Healthcare Conversation Starter

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Over the next little bit, I want to post about healthcare reform in the United States. Before we start calling names and yelling, I thought it might be super fun to see where readers of blurbomat™ stand:

Thanks for playing and stay tuned.

http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

Blech, I’m sorry about the typos. “Obese nation in the world, If yes, why?,” and anything else I am missing. Please forgive moi.
http://simplyblissful.blogspot.com/ tracy

I don’t know whether to call myself a conservative dem or a liberal repub, because there’s issues on both sides that I don’t agree with. But, what I can tell you is that I am paying nearly $800 a month in health care premiums through my employer (a CPA firm) for myself, my husband & my baby. To add insult to injury, my premium deduction was an affordable $170/paycheck previously, and has now jumped to $400/paycheck. This is partially due to the insurance premiums themselves raising (even with keeping our deductibles ridiculously high), and partially due to the f***head in our admin office who said ~ whoops! We weren’t deducting the premiums properly so now not only do you have to pay xxx amount per month, but you also have to repay your premiums for the past year.

My family now has to decide whether to eat or to pay our bills, and I feel like I’m officially in that group of flailing Americans, worrying about just how bad things will get before they turn around. The fear of losing my house, or even meeting our basic needs has become a very reality.

Last summer NPR did a series on health care in other countries, and I couldn’t help but wonder why our country sucked so badly in that regard. I’m looking forward to your posts on the subject ~

TG
billysue

Ya’ know I am trying to be positive, and it would be great if our country could afford to give each and every individual appropriate health care, but how close are we to insolvency? How long is it until the current medicare system goes broke? Increased taxes for healthcare? I don’t think anyone will have to worry about our government not increasing taxes, but it won’t be to pay for our healthcare. It will be for an an ever increasing debt which could very quickly leave us insolvent as a nation. Has anyone noticed how California is doing lately?

Insurance has always seemed like a scam to me.

I’ve worked in the medical profession and for so long have thought it needed to be a pay as you go type of thing. Doctors compete with skill and cost, and we, as consumers, are in charge of our own health. Why does that not seem like common sense to people?

Today Baptist Hospital in my area writes off so many ER visits by people who treat it as a free clinic, never paying a cent for the care they receive.

I love this nation. I have lived in other countries, am proud to be an American.….but sometimes I am perplexed by our utter sense of entitlement. Pay for everyone’s healthcare today and be wary of the future you leave for your children tomorrow.

I am amazed that nobody seems to be looking at a balance sheet.

Congrats on the new addition to your beautiful family, Jon.

I think the following is a great site for a reality check.…
http://www.oftwominds.com/blog.html

http://blurbomat.com blurb

I agree that individuals need to take responsibility for their own health.

What would happen if businesses didn’t have to pony up healthcare costs for employees? Could they not then pass along those savings? Would that not equal a raise? Yes, you’ll pay higher taxes, but a single payer system is good for business, entrepreneurship and innovation in the private sector.

I do not buy your “sense of entitlement” argument. This is not about entitlement. It’s about a philosophy of healthcare that every other developed nation follows but the US does not… healthcare is a right. As it exists now, it’s a privilege and one that causes good people a great deal of stress, financial woe and is bankrupting companies.

Finally, if you believe in the idea of private insurance, you are already buying into a system where resources are pooled into a communal system to be doled out by a central administrative body. Insurance is, in and of itself, a communal system. In our current setup, one that is deeply flawed and guaranteed to leave out a substantial portion of society.

steve-o

I voted against the commies. Sorry blurb. We’ve had this discussion on a few other of your posts.

Here is why I am against a single payer/government sponsored option.

My father-in-law is a general practitioner, otherwise known as the backbone of the health care system. Generally, you’ll see them before you see a specialist, because you didn’t know that you needed to. I asked him about his thoughts on the current US health care system. His answer, it’s horrible. There is a lot of red tape from insurance companies as well as the government and no one side can take all of the blame, but that the insurance companies are definitely a major culprit.

When I asked him about what he thought of the obama version that is being proposed, he said he thought it was a bad idea all around. Now, mind you, he wants to help people and he thinks that everyone should have access to health care.

