I’m off work today, because I had my pre-op anesthesiology appointment this morning. No big deal, just a quick check and medical history by the nurse anesthetist who’s going to put me to sleep for my cataract surgery.
That appointment was over by 0720, but I needed to stop by the ophthalmologist’s office afterward, and he doesn’t open until 0800, so I stopped by a diner for some breakfast: two eggs lookin’ at me, hash browns, corned beef hash, rye toast and coffee. You may rest assured that I eat healthily, getting something from the four main food groups — sugar, salt, caffeine and cholesterol — every day.
As it happens, this particular diner uses heavy paper placemats, with advertising on them. And on my placemat were two medical ads, one for PA Podiatry and one for Open Air MRI of Allentown. Open Air MRI invested in an Hitachi AIRIS II Open MRI, an imaging machine which avoids the closed in aspects of traditional MRIs which can really bother people who are claustrophobic.
Naturally, these ads brought to mind the differences between patient care and service in the United States and the socialized medicine countries. I have previously noted the long waiting times endured by the citizens of our good neighbor to the north, prosperous, single-payer Canada. The Fraser Institute has released its latest survey of Canadian wait times:
Waiting Your Turn: Hospital Waiting Lists in Canada, 19th Edition
Date Published: October 29, 2009 Author(s): Nadeem Esmail Research Topic(s): Health
Hospital Waiting ListsThe Fraser Institute’s nineteenth annual waiting list survey found that Canada-wide waiting times for surgical and other therapeutic treatments decreased in 2009. Total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, fell from 17.3 weeks in 2008 to 16.1 weeks in 2009. This nation wide improvement in access reflects waiting-time decreases in 5 provinces, while concealing increases in waiting times in Alberta, New Brunswick, Prince Edward Island, and Newfoundland & Labrador. The total waiting time in British Columbia was unchanged. Among the provinces, Ontario achieved the shortest total wait in 2009, 12.5 weeks, with Manitoba (14.3 weeks), and Quebec (16.6 weeks), next shortest. Newfoundland & Labrador exhibited the longest total wait at 27.3 weeks; the next longest waits were found in Prince Edward Island (26.7 weeks) and New Brunswick (25.8 weeks). The fall in waiting time between 2008 and 2009 results from a decrease both in the first wait—the wait between visiting a general practitioner and attending a consultation with a specialist—and in the second wait—from the time that a specialist decides that treatment is required to treatment. ISBN: 1918-2090 Type: Studies & Reports Free Download: Download Files: Complete Publication Buy Now
It’s certainly good news that waiting times in Canada have fallen, but I’d point out that they are less than a season in only one province, Ontario, and even there they are 12½ weeks, just barely under a season. Still, that’s better than 2008, where average wait times were over a season in every province. But while that’s some improvement, in Newfoundland & Labrador, and Prince Edward Island, average wait times were over half a year.
Here in the good ol’ US of A? Medical specialties are advertising to get more clients!
How about me? Well, I went to my original ophthalmologist on Tuesday, 22 December 2009, where he diagnosed my problems; I had set the appointment the previous week. As it happens, he had just retired from doing surgeries — he’s in his mid-sixties — so there was some delay in finding an eye surgeon he trusted, who’d be able to do my procedures and who accepted my health insurance. My original ophthalmologist took off the week between Christmas and New Year, so no work got done then. But once he got back into the office, he took care of things; I was called on Monday, 4 January 2010 with the name of the ophthalmologist he recommended, and asked if I wanted to use him. I said fine, and later that same day, the new ophthalmologist’s office, Bausch and Jones, called me to set up an appointment, for Wednesday, 6 January 2010.
Now, I needed two separate procedures. I had cataract surgery on my right eye in 2003, and some scar tissue had grown in my right eye, clouding my vision in that eye. And a cataract has developed in my left eye. Quite frankly, I shouldn’t have been driving for the past several months!
On Friday, 8 January 2010, Dr Andrew Bausch performed a laser treatment to disintegrate the scar tissue in my right eye, and I can see clearly out of that eye for the first time in a while. Time from initial appointment with my first ophthalmologist to getting the procedure done: seventeen days, and the Christmas holidays were in the middle of that.
My cataract surgery is scheduled for tomorrow, the 19th of January. Total wait time, from the original diagnosis will have been 28 days, and, again, that includes the Christmas holidays and having to change ophthalmologists since my original one had retired from surgery. Realistically, the wait time from the new ophthalmologist alone was four days for the right eye procedure to be completed, and will be fifteen days for the cataract surgery, with a well-regarded surgeon with eighteen years experience in cataract surgery.
