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Why do we need healthcare reform? (Page 2)
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 2010-03-07 4:57 PM in reply to: #2712871 |
 Louisiana |  Subject: RE: Why do we need healthcare reform?DerekL - 2010-03-07 3:49 PM Tripolar - 2010-03-07 3:34 PM I can see how doctors are basically forced nowadays to practice defensive medicine -- in the offhand chance they might get sued. So what's the best way to deal with this? Would it be possible to set up an independent arbitration board that decides if something was unfortunate/accidental vs. gross negligence, and sets reimbursement rates for the former? Do any countries do something like that? Some states do that already, and it's a fantastic model that I wish we'd all adopt. In Louisiana there is a 3 physician panel that reviews the merits of the case before it ever goes to trial. One is picked by the plaintiff, one by the defense, and I believe the third is chosen by the first two docs. There's nothing to prevent the case from going to trial even if they rule negatively, but it's a powerful tool for the defense to present as these aren't paid "experts" who specialize in testifying at trials. I wish we had that everywhere. Why do you think other states do not use the Medical Review Panel model? Is the cost of healthcare less in LA? |
| 2010-03-07 5:04 PM in reply to: #2712366 |
Expert  703  Colorado Springs | Subject: RE: Why do we need healthcare reform? Two thumbs up to DerekL. You are on target. |
| 2010-03-07 5:26 PM in reply to: #2712754 |
| Subject: RE: Why do we need healthcare reform? bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 |
| 2010-03-07 6:13 PM in reply to: #2712930 |
Champion 8936    | Subject: RE: Why do we need healthcare reform? twylite148 - 2010-03-07 4:57 PM DerekL - 2010-03-07 3:49 PM Tripolar - 2010-03-07 3:34 PM I can see how doctors are basically forced nowadays to practice defensive medicine -- in the offhand chance they might get sued. So what's the best way to deal with this? Would it be possible to set up an independent arbitration board that decides if something was unfortunate/accidental vs. gross negligence, and sets reimbursement rates for the former? Do any countries do something like that? Some states do that already, and it's a fantastic model that I wish we'd all adopt. In Louisiana there is a 3 physician panel that reviews the merits of the case before it ever goes to trial. One is picked by the plaintiff, one by the defense, and I believe the third is chosen by the first two docs. There's nothing to prevent the case from going to trial even if they rule negatively, but it's a powerful tool for the defense to present as these aren't paid "experts" who specialize in testifying at trials. I wish we had that everywhere. Why do you think other states do not use the Medical Review Panel model? Is the cost of healthcare less in LA? 1. Don't know. 2. Don't know either. I do know that when I practiced there and had a bad outcome, I could be assured that fellow physicians would be reviewing it rather than lawyers. No offense to lawyers (and I have lots of friends who are), but I'd prefer to have a colleague determine the legitimacy of the claim. I don't think the Medical Review Panel is the only answer, but I think it can be part of the solution. |
| 2010-03-07 7:30 PM in reply to: #2712968 |
| New user 900 , | Subject: RE: Why do we need healthcare reform? triOK - 2010-03-07 5:26 PM bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 Let me give you an example why those numbers don't mean much. Louisiana has a charity (state) hospital system where no one is refused treatment for any reason. It is based on ability to pay. Can't afford it, no problem, your healthcare is free. Shreveport is home to one such hospital, LSUHSC, a medical school and teaching hospital. Care second to none, with some of the best medical docs anywhere. You can walk or take a bus anywhere in Shreveport and be at that facility in less than 30 minutes because the city is not that big. Would you care to guess what the infant mortality rate is? Keep in mind you can have FREE HEALTHCARE at a wonderful hospital and clinic. The answer is 32.7. Does that mean that access to quality care is the problem? No, access to healthcare is not the problem, neither is quality of care. The problem is that a segment of the population doesn't give a rat's azz about their own prenatal care. The WHO numbers you posted are misleading at best. |
| 2010-03-07 7:46 PM in reply to: #2713140 |
