Health care - administrative incompetence

[Ducky]

Are you going to address my questions, xjx388?

So again: How should I have been budgeting for my situation? What personal irresponsibility is to blame for my getting multiple myeloma, having a chunk of spine replaced, learning to walk again and overall medical costs for 7 years of treatment and recovery at 1.2 million (ETA: Of which I personally owe quite a bit, but not all)? What, exactly, do we do about people currently embroiled in out of control medical debt?

Exactly what fiscal or personal irresponsibility is it I can look to in my past and say "yes, were it not for that choice I would not be facing more in medical debt than most people face in their mortgage."?

How is it we are to encourage startup businesses if those starting one cannot possibly hope to have their business survive an illness?

 

[xjx388]

Who said they have the right to the best?

So full of holes and logical fallacies.

People don't have a basic right to prime rib. They have a basic right to food. The basic right is the right to not starve.

People don't have a basic right to the 'best health care available'. For a brief period of time, I was seeing a doctor only available to the very rich. His visits are an hour and a half long (no matter what), and they cost two thousand dollars each, and he does not accept any type of insurance whatsoever.

THAT is the kind of health care available to the very rich. I don't see anyone here insisting that we all have that level because it is a basic human right.

OK then, what is the very best healthcare and what is the basic level of healthcare? Mind you, I'm not talking about cosmetic things like boob jobs.

Are transplants the basic level of healthcare?

 

[xjx388]

Are you going to address my questions, xjx388?

There is no way you could have budgeted for your condition in our current system. I acknowledge this. But if it were a free market system and costs were lower, you might be able to. I never said you were irresponsible.

In a one-payer system, how is American society going to budget for your complex and high-cost health care?

 

[Professor Yaffle]

OK then, what is the very best healthcare and what is the basic level of healthcare? Mind you, I'm not talking about cosmetic things like boob jobs.

Are transplants the basic level of healthcare?

Basic care is the stuff covered by universal health systems - and yes it does include transplants. My grandfather had a liver transplant and my niece a heart transplant on the NHS. If you want anything over and above this, or want a plusher room or a quicker appointment, or cosmetic surgery, you are still perfectly at liberty to buy private insurance or pay out of pocket. We just don't let people die because they are poor, or bankrupt people because they had the misfortune to get ill.

 

[Uncayimmy]

In a one-payer system, how is American society going to budget for your complex and high-cost health care?

What a ridiculous question. How does an insurance company do it?

 

[xjx388]

What a ridiculous question. How does an insurance company do it?

What a ridiculous response. Insurances companies already budgeted for his healthcare and he ended up with a huge bill. How is an already overtaxed and overstretched US economy going to bear the burden of such a high-cost medical procedure for everyone who needs it?

 

[Fiona]

The same way every other western developed country does ?

 

[xjx388]

The same way every other western developed country does ?

OH, I see. It's that easy, is it? I don't think you are looking at economic reality here. As you guys have been so kind to point out, the US already spends way more on healthcare out of the federal budget than any other country and it's killing our economy. How do we implement a one-payer system and somehow reduce the expenditure by more than half and not raise taxes to cover it? I already pay 38% of my income to the Federal Government. How much more do I have to deprive myself of?

 

[RemieV]

OK then, what is the very best healthcare and what is the basic level of healthcare? Mind you, I'm not talking about cosmetic things like boob jobs.

Are transplants the basic level of healthcare?

xjx388:

I can see your attempt to sweep the conversation in a particular direction, and I find it odd for someone who claims to have an open mind about what will be the best course of action.

Are you about to discuss transplant committees, and how it has to be decided whether or not a person gets a transplant?

It is not a comparable line of thinking.

 

[Fiona]

OH, I see. It's that easy, is it? I don't think you are looking at economic reality here. As you guys have been so kind to point out, the US already spends way more on healthcare out of the federal budget than any other country and it's killing our economy. How do we implement a one-payer system and somehow reduce the expenditure by more than half and not raise taxes to cover it? I already pay 38% of my income to the Federal Government. How much more do I have to deprive myself of?

The mantra of the right in defence of their woo. I am afraid it is you who is not looking at econimic reality. That is because your position is ideological. Nobody said it was easy, however, any more than they said everyone is entitled to he "best" health care. You got any more straw dolls? If so why not put them all in one post and save some time?

 

[Gandalfs Beard]

Sure it is. The US has a "Food Stamp" program to provide for the poor. This does nothing for the little boys and girls who live in one of those colonias I mentioned earlier. Sometimes they don't have breakfast in the morning or dinner at night. Barak Obama's kids will never have that problem.

Let's talk about people who aren't poor. The average middle-class person in any country can't afford to eat the variety and quality of foods that are available to the rich. Why is this inequality tolerated? Shouldn't we all have equal access to the same variety and quality of food that the rich enjoy? After all, food is a basic right, isn't it?

