BS: Universal Medicine in the USA.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 01 Oct 07 - 08:13 PM

I read, kat. That doesn't mean I agree. No evil intent there, I'm just not seeing how an already existing practice -- for instance a practice that already KNOWS it cannot survive on medicare/medicade levels of payments (not in theory, but in real life practice) could expect that it will suddenly have its fixed costs of doing business taken care of when all payments are at the government-determined medicare/medicade level. It's not a hypothetical. It's real and my brother lives it.

And sure, it's just doctors. They're expendable just like any other worker whose livilhood is based on an outmoded idea. I'm sure no tears were wept for the slide-rule manufacturer when TI came along and made them obsolete.

On the other hand, it's a little different too. The slide-rule manufacturer was made obsolete and just went to another industry. But we will still need the doctors. Even the ones who used to be able to have a private practice (it'll be sort of a rich irony -- the private practices like my brother's will go up for sale and be picked up by younger doctors who will be able to buy them a penny on the dollar from the suckers like my brother, and with a new financial structure (that doesn't include a huge business loan -- having gotten the business so cheap), may well be able to make the same practice then work with medicare/medicade level payments).

This discussion has made me think about contacting my cousin to get his opinion. I hadn't really thought about him (relative to this discussion) because I just met him. We're both in our fifties, but because my father died when I was very young, and our families have always lived more than 700 miles apart, I never met the guy 'til last Summer. Anyway, he's a doctor who lectures internationally on stem cell treatment. He's a Johns Hopkins guy and has always been hospital-connected. I'd be curious to hear his take on the whole thing and how he thinks it will impact him. Would anyone be interested in his response if I called him and discussed it?

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 01 Oct 07 - 08:28 PM

their cost of living won't just disappear just because they no longer have their own practices.

Why won't they have their own practices? How on earth do you think medicine runs in my country? Of course doctors have their own practices. Or put it the other way, of course patients have their own doctors.

I really do get the impression that the kind of system that you are objecting to, John, must have been dreamed up by people who are trying to sabotage universal health care in the States. Is this system you are on about actually really proposed, or is it black propaganda, maybe put out by the big insurance companies?

If it's real, it would hardly be difficult to come up with a system that wouldn't have those kind of drawbacks - just look around to countries which have been running systems like that for decades. And that's the way to oppose it, not trying to defend a totally absurd system that happens to have grown up in the absence of something better.

"they no longer have their own practices." Weird!!

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 01 Oct 07 - 09:11 PM

McGrath, The doctors in your country did not buy their practices (which generally entails paying for them -- an ongoing thing when practices cost deeply into six figures) under a system whereby they could make the payments on their practices and still have sufficient left over for living...

...and then have the entire payment structure upon which those commitments to pay were pulled out from under them. All your doctors who own practices bought them under your current system. Do you think they could hold onto them if suddenly your "system" decided that all of a sudden your government was not going to pay as much as it had paying all along? Do you think the doctors who own their own practices could keep them if they were suddenly given only a small percentage of the fees upon which they had predicated the purchase of their practices?

Subject: RE: BS: Universal Medicine in the USA.
From: artbrooks
Date: 01 Oct 07 - 09:16 PM

McGrath, to the best of my knowledge, nobody has proposed a plan that has all medical providers either working for the government or required to accept Medicare payments. Hillary Clinton's plan, which has been seriously lambasted by her critics as the prelude to socialized medicine, is if you have a [insurance] plan you like, you keep it. If you want to change plans or aren't currently covered, you can choose from dozens of the same plans available to members of Congress, or you can opt into a public plan option like Medicare. And working families will get tax credits to help pay their premiums. That is from her campaign website.

Subject: RE: BS: Universal Medicine in the USA.
From: Bee
Date: 01 Oct 07 - 09:26 PM

Doctors here in Canada all have their own practices, their choice of how they deliver care, their choice of where they want to practice, how much time they want to put into it - why would a doctor lose his practice because of public medical care? We have shortages of doctors in some rural areas because most doctors prefer living in cities, but those shortages are usually short term: sometimes incentives are offered young doctors to practice in rural settings.