| Subject: RE: Why do we need healthcare reform? NXS - 2010-03-07 6:30 PM triOK - 2010-03-07 5:26 PM bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 Let me give you an example why those numbers don't mean much. Louisiana has a charity (state) hospital system where no one is refused treatment for any reason. It is based on ability to pay. Can't afford it, no problem, your healthcare is free. Shreveport is home to one such hospital, LSUHSC, a medical school and teaching hospital. Care second to none, with some of the best medical docs anywhere. You can walk or take a bus anywhere in Shreveport and be at that facility in less than 30 minutes because the city is not that big. Would you care to guess what the infant mortality rate is? Keep in mind you can have FREE HEALTHCARE at a wonderful hospital and clinic. The answer is 32.7. Does that mean that access to quality care is the problem? No, access to healthcare is not the problem, neither is quality of care. The problem is that a segment of the population doesn't give a rat's azz about their own prenatal care. The WHO numbers you posted are misleading at best. I am not entirely sure how racial/income disparities have anything to do with the amount of money INVESTED in healthcare by national governments. Are there confounding factors involved with health outcomes? Sure. But the arguement I was making was that the healthcare system in the United States is FAR from the best in the world. I am arguing the system as a whole sucks.... that includes access to care, education, preventative medicine, and the fairness of the system. Your statistic of the infant mortality in Shreveport proves my point exactly. Its not fair and needs reform desparately. |
| 2010-03-07 7:51 PM in reply to: #2712366 |
| Louisiana | Subject: RE: Why do we need healthcare reform? In a previous poll, respondents were more interested in lowering their personal cost of care, rather than providing universal coverage. What do you think is the overall motivation for the healthcare reform movement? |
| 2010-03-07 7:56 PM in reply to: #2712500 |
| Expert 701 Boise | Subject: RE: Why do we need healthcare reform? KeriKadi - 2010-03-07 9:53 AM I've been thinking about this whole heathcare thing and I am sure there are no simple cost effective solutions or we wouldn't be in the boat we are in now. I have a question though which may sound silly but humor me if you will. Did anybody watch the show Northern Exposure in the 90s? The doctor that worked in the small town in Alaska was paying his dues after the state of Alaska paid for his medical school. He was obligated to work in this town for X number of years to pay back his tuition. Otherwise he would not have been able to afford medical school. I haven't researched this myself but have heard that doctors graduate medical school and complete their residency with tens-hundreds of thousands of dollars in student loans. I wonder if there couldn't be some kind of program similiar to Northern Exposure and even the G.I. Bill where doctors would work for the government/state at a set salary to have their education paid for. I wonder if this wouldn't help with the folks who have no insurance. They would be seeing doctors who are paying back their student loans. Obviously this doesn't help with the current insurance issues. I have worked in billing in the medical field and gone most of my childhood without insurance so I know there is much work to be done. However, it seems like these are two separate issues - Those who need some kind of health care without insurance and those who pay a lot of money for insurance getting quality health care. There are programs just like what you're talking about that forgive X% of your loans for working with an under served patient population. For PT's at least part of healthcare reform is increasing the % that they get forgiven. I believe but don't quote me that MDs are getting the same thing. |
| 2010-03-07 7:57 PM in reply to: #2712779 |
| Expert 701 Boise | Subject: RE: Why do we need healthcare reform? DerekL - 2010-03-07 2:44 PM Ok, as somebody on the inside who can control some of the costs, I'll give an answer that would bring down costs (at least on my end of things). Make it much harder to sue me as a doctor. Let me use my clinical judgement, and don't make me continually be afraid of being sued for missing things no matter how rare they might be. Let me not have to do a head CT on 98 year olds with altered mental status. Let me not have to observe every single patient overnight who has any inkling of chest pain no matter how low risk they are. I WILL order fewer tests. I WILL NOT hospitalize people for trivial things. I WILL bring down costs for my patients, the hospitals, and the insurance companies. I don't think we should be immune from lawsuits for gross negligence, but I do think we need to stop suits simply for bad outcomes regardless of whether the care was appropriate or not. Amen Derek. Amen. Take them to church preacher.  I couldn't agree more with you! |