However, the issue comes down to quality of care. Right now, he’s a pretty thorough doctor, if you come in, he’s not just interested in taking care of a splinter or a rash, he’s interested in long term disease prevention. He gives every patient the very best that he can possibly give to make sure that their life will be as healthy as possible. To do that however, it takes time, and it costs money.

If we go to a public option, then the government will pay him less for the services he does and also will limit his time with each patient by requiring him to take on more patients. As it is, he usually puts in a 60 hour week in his private practice.

If the government gets involved, quality of care will decline. It’s not a talking point, it’s a fact. My sister in law used to date a guy from Sweden. He told us about how while he was back home, he tore his rotator cup. When he went to see the doctor, he was told it would be at least 6 months to have a surgery to correct it. He flew back to the states and within a few weeks was already at his first physical therapy appointment.

Finally, why should the government be the ones to set the cost of health care? The government (excepting grants) did not pay for these doctors 200K+ in tuition to become doctors.

http://blurbomat.com blurb

I would argue that the insurance companies are already limiting the time your father-in-law spends with patients. And his motivation is see as many as possible in order to maintain his income.

I would also argue that people who go to med school should be eligible for tuition waivers (grants) as they are going to assume a career that is of great benefit to society.

Your father-in-law also likely pays a heavy admin expense to exist in the current system as well.

I’d argue about “quality of care”. On whose metric are you measuring? Because the US has a long way to go in that regard.

steve-o

I’d be measuring quality more in the technology and skill level that is available. I doubt many would dispute that the US has the best medical technology as well as best doctors the world has to offer.

His biggest expense if I remember correctly is his insurance premiums. It’s not as bad as an OBGYN (who have to pay 200K in premiums — that’s not a made up number, but I can’t cite the source to be fair).

He does have a pretty sizable expense in dealing with admin costs for insurance companies though, which I completely agree needs to be fixed. But will the government be any better? I doubt it.

You are correct in that the insurance companies do a decent job of limiting what he can/can’t do but can you guess who the worst offenders are? That’s right, medicare/medicaid. A lot of doctors have stopped accepting patients with that for a number of reasons, one being that medicare pays them incredibly little to do even basic procedures, the second being that Medicare barely lets them do anything.

As far as giving more grants, you’d have to then create more tax revenue, which would end up with the doctors still paying for themselves to go to school (cause they are mostly in the 200K+ income arena).

So again, I would say that Obama’s option screws the doctors no matter what.

I don’t think there is a perfect solution, but I’m certain that a government intervention will lead to a worse situation. Historically, every time the government gets involved, things get worse, not better.

http://keeponsmyelin.blogspot.com/ Nico Blue

One of the blogs I read (http://wordsalads.blogspot.com/ and http://medihell.blogspot.com/) had an entry recently about her daughter passing away and not having any health coverage.

I guess I’m not understanding what she means by her daughter not being covered. Is there nothing like OHIP in the United States like we have here in Canada (or I should say in the province on Ontario because our coverage is Provinvial so every provice has their own version http://www.health.gov.on.ca/en/public/programs/ohip/default.aspx)? Are you only covered in the US if you’re working and your job has health insurance? Can you not just walk into any hospital or doctors office without having to pay to be seen? Do you have to pay every time you’re admitted to hopsital and have to stay?

http://blurbomat.com blurb

Most clinics will see you, but you’ll have had to have leapt through some paperwork and they’ll have tried to squeeze you pretty hard. They also have financing plans, but those aren’t optimal.

Emergency Rooms are supposed to see and treat everybody, but that can be a minefield.

In the U.S., if your employer does not offer (or if they do and you decline coverage), you are not covered. You have to try to get your own coverage, which is extraordinarily difficult, particularly if you’ve had any pre-existing condition. Last time I asked about insurance (3 months ago) they said that my hay fever was a pre-existing condition that they would not treat.

When we got on our “high-risk” individual plans, the administrating insurance company would not treat any pre-existing conditions for 90 days. It has a huge deductible and the out of pocket expenses are high.

http://blurbomat.com blurb

Ok. I’ve hopefully responded to all the comments who asked a question or for feedback.

Thank you all for your insights, opinions and for taking the time to share.

