other medications."

Uhmm, no.
 

hal2kilo

Lifer
Feb 24, 2009
26,489
12,610
136
In Greece, which has social medicine, you can walk into a Pharmacy, tell the person behind the counter what is wrong with you, and they will sell you what they think will cure it.

You can buy antibiotics without an Rx script.

Antibiotics are the last drugs that should be self prescribed. They are overused as it is.
 

Spungo

Diamond Member
Jul 22, 2012
3,217
2
81
Nope. Studies have been done on defensive medicine. Still not driving our costs.
http://www.jacksonhealthcare.com/media-room/surveys/defensive-medicine-study-2010.aspx
-Physicians attributed 34 percent of overall healthcare costs to defensive medicine
-Emergency room, primary care and OB/GYN physicians are most likely to practice defensive medicine
-Physicians who reported practicing defensive medicine, estimated the following:
35 percent of diagnostic tests were ordered to avoid lawsuits
29 percent of lab tests were ordered to avoid lawsuits
19 percent of hospitalizations were ordered to avoid lawsuits
14 percent of prescriptions were ordered to avoid lawsuits
8 percent of surgeries were performed to avoid lawsuits

-Physicians appear afraid to trust their own clinical judgment and trust first-round tests, resulting in tests to confirm the results of tests
-Physicians expressed concern over not only missing a diagnosis, but being charged with delay in diagnosis
These are survey numbers. They asked doctors about defensive medicine, and this is what doctors said. According to doctors, a very significant percentage of the work they do is to avoid lawsuits. This includes testing for things that are second or third guesses. If there's a 90% chance of something being problem A, 9% chance of problem B, and 1% chance of problem C, the doctor will order all 3 of them to be done at the same time instead of testing for A then B then C. You might be getting an MRI to check for something the doctor doesn't think you have.


Okay, so now you're arguing against the concept of doctors.
Mostly yes. People need to stop relying on doctors for everything.

From the doctor's perspective:
The doctor assumes the patient is extremely sick. Why would someone go to the doctor if they didn't have a major problem? You say your son has attention problems. Obviously, you've already tried non-medical solutions, none of them worked, and that's why you're here. The only thing left to try is amphetamine. If that doesn't work, we'll try changing the dosage. This is a perfectly valid medical approach for someone with real attention problems.

From the parent's perspective:
The doctor is the first person they go to. The kid might not have a real medical problem, so the doctor is doing his best to treat a problem that isn't real. The doctor might be very skilled, but he could easily make the problem worse.


This is a lot of dancing to avoid admitting that what you said about marijuana was wrong.
Show me a source saying the federal government has legalized marijuana. Also, show me a source showing that state laws trump federal laws.
http://www.huffingtonpost.com/2012/04/25/obama-marijuana-raids-rolling-stone_n_1451744.html


This is downright quackery. I doubt you have much of an understanding of chemo either.
Would it kill you to do 3 seconds of googling before posting nonsense?
Antibiotics make it harder to fight the flu
Antibiotics lead to intestinal infections
Antibiotics causing vitamin deficiency
http://www.wired.com/2011/08/killing-beneficial-bacteria/

I don't know why, but it doesn't surprise me that you don't think chemotherapy completely destroys a person's immune system and causes hair to fall out.
 

fskimospy

Elite Member
Mar 10, 2006
88,236
55,791
136
http://www.jacksonhealthcare.com/media-room/surveys/defensive-medicine-study-2010.aspx

These are survey numbers. They asked doctors about defensive medicine, and this is what doctors said. According to doctors, a very significant percentage of the work they do is to avoid lawsuits. This includes testing for things that are second or third guesses. If there's a 90% chance of something being problem A, 9% chance of problem B, and 1% chance of problem C, the doctor will order all 3 of them to be done at the same time instead of testing for A then B then C. You might be getting an MRI to check for something the doctor doesn't think you have.

And according to actual studies on defensive medicine it's not. ie: when doctors are protected from lawsuits they behave the same.

http://www.nejm.org/doi/full/10.1056/NEJMsa1313308

Mostly yes. People need to stop relying on doctors for everything.

From the doctor's perspective:
The doctor assumes the patient is extremely sick. Why would someone go to the doctor if they didn't have a major problem? You say your son has attention problems. Obviously, you've already tried non-medical solutions, none of them worked, and that's why you're here. The only thing left to try is amphetamine. If that doesn't work, we'll try changing the dosage. This is a perfectly valid medical approach for someone with real attention problems.