| 2010-03-07 7:59 PM in reply to: #2712748 |
| Expert 701 Boise | Subject: RE: Why do we need healthcare reform? triOK - 2010-03-07 2:17 PM louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. I feel like we have 2 health systems 1 that is GREAT if you have good insurance and can go see the best doctors. System 2 is for people with bad insurance and you're screwed if that's you. |
| 2010-03-07 8:41 PM in reply to: #2713164 |
| New user 900 , | Subject: RE: Why do we need healthcare reform? triOK - 2010-03-07 7:46 PM NXS - 2010-03-07 6:30 PM triOK - 2010-03-07 5:26 PM bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 Let me give you an example why those numbers don't mean much. Louisiana has a charity (state) hospital system where no one is refused treatment for any reason. It is based on ability to pay. Can't afford it, no problem, your healthcare is free. Shreveport is home to one such hospital, LSUHSC, a medical school and teaching hospital. Care second to none, with some of the best medical docs anywhere. You can walk or take a bus anywhere in Shreveport and be at that facility in less than 30 minutes because the city is not that big. Would you care to guess what the infant mortality rate is? Keep in mind you can have FREE HEALTHCARE at a wonderful hospital and clinic. The answer is 32.7. Does that mean that access to quality care is the problem? No, access to healthcare is not the problem, neither is quality of care. The problem is that a segment of the population doesn't give a rat's azz about their own prenatal care. The WHO numbers you posted are misleading at best. I am not entirely sure how racial/income disparities have anything to do with the amount of money INVESTED in healthcare by national governments. Are there confounding factors involved with health outcomes? Sure. But the arguement I was making was that the healthcare system in the United States is FAR from the best in the world. I am arguing the system as a whole sucks.... that includes access to care, education, preventative medicine, and the fairness of the system. Your statistic of the infant mortality in Shreveport proves my point exactly. Its not fair and needs reform desparately. So what is not fair about free healthcare provided by the best docs? What could be more fair? The only thing the stats in S'port show is that there is a large segment of the population for whom their health and that of their unborn is not a priority. |
| 2010-03-07 9:18 PM in reply to: #2713238 |
| Subject: RE: Why do we need healthcare reform? NXS - 2010-03-07 7:41 PM triOK - 2010-03-07 7:46 PM NXS - 2010-03-07 6:30 PM triOK - 2010-03-07 5:26 PM bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 Let me give you an example why those numbers don't mean much. Louisiana has a charity (state) hospital system where no one is refused treatment for any reason. It is based on ability to pay. Can't afford it, no problem, your healthcare is free. Shreveport is home to one such hospital, LSUHSC, a medical school and teaching hospital. Care second to none, with some of the best medical docs anywhere. You can walk or take a bus anywhere in Shreveport and be at that facility in less than 30 minutes because the city is not that big. Would you care to guess what the infant mortality rate is? Keep in mind you can have FREE HEALTHCARE at a wonderful hospital and clinic. The answer is 32.7. Does that mean that access to quality care is the problem? No, access to healthcare is not the problem, neither is quality of care. The problem is that a segment of the population doesn't give a rat's azz about their own prenatal care. The WHO numbers you posted are misleading at best. I am not entirely sure how racial/income disparities have anything to do with the amount of money INVESTED in healthcare by national governments. Are there confounding factors involved with health outcomes? Sure. But the arguement I was making was that the healthcare system in the United States is FAR from the best in the world. I am arguing the system as a whole sucks.... that includes access to care, education, preventative medicine, and the fairness of the system. Your statistic of the infant mortality in Shreveport proves my point exactly. Its not fair and needs reform desparately. So what is not fair about free healthcare provided by the best docs? What could be more fair? The only thing the stats in S'port show is that there is a large segment of the population for whom their health and that of their unborn is not a priority. No, actually it shows that there is an enitre section of the population that isn't educated about the importance of healthy sexual activity and prenatal care. I think you'd be pretty hard pressed to find a mother that doesn't care about her child. And I seriously doubt that all of the mothers in America that don't care about their children flock to Shreveport. |