Our favorite Kiwi Kommenter would say, “But y’all pay much, much more for medical care than anyone else,” and he’d be right: we certainly do. But if I lived on Prince Edward Island, while my medical care would be “free” — “free” if I didn’t count having to pay higher taxes to support the Canadian health care system — I’d be having my first procedure sometime around the end of June, and only God knows when the second one would occur.
Perry has told us, many times, that physicians are overpaid, that doctors make way too much money, and that that is a big problem with our health care system. John C answered that point:
Let me tell you about my buddy, Karl. Karl is a doctor in Canada and every year when he reaches is prescribed income limit under the Canadian system, he drives to Boca Raton to open his Medical Concierge service. Karl, his wife, June and I go out for dinner often. Karl tells me that in four months in Boca he TRIPLES his income. In Boca he accepts only private insurance or cash.
This means that while Karl is in Boca, Canada is minus one doctor. Karl has several friends who do the same. He has also explained to me how he and his associates refer Canadians to US clinics and hospitals for service they cannot receive in Canada. I asked Karl why Canada doesn’t just pass a law saying they can’t do that. Karl’s answer was: “If they try that we will all just leave the system”.
In principle, provision of health care services should not be a for-profit system, because health care services are a basic human right, in my view.
Were I to get snarky, I’d ask if that means that grocery stores shouldn’t be allowed to make a profit, since food is certainly an essential, but that’s a debate for another day. But look at the results of a low-profit system in single-payer Canada: long waiting lists, and doctors maxing out their income in eight months, effectively leaving the Canadian system short on physicians when they’ve topped out. Meanwhile, in our very much for profit system, we have very well-compensated physicians, and so much capacity in our health care system that practitioners are advertising for new patients.
I’d guess that this is why the health care reform plans going through Congress are all based on retention of our private health insurance system: the Members of Congress know that, if we adopt something similar to what the Canadians have, we’ll wind up with the same quality of health care Canadians receive: low and slow. Americans know, instinctively, that you get what you pay for.
Trouble is, as the federal government gets more and more involved in our health care system, and incurs more and more of the costs, it will necessarily have to take measures to cut costs; we’ve already seen how that has led to Medicare and Medicaid dramatically underpaying patient care costs. Even with the system being proposed now, eventually, almost inevitably, we’ll wind up with something cheaper, and we’ll pay for cheaper in lower quality and longer waits.
Dana:
You knew I’d have to respond. Your comparisons and logic need to be improved if your points are to be believed.
First, you are comparing your ophthalmologic experiences to the total of all procedures in the US. That’s apples and oranges.
Second, you are using the Canadian system as the standard, when actually they are about the worst of the universal health care plans. Why not compare it to the Swiss, or to any of the other more effective systems in most other developed nations? There are plenty of them: We’re 37th in the quality of outcomes! Right, let’s be proud of that!!
Third, I am not against profit in health care per se, I am against the incredible mark-up due to our insurance company imposed overheads, upwards of 25%, and then to have them deny care. Wow! What would you say if your surgeries were denied because of preexisting conditions, and you were set back probably somewhere between $5K and $10K? You would not be a happy camper, yet this happens routinely to too many of our fellow citizens. Profit for the providers, sure, within limits. I have personal knowledge, anecdotal to be sure, of both hospital fees and surgeon’s fees: both are truly outrageous, the most costly among the developed nations. Almost $11K for the laproscopic removal of a gall bladder, involving a 20 minute surgery plus three hours total in hospital recovery. $11K! No, not justified!
And yes, our Kiwi Commenter, seriously ill, many, many days in the hospital, almost a month I believe, tons of tests, at a cost of about zero. If this happened to an uninsured person here, or perhaps even an insured person, are we speaking of bankruptcy? For the insured, after all this would he/she be able to get insurance? You know the answer. Our system is badly broken, but you are in denial of that, because you are doing just fine. How you are doing doesn’t count for the rest of our country.
I ask you very seriously, Dana, how can you be satisfied with our provision shortfalls of medical service provision in this nation, when well over half of our bankruptcies are caused, not by mortgage defaults, but by defaults in medical bills.
For someone like you, of course you can get inexpensive, high quality care. You’re fortunate enough to be insured.
Are those like you the only ones that deserve quality care. Seems like your answer is YES. Not mine, Dana!
Moreover, I would point out, why should I care about health insurance? Through Medicare and supplemental (provided by my former employer), why should I care if my next door neighbor either isn’t getting sufficient medical services because he cannot afford the insurance or paying the bill, when he has congestive heart failure at the age of 48, and has a wife and three children to support?
Maybe you don’t care, Dana; I do!
