Healthcare

[peakbagger]

During the ACA deliberations there was a lot of money spent to keep the status quo and in private hands. I believe there has been third party reviews that show that medicare spends far less as percentage of total dollars on administration of the program compared to private insurance. Medicare would love to negotiate drug prices but well supported congressmen make sure that that obvious cost savings is off the table.

The interesting part is that conservative republicans have somehow gotten the folks most likely to benefit from health care reform to vote for the politicians who are most opposed to reforming the system. Remember the "death panels" discussion? That was dreamed up and paid for by folks opposed to ACA. It was dreamed up to keep the poorly educated folks who have a tough time understanding a very complex system to vote for the status quo. There are death panels by default already, those in poor rural areas just dont have access to good preventative care and die earlier or preventative diseases. The death panels are the boards of rural hospitals who have to shut thier hospitals as too much of their business is un and underinsured patients or underreimbursed Medicare or Medicaid patients.

 

[begreen]

I paid about $180/month for a family plan under the company Aetna plan. The company paid the lion's share. It was very comprehensive and included vision and dental. $10 copay for office visits and I think we had a $2500 deductible. But that was 7 yrs ago. Since retirement, we are now paying for my wife and I about $66/month for part D? which covers medical and vision, no copay for most work and very good prescription benefits too. but that doesn't include the medicare part A deduction which I'd have to look up. I have no complaints about the system, our annual wellness checkups are free and copays are cheap for other items and meds.

 

[Sodbuster]

And you don't see that abuse in our current system every step of the way?

I constantly hear excuses why our system couldn't work with govt run healthcare. But those people never offer any solutions to fix the major problems with our current system.

Well both parties have had chances and both failed to do so, gov't by it's own nature is inefficient. Almost every candidate that runs says they are going to make gov't leaner and more transparent, and it just doesn't happen. In my personal opinion, it is that people in DC all have their own little kingdoms, and changes are fine, but don't touch mine.

During the ACA deliberations there was a lot of money spent to keep the status quo and in private hands. I believe there has been third party reviews that show that medicare spends far less as percentage of total dollars on administration of the program compared to private insurance. Medicare would love to negotiate drug prices but well supported congressmen make sure that that obvious cost savings is off the table.

The interesting part is that conservative republicans have somehow gotten the folks most likely to benefit from health care reform to vote for the politicians who are most opposed to reforming the system. Remember the "death panels" discussion? That was dreamed up and paid for by folks opposed to ACA. It was dreamed up to keep the poorly educated folks who have a tough time understanding a very complex system to vote for the status quo. There are death panels by default already, those in poor rural areas just dont have access to good preventative care and die earlier or preventative diseases. The death panels are the boards of rural hospitals who have to shut thier hospitals as too much of their business is un and underinsured patients or underreimbursed Medicare or Medicaid patients.

Your use of the word "death panels" while first warned of by Republicans is a real thing. Dr's decide whether you are a candidate for a procedure not a family, with gov't controlled health care. I have tried very hard to keep politics out of this conversation, just go back through my posts. Apparently Bholler lets it slide when it's from a liberal point of view. Our friend who holds dual citizenship in both the US and Canada has confirmed this. Her mother is suffering from a health condition, that could be fixed surgically and would extend her life for about 5 years, but she was deemed to old to have the procedure. She is healthy in every other way.

 

[begreen]

Works both ways. The attempts to dismantle the popular ACA have left millions without insurance. That is a death sentence for many.
And now we have the leaders telling us to be warriors, some thousands more are going to die, mostly the elderly and poor.

 

[bholler]

Well both parties have had chances and both failed to do so, gov't by it's own nature is inefficient. Almost every candidate that runs says they are going to make gov't leaner and more transparent, and it just doesn't happen. In my personal opinion, it is that people in DC all have their own little kingdoms, and changes are fine, but don't touch mine.


Your use of the word "death panels" while first warned of by Republicans is a real thing. Dr's decide whether you are a candidate for a procedure not a family, with gov't controlled health care. I have tried very hard to keep politics out of this conversation, just go back through my posts. Apparently Bholler lets it slide when it's from a liberal point of view. Our friend who holds dual citizenship in both the US and Canada has confirmed this. Her mother is suffering from a health condition, that could be fixed surgically and would extend her life for about 5 years, but she was deemed to old to have the procedure. She is healthy in every other way.

I let some slide both ways as long as things stay civil and it doesn't get into partisan bashing. But I really don't understand why making sure Americans have affordable access to heàlthcare needs to be political.

I completely agree both parties are at fault for the dismal state our govt is in. I have never said otherwise. Personally my views definitely lean to the liberal side but that doesn't mean I don't see the value of conservative views as well. And I am actually much more moderate on many points. We need both sides working together if we ever want to move forward.

