Health care - administrative incompetence

Rolfe and I are so British, despite she being Scottish and I being English! We both use the phrase "couldn't run a piss-up in a brewery" to describe the apparent view Americans have of the Government they elect.

Rights are granted or revoked by society, they are not inalienable. If you live in the UK, some of your taxes, direct and indirect, fund the health service that everyone can use and which will pay for everything that you need. If you live in the UK, more of your taxes go to fund Medicare/Medicaid which not everyone can use, and apparently only provides a very basic level of care.

That attitude to government is apparently the fundamental difference between America and most of the rest of the world. I find it fascinating. It makes no sense to assert that the government can't run anything and yet believe that the armed forces are very good: and the fire service etc etc. The inherent contradiction in that boggles my mind.

Of course it may be that those who believe the government can't run anything are not the same people who admire those services. It is hard to tell from here. I have not seen any americans on this board stating that the us armed forces are completely useless, but they may believe that. In which case they presumably oppose anyone joining up because they are going to certain unnecessary death.

It is just weird
 
Not our country, but the way our government (and any government really) has botched public health care, education, defense spending, etc. America is, despite it's problems, still the greatest country in the world.:D
You'll have to forgive me, then, for thinking that you must be a very poor advocate for it. Because purely based on your posts, I don't get that impression.
That is a huge twist of what I've said and not worthy of comment.
That's exactly what I've been told on this thread. You yourself said that if you couldn't afford your healthcare you would make the choice to die (despite having a family, AIU). I am also told that the only way I, as a person with several long term chronic illnesses and unable to work full time could get care, would be to not work so that I am poor enough to qualify for Medicare/Medicaid. In what way have I twisted it?
 
Not with insurance involved. (Your money being spent by other people on other people.)

So, how are you going to bring down the costs of Ducky's surgery/treatment by increasing the freeness of the market?

Unless you're advocating high-tech, expensive treatments becoming "niche market" products for the rich, it's not possible.

I can't tell if you are unable to grok this, or are just too ashamed to admit that's what you actually want.

Bump.
I really want an answer to this.
 
Of all the anecdotes on this thread, yours is the only one that I don't believe.

GB

Gandalf,

I know you don't know me as I am an 'internet poster' but I assure you I do not lie, I do not cheat on my taxes, and I definitely do not make up stories. Lord knows I wouldn't be able to keep them straight if I did.

If you'd like I'll give you his name and phone number. But beware, he will ask you for a handout.
 
And how has the UK "botched" the NHS???

The UK gov pays half the price for similar outcomes to the US.
 
I feel sick...sick enough to throw up actually.

Here is how Medicaid works in Practice, not in theory. Every year you have to re-up, fill in forms and go through the humiliating process of proving that you are poor enough to receive it. Medicaid covers the premiums due for Medicare (that's right, you still have to pay premiums for Medicare even after you qualify through disability, or social security pensions).

The premiums are directly taken from your SS Disability or Pension checks.

On Oct 7th, a Medicaid Benefits agent claimed after a phone interview with my mother that as long as the forms were returned by Oct 31st, my mothers Medicaid benefits would continue without any break in coverage.

That agent lied. The forms were returned before Oct 31st with all the same information that my mother had given during the phone interview. The agent then claimed (after I phoned several weeks later to confirm that coverage was continuing as it should) that not all the information was received, AND THAT SHE HAD NOT EVEN GOT AROUND TO REVIEWING THE FORMS YET.

She threatened to send my mother's benefits claim to the fraud dept. The agent never even informed me that all she had to do was send an affidavit to be signed.

Several more weeks go by. Another phone call to the benefits department (this time with the help of a seniors aid group) and it was finally revealed that all my mother needed was to have an affidavit form signed. The form was mailed out, signed and returned.

Several weeks later, still nothing. Another call from Senior Network Services got through, and after a lengthy run-around with another agent, the Medicaid agency finally got around to approving the re-up. Benefits would be retroactive to the date of Oct 31st, the date of continuance.

I have just received a letter from the Social Security Administration, that my mother's Medicare premiums would be retroactively charged back to Nov 1st, and that her Social Security retirement check for January would have the deductions for two months worth of premiums from her already miniscule retirement check. And starting in February her retirement check will have the regular monthly premium for Medicare taken out.