What I care about is the way the Democrats are pushing Obamacare through. What are all these exemptions for? Why is everything behind closed doors? There’s nothing wrong with trying to improve our present system, but let’s really improve it, not just line everybody’s pockets. We, the people, will be getting the shaft, as usual, with Obamacare.
Our favorite Kiwi Kommenter would say, “But y’all pay much, much more for medical care than anyone else,” and he’d be right: we certainly do.
No, I’d be pointing out the story I posted earlier:
The waiting time for that American was infinite; he died because he could not get care.
So if we add your wait of a month to his wait of infinity, and divide by two, we get an average wait of – infinity.
Here’s the thing – I can get the same sort of treatment as you by paying for it. Indeed, I have – when I needed surgery for ingrown toenails, I decided to go private rather than waiting for four months, and got it done within a week. Cost me $600, with two surgeons working on both feet.
I have the option of the same sort of care you do.
But I also have the option of waiting and getting minor problems such as ingrown toenails done for free. And I also know that when a major problem comes up (as it has done recently), I will get good care immediately, and not go bankrupt in the process.
You do not necessarily have those options. 7 out of 10 American medical bankruptcies had insurance. Overall, your medical system costs considerably more than those of other countries that give better results.
Because we have a nationalised system in NZ, we pay less and get more options than Americans have. We have more actual freedom and more actual security – I have the choice of going private and the knowledge that I will be taken care of if anything goes seriously wrong.
As Perry said, you are in denial because you are doing fine. However, not everyone is doing fine, and there is no guarantee that you will continue to do fine, that you won’t be screwed over by an insurance company at some time in the future. Unless, of course, you turn 65 and go onto (*gasp*) socialised medicine.
How do you know from your anecdotes that everyone in America is doing fine, Dana?
How do you know from your anecdotes that you will continue to do fine, Dana?
Our favorite Kiwi Kommenter would say, “But y’all pay much, much more for medical care than anyone else,” and he’d be right: we certainly do.
No, I’d be pointing out the story I posted earlier:
The waiting time for that American was infinite; he died because he could not get care.
So if we add your wait of a month to his wait of infinity, and divide by two, we get an average wait of – infinity.
[continued - bloody WordPress!]
Here’s the thing – I can get the same sort of treatment as you by paying for it. Indeed, I have – when I needed surgery for ingrown toenails, I decided to go private rather than waiting for four months, and got it done within a week. Cost me $600, with two surgeons working on both feet.
I have the option of the same sort of care you do.
But I also have the option of waiting and getting minor problems such as ingrown toenails done for free. And I also know that when a major problem comes up (as it has done recently), I will get good care immediately, and not go bankrupt in the process.
You do not necessarily have those options. 7 out of 10 American medical bankruptcies had insurance. Overall, your medical system costs considerably more than those of other countries that give better results.
Because we have a nationalised system in NZ, we pay less and get more options than Americans have. We have more actual freedom and more actual security – I have the choice of going private and the knowledge that I will be taken care of if anything goes seriously wrong.
As Perry said, you are in denial because you are doing fine. However, not everyone is doing fine, and there is no guarantee that you will continue to do fine, that you won’t be screwed over by an insurance company at some time in the future. Unless, of course, you turn 65 and go onto (*gasp*) socialised medicine.
How do you know from your anecdotes that everyone in America is doing fine, Dana?
How do you know from your anecdotes that you will continue to do fine, Dana?
Here’s the thing – I can get the same sort of treatment as you by paying for it. Indeed, I have – when I needed surgery for ingrown toenails, I decided to go private rather than waiting for four months, and got it done within a week. Cost me $600, with two surgeons working on both feet.
I have the option of the same sort of care you do.
But I also have the option of waiting and getting minor problems such as ingrown toenails done for free. And I also know that when a major problem comes up (as it has done recently), I will get good care immediately, and not go bankrupt in the process.
You do not necessarily have those options. 7 out of 10 American medical bankruptcies had insurance. Overall, your medical system costs considerably more than those of other countries that give better results.
Because we have a nationalised system in NZ, we pay less and get more options than Americans have. We have more actual freedom and more actual security – I have the choice of going private and the knowledge that I will be taken care of if anything goes seriously wrong.
As Perry said, you are in denial because you are doing fine. However, not everyone is doing fine, and there is no guarantee that you will continue to do fine, that you won’t be screwed over by an insurance company at some time in the future. Unless, of course, you turn 65 and go onto (*gasp*) soc1alized medicine.
How do you know from your anecdotes that everyone in America is doing fine, Dana?
How do you know from your anecdotes that you will continue to do fine, Dana?