From the parent's perspective:
The doctor is the first person they go to. The kid might not have a real medical problem, so the doctor is doing his best to treat a problem that isn't real. The doctor might be very skilled, but he could easily make the problem worse.

As compelling as your scenario based on absolutely nothing is, we should definitely not be arguing against doctors.

Show me a source saying the federal government has legalized marijuana. Also, show me a source showing that state laws trump federal laws.
http://www.huffingtonpost.com/2012/04/25/obama-marijuana-raids-rolling-stone_n_1451744.html

/facepalm


Some kinds of antibiotics can kill other bacteria in your system other than the ones targeted, but nothing you linked there supports your idea that by taking antibiotics you're attacking all bacteria.

Each antibiotic works differently and targets bacteria in different ways. Based on this an antibiotic affects the other bacteria in your body differently. You need to educate yourself on this.

I don't know why, but it doesn't surprise me that you don't think chemotherapy completely destroys a person's immune system and causes hair to fall out.

As someone who as actually undergone chemotherapy I can say that it most certainly doesn't 'completely destroy' your immune system. (although it does weaken it) I have no idea what the hair thing has to do with this, but I can tell you this: I would be dead today if it weren't for doctors prescribing chemotherapy. Zero doubt.

Something to think about, no?
 

Pneumothorax

Golden Member
Nov 4, 2002
1,182
23
81
http://www.jacksonhealthcare.com/media-room/surveys/defensive-medicine-study-2010.aspx

These are survey numbers. They asked doctors about defensive medicine, and this is what doctors said. According to doctors, a very significant percentage of the work they do is to avoid lawsuits. This includes testing for things that are second or third guesses. If there's a 90% chance of something being problem A, 9% chance of problem B, and 1% chance of problem C, the doctor will order all 3 of them to be done at the same time instead of testing for A then B then C. You might be getting an MRI to check for something the doctor doesn't think you have.



Mostly yes. People need to stop relying on doctors for everything.

From the doctor's perspective:
The doctor assumes the patient is extremely sick. Why would someone go to the doctor if they didn't have a major problem? You say your son has attention problems. Obviously, you've already tried non-medical solutions, none of them worked, and that's why you're here. The only thing left to try is amphetamine. If that doesn't work, we'll try changing the dosage. This is a perfectly valid medical approach for someone with real attention problems.

From the parent's perspective:
The doctor is the first person they go to. The kid might not have a real medical problem, so the doctor is doing his best to treat a problem that isn't real. The doctor might be very skilled, but he could easily make the problem worse.



Show me a source saying the federal government has legalized marijuana. Also, show me a source showing that state laws trump federal laws.
http://www.huffingtonpost.com/2012/04/25/obama-marijuana-raids-rolling-stone_n_1451744.html



Would it kill you to do 3 seconds of googling before posting nonsense?
Antibiotics make it harder to fight the flu
Antibiotics lead to intestinal infections
Antibiotics causing vitamin deficiency
http://www.wired.com/2011/08/killing-beneficial-bacteria/

I don't know why, but it doesn't surprise me that you don't think chemotherapy completely destroys a person's immune system and causes hair to fall out.

Ok, so you believe antibiotics can be/are very dangerous medications..
Reading your posts above shows that you believe the Physician should be taken out of the process in procuring the antibiotics and the general public should be able to buy it at whim. Considering how well those Surgeon General's warnings on cigarette boxes work, it sounds like your idea is a win-win.

I'm a family practice physician in a rural clinic in CA and my visit time routinely doubles when I have to talk the parents of a child with a cold/flu out of demanding that I write them a script for antibiotics. I go into a lecture on 'normal flora getting killed' and 'superbug creation' They still leave upset as they get told to get an O.T.C. cold medication and they just paid a now $40 co-pay to see me thanks to the new 'low monthly premium' 'high deductible/high co-pay' Covered California plans tend to have.
 
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Zodiark1593

Platinum Member
Oct 21, 2012
2,230
4
81
Ok, so you believe antibiotics can be/are very dangerous medications..
Reading your posts above shows that you believe the Physician should be taken out of the process in procuring the antibiotics and the general public should be able to buy it at whim. Considering how well those Surgeon General's warnings on cigarette boxes work, it sounds like your idea is a win-win.