 

[bholler]

And yes of course doctor's choose whether a patient is a candidate for a certain procedure. They are the ones who have the expertise to know. Why should they be forced to perform procedures they don't believe are worthwhile? That isn't death panels it is just a fact of life. Sometimes there is nothing more that can be done to extend a life with in any meaningful way. In the example of your friends mother she may be perfectly healthy for her age but that doesn't mean that the risks involved with the surgery don't outweigh the benifits. Only her doctors know that. You or I certainly don't.

 

[Sodbuster]

And yes of course doctor's choose whether a patient is a candidate for a certain procedure. They are the ones who have the expertise to know. Why should they be forced to perform procedures they don't believe are worthwhile? That isn't death panels it is just a fact of life. Sometimes there is nothing more that can be done to extend a life with in any meaningful way. In the example of your friends mother she may be perfectly healthy for her age but that doesn't mean that the risks involved with the surgery don't outweigh the benifits. Only her doctors know that. You or I certainly don't.

I think you missed my point, she was a physical candidate for surgery health wise, the gov't decided she wasn't worth the cost. My wife is an MD and here in the states they do everything that is possible to save a life. Whether is gives the patient another 5 years or 6 months, it's not up to them to play God. I hope your never laying on that hospital bed when they tell you that you are not a candidate for surgery because you are too old, or too young for that matter, my wife does a lot of Peds cases.

 

[mcdougy]

Well both parties have had chances and both failed to do so, gov't by it's own nature is inefficient. Almost every candidate that runs says they are going to make gov't leaner and more transparent, and it just doesn't happen. In my personal opinion, it is that people in DC all have their own little kingdoms, and changes are fine, but don't touch mine.


Your use of the word "death panels" while first warned of by Republicans is a real thing. Dr's decide whether you are a candidate for a procedure not a family, with gov't controlled health care. I have tried very hard to keep politics out of this conversation, just go back through my posts. Apparently Bholler lets it slide when it's from a liberal point of view. Our friend who holds dual citizenship in both the US and Canada has confirmed this. Her mother is suffering from a health condition, that could be fixed surgically and would extend her life for about 5 years, but she was deemed to old to have the procedure. She is healthy in every other way.

In my experience it's not the case at all about a death panel here or denial of a surgery, it's the polar opposite. Your friend may have her own story, but the patient/family is given the choice wether you want to proceed, your told the possible difficulties and you choose. The only time they will reject a procedure is if they feel it will result in probable death. If you or loved one is willing to proceed they will more than happily do ANYTHING. Maybe you don't realize that the doctors and surgeons have a license to practice and can only bill for procedures done. The remaining staff ,nurses etc... Get paid wether they're overun or no one in the place. Like yourself my experience is real as I cohabitate with a CCTC/ICU nurse who has referenced many times that she is helping a guinea pig. Lack of care is not usually the issue, it often becomes a case of overspending for the known results of mortality. The 2 most common complaints in our system would be 1. Having to find a new family doctor once yours has retired. 2. Wait times in the E.R. and getting admitted a room. They often have hospitals running at 100% to 110% capacity.

 

[bholler]

I think you missed my point, she was a physical candidate for surgery health wise, the gov't decided she wasn't worth the cost. My wife is an MD and here in the states they do everything that is possible to save a life. Whether is gives the patient another 5 years or 6 months, it's not up to them to play God. I hope your never laying on that hospital bed when they tell you that you are not a candidate for surgery because you are too old, or too young for that matter, my wife does a lot of Peds cases.

Doctors here make decisions that a patient isn't a good candidate for a procedure all the time. And yes age absolutely enters into that. The risk of complications is drastically higher for very young and very old patients. And performing a high risk procedure could easily shorten a patient's life or reduce their quality of life.

Do you know for a fact that the govt determined she was not going to get that procedure or did her doctors?

 

[Sodbuster]

Doctors here make decisions that a patient isn't a good candidate for a procedure all the time. And yes age absolutely enters into that. The risk of complications is drastically higher for very young and very old patients. And performing a high risk procedure could easily shorten a patient's life or reduce their quality of life.

Do you know for a fact that the govt determined she was not going to get that procedure or did her doctors?

Yes I do, and you don't need to educate me on healthcare, my wife is an Anesthesiologist MD, so she's up to speed on the matter. Try telling the parent of a 3 year old that you're not going to extend their child's life by 3 years because it's a waste of resources. How do you think we make advancements in healthcare? It's by trying new things, in hopes that is will prolong the patients life, but it all costs money. What if we never tried a heart bypass, saying too bad you're going to die. Pushing the bounds of medicine leads to breakthroughs. Another breakthrough in medicine is infants with Hypoplastic Left Heart Syndrome, these infants mostly all died 30 years ago but now they are surviving into adulthood. If surgeons didn't push forward, all these infants would have been lost. Now infants around the world are saved due to the advancements in healthcare. With a socialistic health care system this type of research would have been deemed too expensive, try looking up who leads the world in medical advancements.