(Damn it – WordPress keeps censoring without saying so, based on the word “c1alis” in “soc1alised”)
Perry wrote:
No, actually, I’m comparing my ophthalmologic experiences with what the Fraser Institute found to be the average waiting times to see a specialist in Canada. If we assume that ophthalmology has exactly same waiting time in the best province as it does here, then we’d have to ask: what specialties in Ontario have such extremely long waiting times as to make the average 12½ weeks.
And I’d point out here that I noted two medical providers who apparently have sufficient time to take on new patients, enough so that they were advertising for new patients.
Naturally, I followed your link to the story about the Swiss model:
Doesn’t seem like the Swiss’ plan has solved the problem of rising health care costs. And the story noted that:
Which would drive American health insurance companies out of business, meaning we’d wind up with something like single-payer, which is performing just so well in Canada! And note that the basic policy is 400 francs a month, very close to $400 a month. (Current exchange rate is 1 franc = $0.974497.) That’s a lot more than employees at my company pay ($61 a week.) And the Swiss are paying $400 a month and it doesn’t even include dental care?
If you read the entire article you linked, you’ll see that the family in question doesn’t pay 400 francs a month: they pay 1,100 francs, because they want really radical things like semi-private rooms rather than a huge ward. Most decent hospitals in the United States don’t even have anything larger than a semi-private (two patient) room anymore. To get what they see as decent health care coverage, they are paying $13,200 a year. For a full-time American worker, that’s the equivalent of $6.35 an hour, every hour he works, for the entire year, just for health insurance.
You sure you want to hold up the Swiss model?
There is one aspect I liked about the Swiss plan, though:
Perry continued:
Oh, he paid for it: instead of insurance premiums, he pays higher taxes. But remember, he told us that his grandmother chose to buy additional health care coverage, so that she wouldn’t have to wait in long lines for care.
And no, our system is not badly broken: it works just fine, and it has worked just fine for me. It has worked just fine for Yorkshire, it has worked just fine for my wife. And if someone chooses not to buy health insurance, gets sick, and winds up facing bankruptcy, as far as I am concerned, that’s the chance he took by not buying insurance! If he was too poor, he could have filed for Medicaid, which is available in every state.
Of course, that’d mean he’d have a much more difficult time finding a doctor, since so many of them won’t take Medicaid patients!
I see this as a real choice: a choice between high quality, promptly delivered health care for the majority of us — 5 out of 6 Americans have health insurance already — or universal health care coverage, but in a system that delivers lesser quality, slower service. What you would like to see, universal coverage with high quality, promptly delivered health care has never been accomplished anywhere else, and I don’t believe it can be accomplished here, either.
The Phoenician just told us an amazing story:
As it happens, I know about an ingrown toenail. I had one sometime in the nineties, and had to go to a podiatrist to get it cut out. It was only one, big toe of my left foot, and the podiatrist took care of it in the office, not a surgical suite. he numbed the toe, so that he was able to get where he needed to get, and cut out the too-long growth, bandaged the wound and sent me on my merry way. I don’t remember how much it cost, but it couldn’t have been too much, because that was when we were a lot poorer than we are now. I had insurance, but this was before Elaine got her nursing license, and she was a stay-at-home mom.
But one thing I do remember is that it hurt like crazy, so much so that I couldn’t do, on my own, without anesthetic, what the podiatrist did, get an implement where it needed to get and simply cut the nail. And you have just told us that, for a New Zealander of fewer resources than yourself, the single-payer system would take care of it, for free, after he had suffered in pain for four months!
I had assumed that your lengthy hospitalization was something attended to promptly, because it was acute, and seriously health, if not life-threatening. Of course, in the US of A, if someone comes into the ER with a life-threatening problem, he gets taken care of, regardless of whether he has insurance.
But, back to the toenails. Just because a toenail gets ingrown does not mean it stops growing. Toenails grow at an average of 0.1 mm/day, or 1.2 cm in the four months of New Zealand wait that your described, roughly half an inch. Had I been a poorer Kiwi in the nineties, and couldn’t go around the system for private care, my ingrown toenail would have grown completely out the front of my big toe in the wait you just described.
So, why did you decide to go private? I’d guess it was for a very simple reason: you were in pain, pain you didn’t want to suffer for four months.
Now, you tell me that a system which would place a four month wait on an acutely painful condition is a good one, is one we should emulate.
After reading everyone’s story here it seems to me that you all are happy with your Health Care. Pho was happy with his and it also afforded him the ability to go private when he chose to. Dana Pico was happy with his care and intimated that both John Hitchcock and Yorkshire were happy with theirs. Speaking for myself, June and I are happy with ours. It seems it is the Health Insurance Industry that has a lot of people’s panties in a wad. But can’t that be solved with changes in insurance law?