I live sixty five km from the city. There's a small 'emergency care' hospital about 20km away, attached to a nursing home. There's a medical clinic near that mini-hospital which has six doctors and three nurses in family practice, all with their own patients. One of them is my family doctor, but if I need an appointment before he can see me (he's very popular), one of the others will see me (I've never had to wait more than three days to see someone on a minor complaint - and that was my judgement; if I needed to be seen, I would get a same day app.). There are also plenty of single practice doctors in the city, and most specialists have private practices.

Doctors get paid per service, they aren't on salary.

Subject: RE: BS: Universal Medicine in the USA.
From: bobad
Date: 01 Oct 07 - 09:28 PM

The way it works here in Canada is that doctors either join an established practice or open one of their own, they then bill the government instead of the patients for services rendered. Pretty simple really.

Subject: RE: BS: Universal Medicine in the USA.
From: Barry Finn
Date: 02 Oct 07 - 02:52 AM

In this rich & wealthy land of ours we rate internationally pretty low overall on the health care scale, infant mortality, life expectancy, acess to proper medical treatment, costs, etc are 37th though we are consided to be one the formost in technology & wealth, so something isn't right. Our system is not in need of repair it is broken & is in need of replacement. It's not hard to take a lookat some US state systems that work as well as looking to those nations that run better programs (there are at least 36 of them) & taking a look at what works for them & applying the better parts of their systems into one that would work for us. Ms Clinton's plan may not be the best but at least she's looking towards a start which is better than what most are doing & even the presenting of a national health care plan is a step that most others are refusing to do. She was slamed the last time she brought this up & even then it's time was well over due.
I'd love to see her (once she's in the Oval Office) set up a commision to look at what the rest of the world is doing & go from there.
As it is outside of the wealthy one of the most important attractions of ione's job today is it's health benifits & those range anywhere from complete coverage at hardly any cost to no coverage & they either pay out of pocket, get their own coverage or go without. Much of the population that I see are trapped by their on the job health care coverage. Retire or quit, forget it your coverage costs skyrockets & the actual coverage plumets (don't tell me about Medicare coverage I opted for as much coverage as possible & that's slim for someone who needs a lot of it & very costly to boot). Your kids are screwd once the turn 18 (with the exception of a few states that are only now just changing that coverage to age 23-26 weither they're in college or not. Unions usually provide better coverage for their people because they are in a beter position to bargin for it but their getting hit too as we see from the new Auto contract. The Drug manufactures are making a killing on the living. My mother used to raise dogs, we have one of her's, she mentioned a medication & I said that that's the same thing my son takes. We were sure it couldn't be the same because she paid about .50 per pir for her dog's perscription when my son's cost about $5 for the same pill, it turns out to be the exact same pill & then we found out r=that this isn't uncommon. Canada's become an American market place for many older & not so old who are in need of cheaper med's, there's absolutely no just reason for this, it's a shame.
The high costs of liability medical insurance is uncalled for. Malepractice is more a threat than a reality, it's the insurance companies scapegoat for unduly raping the medical community. IN the Boston aarea yrs ago we had a scandle at a day care facility, three people were charged with abuse (falsely in the opinion of many) this gave the insurance companies the excuse they needed to hit this industry with uncalled price gouges for premium to be paid for even though incidents of this kind were extremely uncommon & still are even 15 yrs later but the costs of those premiums are still sky high even with the general knowledge that these 3 were not guilty of what they'd been convicted of. This is what the malepractice insurance is about high costs for high profits! Many of our elderly even though they're covered by medicare & medicade have to make the discision between medical care &/or prescriptions or decent food shopping, that's a system gone broke.
Much of the insurance industry today believes that they are the botton line on what type of medicane & medical procedures are exceptable too. They decide weither or not some prescriptions & procedures will be covered regurdless of what the medical staff may say. Many companies just routinely deny pretty much anything as policy & then it's a case for the sickly sucker to start chasing the insurance money down for the medical parctice that's getting the same shaft as the insured, that's part of what's killing the patient & the doctor, aside from the insurance companies overwhelming both to death in paper work that neither can afford to keep up with. So both doctor & patient head towards becoming bankrupt. The government is just as bad as the insurance companies in this aspect, they are extremely slow sometimes in paying they per set undercutting costs, it's funny that everyone except the uninsured pays out so little for services rendered that costs so much higher for the same & the payment is usually collected upon reciept from the same too or else the leg breaker comes for the deed to the family ranch or whatever else.
Anyone who thinks the system works hasn't had much experience dealing with it or is well off or one of the lucky ones to either have a very good plan from work or belongs to a very healthy family!