| 2010-03-07 9:42 PM in reply to: #2712366 |
Master 1795 Boynton Beach, FL | Subject: RE: Why do we need healthcare reform? good poll to take: You are diagnosed with (fill in the blank). A quick response and specialized treatment is needed ASAP. Do you: A) Look to see whih Dr. in another Country is best in field B) consider flight to Slovenia cause its ranked higher c) change citizenship to take advantage of Universal health care d) Thank your A$$ you live in America and have access to the best technology and medical minds that can be offered I will take 'D' anyday and know that by paying more gets me this peace of mind is fine by me. Start watering down the healthcare industry and A, B, C become better options. There are problems which need to be addressed no question, but a compete overhaul is not it. |
| 2010-03-07 10:05 PM in reply to: #2713306 |
| Louisiana | Subject: RE: Why do we need healthcare reform? cardenas1 - 2010-03-07 9:42 PM good poll to take: You are diagnosed with (fill in the blank). A quick response and specialized treatment is needed ASAP. Do you: A) Look to see whih Dr. in another Country is best in field B) consider flight to Slovenia cause its ranked higher c) change citizenship to take advantage of Universal health care d) Thank your A$$ you live in America and have access to the best technology and medical minds that can be offered I will take 'D' anyday and know that by paying more gets me this peace of mind is fine by me. Start watering down the healthcare industry and A, B, C become better options. There are problems which need to be addressed no question, but a compete overhaul is not it. Could not have been put better. It seems people don't want reform. They just want their great healthcare cheaper. Who wouldn't? I'd like cheaper organic food, cheaper private schools (La's public school system is at the bottom of the heap), cheaper electricity, cheaper gasoline (I live rural and have to drive in to work), and a cheaper carbon fiber bike (my last ride sucked...maybe it's the bike). But I'm not whining to the gov't to provide it for me. |
| 2010-03-07 10:17 PM in reply to: #2713306 |
Elite 4564 Boise | Subject: RE: Why do we need healthcare reform? cardenas1 - 2010-03-07 8:42 PM good poll to take: You are diagnosed with (fill in the blank). A quick response and specialized treatment is needed ASAP. Do you: A) Look to see whih Dr. in another Country is best in field B) consider flight to Slovenia cause its ranked higher c) change citizenship to take advantage of Universal health care d) Thank your A$$ you live in America and have access to the best technology and medical minds that can be offered I will take 'D' anyday and know that by paying more gets me this peace of mind is fine by me. Start watering down the healthcare industry and A, B, C become better options. There are problems which need to be addressed no question, but a compete overhaul is not it. e) do nothing and hope it gets better because I don't have health insurance. |
| 2010-03-07 10:30 PM in reply to: #2713281 |
| New user 900 , | Subject: RE: Why do we need healthcare reform? triOK - 2010-03-07 9:18 PM NXS - 2010-03-07 7:41 PM triOK - 2010-03-07 7:46 PM NXS - 2010-03-07 6:30 PM triOK - 2010-03-07 5:26 PM bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 Let me give you an example why those numbers don't mean much. Louisiana has a charity (state) hospital system where no one is refused treatment for any reason. It is based on ability to pay. Can't afford it, no problem, your healthcare is free. Shreveport is home to one such hospital, LSUHSC, a medical school and teaching hospital. Care second to none, with some of the best medical docs anywhere. You can walk or take a bus anywhere in Shreveport and be at that facility in less than 30 minutes because the city is not that big. Would you care to guess what the infant mortality rate is? Keep in mind you can have FREE HEALTHCARE at a wonderful hospital and clinic. The