As I have time, I’ll be posting more on this topic and hopefully we can understand each other better as well as emerge with ammo for our Reps and Senators in Congress.
http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

The same argument applies, EMTALA covers everyone. So everyone does have healthcare. Right?

Here’s a link for you re: Medicare. Straight from the horse’s mouth.

http://www.ssa.gov/OACT/TRSUM/index.html

and another

http://www.cms.hhs.gov/ReportsTrustFunds/

I do agree with you re: the single payor system; however, peruse the RVU system set up by Medicare.

I don’t like this guy all of the time, but his explanations on the complex world of Medicare RVU billing is worthy of a read.

http://thehappyhospitalist.blogspot.com/2007/11/what-is-99223-worth.html

How does one “encourage healthy behavior and wellness?” Tax deductions? Wellness checks by the government? Weigh-ins? Blood tests? How are we going to get people to go to get this preventative care? Fact is, many people on Medicaid visit the ER for something as simple as a pregnancy test. Why? Because there are no doctors willing to take Medicaid? Lazy? Ignorant to the role of primary care?

Yes, specifics. Sickle cell anemia. Mostly a “black” disease. It is very painful and most often fatal by one’s early 40s. Diabetes is extremely high in the Hispanic population. Why? I have no clue. What about Down’s babies? If you want to call that cultural? Sociological?

Just to muddy the waters further, what about genetics? Skin cancer, heart disease, early coronary artery disease, hypertension, lupus, multiple sclerosis, colon cancer…the list goes on and on.… Are we to end up like Gattaga?

http://www.imdb.com/title/tt0119177/plotsummary

http://blurbomat.com blurb

I would argue that we already live in a Gattaca–like culture. Only those without pre-existing conditions (cultural or genetic) are able to get coverage outside of a group/employer plan. And even if you do get coverage, an insurance company can jack you around and drop you at will.

My five year old daughter does not qualify for private insurance because she was diagnosed with plagiocephaly as an infant. Straight up discrimination on the part of the insurance industry and one of the biggest reasons I want to have this conversation.

If we cover everybody, most of your issues are made moot save how we fund it. Make no mistake, Social Security and Medicare both will have to be re-finagled if they are to continue. George W. Bush’s attempt to reform Social Security hit a huge brick wall, with a GOP president and a GOP-controlled Congress because as a program, it’s to integral to society. Whether or not you like FDR or the idea of Social Security, I don’t believe that it’s going away. If we can save the banks and the car companies, surely we’ll save Social Security and Medicare.

http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

“My five year old daughter does not qualify for private insurance because she was diagnosed with plagiocephaly as an infant. Straight up discrimination on the part of the insurance industry and one of the biggest reasons I want to have this conversation.”

And, AMEN!! I too suffer from something similar and a reason (sadly) I avoid doctors because if I did go for every ache and pain, mine and our children’s individual policy would go through the roof.

I disagree with the “insurance industry” agreement as a whole. EMTALA started this.…cost shifting. Medicare/Medicaid have outlasted their solvency. It was never meant to be a lifetime/over 65 program. FDR’s programs had the right idea, but we have made the very WRONG execution over the years. It was meant as a safety net, not a social program for everyone to rely upon.

Just ask your parents how “insurance” was back in the day…80/20? How much did they spend to have a surgery, a baby, a minor stay in the hospital. What were their ethics as far as their health? People were responsible for their health and had to (gasp) pay something to see an ER doctor or their private physician.

You say you do not entertain the idea of “entitlement.” Why?

“If we can save the banks and the car companies, surely we’ll save Social Security and Medicare.”

We can’t “save” them all. Priorities must prevail at some point, just like in real life.

http://blurbomat.com blurb

The time has come to view healthcare as a right, not a privilege. Every other developed nation is ahead of the US in this regard. We can’t stop at the letter of the Bill of Rights.

The time has come to match and then lead other developed nations.

Take a hard look at the Danes. Highly taxed. But the happiest of all the nations. Your outdated notion that entitlements are exactly that is stopping you from seeing a better way of living.

Have you told anybody to get off your grass today?

http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

What? You mean with my osteoporitic-ridden back with cane in hand shooing the children away? LOL.

