Health care - administrative incompetence

Well that explains it. Garbage in - Garbage out.
And here:

It's just more crap you're throwing at the wall.
But it's that kind of crap that will prevent UHC as practiced in the UK from coming to America.

Fortunately, there are only about 6 doctors per 1,000 people in the USA. They don't have to like it. If you think negotiating with Cigna is tough, try negotiating with the USA. Good luck!

Besides, let's see them go get jobs that pay as much doing anything else.
If that were the case, why don't we have UHC now?
 
A freer market will reduce costs overall.

The sad fact is that MM is a niche market, if you want to use those terms.

How are you proposing to even create a freer marker for MM treatment?

There are tens or hundreds of thousands (maybe millions?) of people like me and Ducky "screwed" by medical debt.
 
If that were the case, why don't we have UHC now?

Because only around 1% of the US population is even aware of the fact that what we pay for Medicare and Medicade alone can fund an entire US NHS without taxes being raised by a single cent.
 
Well that explains it. Garbage in - Garbage out.
And here:
I saw what you did there. You threw out the number from the Bureau of Labor Statistics without comment. Then you ignored all of the other factors that must be accounted for to compare apples to apples. You can't just ignore $15K to $20K in lowered expenses when comparing the salaries.

But it's that kind of crap that will prevent UHC as practiced in the UK from coming to America.
Right. Americans will revolt learning that a family physician is earning what senators earn.

If that were the case, why don't we have UHC now?
It's not because of physicians, that's for sure. They actually have very little power because they are not well organized. They are a bunch of relatively small partnerships, most of whom suck at business (I've had a number as clients). The two major obstacles I see are the insurance companies and the woeful ignorance of Americans, which you've so aptly demonstrated in this thread with all the misconceptions you had (and still have) about how much better other countries do. Maybe Bill Gates will fork over $100M to run an advertising campaign to educate the teeming millions.
 
How are you proposing to even create a freer marker for MM treatment?

There are tens or hundreds of thousands (maybe millions?) of people like me and Ducky "screwed" by medical debt.

And that's just the extreme example. There are plenty of people whose quality of life is diminished by the lack of affordable health care, and that includes people with insurance. Don't let xjx388 suck you into just discussing people like Ducky.
 
And that's just the extreme example. There are plenty of people whose quality of life is diminished by the lack of affordable health care, and that includes people with insurance. Don't let xjx388 suck you into just discussing people like Ducky.

OI! I'm not that bad!

;)
 
And that's just the extreme example. There are plenty of people whose quality of life is diminished by the lack of affordable health care, and that includes people with insurance. Don't let xjx388 suck you into just discussing people like Ducky.

Ducky's $1 mil treatment is a pretty perfect example of an area where "freer markets" aren't going to help much, if at all, though (and actually, NOT covering/treating the Duckies of the world might make such treatments go UP in price, because of economies of scale issues.)
 
OI! I'm not that bad!

;)

Well, you are someone who conservatives think should be sacrificed (like, actual human sacrifice-style) to the "invisible hand" (aka, god-like force) of the free market.

Funny how they back peddle and get all "Oh, I'm not really, necessarily saying that, exactly" when faced with an actual human they would, if it were more anonymous, rather see die than see tax money save.
 
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

It's not really true that the Right Wing in the US believe government can't run anything. It's just a propaganda tool.

The Right are perfectly happy to overspend on the military and underspend on human services. Then the Right fills all the governments regulatory agencies with their own kind, who then don't bother to regulate at all.

Then they point to the inefficiencies of an underfunded agency full of Right Wing Tools during a Katrina or BP/Halliburton disaster and say "See government doesn't work. We told you so."

The government works perfectly fine when it's funded and staffed by people that actually believe in it.

GB
 
It's not really true that the Right Wing in the US believe government can't run anything. It's just a propaganda tool.

Not on the part of average conservative voters. It's not like the posters here saying this stuff are being intentionally deceptive about their "gov is always inefficient and wasteful" beliefs.
 
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A freer market will reduce costs overall.

The sad fact is that MM is a niche market, if you want to use those terms. It's pretty rare and it's going to cost a lot to treat it no matter what. What would have helped Ducky (and might help him now) is the new law which says insurers can't discriminate based on pre-existing conditions. I wonder if he's applied for disability? Once you have that going, you can get Medicare. The current system is far from perfect, but there are ways to get help -very few people are totally screwed.

Let them eat cake, right?