I am outraged :mad: . After two months of argy bargying over a clerical snafu, the Medicaid benefits agent has ****** everything up. Now I will have to contact Social Security (because the local Medicaid agency will likely not bother to deal with it for weeks) and explain that my mother's Medicaid coverage should be retroactively applied and her checks not be debited.

I doubt I will be able to do this until after the New Year, because both the Social Security Department and the Medicaid Department have lovely holidays during which time no business will be conducted.

So that's how it works in America folks. If you're poor, and some bitchy agent ***** up your paperwork, you're ******.

So xjx388 explain again the wonders of America's ****** up health care packages for the needy. What's that? Charity you say. Bollocks. :mad::mad::mad::mad::mad::mad:

GB

Yep. Been there. And if any aspect changes - if your mother needs more frequent care, if she moves, if a different agent is assigned to the case, if they "upgrade" their system - you get to go through it again.

I am so sorry. It's beyond maddening.
 
Thank you!

The United States government has not been shown to provide anything effectively and efficiently. We have no choice with some of the things it provides (defense, police, etc) because it's the governments job. But we do have a choice when it comes to healthcare, education, energy, etc.

Let me ask you this: Do I have a right to the fruits of your labor?

Are you driving on roads? Is your home protected from fire? Do your children go to school? Do you sleep better at night knowing that the US can remain an super-power because of military overspending? Do you eat any grains?

If so, get your grubby paws off the fruits of my labor!
 
Gandalf,

I know you don't know me as I am an 'internet poster' but I assure you I do not lie, I do not cheat on my taxes, and I definitely do not make up stories. Lord knows I wouldn't be able to keep them straight if I did.

If you'd like I'll give you his name and phone number. But beware, he will ask you for a handout.


I believe you. I'm just tickled pink by the contrast between your plaint, and xjx388's starry-eyed exposition of the great family love whereby he sponged off his family when he knocked-up his teenage girlfriend. That was the way to do it, families supporting each other, absolutely natural and fine and praiseworthy.

Get with the programme! :D

Rolfe.
 
VAT vs. sales tax?

A digression here, but since it seems to be under discussion, could a Brit articulate the difference between your value added tax and the traditional sales tax? In the U.S. many states and cities impose a sales tax, which is generally a flat percentage of a transaction added to the amount, with some goods (often groceries) exempt. So if I, as a retailer, order 100 tubes of toothpaste from a wholesaler for a dollar each, and the sales tax rate is 6 percent, the wholesaler collects an additional $6 from me as sales tax. Then when I sell each tube for $2, I collect an additional 12 cents tax from each customer. If it doesn't sell at that price and I mark it down to 50 cents, I sell it a loss to me but still collect 3 cents tax on each tube. Pretty straightforward. But as I understand the value added tax, it requires potentially complex calculations about the costs and profits at each step of the way. In my simple example, the VAT would only be collected on the difference between my $1 cost and my $2 retail sale. If I sell it for less than my cost no tax is collected. If I run a restaurant, where I am buying dozens of foods and supplies from numerous providers and paying wages to workers and rent to landlords, I must apportion my costs and expenses against my sales to determine how much I owe. Each of my suppliers does the same, all the way up and down the chain. Obviously at every step of the way there is room to fudge the figures. Is my understanding anywhere close to correct? If so, why is a VAT, with its complex calculations and record-keeping, more desirable than a simple sales tax? (Another big difference is that a U.S. sales tax is identified separately on the receipt, where the VAT is built inconspicuously into the price. )
 
Vat is shown separately on receipts

But the price displayed is the price paid.
 
I believe you. I'm just tickled pink by the contrast between your plaint, and xjx388's starry-eyed exposition of the great family love whereby he sponged off his family when he knocked-up his teenage girlfriend. That was the way to do it, families supporting each other, absolutely natural and fine and praiseworthy.

Get with the programme! :D

Rolfe.

Yup, just as I expected. My depiction of exactly what happened is starry-eyed, but your rosy-cheeked depiction of the UK health system is "reality," despite the numerous proofs offered to the contrary.

