My look at US healthcare

originally posted by: dawnstar
a reply to: Phoenix

Name one large scale government program that has not turned to "snip" due fraud, waste or beauracracy maintaining employment scheme that has met it's goals, budget and has not led to massive deficit increases - did I mention limited access to favored minority classes as well over majority population due political voting blocks, ahem.

this describes our military complex better than any other program the gov't has though... and it seems that the republicans are all for sending them more and more money to waste, lose, and screw us with!

medicare fraud and waste is just a speck of dust compared to what's been going on in the military budget!

It's laudable to wisely spend tax dollars wherever the government is concerned.

However military spending at 4-5% GDP hardly qualifies as significant compared to medical spending at 20% GDP.

Besides simply redeploying money from one black hole to a much larger black hole doesn't fix anything - it just extends problem and leads to even more pain to correct.

The problem is Washington and State leadership absolutely refuses to uphold longstanding law while using shiny new legislation to carve out protection for their cronys.

Medical should be up to 85% less were egregious violations of law addressed.

Think about that.........

Brings it in at less than most spend on cell and cable service for routine care.

And without doubt makes it extremely likely that coverage for downtrodden, poor and those having chronic or pre-existing conditions can have healthcare without bankrupting taxpayers.

Downside is short term economic disruption as 15% of GDP redeployed to productive uses.

Unfortunately persons doing the right thing would suffer partisan attack for the resulting correction in economic spending despite fact law exists right now this minute to hold those responsible for economic rape of America.

originally posted by: Gryphon66

Offer membership in the Federal Employees Health Benefits Program to all Americans for the same payroll contribution that Federal employees pay.

Let the market sort itself out.

originally posted by: MacK80

originally posted by: Gryphon66

Offer membership in the Federal Employees Health Benefits Program to all Americans for the same payroll contribution that Federal employees pay.

Let the market sort itself out.

See here is the genius though: That would literally work, people just can't stick to one idea and focus.

It's almost like it's supposed to be broken at this level of movement.

The attractiveness of that particular idea is easily 8/10 though in a room of 1's and 0's on the whole scene.

*crickets*

told ya.

Whatever fixes it will have to need to be able to turn cancer cells to gold to gain attention.

originally posted by: BubbaJoe

originally posted by: queenofswords
Half the country will pay for the other half regardless. Workers and producers will be taxed to pay for the non-workers and non-producers. It will be an expensive tax because there are a helluva lot of the latter.

Already about 50% of babies born here are financed by Medicaid.

There will be fraud, waste, and abuse because....well, it will be government run.

It's a conundrum. It is something we have to grapple with ideologically, morally, and economically.

Lets crack down on the fraud, have witnessed this first hand, and resulted in a multi million settlement, unfortunately the defendant died and they were never able to collect.

The fraud is VERY deep indeed.....I have worked in medicine most of my life....and I have seen things first hand that would give ya'll a little idea why prices are so high in healthcare....and it IS a big racket!! So few really care....why I try to work for small practices, get my own healthcare at the smaller practices.......and the PHARM companies? The insurance companies? It makes big government look small in MY opinion.......

a reply to: Phoenix

the fraud and waste have been used as a justification to ignore the needs of the american people for affordable healthcare for decades while the gov't has used taxpayer money to prop up the healthcare system and provide customers they deem worthy assistance access to it while other taxpayers paid the taxes while watching their health deteriorate without healthcare, or faced bankruptcy if they tried to get the medical care. ignoring the symptoms till they get to emergency status and they are forced to visit the emergency room. struggling doing their jobs, so they can pay their taxes, so that the more worthy can get all their healthcare needs taken care of, till their health is so bad that they end up on disability, needing much more assistance than just a little with their medical costs...

enough is enough!! unless you are bold enough to end all taxpayer dollars going into the healthcare system, it's far past time to ensure that all have healthcare!!

originally posted by: Phoenix
a reply to: Bluesma

Yeah hear you, being more or less exposed to the executive level and witnessing through experience of spouse the corruption on daily basis I have no illusions of altruism by any connected to financial end of the business.

I... am confused by this. By spouse? What? I was a hospital employee- not my spouse...?

I never spoke of any altruism.

I was thinking more about the laws which make it obligatory for the syndicates to be involved and having to approve of any and all investments or decisions- it seems to sort of give a chance for someone to say hey, that's BS!