answer is 32.7. Does that mean that access to quality care is the problem? No, access to healthcare is not the problem, neither is quality of care. The problem is that a segment of the population doesn't give a rat's azz about their own prenatal care. The WHO numbers you posted are misleading at best. I am not entirely sure how racial/income disparities have anything to do with the amount of money INVESTED in healthcare by national governments. Are there confounding factors involved with health outcomes? Sure. But the arguement I was making was that the healthcare system in the United States is FAR from the best in the world. I am arguing the system as a whole sucks.... that includes access to care, education, preventative medicine, and the fairness of the system. Your statistic of the infant mortality in Shreveport proves my point exactly. Its not fair and needs reform desparately. So what is not fair about free healthcare provided by the best docs? What could be more fair? The only thing the stats in S'port show is that there is a large segment of the population for whom their health and that of their unborn is not a priority. No, actually it shows that there is an enitre section of the population that isn't educated about the importance of healthy sexual activity and prenatal care. I think you'd be pretty hard pressed to find a mother that doesn't care about her child. And I seriously doubt that all of the mothers in America that don't care about their children flock to Shreveport. I didn't say that they didn't care, I said that it wasn't a priority. You can make all the excuses you want for them but the facts don't change. These people have access to great free healthcare and CHOOSE not to use it. Just let me know if you ever want to leave La-La Land to see what I am talking about, and I'll meet you in Sport and give you a tour. |
| 2010-03-07 10:46 PM in reply to: #2713324 |
| Expert 701 Boise | Subject: RE: Why do we need healthcare reform? twylite148 - 2010-03-07 10:05 PM cardenas1 - 2010-03-07 9:42 PM good poll to take: You are diagnosed with (fill in the blank). A quick response and specialized treatment is needed ASAP. Do you: A) Look to see whih Dr. in another Country is best in field B) consider flight to Slovenia cause its ranked higher c) change citizenship to take advantage of Universal health care d) Thank your A$$ you live in America and have access to the best technology and medical minds that can be offered I will take 'D' anyday and know that by paying more gets me this peace of mind is fine by me. Start watering down the healthcare industry and A, B, C become better options. There are problems which need to be addressed no question, but a compete overhaul is not it. Could not have been put better. It seems people don't want reform. They just want their great healthcare cheaper. Who wouldn't? I'd like cheaper organic food, cheaper private schools (La's public school system is at the bottom of the heap), cheaper electricity, cheaper gasoline (I live rural and have to drive in to work), and a cheaper carbon fiber bike (my last ride sucked...maybe it's the bike). But I'm not whining to the gov't to provide it for me. Option D only works if you have good health insurance because if you don't a lot of docs won't see you (ie if you have an HMO). So instead of going to the best hospital in the area when you have something like cancer, lets use Chicago as an example, University of Chicago, Northwestern Memorial, Loyola University Medical Center. You're going to a neighborhood hospital where the level of care is not as high as those hospitals where the best and brightest truly tend to work. No healthcare/Not very good insurance = often lower level of care Edited by crazyquick23 2010-03-07 10:49 PM |
| 2010-03-07 11:01 PM in reply to: #2713354 |
Master 1585 Folsom (Sacramento), CA | Subject: RE: Why do we need healthcare reform? crazyquick23 - 2010-03-07 8:46 PM twylite148 - 2010-03-07 10:05 PM cardenas1 - 2010-03-07 9:42 PM good poll to take: You are diagnosed with (fill in the blank). A quick response and specialized treatment is needed ASAP. Do you: A) Look to see whih Dr. in another Country is best in field B) consider flight to Slovenia cause its ranked higher c) change citizenship to take advantage of Universal health care d) Thank your A$$ you live in America and have access to the best technology and medical minds that can be offered I will take 'D' anyday and know that by paying more gets me this peace of mind is fine by me. Start watering down the healthcare industry and A, B, C become better options. There are problems