You are aware that millions of people in the US are under-insured, right?

Your solution is to have them get money from the government if something goes wrong. So basically, in order to keep government out of the medical industry, you would rather have individuals deal with the government. Instead of creating a system where everyone is treated fairly, you drive a certain percentage to bankruptcy and then give them a government hand out.

And you know what, there are actually doctors out there who would be ok with making $100,000+ a year. Not every person who joins the medical profession is in it to milk every last dime from the ill. Some of them want to help people. Especially if those people paid for the doctor to go to school in the first place.
 
Let them eat cake, right?

You are aware that millions of people in the US are under-insured, right?

Your solution is to have them get money from the government if something goes wrong. So basically, in order to keep government out of the medical industry, you would rather have individuals deal with the government. Instead of creating a system where everyone is treated fairly, you drive a certain percentage to bankruptcy and then give them a government hand out.

And you know what, there are actually doctors out there who would be ok with making $100,000+ a year. Not every person who joins the medical profession is in it to milk every last dime from the ill. Some of them want to help people. Especially if those people paid for the doctor to go to school in the first place.

As someone looking to become a physician one day, I have to say when I look salaries for FPs that range around something like 140,000 $ /yr, I can't say I'd mind such a salary, but then again I've come from an impoverished background, so that could be something to do with it.
 
As someone looking to become a physician one day, I have to say when I look salaries for FPs that range around something like 140,000 $ /yr, I can't say I'd mind such a salary, but then again I've come from an impoverished background, so that could be something to do with it.

Also, there is no evidence to indicate that doctors would need to take a cut in salary. It might be that centralizing the administration of health care would create such a surplus that doctors would be paid the same. (How much money do you think the insurance companies spend just to handle the paperwork?) Doctors may need to be lured into the new system and rewarded for doing so. If there is currently a lack of doctors in the US, there might even be extreme tax cuts for doctors who joined the public sector and heavier taxes for those who remained private.
 
Also, there is no evidence to indicate that doctors would need to take a cut in salary. It might be that centralizing the administration of health care would create such a surplus that doctors would be paid the same. (How much money do you think the insurance companies spend just to handle the paperwork?) Doctors may need to be lured into the new system and rewarded for doing so. If there is currently a lack of doctors in the US, there might even be extreme tax cuts for doctors who joined the public sector and heavier taxes for those who remained private.

Also keep in mind how much less I'd have to spend on healthcare if we had a universal system. As health insurance premiums keep rising, and rising...and rising, that's more and more disposable cash I have to take out of my income to go to healthcare. With a universal system, I really don't have to worry about that, hence less income I need to secure that aspect of my living.

Also I agree. The claim that physicians inevitably make less money in a universal system is unfounded. Though, dermatologists may not be able to make nearly a million dollars a year just popping zits :P
 
I would like to ask the Americans who are unhappy with the current situation if it was always like this in America. I ask because upthread someone said they saw the origin of the problem in the Reagan years. As others have mentioned, we in the uk are currently seeing active threat to the health service, although the government making that threat lied about their intentions in order to get elected (IMO). To me this seems to be yet another step along a road which has been travelled since the Thatcher years and there is a tendency to see this as americanisation (a tendency I often fall into). Yet it seems to me that that is a misnomer and that what we are seeing is not nationally based at all. It is rather a change in the nature of government from democracy to plutocracy, though unacknowledged. I think that move is further advanced in America, perhaps because they started earlier; or because it fits better with the national narrative; or for some other reason. I understand from some other europeans that the move is also happening in some other countries though they are maybe less far down the road than we are. It is at least noticeable that some premises which are eminently challengeable are treated as fact and that the debate has become limited in terms of what is seen as reasonable to discuss. Perhaps the phenomenon is truly american, as it is often seen: but perhaps it is no more american than it is british or european: but is rather transnational because plutocrats have more interests in common with each other than they do with nations or populations. Sorry if that is derail but I am interested in how this woo developed and gained ascendancy

Being in a prime position as both a UK and US citizen, I think I am qualified to explain.

After WWII, the US (and the UK too for that matter) was forced to compete in the Ideological Marketplace. The Right Wing screamed and hollered about Socialism, but Keynesian economics was adopted by the more reasonable of the ruling classes.