Also, the laws get involved in costs... I'm exhausted and I admit my mind is blurry, here's an extract pulled from wiki, though I have found much clearer descriptions before from more reliable sources in the past:

The government has two responsibilities in this system:

The first is a government responsibility that fixes the rate at which medical expenses should be negotiated and it does this in two ways. The Ministry of Health directly negotiates prices of medicine with the manufacturers, based on the average price of sale observed in neighbouring countries. A board of doctors and experts decides if the medicine provides a valuable enough medical benefit to be reimbursed (note that most medicine is reimbursed, including homeopathy). In parallel, the government fixes the reimbursement rate for medical services. Doctors choose to be in Sector 1 and adhere to the negotiated fees, to Sector 2 and be allowed to charge higher fees within reason ("tact and mesure") or Sector 3 and have no fee limits (a very small percentage of physicians, and their patients have reduced reimbursements). The social security system will only reimburse at the pre-set rate. These tariffs are set annually through negotiation with doctors' representative organisations.

The second government responsibility is oversight of health-insurance funds, to ensure that they are correctly managing the sums they receive, and to ensure oversight of the public hospital network.

I never said people were so altruistic and trustworthy - I mean that the system assumes they AREN'T, and provides lots of checks and balances coming from different directions to limit the abuses.

originally posted by: Phage
a reply to: Bluesma

What I perceive here is that the public sector has to compete in terms of quality of care.

The idea of competition doesn't really fit into the model. I understand your point about competition, but why would a public sector operation (none of which are renowned for efficiency) be able to offer anything at a lower cost (not to be confused with price) than a private sector operation? Is the public sector operation going to give itself a marketplace advantage somehow? If so, how is that a matter of competition?


The reason I separate cost and price, is that presumably the public sector operation would operate at cost, no fees added.

I took time to contemplate your post, because I didn't quite understand it- and admittedly still not sure I do.

What I observe is that the competition exists because the public hospitals get more patients than the private- I think it is 65%. Then the rest is split evenly between the private non-profit ones, and the private for-profit. The public hospitals just need to keep their quality of care high enough to keep that advantage in the market.

When I first got here with my typical american mentality, I chose to have my baby at a private for profit hospital assuming it would have to be better care. Found out after that was wrong. They had prettier rooms, but no post natal care unit in case of a problem - if my baby was in trouble at birth, he would have to be rushed to the nearest post natal service which was.... the public hospital.

The only reason the private one didn't have it was funds- even with added price to the cost, it didn't bring them out ahead because of the lower number of patients they received. They could try raising their prices more... but that would bring in even less patients then. The patients had the choice.

But to be clear too, the national coverage isn't 100% (except in cases of long term or life threatening disease or problems, like cancer). They pay a percentage, according to your income. It is multipayer, like I said earlier. You can get insurance (for profit or non profit companies) to add to it, and you always have a pay something out of your own pocket (even if it is only 2 euros).

a reply to: Bluesma

I took time to contemplate your post,

Thank you

It seems to me that your birthing experience expresses what I was trying to; that there really can't be true competition between the public and private sectors. The private sector cannot compete with the public sector. In your case, it could not offer the range of coverage provided by the public facilities. If it could have, it would have, in order to increase its appeal. Instead, well, nice drapes.

The public sector is not concerned with profits, with returns to shareholders. It also has the economic "weight" to bear on pharmaceutical and other medical product providers even without legislative pressure. They "represent" a large, single block, source of revenue for those entities. That alone gives them power in making deals to reduce costs. Against public health care, private enterprise cannot compete. That is what I was trying to say and it seems you did understand it.

For your next child, if there is one, would you choose the private provider from the get go? From your experience, do you have concerns about the quality of care from either? These aren't leading questions. I'm curious about your personal experience.

Public sector = more money for hiring beauracracy not care, VA anybody!

I'd like folks in this discussion to read,

Facts On Healthcare

And then discuss viable options, without the detail provided in article I'm not sure that many are responding on factual data, but rather use emotive response to anything anti-insurance, anti-government operated solutions.

I'd be interested if anyone has COGENT reasons why the article does not offer permanent cure to the issue of healthcare.

Phoenix

IMO doctors should be private. If you have a disease, see a private doctor, get drugs off the counter. There are so many drugs nowadays in supermarkets. Traditional drugs. Natural drugs. Herbs. You name it. Medicare should not be a government law. Only emergency should be done at hospitals.

Phage :
I think I understand a little better. Thank you for being patient.

For your next child, if there is one, would you choose the private provider from the get go? From your experience, do you have concerns about the quality of care from either? These aren't leading questions. I'm curious about your personal experience.

I won't be having anymore, but the second child I also had the same facility, basically because I wanted to stay with the same doctor I was familiar with. Unfortunately, she wasn't available the night I went into labor, and things went sort of badly after that.

At that time, I was still clinging to some deeply ingrained ideas about public anything being worthless.

But if I were to have another child, I would choose the public hospital. I have had some minor operations since, and chose public. Nothing to do with cost, because between the social security coverage and my mutual, it was the same.
But the quality is just much better.