We have an existing Medicare system for the poor. Can’t we increase support for that to aide the poor? Portability and tort reform could help the middle class (us) by increasing competition and reducing ambulance chasing both of which would help bring down middle class premiums.
Finally, if the law were changed to allow the individual to both own and deduct the premiums of insurance, we would then “shop it” like we do other commodities. Plus, wages would begin to rise in an effort to attract good employees since employers would not be locked into priemiums. I know in my business I’ve lost some potentially good people because I couldn’t pay as high as they wanted and they didn’t want the benny’s they wanted the cash. Not a rule of thumb, but it happens.
We just need compromises here because Americans basically neither trust the government to provide quality service nor believe they will provide said service equally when they never have. The government always starts handing out benny’s to friends and supporters and special or protected classes. Hell, we’ve seen this in the negotiations just to try and pass reform. Wait till everyone gets their paws into the pot.
One more thing that bothers me is that much of the so called health care reform seems to be driven by folks like blubonnet.
Blubonnet seems to desire to rape the “rich”, destroy the evil insurance companies and eliminate big pharma. Rather than being desirous of bringing up health care for all Americans, she seems to have a vendetta against anyone making money in the health care industry. This does not seem to be good mental health. To destroy an entire system so you can wreak havoc on people you envy. Oh blubonnet, NEWSFLASH, those eeeeevil rich guys will still get better care than you or me. They’ll just go somewhere else to get it (and they’ll take the best doctors with them, just ask Karl).
“The costs have increased in the last 10 years by 50 to 60 percent,” says Roland Brunner, a banker from Baden.
[...]
Doesn’t seem like the Swiss’ plan has solved the problem of rising health care costs.
Dana, during that decade, American health insurance premiums rose 131%.
So, let’s see – if a Swiss and an American were paying $5000 each in 2000, the Swiss would be paying $7750 in 2010, $12,012 in 2020, and $18,619 in 2030. The American would be paying $11,550 in 2010, $26,680 in 2020, and $61,632 in 2030.
Well done, wingnuts. If you can just put off reform for another twenty years, you can wind up paying all your salaries to insurance companies.
And you have just told us that, for a New Zealander of fewer resources than yourself, the single-payer system would take care of it, for free, after he had suffered in pain for four months!
Dana, under your system, the American who couldn’t afford it WOULD NOT GET TREATED AT ALL.
So, yeah, our system wins again.
But, hey, Dana, let me quote a bit from my link above:
Now, I realise wingnuts hate having to face facts, but let’s try with a couple of questions based on those facts:
i, Is that situation sustainable for Americans?
ii, If not, then for how long do wingnuts think America should wait before addressing it? How many years of health care costs rising at over 3 times the wage rate before something should be done?
iii, And if something should be done, what can change these rates without doing something about insurance companies? Do you honestly believe these sorts of systematic rate rises can be changed by simple bandaids or a couple of regulations?
Except, Phoe, Americans are paying less than the Swiss right now. In some ways, it isn’t a fair comparison, because the employer/employee ration of assumed costs is very different — Perry’s linked story said that the family in question had a 400 franc basic bill, to which the employer contributed 60 francs — but by the time you got around to everything, the health insurance bill was around 1,100 francs per month. One family, paying health insurance with add-ons which made it reasonably comparable to what I get right now, was paying around $13,200 a year!
The Phoenician confirmed what I wrote:
Except, of course, that that’s not true. If someone presented in an emergency room with such a painful condition, he would be treated, that day, though he might have to wait several hours while more serious cases were treated.. The hospital staff would take what information could be taken, and attempt to bill Medicaid, which would succeed or fail.
Now that certainly isn’t a perfect system, and privately insured patients wind up bearing part of the cost of treating Medicare, Medicaid and indigent patients; I guess that’s how we “socialize” medicine here. But it’s a heck of a lot better than the government messing with the system and fouling it up for everybody.
About 15 years ago we had a Finnish student visit us for a weekend. They were having an exchange student program at my son’s school. We discussed things about the two countries and health care and population came up.
She had visited NYC and asked how many people lived there. I said there were two answers to her question. NYC borders held over 7 million. Metropolitan NY to include all the immediate suburban areas had about 15 million. She was shocked and said all of Finland had 5 million. It just boggled her mind.
The same happened with the Dane that stayed with us.
But the subject of universal health care came up. I saw how easy it was for 5 million like minded folf of a homogeneous society could come together and have each Finn help the rest as well as the Danes.
Then I just looked up the population of New Zealand. It is 4.3 million. I can see the same there.
Now the USA has 300 million and a diverse society and country. You all can figure out the rest.