Barry

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 03:33 AM

John's assumption seems to be that in a universal free-at-the-point-of-use system the doctors would get paid less than under the present one, and insufficient to cover their costs and give them an adequate income.

I suppose it would be possible to invent a system that worked like that, perhaps as a way of making sure it didn't get introduced, but it's not how it works in the other industrialised countries which have such systems.

Subject: RE: BS: Universal Medicine in the USA.
From: mandotim
Date: 02 Oct 07 - 06:19 AM

Just to correct a couple of assumptions about the UK National Health Service; General practitioners ('family doctors') do indeed have to buy their practices in the UK, as they are set up as independent contractors to the NHS. Hospital doctors are partially salaried, but are free to develop whatever private practice they wish, and they have to fund premises, staff etc. for this practice.
In a recent comparison, UK doctors were described as the best rewarded (financially) in the developed world.
Also; US healthcare is no longer a world leader in all areas of clinical practice and research (though it remains high on the list); much important work is now done in countries where costs are lower, such as the former Soviet states, China and India. This is particularly true in pharmaceutical development.
Hope this helps to inform a good debate.
Tim

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 08:22 AM

"John's assumption seems to be that in a universal free-at-the-point-of-use system the doctors would get paid less than under the present one, and insufficient to cover their costs and give them an adequate income."

My assumption is that:

1. ....in a universal free-at-the-point-of-use system OUR doctors (in private practice) would get paid less than under OUR present one, and insufficient to cover their costs --costs, the financial risks of which were fixed and figured under our present system -- and give them an adequate income -- adequate enough to keep their present practices

2. This isn't a blind assumption -- we have the track record of insufficient payment from medicare/medicade to go on.

3. Many regular, middle class sorking grunts in America are invested in the medical care system we have -- by virtue of stocks and mutual funds in which their retirement accounts have been placed. Those too would become severely devalued.

We may decide that that's okay. We may decide to hell with doctors like my brother who invested his life into something for which he will get nothing. That happens all the time. That's why they call it "risk". But don't claim it's a win/win for everyone.

And, please....It doesn't help to have five or six of you repeating that your countries doctors own their own practices. I understand that. I read it the first time. I answered it the first time. Your doctors bought their practices (assumed the risk) under the system you have -- in other words, they knew going in what they could expect to be paid for services rendered. To make a comparison to what we are up against, you would have to imagine that your doctors assumed the risk of buying their practices AND THEN your health care system suddenly told them that their fee for services rendered was going to be severely reduced.

Subject: RE: BS: Universal Medicine in the USA.
From: Emma B
Date: 02 Oct 07 - 08:38 AM

John, I think it has already been explained to you that that is PRECISELY what happened to private practice when the National Helath Service was set up in the UK after World War 2.

There was initially considerable resistance, much as you have dwelt on

"Despite Bevan's repeated guarantees of clinical autonomy for both family doctors and specialists, and a massive majority in favour of the NHS Act in parliament, the BMA chose defence of "clinical freedom" as its rallying cry for opposition to the new service. One BMA leader described the NHS as "a step toward Nazism as practised in Hitler's Germany". Only four months before the NHS was due to start in 1948, the BMA was still refusing even to negotiate with the Minister, a stand endorsed by 9 out of 10 GPs on an 84% vote."

However.......

"Two months after the appointed day, 93% of the population was enrolled, reaching 97% by the end of the year. In spite of themselves, the doctors' feet were indeed set on a new path entirely. They learned from their own experience that release from fee- earning improved rather than impaired doctor-patient relationships. Public service enabled them to serve more people more effectively, at lower cost to the nation, with greater personal security and integrity than they ever had in private practice. By the end of the 1960s, most were supporting the NHS as vigorously as they had once opposed it, and so they have remained."

from ORIGINS OF THE NATIONAL HEALTH SERVICE

I think many other people from the UK have also commented on the excellent remuneration that General Practioners receive for this service.

Subject: RE: BS: Universal Medicine in the USA.
From: artbrooks
Date: 02 Oct 07 - 08:47 AM

Emma, I don't think John Hardley has yet answered McGrath's question: Is this system you are on about actually really proposed, or is it black propaganda, maybe put out by the big insurance companies? It appears to be an imaginary target, designed to provide an opportunity to rant. At any rate, having been involved in health care for many years as an administrator, and with a wife who is a health care provider, I follow the news on that topic pretty closely, and I've never heard of such a thing being seriously proposed.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 08:50 AM

" I've never heard of such a thing being seriously proposed."