which need to be addressed no question, but a compete overhaul is not it. Could not have been put better. It seems people don't want reform. They just want their great healthcare cheaper. Who wouldn't? I'd like cheaper organic food, cheaper private schools (La's public school system is at the bottom of the heap), cheaper electricity, cheaper gasoline (I live rural and have to drive in to work), and a cheaper carbon fiber bike (my last ride sucked...maybe it's the bike). But I'm not whining to the gov't to provide it for me. Option D only works if you have good health insurance because if you don't a lot of docs won't see you (ie if you have an HMO). So instead of going to the best hospital in the area when you have something like cancer, lets use Chicago as an example, University of Chicago, Northwestern Memorial, Loyola University Medical Center. You're going to a neighborhood hospital where the level of care is not as high as those hospitals where the best and brightest truly tend to work. No healthcare/Not very good insurance = often lower level of care How do we determine who gets to see the best and the brightest? In an ideal world, everyone would have access to the best quality of everything. Unfortunately, that is not the reality of the situation. We live in a world with finite medical resources. The best and the brightest deserve to be fairly compensated for being the best in their respective fields, correct? Then doesn't it follow that those who want to see the best and the brightest would need to be able to afford to properly compensate those doctors. Now this could be done through direct payment or through paying for a more expensive insurance plan that gives you access to such doctors. I think the goal would be for there to be enough great doctors that everyone can receive the same level of medical care. Until we reach that point however, is there any better way to do decide who gets to see what doctors than by who can afford to properly compensate that doctor? |
| 2010-03-07 11:23 PM in reply to: #2712449 |
Master 1585 Folsom (Sacramento), CA | Subject: RE: Why do we need healthcare reform? k_watzek - 2010-03-07 6:58 AM When DH was in the Army I was covered by Tricare. However because I didn't live near a base/post I wanted to go to a local Dr. I found that many of them would NOT accept Tricare. How can you refuse to accept my insurance but my gov't insurance?!? Easy. They are paid the same amount as medicare and the dr's office thinks that amount is too low. They are paid more for the same procedure for private insurance companies so they didn't want to bother with me. Healthcare is not the problem. Insurance companies are the problem. The billing system is the problem. I'm not sure how doctors not accepting Tricare is the fault of the private insurance industry. It sounds like it is more the fault of the government plan. I'm not sure if that is what you were trying to say or not. It sounds like in this case that Tricare isn't paying the going rate for medical care in your area. I personally have no problem with doctors being paid what their fair market rate is. If I sold widgets for $100 and the government would only pay $60 for them, I would imagine that I might not be interested in selling them widgets unless the volume made up for the lower profit margin. If you don't live near a base, the doctor just isn't going to see a volume from Tricare that would be worth the lower profit margin. |
| 2010-03-07 11:27 PM in reply to: #2713341 |
| Subject: RE: Why do we need healthcare reform? NXS - 2010-03-07 9:30 PM I didn't say that they didn't care, I said that it wasn't a priority. You can make all the excuses you want for them but the facts don't change. These people have access to great free healthcare and CHOOSE not to use it. Just let me know if you ever want to leave La-La Land to see what I am talking about, and I'll meet you in Sport and give you a tour. Hahahah! Wow. That's so nice of you. You're right. I have spent tens of thousands of dollars on a Master degree in Health Policy and I have no idea what I am talking about. You might want to take a spin through the rules here on BT. Personal attacks are a big no no. If you can't have a grown up conversation, they you might want to keep your opinions to yourself. You also might want to watch who you pick fights with. Edited by triOK 2010-03-07 11:29 PM |
| 2010-03-08 1:39 AM in reply to: #2712968 |