 

[bholler]

Yes I do, and you don't need to educate me on healthcare, my wife is an Anesthesiologist MD, so she's up to speed on the matter. Try telling the parent of a 3 year old that you're not going to extend their child's life by 3 years because it's a waste of resources. How do you think we make advancements in healthcare? It's by trying new things, in hopes that is will prolong the patients life, but it all costs money. What if we never tried a heart bypass, saying too bad you're going to die. Pushing the bounds of medicine leads to breakthroughs. Another breakthrough in medicine is infants with Hypoplastic Left Heart Syndrome, these infants mostly all died 30 years ago but now they are surviving into adulthood. If surgeons didn't push forward, all these infants would have been lost. Now infants around the world are saved due to the advancements in healthcare. With a socialistic health care system this type of research would have been deemed too expensive, try looking up who leads the world in medical advancements.

Who says socialist healthcare has to stifle innovation???? There is plenty of research done in countries with socialized healthcare.

Where you in the meeting your friends mother had with her doctors? Did they say it was a waste of recourses or did they say at your age we feel the risks out weigh the benifits?

You seem to be making lots of assumtions which align with what certain media outlets say about what happens in countries with socialized healthcare. But people who live in those systems really don't back up those claims.

 

[bholler]

Oh and how often are experimental procedures turned down by private insurance companies here? You love to point out all the the potential problems that could come from socialised healthcare. But completely ignore the problems many in our country are currently dealing with caused by our medical insurance system.

 

[mcdougy]

It's completely insane to think dollars outweigh life, it's never the case here. If dollars affected outcome/care anytime I would think it happens far more frequently in a insurance system. Space bus just mentioned not receiveing a MRI due to coverage not allowing 2 in a 6 month period?

 

[maple1]

I think you missed my point, she was a physical candidate for surgery health wise, the gov't decided she wasn't worth the cost. My wife is an MD and here in the states they do everything that is possible to save a life. Whether is gives the patient another 5 years or 6 months, it's not up to them to play God. I hope your never laying on that hospital bed when they tell you that you are not a candidate for surgery because you are too old, or too young for that matter, my wife does a lot of Peds cases.

I think you are somewhat misinformed. Our family has been though it. Friends have been through it. No God playing. If a procedure could have a positive outcome, it is done.

 

[Sodbuster]

Oh and how often are experimental procedures turned down by private insurance companies here? You love to point out all the the potential problems that could come from socialised healthcare. But completely ignore the problems many in our country are currently dealing with caused by our medical insurance system.

Oh, and you are apparently an expert on everything that makes this world spin around, where is your medical degree from? Most of these innovations come from teaching hospitals, tied to Universities that can absorb the cost of experimental health care, so private insurance plays no part in this. It's amazing what 13 years of post high school education can teach you.

 

[bholler]

Oh, and you are apparently an expert on everything that makes this world spin around, where is your medical degree from? Most of these innovations come from teaching hospitals, tied to Universities that can absorb the cost of experimental health care, so private insurance plays no part in this. It's amazing what 13 years of post high school education can teach you.

I clearly said I am not an expert multiple times. But you continually contradict yourself. You say research couldn't happen because with socialised healthcare the procedures would never be paid for. Then say most research is done by universities who pay for it and our private insurance doesn't pay for it. So which is it? Both things you claim that are completely contradictory cannot be true.

 

[peakbagger]

IMHO Ultimately it comes down to, there can not be unlimited medical resources and have an affordable health care system. Someone or some group ultimately has to decide to maximize the return of dollars to minimize costs. If its not done rationally then its done through rationing access. I worked with a person who's dad was on a "death panel" in a US state 20 years ago. He was retired surgeon that met with a board to establish guidelines used to decide what levels of extraordinary care made sense. The reason why this state had this board was the cost of their healthcare was too expensive.

The statistics are pretty clear that the vast majority of medical dollars per capita go to folks in the last months of life. Much of this care is very profitable for the health care institutions which offset other losses to the facilities. Its not unusual for dementia patients to have bypasses and even joint replacements. There is rarely any independent review of quality of life post treatment. Advanced directives drawn up in advance if they are followed can mitigate some of this but in my recent experience as a health care proxy for two now deceased elderly parents even with ADs in place and filed with their caregivers, the system tries to circumvent the ADs. Both parents were under hospice care at a nursing facility and even with hospice acting to support the instructions in the ADs there were attempts by well meaning individuals to circumvent them. One thing I was not aware is that most elderly folks that end up in intensive care after a major medical procedure tend to have a short term symptoms of dementia that may take weeks or months to subside and in many cases those with dementia never recover. I experienced that with my mom, she went in with mild symptons after a broken hip and came out a changed person, she did recover somewhat after months but was far diminished at her best post surgery. The gerontologist for the facility warned me that this was quite normal. Unfortunately most MDs are trained at save at all cost and let someone else worry about cost but ultimately at some point in the chain a value discussion will made be it formally or informally.