I'm a family practice physician in a rural clinic in CA and my visit time routinely doubles when I have to talk the parents of a child with a cold/flu out of demanding that I write them a script for antibiotics. I go into a lecture on 'normal flora getting killed' and 'superbug creation' They still leave upset as they get told to get an O.T.C. cold medication and they just paid a now $40 co-pay to see me thanks to the new 'low monthly premium' 'high deductible/high co-pay' Covered California plans tend to have.

Really seems like stuff I've learned in grade school biology. Apparently, kids that pay attention in class are a vast minority.
 

bshole

Diamond Member
Mar 12, 2013
8,315
1,215
126
Nope. Studies have been done on defensive medicine. Still not driving our costs.

I am curious of the source of your studies. Everything I am reading is diametrically opposed to your position.

From the American Academy of Orthopaedic Surgeons website, here is an excerpt for an article which is a skewering indictment of the current tort system.

In recent studies, more than 90 percent of physicians reported practicing positive defensive medicine in the past 12 months; unnecessary imaging tests accounted for 43 percent of these actions. More than 92 percent of surgeons reported ordering unnecessary tests to protect themselves.

Another study found a direct relationship between higher malpractice awards and malpractice premiums and Medicare spending, especially with imaging services. The increased spending, however, had no measurable effects on mortality.

In a recent Gallup survey, physicians attributed 34 percent of overall healthcare costs to defensive medicine and 21 percent of their practice to be defensive in nature. Specifically, they estimated that 35 percent of diagnostic tests, 29 percent of lab tests, 19 percent of hospitalizations, 14 percent of prescriptions, and 8 percent of surgeries were performed to avoid lawsuits.

Liability reform has been estimated to result in anywhere from a 5 percent to a 34 percent reduction in medical expenditures by reducing defensive medicine practices, with estimates of savings from $54 billion to $650 billion.

http://www.aaos.org/news/aaosnow/dec10/advocacy2.asp
 
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fskimospy

Elite Member
Mar 10, 2006
88,236
55,791
136
I am curious of the source of your studies. Everything I am reading is diametrically opposed to your position.

From the American Academy of Orthopaedic Surgeons website, here is an excerpt for an article which is a skewering indictment of the current tort system.

http://www.aaos.org/news/aaosnow/dec10/advocacy2.asp

I'm shocked that a doctor's special interest group is advocating for liability exemptions for doctors. SHOCKED, I TELL YOU.

As I already linked in here before, my source is the New England Journal of Medicine.

http://www.nejm.org/doi/full/10.1056/NEJMsa1313308

Legislation that substantially changed the malpractice standard for emergency physicians in three states had little effect on the intensity of practice, as measured by imaging rates, average charges, or hospital admission rates.
 

piasabird

Lifer
Feb 6, 2002
17,168
60
91
The only thing idiot doctors in the USA do is make you take a bunch of tests that are real expensive and reveal very little. A simple hair sample test tells you more correct information.
 

glenn1

Lifer
Sep 6, 2000
25,383
1,013
126
I am curious of the source of your studies. Everything I am reading is diametrically opposed to your position.

From the American Academy of Orthopaedic Surgeons website, here is an excerpt for an article which is a skewering indictment of the current tort system.

http://www.aaos.org/news/aaosnow/dec10/advocacy2.asp

It's a lotto system and nothing more, which is exactly why the left likes it (at least in private healthcare, talk the VA medical system and that's a different story altogether). We'd be better off just having doctors pay a set fee into a payout pool the lawyers can fight over like hyenas at a lion kill and then let them practice medicine without having to be stupid about it.
 

hal2kilo

Lifer
Feb 24, 2009
26,489
12,610
136
Ok, so you believe antibiotics can be/are very dangerous medications..
Reading your posts above shows that you believe the Physician should be taken out of the process in procuring the antibiotics and the general public should be able to buy it at whim. Considering how well those Surgeon General's warnings on cigarette boxes work, it sounds like your idea is a win-win.

I'm a family practice physician in a rural clinic in CA and my visit time routinely doubles when I have to talk the parents of a child with a cold/flu out of demanding that I write them a script for antibiotics. I go into a lecture on 'normal flora getting killed' and 'superbug creation' They still leave upset as they get told to get an O.T.C. cold medication and they just paid a now $40 co-pay to see me thanks to the new 'low monthly premium' 'high deductible/high co-pay' Covered California plans tend to have.