Federal Taxes on the highest income earners (like millionaires) was roughly 90%. Taxes on unearned income, i.e. profits (which was how most of the Rich actually made their money) was much higher too. Then the Corporations, eager to show what great citizens they were offered excellent benefits packages to their workers. The Veterans Administration paid for the education of all the soldiers returning from war (the GI bill). Unions were at their peak. Thus a large percentage of the US public shifted into the middle class.

Then came Ronnie in the US and Maggie in the UK. And they weren't having any more of this "coddling" of the populace. They Smashed Unions, cut tax rates on the Wealthy, slashed public services (harder to do in the UK), Corporations cut benefits packages...Keynesian economics was on the way out.

The propaganda machine went into high gear promoting hyper-individualism, and anti-government BS (see Century of the Self, an excellent BBC production). This had all been around to some degree through most of the 20th century, but it kicked into overdrive in the 1980s. And it's been downhill ever since.

The Plutocrats had always been in charge, but, as I implied, the more reasonable wing of the Rich had been ascendant since FDR, and started declining after the assassinations of political leaders in the 1960s. But it still took a couple of decades for the Ultra Right to wrest nearly complete control of the government and to institute a new paradigm.

After Ronnie and Maggie, the fix was in. Any Democratic candidate in the US and any Labour candidate in the UK were forced to cede the ideological ground. Thus the "Third Wayers" like Clinton and Blair were able to get elected by promising progressivism to their base, but in practice continuing the Rightward trends in flattening tax-rates and underfunding public services.

The rest is recent history. Bush the II and the Cabal of so-called "neo-conservatives" (nothing "neo" about them, most of these guys have been high up on the scene since the Nixon years) deliberately ran the economy into the ground and created a Market Crash, just in time for the election of the New Clinton, Barack Obama. Thus the Economic Ideology train runs ever Rightward, even as some ground is begrudgingly ceded on social issues.

The idea of Medicare for all, or some kind of NHS like system was never on the table during the health-care debates. So Barry and his buddies started off the debate from a compromised position: the so-called public option to compete in the market with private insurers.

This was called Socialism/Fascism/Hitlerian/and Stalinism by the Right Wing Screamers, who then organized a campaign of warfare, sending out belligerent activists to disrupt health-care meetings, and Armed Thugs to intimidate Health Care Rallies. The party of NOPE and a few Right Wing Democrats, filibustered everything in the Senate until the Public Option was dead. (Along the way a Right Wing Supreme Court stripped away the remnants of constraints on Corporate election spending).

All that was left was a tentative and mild insurance "reform" package with an Individual Mandate to force people to buy Private For Profit Insurance. This was a windfall for the Insurance Companies looking for more people to fleece. Then the midterms happened. Democrats lost the House, and the Republicans promised to eviscerate any of the good parts of the Insurance Reform bill and make Barry a one term president (to be a lesson to the more Progressive wing of the Democratic Party for ever having the "Audacity to Hope."

The End (of Democracy as we know it)

GB
 
Not on the part of average conservative voters. It's not like the posters here saying this stuff are being intentionally deceptive about their "gov is always inefficient and wasteful" beliefs.

True, they just believe the lies of the Right Wing pundits.

GB
 
Being in a prime position as both a UK and US citizen, I think I am qualified to explain.

After WWII, the US (and the UK too for that matter) was forced to compete in the Ideological Marketplace. The Right Wing screamed and hollered about Socialism, but Keynesian economics was adopted by the more reasonable of the ruling classes.

Federal Taxes on the highest income earners (like millionaires) was roughly 90%. Taxes on unearned income, i.e. profits (which was how most of the Rich actually made their money) was much higher too. Then the Corporations, eager to show what great citizens they were offered excellent benefits packages to their workers. The Veterans Administration paid for the education of all the soldiers returning from war (the GI bill). Unions were at their peak. Thus a large percentage of the US public shifted into the middle class.

Then came Ronnie in the US and Maggie in the UK. And they weren't having any more of this "coddling" of the populace. They Smashed Unions, cut tax rates on the Wealthy, slashed public services (harder to do in the UK), Corporations cut benefits packages...Keynesian economics was on the way out.

The propaganda machine went into high gear promoting hyper-individualism, and anti-government BS (see Century of the Self, an excellent BBC production). This had all been around to some degree through most of the 20th century, but it kicked into overdrive in the 1980s. And it's been downhill ever since.

The Plutocrats had always been in charge, but, as I implied, the more reasonable wing of the Rich had been ascendant since FDR, and started declining after the assassinations of political leaders in the 1960s. But it still took a couple of decades for the Ultra Right to wrest nearly complete control of the government and to institute a new paradigm.