I won't hold my breath for the law that mandates that my family gets to have prime ribeyes from Pappa's Brothers Steakhouse once a month.

Let me ask this another way. Try to put emotions aside when you read this. Why do people have a right to the best healthcare available, but not the best homes or food available?

The thing is food stamp programmes and many other programmes that help the needy are being gutted and slashed in the US. While Billionaires get their banks bailed out. This is by design of the Plutocrats that have bought off most of our democratic institutions. Yes, our distributive policies should be more egalitarian. The wealthy should be taxed at much higher rates than the middle and lower classes. And the Public funds should be used to subsidize the poorest among us, and to prevent the middle class from having their homes foreclosed on by the derivative speculators. Privatized Federal Reserve Banking and debt based currencies should be abolished.

It is up to a democratically based Government to ensure democratic distributive policies, whether it's health care, housing, or food. These should all be Human Rights, and these are the issues I am addressing.

I'm not saying that we would end up in a perfect utopian system. There will always be some that game the system to ensure that they will remain on top of the food chain and get "the best" of everything.

And frankly, as long as everyone else's basic needs for food, shelter, clothing, health-care, and even entertainment are being met, I don't care if a few people live it up a little better.

I just care when those people living high on the hog parasitically suck up all the wealth that the rest of us are producing, and leave the rest of us to hang out to dry. That's always been their game plan.

It's called Class Warfare, and the Wealthy generally have the upper hand unless popular movements have forced them to begrudgingly give back some of the surplus that our production creates.

The last 30 years have seen roll backs on all kinds of political/economic gains for the middle and lower classes. And this includes depriving people of the Right to Health Care.

Call me a Socialist if you want, but if you don't add the qualifier of Democratic to the Socialist part, then you would be misrepresenting my position. I'm no Stalinist.

And like I said, I don't care if a few people are richer than the rest of us, I just care when they actively engage in UPPER redistributive policies that deprive the rest of us from living reasonably decent lives.

GB

 

[Uncayimmy]

What a ridiculous response. Insurances companies already budgeted for his healthcare and he ended up with a huge bill. How is an already overtaxed and overstretched US economy going to bear the burden of such a high-cost medical procedure for everyone who needs it?

So, you're saying the good ole U. S. of A can't do it?

 

[Gandalfs Beard]

Are transplants the basic level of healthcare?

Yes!

GB

 

[xjx388]

The mantra of the right in defence of their woo. I am afraid it is you who is not looking at econimic reality. That is because your position is ideological. Nobody said it was easy, however, any more than they said everyone is entitled to he "best" health care. You got any more straw dolls? If so why not put them all in one post and save some time?

Of course it's ideological. Your position is ideological as well and I find it to be equally full of woo and ignorant of economic reality.

And people ARE saying that everyone is entitled to the best healthcare. The idea seems to be that the "Best Healthcare" means you get a private room or more time with the doctor. But liver transplants, an extremely costly and delicate surgery that requires exquisite skill to perform, is basic healthcare.

And so many of you seem to think that doctors making money = bad. From what I can find, the average surgeon makes the equivalent of about $150,000 in the UK. That seems like a lot and it's probably more than most people make in the UK. Fine. But why is it bad for a transplant surgeon to make money when they supply such a valuable skill? What about pop stars, athletes, actors, etc.? All they do is entertain us, which is not saving anyone's life, yet the best of them make well over $1,000,000 per year. How are our values so screwed up that we reward the least skilled and tell the most skilled that they are comparatively worthless?

 

[xjx388]

So, you're saying the good ole U. S. of A can't do it?

I don't think the USA can implement one-payer health care without destroying the economy.

 

[Tatyana]

Of course it's ideological. Your position is ideological as well and I find it to be equally full of woo and ignorant of economic reality.

And people ARE saying that everyone is entitled to the best healthcare. The idea seems to be that the "Best Healthcare" means you get a private room or more time with the doctor. But liver transplants, an extremely costly and delicate surgery that requires exquisite skill to perform, is basic healthcare.

And so many of you seem to think that doctors making money = bad. From what I can find, the average surgeon makes the equivalent of about $150,000 in the UK. That seems like a lot and it's probably more than most people make in the UK. Fine. But why is it bad for a transplant surgeon to make money when they supply such a valuable skill? What about pop stars, athletes, actors, etc.? All they do is entertain us, which is not saving anyone's life, yet the best of them make well over $1,000,000 per year. How are our values so screwed up that we reward the least skilled and tell the most skilled that they are comparatively worthless?

I was just curious as what happens in the practice you manage when a patient has abnormal results?

Something really life threatening?

What happens?

The money thing, some consultants can make more.

In fact, I think GPs have the greatest ability to make the most money (unlike the US where there is a shortage of GPs as the money is based on procedures).