Master 1585 Folsom (Sacramento), CA | Subject: RE: Why do we need healthcare reform? triOK - 2010-03-07 3:26 PM bradword - 2010-03-07 1:23 PM triOK - 2010-03-07 1:17 PM Lots of words on both sides, yet no numbers or references here. louamerica - 2010-03-07 8:34 AM Healthcare in the US is the best in the world. We have the best doctors, best hospitals and best equipment. Sadly, this is not even close to being true, which is why reform is needed. The United States is merely mediocre (and even that is debatable) in terms of health outcomes among other developed nations, yet the US pays 2-4x PER PERSON what those other nations do. Numbers? No problem. Its fact. From the Kaiser Family Foundation... "In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries". A 2000 study conducted by the World Health Organization ranked the United States healthcare system 37th in the world, "slightly better than Slovenia". A few comparative health outcomes: US: Money spent per capita on healthcare: $4,631 Infant mortality rate (# of infants that die per 1000 births): 7.2 Disability-adjusted life expectancy: 70.0 years Years of life lost per 100,000 years <70 for all causes: 5,120 Ranked 26th in terms of infant mortality Ranked lowest out of 191 WHO nations in terms of fairness of health care coverage (World Health Report 2000) Ranked 15th in the world for attainment Ranked 37th in the world for performance Only 40% of US citizens report being satisfied with their health care system Switzerland: (the runner-up in terms of healthcare spending) Money spent per capita: $2,794 Infant mortality: 4.7 Disability-adjusted life expectancy: 72.5 years Years of life lost per 100,000 years <70 for all causes: ??? Canada: Money spent per capita: $2,312 Infant mortality: 5.2 Disability-adjusted life expectancy: 72.0 years Years of life lost per 100,000 years <70 for all causes: 3,571 France: Money spent per capita: $2,077 Infant mortality: 4.6 Disability-adjusted life expectancy: 73.1 years Years of life lost per 100,000 years <70 for all causes: 4,182 U.K.: Money spent per capita: $1,461 Infant mortality: 5.9 Disability-adjusted life expectancy: 71.7 years Years of life lost per 100,000 years <70 for all causes: 3,888 Statistics are like bikinis. What they reveal is suggestive, but what they conceal is vital. ~Aaron Levenstein Here is the issue with using statistics as fact. Statistics can be used to say almost anything. Yes, the US infant mortality rate is higher than that of the other countries you mentioned. However, each country uses different standards in how to measure infant mortality. In the US, any baby that shoes signs of life when born is counted. This can be breathing, heart beat or voluntary muscle movement. In some countries, any baby under 1 pound is not counted. In others, any baby under 12 inches is not counted as a live birth. Some countries don't register babies that live for under 24 hours. The organization that gathers the European statistics,Organization for Economic Cooperation and Development, specifically warns about the validity of head to head comparisons. In regards to life expectancy, there are additional factors there as well. The United States has a traffic death rate that is 238% that of the UK. The death rate for violence rated crimes in the US is nearly 5x that of the UK. Both of those numbers are for 2002 and were released in a 2004 WHO report. Are these failures in our health care system? I would think not, but they would account for some of the disparity in average life span. The 2000 WHO report that you referenced also ranked the United States #1 in responsiveness. From the WHO website: Currently, WHO identifies eight domains of responsiveness: dignity, autonomy, confidentiality, communication, prompt attention, access to social support networks during care, quality of basic amenities, and choice of provider One of the big things that killed the United States ranking in the WHO is the fairness in financial contribution, basically cost based on your ability to pay. In effect, the US got dinged for not having socialized health care. Does all of this mean that I think that the United States has the #1 health care system in the world. Not at all. I honestly don't have the kind of knowledge about global health care to make a judgment on that. The point I wanted to make was that with the amount of health care data out there, statistics can be found to support anything. I don't think it can be broken down as simply as to say these numbers prove this. I believe most of this data is self reported and who knows how accurate the data even is. |
| 2010-03-08 3:06 AM in reply to: #2712366 |
Member 85 | Subject: RE: Why do we need healthcare reform? It's no wonder the US is in a state of paralysis on issues like this. Everyone wants concrete data, but when data is presented it is shown (I think rightfully so in many cases) to be of dubious value. |