Yorkshire:“Now the USA has 300 million and a diverse society and country. You all can figure out the rest.”
Homogeneity vs diverse, good point that countries with relatively homogeneous populations are more likely to come together.
Counter to that, however, would be the economy of scale argument, comparing our 300 million to their 5 million, where we have the potential to have lower cost per capita. However, problems we have, such as lack of universal coverage, such as the insurance company middle-men who take a sizable cut, such as high fees charged by surgeons and hospitals, these cost adders increase our capita health care costs far beyond all other developed nations.
Thus, the obviously dire need we have for reform, all of which now oddly enough rests on the outcome of the race for the Ted Kennedy seat in MA, and rests on the Repubs refusal, to the man/woman, to face up to the need for reform and to do something about it!
We are indeed a backwards, you might say third world country, on this health care issue, which a large minority of whom is unwilling to face.
Yorkshire, I mentioned that to Pho (or Perry) long ago. I cited the population of NZ and noted we have more than that in the Philadelphia Metro area alone. We have more than that insured by BC/BS in Pennsylvania. How about the other 56 states? We are dealing here with 307 million people. All of these systems which are cited to actually deliver good health care are in much smaller populations.. Perry uses the Swiss system which looks very good, but again can we apply it to 307 million?
JohnC.:
Yorkshire, I mentioned that to Pho (or Perry) long ago. I cited the population of NZ and noted we have more than that in the Philadelphia Metro area alone. We have more than that insured by BC/BS in Pennsylvania. How about the other 56 states? We are dealing here with 307 million people. All of these systems which are cited to actually deliver good health care are in much smaller populations.. Perry uses the Swiss system which looks very good, but again can we apply it to 307 million?
Another thing overlooked by our Liberal friends is that countries like Finland, Denmark and other small populated countries have a less genetically diverse country than we do. Consider, we have all the genes of the world here, along with all those prone to diseases because of those genes. With Jewish people, you have Tays-sak(sp), with some blcks, sickle cell anemia. Very little of that will show up in homogeneous societies.
Perry, the race in MA may or may not determine the outcome of HC reform. However, if it stops HC reform the Dems have no one to blame but themselves. Had they opened up the HC debate in good faith instead of running around screaming “crisis”, had they not bribed, strong armed and carved out special interests, we would not be having this conversation. If they had had to negotiate with Repubs instead of only other Dems it would be different.
They muddied the waters by constantly crossing the term Health Care with Health Insurance. Very few Americans believe we have poor Health Care. Millions believe we need Health Insurance reform. As usual, the Dems had to have a boogie man: big pharma, big insurance, big hospitals, etc.
Listen to blubonnets rants. It’s more about hurting “the rich” than providing good health coverage to everybody.
For some reason they felt they couldn’t sell insurance reform without a boogie man approach. We don’t need to Demonize other Americans to Realize we need reform.
Further, the constant push to ram “something, anything” down our throats and “we’ll fix it later” ain’t flying any more. We saw how that worked out with bail-outs and TARP.
I really want to see a conversation about how we correct the failings of our Health Insurance delivery system without destroying our Health Care system, our research, our technology, our medical students and doctors and yes, our insurance companies. I don’t want to see 2.2 million insurance company eployees looking for work or worse, becoming government employees. I don’t want to see doctors leaving the system or medical students going to other fields because we decided they make too much money and need to cap their income.
Dana: There are many flaws in your argument, as Phoenician has addressed some, but there are more.
“No, actually, I’m comparing my ophthalmologic experiences with what the Fraser Institute found to be the average waiting times to see a specialist in Canada.”
Average waiting times covers all cases and procedures, therefore to compare you opthalmologic experiences to Canadian averages for all is simply, again, obviously, apples to oranges.
“Doesn’t seem like the Swiss’ plan has solved the problem of rising health care costs.”
True, but neither have we, as Phoenician has well pointed out. The fact that ours is rising at astronomical rates has to be a concern to every single American, including retrograde Repubs! But you wish to gloss over this problem.
“Under Swiss law, insurers may not make a profit on the basic plan, which is quite comprehensive, [and] which would drive American health insurance companies out of business, meaning we’d wind up with something like single-payer, which is performing just so well in Canada!”
No, Dana, you forgot to note that Swiss insurance companies make their profits by selling supplementary insurance plans, supplementary to the basic plans required by law, and mandated that every Swiss citizen must have. So you are wrong, with this approach, our insurance companies will not go out of business, although they will make less profit, a good thing!
“And note that the basic policy is 400 francs a month, very close to $400 a month. (Current exchange rate is 1 franc = $0.974497.) That’s a lot more than employees at my company pay ($61 a week.) And the Swiss are paying $400 a month and it doesn’t even include dental care?”
