Health care - administrative incompetence
- Thread starter bigred
- Start date
The more and more I read, the more and more I want an NHS here
You don't - the NHS is certainly not the best UHC system out there - I would look at somewhere like France or given the apparent culture of the USA the Australian model.
This game of whack-a-mole is getting old. What's the biggest difference between the two groups of recipients above? Think about it. Go ahead, take a moment. I'll wait. <taps fingers on desk> Ready? Click the button.
Last edited:
So you finally admit that we spend significantly less than you for comparable clinical outcomes?
This is presumably part of your argument that your government couldn't organise a piss-up in a brewery?
bookitty
Philosopher
- Joined
- Jul 26, 2009
- Messages
- 5,732
But...but, people in the UK can still pay through the nose for private insurance, right? If the US were to set up some sort of universal system, there would still be private insurance and there would even be private hospitals. All of which would be free market and too expensive for the riff-raff.
He could have his free-market cake and everyone else could eat, too.
kellyb
Penultimate Amazing
- Joined
- Jan 18, 2006
- Messages
- 12,632
What % of the patients your wife currently treats are paying with Medicare or Medicaid?
kellyb
Penultimate Amazing
- Joined
- Jan 18, 2006
- Messages
- 12,632
LOL!
Even if this wasn't comparing apples to chipmunks, what would be the NHS's motivation to reduce fraud and abuse?
Tatyana
Illuminator
- Joined
- Oct 23, 2009
- Messages
- 3,701
There is this thing called 'google' you can type in things like 'Fraud in the NHS'.
http://www.nhsbsa.nhs.uk/CounterFraud.aspx
http://www.prnewswire.co.uk/cgi/news/release?id=104200
Am I being asked to believe that americans are uniquely incompetent AND uniquely dishonest now? That is what it seems like. It is funny: I never thought of america as suffering from low self esteem, but since I cannot believe this is a realistic perception I suppose it must be so. 
Am I being asked to believe that americans are uniquely incompetent AND uniquely dishonest now? That is what it seems like. It is funny: I never thought of america as suffering from low self esteem, but since I cannot believe this is a realistic perception I suppose it must be so.
Please capitalize America in the future. Our self-esteem is low enough as it is.
Earlier in the thread, xjx388 claimed that companies "convince" Medicare patients that they need (I kid you not) diapers. I'm not quite sure how you convince someone of that, but that's what he claimed. Adult diapers can be found for sale at flea markets. These things are 75 cents each (large size) on the web. I just checked ebay, and there are two sales closing where 12 packs at $2 (total) have zero bids.
Yep, Medicare is rife with adult diaper fraud!! Big business!
Gandalfs Beard
Graduate Poster
- Joined
- Feb 14, 2009
- Messages
- 1,548
Unless you're rich. then you can just offshore your accounts, claim losses in your American branch of your corporation, get Tax Breaks targeted at the top 2 percent, get subsidies for outsourcing jobs...etc. there are so many tax loopholes and breaks the wealthy get, that the average American can't, that the effective tax rates for many millionaires and billionaires are either 0% or they actually make money.
It makes me wonder why they howl so much at the idea that Obama might have allowed the Bush Tax Cuts for the Rich to end. I guess a few of them might actually have to pay some taxes, or the tax reinstatements would balance out their subsidies so they wouldn't get money back from the US government.
GB
xjx388
Penultimate Amazing
- Joined
- Dec 1, 2010
- Messages
- 11,392
Please capitalize America in the future. Our self-esteem is low enough as it is.
Earlier in the thread, xjx388 claimed that companies "convince" Medicare patients that they need (I kid you not) diapers. I'm not quite sure how you convince someone of that, but that's what he claimed. Adult diapers can be found for sale at flea markets. These things are 75 cents each (large size) on the web. I just checked ebay, and there are two sales closing where 12 packs at $2 (total) have zero bids.
Yep, Medicare is rife with adult diaper fraud!! Big business!
Scoff all you want. It happens. And that's just one part of the fraud equation.
Ampulla of Vater
Illuminator
I think you misunderstood me. I think cheating is wrong, at any level. My point was that Medicare, which is governmentally run, has methods of measuring what a particular physician does which boil down to exactly what is written and has absolutely zero interest in outcomes. If a physician performs a level of service for a patient but does not write it down exactly per the rules, s/he can (and will) go to prison and pay $10,000.00 per infraction. It is my opinion this is not in the best interest of the patient as the doctor's focus must be on ridiculous documentation rules as opposed to the patient. The documentation guidelines require one to be a rocket scientist to interpret them. This is how our government "runs" the sector of healthcare of which it is in charge.