There was a fairly well vetted study based on a long term group of doctors that have been tracked since they were in school and are now nearing or in retirement. The doctors as a group tend to support very little extraordinary care to keep them alive into old age if they risk a diminished life quality. Most tend to support access to plenty of drugs for pain management. A fair share also tend to support access to assisted suicide. Unfortunately Americans, especially boomers tend to avoid discussion of death. They figure if they spend enough they can avoid it.

 

[maple1]

It would be a shame to lose another good thread to unfortunately worded postings.

 

[Sodbuster]

I clearly said I am not an expert multiple times. But you continually contradict yourself. You say research couldn't happen because with socialised healthcare the procedures would never be paid for. Then say most research is done by universities who pay for it and our private insurance doesn't pay for it. So which is it? Both things you claim that are completely contradictory cannot be true.

Who says socialist healthcare has to stifle innovation???? There is plenty of research done in countries with socialized healthcare.

Where you in the meeting your friends mother had with her doctors? Did they say it was a waste of recourses or did they say at your age we feel the risks out weigh the benifits?

You seem to be making lots of assumtions which align with what certain media outlets say about what happens in countries with socialized healthcare. But people who live in those systems really don't back up those claims.

While other countries are gaining ground, the US leads the world in medical innovation, a simple google search shows that we, for the last 20 years or so have led the pack. Shouldn't the countries with 100% gov't (taxpayer) funding be leading the pack?

who leads the world in medical innovation - Google Search

 

[bholler]

While other countries are gaining ground, the US leads the world in medical innovation, a simple google search shows that we, for the last 20 years or so have led the pack. Shouldn't the countries with 100% gov't (taxpayer) funding be leading the pack?

who leads the world in medical innovation - Google Search

Still not following your argument. Do universities fund the research or does the health insurance system fund it?

There is no reason public heàlthcare would prevent research at all.

 

[mcdougy]

It would be a shame to lose another good thread to unfortunately worded postings.

True.
I've been asking alot of questions, and by no means am I trying to force my thoughts or insult anyone. I am only speaking about my thoughts and EXPERIENCE with a socialized health system. When I hear the EXPERIENCES (costly/ lack of coverage) of people in the private system, as a person, I feel that it's really unfortunate. Therefore I will advocate that our social system seems like a much better service, as in for ALL. I trust that nobody here is able to advocate that leaving people without the ability to seek medical help is OK. Then add the out of pocket potential costs that I'm hearing about and it makes a social system sound that much better. Although I doubt my thoughts will change, I do realize and try to understand that people think otherwise.

This leads me to possibly my last question of interest in trying to look for good points in one or the other systems..... Is there mental health coverages within the average medical health plans?

 

[Sodbuster]

Still not following your argument. Do universities fund the research or does the health insurance system fund it?

There is no reason public heàlthcare would prevent research at all.

True, but research is very expensive, with little or no payback unless a cure for something major is found, so most research would be done via private universities. Public healthcare would be better served treating those who truly need it, with proven treatments, not on research.

 

[mcdougy]

True, but research is very expensive, with little or no payback unless a cure for something major is found, so most research would be done via private universities. Public healthcare would be better served treating those who truly need it, with proven treatments, not on research.

Here that's the exact situation. Hospitals work with the schools. Tons of research and development come out of it, teaching hospitals are where the new procedures are tried and tested. Which I'm sure is a world wide situation not just a USA and Canada thing.

 

[bholler]

True, but research is very expensive, with little or no payback unless a cure for something major is found, so most research would be done via private universities. Public healthcare would be better served treating those who truly need it, with proven treatments, not on research.

Yes and that is bad why?

And is different than the way it's done here how?

The same universities would be doing the research here regardless of public or private health care

 

[Sodbuster]

I think we're just going to have to agree to disagree on this one fella's, It will eventually shake out one way or the other, and only time will tell which was the right choice. I am not a proponent of the gov't controlling more than they are constitutionally obligated to. How much competition does the DMV have, and you can see how that is run. I hope that all of you with mothers still with you have a happy time tomorrow. I know ours will be strange, since my wife has lung issues, we will be holding it in the garage with folding chairs and a kerosene heater to keep us warm. All stay well and safe, and lets make this through this as a country, united.