So the Swiss pay about $400 per month, and you pay about $262 per month. But what is your employer paying per employee? Assuming a typical 60% of the total premium, your employer is paying $436 per month, for a total premium of about $700 per month. Now compare $700 to $400 the Swiss are paying, Dana.
“To get what they see as decent health care coverage, they are paying $13,200 a year.”
Well that is a little under what the average US health insurance premium costs an American, $13,375 per year !
Now let’s look at the coverage, besides basic, that a Swiss citizen gets for $13,200 per year: prevention, not-on-the-list medication, help at home, glasses, transport, alternative medicine, semi-private room, and dentistry. That’s pretty good coverage! And don’t forget, there is always the basic plan for those who cannot afford the supplemental, for $400 per month.
“Except, Phoe, Americans are paying less than the Swiss right now.”
Not true, Dana, as I pointed out here.
In conclusion, I think Phoenician’s closing comments must be considered by all Americans, to wit:
“i, Is that situation sustainable for Americans?
ii, If not, then for how long do wingnuts think America should wait before addressing it? How many years of health care costs rising at over 3 times the wage rate before something should be done?
iii, And if something should be done, what can change these rates without doing something about insurance companies? Do you honestly believe these sorts of systematic rate rises can be changed by simple bandaids or a couple of regulations?”
Indeed, our system is not sustainable, with medical costs rising at a rate 4 times inflation, and with so many of us uninsured, too many of whom are going bankrupt due to medical bills.
What kind of a people are we that have allowed this festering sore to persist so long, I ask you all?
JohnC: “If they had had to negotiate with Repubs instead of only other Dems it would be different.”
John, you know as well as I that the Repubs are banking on the failure of ObamaCare in order to regain their power, hoping to repeat what happened in 1994.
Earlier on in this health care reform initiatives, Obama and Dem leaders extended to include Repubs, with no significant response, except to do their best to delay the process.
And regarding “Blubonnet’s rants”, hers is a response to the terrible income distribution that has happened as a result of Reagan/Clinton/Bush policies, on the road to wiping out the middle class. Even under Obama, this trend is continuing, much to my consternation. Therefore, I fully understand where she is coming from.
I strongly relate to this philosophy expressed by a Swiss citizen, comparing her perception of the American way to theirs, stated here, to wit:
“Yet Rappaz looks puzzled when asked about people in the United States who say that it would be intrusive to mandate health insurance.
“I’m not sure that I get you,” she says, cocking her head.
When the question is put another way, she laughs. “Oh, I see. That’s really an American question. You are so used to having this individualistic way of thinking, and that’s why you don’t have these social [safety] nets. You still have this pioneer mentality where everyone has to take care of themselves.”
That’s not how people in Switzerland think about it, she says. That pioneer mentality, “is good for people who have no problems, but there are a bunch of people who … need a social net.
“I’m really happy to give part of my salary to a solidarity system,” she says.”
“John, you know as well as I that the Repubs are banking on the failure of ObamaCare in order to regain their power, hoping to repeat what happened in 1994. ”
Perhaps they are Perry, but is not reforming health insurance the larger issue? Who cares which of the parties fixes the “spiraling” costs? Would it matter if a Dem not a Repub saved those 40,000 people a year? Or vice versa? Would not actually having to deal with the opposing party broaden the perspective? Or is steam rolling the only answer?
As I, an Independant who actually despises both parties sees it, the Dems now have ALL the power. And it seems to me they wanted to use that power to foist on the American people a health care bill (as opposted to insurance reform) with a hidden political agenda. That agenda being:
1. Include abortion with total disregard of people’s beliefs.
2. Allow along with abortion, partial birt abortion, sex change, in vetro, implants, ED, birth control, sex therapy, mental disorders, implants and augmentation and several other items and proceedures which although medical in nature are not catastrophic in cost or they are elective or they may have moral overtones which could be objectionable to a great many Americans.
3. Special carve-outs for unions and government workers at the expense of the rest of us Middle Class Taxpayers.
4. Using the “common good” of health care (rather than health insurance) to force certain life choices in food, calories, weight, diet, exercise and other lifestyles they find objectionable.
5. Use the commonality of health care to control the environment and the vehicles we drive all for our own good and to reduce health care costs.
6. Use Government owned health care to inject government laws and mandates ANYWHERE they deem neccessary to control “claims and costs”.
7. Using the health care to manipulate taxes and income as well as benefits and costs to their political advantage by giving “perks” to their pals and constituants.
Now, perhaps neither party will be able to vilify citizens who don’t vote for them. Perhaps just because I don’t agree with someone I won’t be called a killer who wants to see people die and steal the care from the poor. Nah, that’s too much to ask.