| 2010-03-08 5:42 AM in reply to: #2713408 |
| Louisiana | Subject: RE: Why do we need healthcare reform? aquabug - 2010-03-08 3:06 AM It's no wonder the US is in a state of paralysis on issues like this. Everyone wants concrete data, but when data is presented it is shown (I think rightfully so in many cases) to be of dubious value. Thank you for your post. I'm glad you found a solution to you healthcare problem and your wife is improving. A couple of points are interesting. 1.Your MDs were US educated, but outside the US system. Why did they train in the US, then leave? 2. You negotiated directly with the MDs for payment. Yes, your insurance paid a part, but they were not bound by your policy. 3. Your care was more efficient, cheaper and better perceived than traditional US care. Why then do we think healthcare will be cheaper, better, faster if we add more layers of bureaucracy to it, with more rules for the MDs to follow? |
| 2010-03-08 6:01 AM in reply to: #2713428 |
Pro 6767 the Alabama part of Pennsylvania | Subject: RE: Why do we need healthcare reform? twylite148 - 2010-03-08 6:42 AM Thank you for your post. I'm glad you found a solution to you healthcare problem and your wife is improving. A couple of points are interesting. 1.Your MDs were US educated, but outside the US system. Why did they train in the US, then leave? 2. You negotiated directly with the MDs for payment. Yes, your insurance paid a part, but they were not bound by your policy. 3. Your care was more efficient, cheaper and better perceived than traditional US care. Why then do we think healthcare will be cheaper, better, faster if we add more layers of bureaucracy to it, with more rules for the MDs to follow? Because having a single payor system mean FEWER layers of bureaucracy, and FEWER rules to follow. Right now, unless I go back into a private practice and change my policy to take NO insurance, I currently am dealing with multiple insurance companies, each of which has its own bureaucracy and proprietary rules. One of the problems is that I (and the UP people) have to make numerous phone calls to numerous people at numerous agencies in order to get coverage for the inpatients. The rules are all hidden and secret - so I never know (except for an educated guess from dealing with certain individuals in the managed care review process) what magic words will get coverage. And the rules are hidden, even from the reviewers. I have had a LOT of wasted time writing a prescription for a new patient for a standard med for their condition, only to get a phone call from them at the pharmacy that it is not covered by the insurance. A med I may have written for a dozen times that week alone. When I did try on one occasion to pre-empt this process, there was no way on the insurers website to determine whether a med was covered. When I spoke to the person at the insurance who denied the med, THEY could not tell me what meds WERE in formulary, telling me that "the patient will have that information in the book they got". Under a single payor system, I will know the rules going in. I will know what meds are covered, what qualifies for admission or continued care. If you don't think that will streamline medical care and in the end lessen costs, then I don't know what will. |
| 2010-03-08 6:31 AM in reply to: #2713371 |
| New user 900 , | Subject: RE: Why do we need healthcare reform? triOK - 2010-03-07 11:27 PM NXS - 2010-03-07 9:30 PM I didn't say that they didn't care, I said that it wasn't a priority. You can make all the excuses you want for them but the facts don't change. These people have access to great free healthcare and CHOOSE not to use it. Just let me know if you ever want to leave La-La Land to see what I am talking about, and I'll meet you in Sport and give you a tour. Hahahah! Wow. That's so nice of you. You're right. I have spent tens of thousands of dollars on a Master degree in Health Policy and I have no idea what I am talking about. You might want to take a spin through the rules here on BT. Personal attacks are a big no no. If you can't have a grown up conversation, they you might want to keep your opinions to yourself. You also might want to watch who you pick fights with. It wasn't a personal attack, it was an invitation, seriously. If you would like to see why changes in the current healthcare system may not change the WHO stats you posted for the U.S., my offer still stands. |
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