No, not everyone has strong families. This is a very sad situation, but inevitable in human affairs. If worst had come to worst, we could have sponged off the taxpayers. In either case, the parties in question have been amply repaid.
 
A digression here, but since it seems to be under discussion, could a Brit articulate the difference between your value added tax and the traditional sales tax? In the U.S. many states and cities impose a sales tax, which is generally a flat percentage of a transaction added to the amount, with some goods (often groceries) exempt. So if I, as a retailer, order 100 tubes of toothpaste from a wholesaler for a dollar each, and the sales tax rate is 6 percent, the wholesaler collects an additional $6 from me as sales tax. Then when I sell each tube for $2, I collect an additional 12 cents tax from each customer. If it doesn't sell at that price and I mark it down to 50 cents, I sell it a loss to me but still collect 3 cents tax on each tube. Pretty straightforward. But as I understand the value added tax, it requires potentially complex calculations about the costs and profits at each step of the way. In my simple example, the VAT would only be collected on the difference between my $1 cost and my $2 retail sale. If I sell it for less than my cost no tax is collected. If I run a restaurant, where I am buying dozens of foods and supplies from numerous providers and paying wages to workers and rent to landlords, I must apportion my costs and expenses against my sales to determine how much I owe. Each of my suppliers does the same, all the way up and down the chain. Obviously at every step of the way there is room to fudge the figures. Is my understanding anywhere close to correct? If so, why is a VAT, with its complex calculations and record-keeping, more desirable than a simple sales tax? (Another big difference is that a U.S. sales tax is identified separately on the receipt, where the VAT is built inconspicuously into the price. )


Oooh, you made my head hurt. Could you start a new thread for that?

Rolfe.
 
Exactly what we have been saying. You are dealing with the Federal government (Medicare) and the state government (Medicaid). And you want the government to handle a national healthcare system???? They can handle very little effectively and efficiently.

The current system is the result of years and years of compromise. Regulations shoehorned into place by special interests, by politicians "taking a stand" against wasteful spending, or handouts or whatever popular buzzword is understood to mean "poor."

There has been no focus on growth, the focus has always been to reduce spending in these areas. Unfortunately that means shortcuts and micromanaging, which have become needlessly complicated and bloated.

In this case, we have the benefit of working models around the world, many in countries with a similar taxation and social system. This is a huge boon, we don't have to design a system from scratch. We can base a new system on something that has already been field tested.
 
Yup, just as I expected. My depiction of exactly what happened is starry-eyed, but your rosy-cheeked depiction of the UK health system is "reality," despite the numerous proofs offered to the contrary.

.

The trouble is you have not provided any proofs to the contrary.

You appear to have started from a position which assumed that there are no facts, and all opinion is equally valid. You have been given many facts in support of the position taken by those who know about UHC systems. You have provided nothing comparable to challenge those facts. And you do not seem to know much about how UHC works; or about the principles of insurance; or anything much that is relevant. Yet you continue to pretend that you have as much evidence as the others. And that is why it reminds of a DOC thread, actually. The style is so very similar
 
A digression here, but since it seems to be under discussion, could a Brit articulate the difference between your value added tax and the traditional sales tax? In the U.S. many states and cities impose a sales tax, which is generally a flat percentage of a transaction added to the amount, with some goods (often groceries) exempt. So if I, as a retailer, order 100 tubes of toothpaste from a wholesaler for a dollar each, and the sales tax rate is 6 percent, the wholesaler collects an additional $6 from me as sales tax. Then when I sell each tube for $2, I collect an additional 12 cents tax from each customer. If it doesn't sell at that price and I mark it down to 50 cents, I sell it a loss to me but still collect 3 cents tax on each tube. Pretty straightforward. But as I understand the value added tax, it requires potentially complex calculations about the costs and profits at each step of the way. In my simple example, the VAT would only be collected on the difference between my $1 cost and my $2 retail sale. If I sell it for less than my cost no tax is collected. If I run a restaurant, where I am buying dozens of foods and supplies from numerous providers and paying wages to workers and rent to landlords, I must apportion my costs and expenses against my sales to determine how much I owe. Each of my suppliers does the same, all the way up and down the chain. Obviously at every step of the way there is room to fudge the figures. Is my understanding anywhere close to correct? If so, why is a VAT, with its complex calculations and record-keeping, more desirable than a simple sales tax? (Another big difference is that a U.S. sales tax is identified separately on the receipt, where the VAT is built inconspicuously into the price. )

VAT is not simple, and it's too close to my bedtime for me to explain it just now. But if you like (and it's not too much of a derail), I can bore you to tears with the explanation tomorrow, other commitments permitting.
 