Except, Phoe, Americans are paying less than the Swiss right now.
Try again, Dana.
Health expenditure per capita, 2003 $PPP – Switzerland $3,847, US $5,711.
Where’s your data, hmm?
Except, of course, that that’s not true. If someone presented in an emergency room with such a painful condition, he would be treated, that day, though he might have to wait several hours while more serious cases were treated.. The hospital staff would take what information could be taken, and attempt to bill Medicaid, which would succeed or fail.
Uh-huh:
But the subject of universal health care came up. I saw how easy it was for 5 million like minded folf of a homogeneous society could come together and have each Finn help the rest as well as the Danes.
Gee, Yorkshire – you seem to have missed the teeny point that the system regarded as probably the best in the world belongs to FRANCE. France is a large country of 65 million people, Yorkshire – nearly twice as many as California, and certainly not homogeneous either. Try again.
I wouldn’t put forward the NZ system as a model for reform. I will state that it seems more humane and more efficient than the US system.
But again the question which wingnuts are avoiding needs to be asked. Health care premiums are rising at 131% a decade. For how long do wingnuts want to avoid reforming this, and what credible alternative do they offer that would address the problem?
Pho checking the web:
Gee, Yorkshire – you seem to have missed the teeny point that the system regarded as probably the best in the world belongs to FRANCE. France is a large country of 65 million people, Yorkshire – nearly twice as many as California, and certainly not homogeneous either. Try again.
Well, that took you longer than usual to troll the web. But facts please. You just loooooovvvveeeee to quote facts. You live for it!
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Sure, the poor are insured through Medicaid…but you do understand that if the poor person with a preexisting condition wants to actually work and make money, it’s impossible unless s/he can get a job with good insurance. My patients are born with a genetic condition which is terrifically expensive (in excess of 80K per year just for the medication). Almost all of the adults want to work, but getting and keeping a well-paying job with good insurance when you have 1-2 3-week hospitalizations a year is very difficult. So they have to sit at home or do volunteer work and live off the paltry amount they can have on disability when they could be working and contributing. We have to pay for their care anyway; why not let them work and pay taxes and have a shot at a decent life?
My husband and I have health insurance through his company. Since we have pre existing conditions we can’t get an individual plan (we’ve tried). Our insurance costs us $728 a month. My husband gets these fat deposits, they are just unsightly, not harmful, but they need to be cut out. He will usually do it himself since they are not dangerous. Well he got one above his eyebrow, he wanted to do it himself and I pushed the issue to go to the doctor since it was on his head. I had heard that even popping pimples on your forehead could be dangerous if they get infected. So he went to his primary doctor which of course had to refer it out. We then (a month and a half later) got the appointment and went in. The doctor asked if he could come to another appointment to remove it, my husband irritated by this point told him he wasn’t waiting any longer and he would do it when we got home. The doctor said it probably wouldn’t take long so he would just do it. So he did, in 10 minutes. For the 2 appointments the insurance company was billed $2258 we were responsible for $879 of that. That brings me to my points. Number 1 is we pay ALOT for insurance and the coverage is garbage, however since it is a small business and we have pre existing conditions we are stuck! Number 2 over $2000 for 10 minutes work, that is $12000 an hour, ARE YOU KIDDING ME! I have no problem paying for someones expertise but give me a break, no one is that good. So something must be done about this. Do you know 17.3% of our economy is spent on health care? The people who are not for health care reform are the healthy ones or people who have not done without insurance and had to go see a doctor or wait in an emergency room. For our country not to address this problem and try to find a solution would be unconscionable!
I still cannot understand why we didn’t go with Medicare for all to cover basic medical services. The Dems never even put in on the table so it could be costed out by the CBO.
Next best would be the Swiss system, which would fit well into our private insurance approach, referred to in detail earlier in this thread. The benefit would be that basic insurance would be mandated at reduced cost because younger and healthier people would be in the pool. The insurance companies would make their profit in the non-binding supplementary insurance arena. Payments to providers are negotiated once or twice a year.
All that said, if the House passes the Senate Bill, and the reconciliation process is followed, we will have improved the system. People like Sharilou would be able to get an individual plan at lower cost with their preexisting condition, even lower if the public option is inserted by the House.
I saw a statistic the other day, can’t remember where, that the cost of health care will reach 25% of GDP in ten years, up 33% from where we are now. Our economy cannot afford nearly that. The Dems are trying to address this issue, and getting nowhere with it because of the supermajority required in the Senate due to the Repub filibuster obstruction. That’s why I say, let us go the reconciliation route.
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