Medics pay for their first year of medical school, after that, the NHS pays for it, with an agreement they will work in the NHS for so many years after they qualify.

As they don't have crippling debt to begin with, and all aspects of medicine are salary based (rather than needing a specialist position), we get a lot of doctors doing what they want to, and doing it for patient care, rather than pushing procedures and tests to make money to pay their student loans.

 

[xjx388]

I was just curious as what happens in the practice you manage when a patient has abnormal results?

Something really life threatening?

What happens?

The lab calls our office immediately with the panic values. We find the patient and get them help.

 

[Fiona]

Of course it's ideological. Your position is ideological as well and I find it to be equally full of woo and ignorant of economic reality.

Yes, you said

And people ARE saying that everyone is entitled to the best healthcare. The idea seems to be that the "Best Healthcare" means you get a private room or more time with the doctor. But liver transplants, an extremely costly and delicate surgery that requires exquisite skill to perform, is basic healthcare.

Yes liver transplants are basic health care: hotel services aren't. Do you honestly disagree with that?

And so many of you seem to think that doctors making money = bad. From what I can find, the average surgeon makes the equivalent of about $150,000 in the UK. That seems like a lot and it's probably more than most people make in the UK. Fine. But why is it bad for a transplant surgeon to make money when they supply such a valuable skill? What about pop stars, athletes, actors, etc.? All they do is entertain us, which is not saving anyone's life, yet the best of them make well over $1,000,000 per year. How are our values so screwed up that we reward the least skilled and tell the most skilled that they are comparatively worthless?

Thanks. I appreciate you putting more straw dolls in this paragraph. Is that them all?

 

[Gandalfs Beard]

I don't think the USA can implement one-payer health care without destroying the economy.

Of course we could if there was enough political will to stand up to the plutocrats, reinstate high tax rates on their billions of dollars that they suck out of the economy, end the "personhood" of corporations, strictly regulate financial markets, abolish Derivative and Currency Speculation, end Privatized Federal Reserve Banking, abolish Outsourcing Subsidies, Abolish Capital Flight, and change from a debt based currency system to a Government issued Currency system.

The lack of will to enact all those measures has ALREADY destroyed our economy. We are in a Second Great Depression. The actual unemployment figures are double the one's usually published and they are roughly similar to unemployment rates during the First Great Depression, and Housing Foreclosures are at a roughly similar rate to those during the first Great Depression.

The only difference this time, is that Wall Streeters have gamed the system so that THEIR internal economies are maintained by pillaging the Public Coffers.

GB

 

[Uncayimmy]

OH, I see. It's that easy, is it? I don't think you are looking at economic reality here. As you guys have been so kind to point out, the US already spends way more on healthcare out of the federal budget than any other country and it's killing our economy. How do we implement a one-payer system and somehow reduce the expenditure by more than half and not raise taxes to cover it? I already pay 38% of my income to the Federal Government. How much more do I have to deprive myself of?

Here's some reductionist logic for you:

Fact: Health care needs are unpredictable and can be extremely expensive.

Fact: Self-insurance is extremely impractical and simply not possible for most people. We require liability insurance for automobiles. As far as I know you can self-insure by depositing the full cash amount with the appropriate entity (think $30,000 cash you cannot touch). Once that's wiped out in an accident, you have to bring it up back up to $30,000 to be self-insured again.

Fact: If everyone took that much money out of circulation, it would cripple the economy. If one person in 100 per year (numbers out of my ass) needs $50,000, it's much better for the economy if each person pays $600 (a little extra for profit/administration) than for everyone to keep $50,000 in the bank (that would be $5M not in circulation).

Fact: Each individual insurance company has to pay for infrastructure (rent, sales, administration) and take a profit, which by definition becomes less of a burden when there's only one entity.

Fact: As someone who runs a practice, you should know that unless everyone pays cash, you will still need to perform administration to deal with the various insurance companies. Unless insurance is completely eliminated, this burden remains, which increases costs that you must pass on.

So, in theory if everyone could pay cash, administrative costs would go way down. However, as we can clearly see, that's never going to happen. Even if people manage to budget large amounts of money, there will be those who go bankrupt and be unable to pay their bills. Who's going to pay? You and me because every business factors in bad debt when setting their prices.

So, if we're going to be paying for people anyway, why bankrupt them in the process? Who does that benefit?

The fact is that the USA has the highest rates of spending on health care yet by most objective measures lags behind in outcomes. Other countries that do what you are objecting to spend less and do better.

As for where the money comes from, it comes from the same sources it does now. Only instead of going to insurance companies, it goes to a single payer entity, namely the government.

Last Fact: In the USA we're already paying X billions of dollars on health care. If costs remained exactly the same, we as citizens would still be paying the same amount. Only people wouldn't be going bankrupt. The money is already there, so it's rather silly to ask where it comes from.