After Ronnie and Maggie, the fix was in. Any Democratic candidate in the US and any Labour candidate in the UK were forced to cede the ideological ground. Thus the "Third Wayers" like Clinton and Blair were able to get elected by promising progressivism to their base, but in practice continuing the Rightward trends in flattening tax-rates and underfunding public services.

The rest is recent history. Bush the II and the Cabal of so-called "neo-conservatives" (nothing "neo" about them, most of these guys have been high up on the scene since the Nixon years) deliberately ran the economy into the ground and created a Market Crash, just in time for the election of the New Clinton, Barack Obama. Thus the Economic Ideology train runs ever Rightward, even as some ground is begrudgingly ceded on social issues.

The idea of Medicare for all, or some kind of NHS like system was never on the table during the health-care debates. So Barry and his buddies started off the debate from a compromised position: the so-called public option to compete in the market with private insurers.

This was called Socialism/Fascism/Hitlerian/and Stalinism by the Right Wing Screamers, who then organized a campaign of warfare, sending out belligerent activists to disrupt health-care meetings, and Armed Thugs to intimidate Health Care Rallies. The party of NOPE and a few Right Wing Democrats, filibustered everything in the Senate until the Public Option was dead. (Along the way a Right Wing Supreme Court stripped away the remnants of constraints on Corporate election spending).

All that was left was a tentative and mild insurance "reform" package with an Individual Mandate to force people to buy Private For Profit Insurance. This was a windfall for the Insurance Companies looking for more people to fleece. Then the midterms happened. Democrats lost the House, and the Republicans promised to eviscerate any of the good parts of the Insurance Reform bill and make Barry a one term president (to be a lesson to the more Progressive wing of the Democratic Party for ever having the "Audacity to Hope."

The End (of Democracy as we know it)

GB

I think one of the main problems with this issue is the "mainstream" media has been allowed to frame the discussion as "it's either all private healthcare or SOCIALIZED MEDICINE AAAAAAW" The conflation of "universal healthcare" to "socialized medicine" is completely false. Much of the nations that have a universal system don't have anything coming close to the socialized NHS model. You can have universal healthcare with pretty much all private payers, as evidence by Switzerland. Switzerland is arguably less socialized in medicine than the US is (since elderly stick with their private insurance till they die, as far as I understand, unlike ours who often go on Medicare and either use private insurance or Medicaid as a supplementary insurance) yet achieves universal healthcare, and pays much less than we do. Imagine that...
 
I don't know if anyone has pointed this out, but Vermont may be creating a universal single payer health system for their state, developed by the man who developed Taiwan's single payer system. http://www.pnhp.org/news/2010/december/in-vermont-single-payer-health-care-in-a-single-state

Apparently the media around the nation hasn't really covered this interesting development...

Interesting, especially this part:

Supporters also see single-payer as an antidote to the fragmentation of Vermont’s health care system. For example, state Representative Mark Larson, who’s expected to chair the House Health Committee next year, laments that his local hospital, Fletcher Allen Health Care in Burlington, is planning to sell off its outpatient dialysis units.

Fletcher Allen made the move because it was losing money on dialysis. The reimbursements it was receiving from all of Vermont’s various public and private health insurance providers weren’t enough to pay for the costs. In the current system, even if it were clear that the cheapest and best way to care for dialysis patients was for Fletcher Allen to own the units, the state’s power to do anything is limited. The structure of health care is subject to the vagaries of Medicare and private insurers, not coherent planning.

Under single-payer, that would change. “It’s very hard to direct a strategy for accomplishing long-term savings in health care — to manage care better, to minimize unnecessary procedures, to invest in strategies that have demonstrated savings in quality and cost — without some system of financing and payments to direct those efforts,” Larson says.

I, personally, have gotten crazy-expensive lab work company bills and radiology company bills from being in the ER. All these mini-bills totally eclipsed the actual hospital bills.

I had a feeling there were other hospital-based types of companies, each having little $2 million a year (or whatever) CEOs (and shareholders) each.
Dialysis companies are apparently another example.

So very, very many little hands in the US health care cookie jar. Maybe snipering them off state by state really is the way to go.

Vermont doesn't seem to be looking to be able to opt out of Medicare/Medicaid, either.
Hmmm...
I don't know what to think, I guess. I wish them luck, tho. I don't see it being a step in the wrong direction.
 

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