Rolfe
Adult human female
It seems I must have been the only person who couldn't get on to the forum last night - but it was so. Suddenly, around seven o'clock, I got "the server is taking too long to respond" messages, right through till past my bed time. I spent the evening showing pictures of my holidays to other Golf GTi owners!
I'm going to bow out, because there's no arguing with blind ideology, and because I promised to get back to the Lockerbie issues, where informed debaters are a lot thinner on the ground. However, I did want to comment on the Nataline Sarkisyan case.
Architect is right, but not for the reason he thinks. That wouldn't happen in Britain, NHS or private, because the family would never have been given the impression that a liver transplant was a viable option in such a case.
Thou shalt not kill; but shalt not strive
Officiously to keep alive.
It's hard, when the patient is only a teenager. It seems wrong. But Nataline was dying, and all the sensible options had been tried. What on earth was the point in suggesting a liver transplant?
She had had a bone marrow transplant and chemotherapy and all the standard treatments. She was dying. This wasn't a case of a patient in liver failure, say with chronic active hepatitis, who would be returned to health with a new liver. I am frankly astonished that any ethical surgeon would suggest such a procedure in this case. A 65% six-month survival record? God help us. And where about was Nataline on the prognosis range on that one?
If it was my liver, and I'm a registered organ donor, I'd hope to be looking down from my cloud at someone who was given many years of normal happy life from my carefully-tended liver. Not at some poor dying child who was put through the trauma of very major surgery, anti-rejection medication and all the rest, for an only slightly better-than-even chance that she might survive long enough to recover from the surgery.
How many donor livers does the USA medical system have access to, for goodness sake, if it can throw them away like this? Even if donor livers are cheap as chips, is there any way it can be ethical to put a patient through this, for no possibility of cure or long-term benefit?
Maybe it's easier for vets to raise this subject, but we often have to say to owners, gently, "who are you doing this for?" Yes, human patients will take more than animals will, as I remarked about Ducky. But there still has to be a bit of realism. Grief-stricken parents are not the people to be making such decisions. Offering them completely unrealistic heroic interventions is in itself cruelty.
Nataline had been in a vegetative state for weeks. She wasn't the one pushing for this. It was her parents - at the instigation of her medical team.
Cui bono?
If there's a villain in this piece, my vote goes to the leukaemia team and the transplant team for even considering this in the first place, and suggesting it to the parents. They're not thinking, this is a major operation which in itself brings with it considerable pain and suffering, and the best it can do is draw out the dying process by a few months. They're just seeing another straw to clutch at.
How much did these doctors and surgeons stand to gain personally from doing that surgery? I think it's a valid question.
Bingo. No, it wasn't experimental. It wasn't proven to be safe or effective for that patient. But they caved in to overwhelming emotional pressure.
This isn't identical to the Nicky Blunden situation, but it's extremely close. It's even closer to one of the poor example cases in Sicko, where an insurance company wouldn't fund a bone marrow transplant for a man dying of kidney cancer, after all potentially effective treatments had failed. The patient's wife was hysterically begging the insurance executives for her husband's life, and all I could think of was, who the hell suggested to her that a bone marrow transplant was a viable treatment in this case, and how much would he have been paid for doing it.
With Nicky Blunden, as Tatyana has so clearly demonstrated, we have a drug of very questionable efficacy and very questionable safety, being pushed like mad by Big Pharma. The US insurance companies have caved in. Cui bono? Who has shares in whom, I ask? NICE begs to differ, and is looking at the drug on an experimental basis, to see whether its risk/benefit equation is actually acceptable. It's not going to throw money at Big Pharma just on its say-so, because NICE doesn't have shares in anyone, and nobody has shares in NICE.
So, neither of these cases is a good one to demonstrate evil rationing by healthcare payers hell-bent on saving money at the expense of human lives. But so long as Nicky Blunden keeps being brought up in this context, then Nataline Sarkisyan is an excellent counter-example. An excellent demonstration of how desperate patients and media hype can give an entirely false impression of what is going on.
The difference is, searching for real examples of US patients being denied genuinely beneficial treatment is only limited by media fatigue causing many cases to go unreported. This isn't the case when examining NHS patients.
Rolfe.
I'm going to bow out, because there's no arguing with blind ideology, and because I promised to get back to the Lockerbie issues, where informed debaters are a lot thinner on the ground. However, I did want to comment on the Nataline Sarkisyan case.
Architect is right, but not for the reason he thinks. That wouldn't happen in Britain, NHS or private, because the family would never have been given the impression that a liver transplant was a viable option in such a case.
Thou shalt not kill; but shalt not strive
Officiously to keep alive.