Danes are fabulous people, I’m sure. Great country too. Homogeneous and small. Of course they are happy. I’d love to live in a country with all of my peeps too w/o those darned immigrants. Apples and oranges.

http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

If we could only do this here in the US, just like the Danes:

“The measures being voted on Friday include only admitting refugees entitled to protection under international conventions and abolishing a loose category of “de facto refugees.”

There will be an end to the automatic right of entry of a spouse. The minimum age at which immigrants can bring a foreign spouse to live in Denmark is to be raised from 18 to 24.

Permanent residence permits will in the future only be given after seven years instead of the current three, and full entitlement to welfare benefits will be denied to foreigners for the first seven years.

“Foreigners coming to Denmark must support themselves,” says the integration ministry.

Under the new law, applicants for Danish nationality must take a Danish language and citizenship test. Anyone with a criminal conviction will be subject to a waiting period of at least two years.

Any asylum seekers going “underground” will not have his or her application processed. Anyone refused entry will be compelled to leave the country immediately, and not within 15 days.”

http://archives.cnn.com/2002/WORLD/europe/05/31/denmark.immigration/

http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

Actually, now that I think about it, a good place to start encouraging healthy eating would be with EBT/food stamps.

Let’s look at what they do not cover.

http://jobs.utah.gov/opencms/customereducation/services/foodstamps/groceries.html

What do they cover? Sodas. Chips. Ice cream. HFS products. But not deodorant. Weird. I find it odd in this day and age with an EBT card that grocer codes cannot define “healthy” and “nonhealthy” products for those on food stamps and decline payment.

Especially since WIC does.

http://health.utah.gov/wic/pdf/forms_and_modules/Clinic_Forms/Foodcard%20FY2008%2002–08.pdf

http://blurbomat.com blurb

Agreed.

http://www.jeppemorgenthaler.com morgenthaler

Steve-O : Which “commies” are you talking about voting against?

I would never say that our system was perfect, but it’s funny you mention that your government “did not pay for these doctors 200K+ in tuition to become doctors.” Our government pay for our education as well as our medical expenses. Through taxes of course. Doctor’s as well as any other education.

You also state that you “doubt many would dispute that the US has the best medical technology as well as best doctors the world has to offer.”

I would.

Due to the sheer size of the country you have a great deal of amazing technological feats under your belt. No doubt about that. Many great doctors as well. But not the highest standards in the world.

I think it’s familiar to the mindset where in Baseball you crown the “world champions” in a sport that is played only in the US.

As an outsider it seems to be kind of the same tendency that buried the american car industry: Thinking you are the best because you once were.

This sound harsh. I am in no way saying that WE (Danes) are doing better in any of those fields. I just think that a country which artificially raises the standards of “normal weight” to make it fit what their average people weigh — is going the wrong way, fast.
http://emailtoid.net/i/1a942079/f4b7a1d6/ emailtoid.net/i/1a942079/…

OMG, I promise I will shut up after this, save for any rebuttals. My husband is a master plumber. He charges for his skill, and many think way too much.

That said, I really don’t see how healthcare is any more of a “right” than a functioning septic/sewer, fresh water, sanitary essential and yet, we pay for that out of our pockets. We make sure we don’t flush towels, diapers, or trimmings of vegetables (I hope, y’all…don’t do it!). We all pay for our water bill every month and pay the city taxes for the sanitary water (maybe not drinkable, depending on one’s palate, but certainly not disease-ridden). So why is sanitary water any more of a “right” than healthcare? Wouldn’t the reverse be true, all be told? I mean, look at Oprah and her African missions. Wells. Sanitary water.

We are really blessed in this country. More so than others. I have to remind myself of that a lot.
http://www.flickr.com/photos/72feetabovesealevel/ michael

“If people saw their costs, and bore a greater portion of them, they would consume care more carefully, because they’d be paying a greater share of its costs.”

I like this ↑. I used an HSA plan for about a year and really liked both its flexibility and how it made me a more aware consumer. But, part of the expense (and billing errors) in our current system is do to having so many different systems.
http://www.flickr.com/photos/72feetabovesealevel/ michael

In regards to comments about poor quality of treatment at the VA, those are quality of care issues from a health provider, not insurance issues with Tricare.

Tricare may have issues of its own that I haven’t heard about. I’m not very familiar with it.

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Healthcare Conversation Starter