Thank you.
 

glenn1

Lifer
Sep 6, 2000
25,383
1,013
126
I'm shocked that a doctor's special interest group is advocating for liability exemptions for doctors. SHOCKED, I TELL YOU.

As I already linked in here before, my source is the New England Journal of Medicine.

http://www.nejm.org/doi/full/10.1056/NEJMsa1313308

The study does a good job of addressing one side of the issue (fear of malpractice suits) but doesn't speak to the other end - in a fee-for-service model medical professionals have an incentive to over-utilize services because they get paid for what they do. It's not like the doctors have any financial skin in the game which would cause them to defer services of limited value, thus you have a lot of imaging being done with little purpose since where's the downside for the doctor in ordering them?

Of course if you moved to a flat fee model then you might have the other problem of underutilizing "defensive" testing since any additional costs lower the provider's bottom line. In the end, I'd say the current system default is to order more tests and procedures because they offer little risk to the doctor but immense downside if they're neglected.
 

fskimospy

Elite Member
Mar 10, 2006
88,236
55,791
136
The study does a good job of addressing one side of the issue (fear of malpractice suits) but doesn't speak to the other end - in a fee-for-service model medical professionals have an incentive to over-utilize services because they get paid for what they do. It's not like the doctors have any financial skin in the game which would cause them to defer services of limited value, thus you have a lot of imaging being done with little purpose since where's the downside for the doctor in ordering them?

Of course if you moved to a flat fee model then you might have the other problem of underutilizing "defensive" testing since any additional costs lower the provider's bottom line. In the end, I'd say the current system default is to order more tests and procedures because they offer little risk to the doctor but immense downside if they're neglected.

I 100% agree that the fee for service model is an insane way to pay people. We should pay for results, not for the number of procedures performed. I think the big problem is that in systems as complex as the human body sometimes results are hard to quantify, so what is a good result? The longest life? The best quality of life? Cost effectiveness?

(This reminds me of the education system. Everyone argues that we aren't making enough progress, but nobody can even agree on what the goal is)

It seems like doctors should be salaried employees of some sort, but with bonuses for better outcome/cost ratios or something of that sort.
 

doubledeluxe

Golden Member
Oct 1, 2014
1,074
1
0
Everyone will shit a brick when they see the tax bill for universal care.

Have you seen the cost for our current healthcare system? It's absurd. When I owned my company in CA healthcare costs were a major problem. We were facing rising premiums each year around 15%. The number of denied claims that took months to deal with was staggering. Our system is both expensive and cumbersome.

Too many Americans don't seem to understand that their employer pays a huge sum to cover them. Have a great insurance plan with a low deductible and low copays? It's because your company is subsidizing your costs. However most Americans do not enjoy this luxury. The average cost to Americans is staggering.

You have to remember that these universal healthcare systems provide more than just doctors visits for that extra tax burden. Affordable daycare, maternitty leave, sick leave, mental healthcare, and so on.

Tacking on an extra tax burden while eliminating our current insurance, deductable, and copay system and reducing the costs to employers can only be seen as a good thing unless you work for the insurance companies and big pharamecuticals.

So how exactly are we going to shit a tax brick? Only if we are imbeciles and don't implement it properly. There are many different universal or national systems out there that work. Ours doesn't. It's straight up retarded and just throwing your hands up and complaining about the tax bill is defeatest don't you think?

What the fuck is up with that is that you should dig a little deeper on those stats. They are the commonly trotted out stats that fit an agenda but they are not even remotely true. You seem to enjoy research so I am hopeful that you will search out the truth on your own.

And while I'm on the subject of bullshit and lies, although we have always had and more than likely always will have a portion of our population that accepts what our corrupt government tells them without question, we just had an election here where the message was one of 'enough'. Our government yet again decided that deception is the best methodology to achieve a goal. The goal in this case was to make Obamacare the 'law of the land'. It necessitated crafting legislation such that the CBO could not report its true costs, that did not clearly indicate that the basis of the legislation was redistribution of wealth and relied on "stupid American voters" to pass it. Type 'Jonathan Gruber' into your favorite search engine and find out what the mainstream media has decided you don't need to know.