It's hard, when the patient is only a teenager. It seems wrong. But Nataline was dying, and all the sensible options had been tried. What on earth was the point in suggesting a liver transplant?
She had had a bone marrow transplant and chemotherapy and all the standard treatments. She was dying. This wasn't a case of a patient in liver failure, say with chronic active hepatitis, who would be returned to health with a new liver. I am frankly astonished that any ethical surgeon would suggest such a procedure in this case. A 65% six-month survival record? God help us. And where about was Nataline on the prognosis range on that one?
If it was my liver, and I'm a registered organ donor, I'd hope to be looking down from my cloud at someone who was given many years of normal happy life from my carefully-tended liver. Not at some poor dying child who was put through the trauma of very major surgery, anti-rejection medication and all the rest, for an only slightly better-than-even chance that she might survive long enough to recover from the surgery.
How many donor livers does the USA medical system have access to, for goodness sake, if it can throw them away like this? Even if donor livers are cheap as chips, is there any way it can be ethical to put a patient through this, for no possibility of cure or long-term benefit?
Maybe it's easier for vets to raise this subject, but we often have to say to owners, gently, "who are you doing this for?" Yes, human patients will take more than animals will, as I remarked about Ducky. But there still has to be a bit of realism. Grief-stricken parents are not the people to be making such decisions. Offering them completely unrealistic heroic interventions is in itself cruelty.
Nataline had been in a vegetative state for weeks. She wasn't the one pushing for this. It was her parents - at the instigation of her medical team.
Cui bono?
If there's a villain in this piece, my vote goes to the leukaemia team and the transplant team for even considering this in the first place, and suggesting it to the parents. They're not thinking, this is a major operation which in itself brings with it considerable pain and suffering, and the best it can do is draw out the dying process by a few months. They're just seeing another straw to clutch at.
How much did these doctors and surgeons stand to gain personally from doing that surgery? I think it's a valid question.
Bingo. No, it wasn't experimental. It wasn't proven to be safe or effective for that patient. But they caved in to overwhelming emotional pressure.
This isn't identical to the Nicky Blunden situation, but it's extremely close. It's even closer to one of the poor example cases in Sicko, where an insurance company wouldn't fund a bone marrow transplant for a man dying of kidney cancer, after all potentially effective treatments had failed. The patient's wife was hysterically begging the insurance executives for her husband's life, and all I could think of was, who the hell suggested to her that a bone marrow transplant was a viable treatment in this case, and how much would he have been paid for doing it.
With Nicky Blunden, as Tatyana has so clearly demonstrated, we have a drug of very questionable efficacy and very questionable safety, being pushed like mad by Big Pharma. The US insurance companies have caved in. Cui bono? Who has shares in whom, I ask? NICE begs to differ, and is looking at the drug on an experimental basis, to see whether its risk/benefit equation is actually acceptable. It's not going to throw money at Big Pharma just on its say-so, because NICE doesn't have shares in anyone, and nobody has shares in NICE.
So, neither of these cases is a good one to demonstrate evil rationing by healthcare payers hell-bent on saving money at the expense of human lives. But so long as Nicky Blunden keeps being brought up in this context, then Nataline Sarkisyan is an excellent counter-example. An excellent demonstration of how desperate patients and media hype can give an entirely false impression of what is going on.
The difference is, searching for real examples of US patients being denied genuinely beneficial treatment is only limited by media fatigue causing many cases to go unreported. This isn't the case when examining NHS patients.
Rolfe.
Yes, I'm aware that it happens. I'm scoffing at you for yapping about durable goods and patients bilking the system when physicians and hospitals receive 38X as much money. The lion's share of the fraud is not coming from durable goods.
kellyb
Penultimate Amazing
- Joined
- Jan 18, 2006
- Messages
- 12,632
That doesn't say the guy was convincing people they need diapers they don't need!
It says:
And if the government has no incentive to discover/reduce/prosecute fraud, how did he get caught?
Gandalfs Beard
Graduate Poster
- Joined
- Feb 14, 2009
- Messages
- 1,548
Well it WAS good until Halliburton took over Walter Reed.
http://www.washingtonpost.com/wp-dyn/content/article/2007/03/09/AR2007030902082.html
GB
kellyb
Penultimate Amazing
- Joined
- Jan 18, 2006
- Messages
- 12,632
You know good and well that insurance companies are bad, too.
But I agree that the Medicare documentation rules are insane. Evil, even. And THEN you (assuming you're a doctor...you sound like one.
) also have to worry about getting sued for not over-treating.NHS GPs are being abused, it sounds like, too. But not Canadian docs, weirdly. I wish TAM (he's a Canadian MD) would tell us how the Canadian system works wrt MD fraud prevention and malpractice.