This does not mean that the market couldn't be "more free" than it is now
Not with insurance involved. (Your money being spent by other people on other people.)

So, how are you going to bring down the costs of Ducky's surgery/treatment by increasing the freeness of the market?

Unless you're advocating high-tech, expensive treatments becoming "niche market" products for the rich, it's not possible.

I can't tell if you are unable to grok this, or are just too ashamed to admit that's what you actually want.

Bumping again...
 
Yup, just as I expected. My depiction of exactly what happened is starry-eyed, but your rosy-cheeked depiction of the UK health system is "reality," despite the numerous proofs offered to the contrary.


I'm not disputing the factual nature of your story, merely pointing out that it may seem rather different to other players in the game.

My account of the working of the NHS was simply factual, without any interpretation. And you have offered no proof at all that my description was in any way erroneous.

No, not everyone has strong families. This is a very sad situation, but inevitable in human affairs. If worst had come to worst, we could have sponged off the taxpayers. In either case, the parties in question have been amply repaid.


You did "sponge off" the taxpayers to some extent as well, as I understand it. And indeed, it is often the case that people who benefit from subsidised education (as I did myself, to a fairly excessive degree) later pay quite a lot of tax.

However, there is no requirement for recompense when a tax-funded benefit is accessed.

Rolfe.
 
Yup, just as I expected. My depiction of exactly what happened is starry-eyed, but your rosy-cheeked depiction of the UK health system is "reality," despite the numerous proofs offered to the contrary.
What proofs would they be? Please don't say Nikki Blunden, the poor woman's story has been explained to you numerous times. It's hardly our fault if you cannot grasp the difference between "the NHS provided all the care she needed" and "she wanted to try a drug which had not been shown to be of any benefit".
 
I said that any society that thinks healthcare is a right for all people cannot justify expenditures on luxuries until all of the healthcare needs of the people are met. Therefore, how can the British people justify the sums they pay their footballers, pop-stars, movie-stars, etc. while people are denied healthcare they need. I gave examples of people who have been denied in the UK (and if you think they are the only ones who have ever been denied anything, you are very, very naïve).

I assert you are ignorant of medical ethics and clinical practice.

The Hippocratic oath:

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan

The monoclonal antibody drugs still have issues.

Do you have any sort of scientific training at all?

Do you have any ethics training?

What is your education?

I have three science degrees, B Sc Biology, B Sc Biomedical Sciences (first class honours), and a Masters degree in Clinical Biochemistry.

I work as a Biomedical Scientist, I have a special interest in endocrinology.

I find it odd you continue to make such claims despite the evidence presented.

The breast cancer drug Lapatinib is under clinical trials.

http://www.macmillan.org.uk/Canceri...atinib.aspx#DynamicJumpMenuManager_6_Anchor_1

There are more issues in medicine that just giving a patient a treatment or scan because it it NEW.
 
Bump.
I really want an answer to this.

kelly,

I don't think anything can bring down the cost of Ducky's treatment because it is so specialized. I think xjx is more referring to basic healthcare and preventative visits being affected by the free market but I can't speak for him.

As far as the "Your money being spent by other people on other people" - that is exactly what the government does and does so completely inefficiently.


Here is where the US government spent over 16 billion dollars in 2010:

$2,000,000 for the Appalachian Fruit Laboratory
$3,623,453 for wool research
$98,000 for perennial wheat research
$250,000 for turtle protection funding
$700,000 for shrimp industry fishing research
$1,793,000 for a comprehensive study of the Ohio River basin
$1,000,000 for the Idaho Sage-Grouse Management Plan

http://www.cagw.org/assets/pig-book-files/2010/2010-pig-book-summary.pdf

I think the bigger issue is why can't we cover everyone's health with the money they are already stealing from us? Perhaps the US government needs to spend tax dollars on healthcare instead of fruit and shrimp.
 

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