I could go on and on with this but I will get to the point. If you want universal health care in this country there are two paths to it. It can be instituted through a period of damage control where the government must convince the people of the nation that government can be trusted to look out for their best interests and when that trust is restored, they can then make a case for universal health care. I estimate that could take twenty years under the best of circumstances or one hundred years under the worst. The second option is to institute it through force. Which BTW is a hugely appealing option for the Democrat party but the 'light' version of that has already failed. We'll know for sure in June with the SCOTUS ruling.

Oh and on a related note, the ignorant American voters, well they're all the Democrats in Congress. Remember that Obamacare got passed with not a single Republican vote? Yeah. The very same people that got their asses handed to them a week ago voted for it in a show of solidarity. Smart move.

Universal health care has been pushed back for many decades and the blame lies totally on the party of lies and deceit which Michael Moore would tell you is the Republican party. But if you thought Sicko was truth, well...

My advice to anyone that really desires universal health care very badly at this point is to consider moving to a country that offers it. The process can take some time so no better time to start than now. We're not going to have it here anytime soon. The Democrats saw to that.

Dig a little deeper on those stats? I have lived in other countries. You are just throwing out a random talking point about how all the statistics are wrong, there is a conspiracy, and we have it great here. That is non-constructive.

I just don't subscribe to defeatest and politically polarized opinions like yours. This is America. We could do it if we wanted to. Everyone else has.

Honestly you need to take your political shill hat off and look at this objectively. This is not a R vs D discussion. Neither side is doing us any favors.

And, based on discussions I've had with friends that live in Canada and the UK, we get helped a lot faster here in the US. A friend of mine in the UK had to wait over a year to get knee surgery due to the lag time between referrals and tests. She also had to get carpal tunnel surgery and they didn't start PT for her until they had enough evidence that she wasn't recovering quickly enough. She told me that this was not at all uncommon there.

Friend in Canada had blood in her urine. Docs put the fear of God in her had told her it could be cancer. Then she had to wait over 2 months for tests. Found out it was just due to a hernia, but she had to wait almost another 2 months for the surgery.

So just like my example with the hip surgery we have some anecdotal evidence here. However how do we objectively explain that people in these countries live longer and have better health than Americans? We are the richest country in the world, spend the most on healthcare, yet our citizens are not even in the top 10 for the healthiest.

Now in my personal experience I have found that the US offers a different kind of treatment. In the US I get every test known to man. If there is a very small chance that I need an MRI in the future they would refer me to a specialist to get it done. They do not do that in these other systems until they have completed the other tests that confirm there is a need for one. I imagine that this is both a source of higher costs in the US and a reason why certain procedures get done faster in the US. We simply over prescribe procedures. Rather than going through the process of exploratory medicine based on evidence we do it all at once. An argument could be made in favor of getting all the tests done regardless of there being a 1% chance it is needed but not when costs are so high.

Well goddamn, my thoughts exactly.

Tl,Dr. Universal Healthcare will take a very long time to properly implement, and will be painful and messy (due partly to the fact you need to raze the entire health insurance industry before the wheels can even begin to move), and that is assumming politicians are halfway competent. Most likely, none of us reading this will be alive by the time it's finished.

Defeatest. Could be true but it's not constructive. Surely we can get this done? You are of the opinion that there's nothing to do but suffer with the current system. What will you do when you want to retire but your SO has cancer and you can't afford to quit your job because of the rising healthcare costs? Will that make you happy?

This. Democrats have already proven their incompetence and tone deafness about the subject by focusing on the "universal" part which progressives have still not figured out is not a selling point but instead a point of objection for most voters. The majority of folks have employer-subsidized health insurance and whose top 1, 2, 3, etc. concerns are about fixing the problems with their own coverage. Expanding coverage to others is like #999,999,9999 on their priority list and will be abandoned instantly if anything done to address coverage expansion endangers their own coverage or makes it more expensive by anything more than a token amount.

Only an idiot or progressive (redundant I know) would approach this subject by selling it to middle class voters as "sure your tax rates may go up with universal healthcare and I can't guarantee the same benefits you had under private insurance, but my plan will help some unemployed high-school dropout inner city gang kid have the health insurance he's lacked previously!"

It is not a democrat vs republican argument. Neither side has done shit for us. Both sides have made things worse.

You do bring up something that I found to be an interesting observation. When you live in a country that has universal healthcare the people are much healthier and happier. In the US for example if you're having mental problems you still have to go to work. This creates more problems. With a national healthcare system you can take the time off to take care of your health before returning to work as a productive employee.