You've never heard Universal Health care proposed? What is this thread about?

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 08:54 AM

BTW, EmmaB, I appreciate the response. And that may well be the way things will work out. Though risks and investments are exponentially higher than they were back when your country made the switch, it's all a matter of scale.

Besides, our doctors are, by evidence of what they do, among our brightest citizens. They'll land on their feet. Many will probably lose their private practices and investments and retirements, but on a percentage basis, there are probably a number of them young enough to start over. They won't all be like my 60-year-old brother. And he won't starve either. He may just have to work longer. I know my brother. He'll work longer anyway.

Subject: RE: BS: Universal Medicine in the USA.
From: Emma B
Date: 02 Oct 07 - 09:49 AM

According to the philosopher Hegel, the only lesson of history is that men never learn anything from history!

Private Practice, Public Payment
Canadian Medicine and the Politics of Health Insurance 1911-1966
C. David Naylor Published 1986
McGill-Queen's Press

An interesting and objective look at the Canadian experience - many pages are available to read on the web site.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 10:01 AM

The reason history repeats itself is because historians repeat each other.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 10:06 AM

...that, and there's a tiny little scratch on the LP...on the LP...on the LP...on the LP...on the LP

If only there was some cosmic nickel to place on the tone arm.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 10:06 AM

In the parlance, 'drop a dime'.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 10:14 AM

I don't usually drop dimes in the parlance. Heck, I don't even refer to it as "the parlance". I call it "my livingroom". I had a cute little parlance guitar once, though.

Jack Parlance was scary.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 10:16 AM

You are a SICK man, John. Very sick. I could get to like you!

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 10:21 AM

maybe Universal Health care could help me?

prolly not.

Subject: RE: BS: Universal Medicine in the USA.
From: artbrooks
Date: 02 Oct 07 - 11:27 AM

Universal health care, by some definition of the term, has certainly been proposed. A system of single-payer health care, with all medical providers either (1) limited to the amount of compensation authorized by Medicare or some equivalent or (2) required to work for a government entity of some sort has not, by any major political candidate or main-stream political party. If I am incorrect, please refer me to a creditable source for verification otherwise. I will readily admit that there may have been such suggestions made by entities on the idiot fringe.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 11:37 AM

"During his 42 years in politics, Tommy Douglas proved himself as an outstanding Canadian leader. He is largely responsible for our central banking, old age pensions, unemployment insurance, and our universal Medicare. When asked why he stayed with NDP when he could have done better with a more powefful party, Douglas simply replied, " I have watched politicians for the last forty years drop their principles in order to get power only to find that those who paid and controlled the party which they joined prevented them from all the things they really believed in."³ To the end of his days Tommy Douglas was true to himself, to what he stood for, and to the people he represented."

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 01:02 PM

But why on Earth should the money doctors get be any less? If anything they could expect to get more since there'd be more people able to make use of their professional skills.

It may be that the proposed system that's been offered in the States is twisted in such a way as to work in way that screws doctors as well as patients by cutting costs to the bone, but that's just a reason to push for a better system that doesn't have those disadvantages and that still provides the kind of comprehensive health care that works pretty well in every other advanced country.

Or perhaps the appropriate way of putting it, that works pretty well in every advanced country.

Subject: RE: BS: Universal Medicine in the USA.
From: DougR
Date: 02 Oct 07 - 01:26 PM

I, for one, have no interest in a government run healthcare system. I just returned from a two week visit to Scotland and according to stories I read in the British press their system is anything but ideal if you really need healtcare. The government cannot efficiently run itself. We don't need government to screw up our system in the US.

DougR

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 01:35 PM

We don't need government to screw up our system in the US.

That certainly appears to be the case...
...............................................

"anything but ideal" - well that's true of everything in this world isn't it?   Of course we don't think everything here is perfect, still less actually say so, because that's not the way we work over here - but I don't think there are many people, doctors or patients, who'd switch with the American system.

Subject: RE: BS: Universal Medicine in the USA.
From: DougR
Date: 02 Oct 07 - 01:48 PM

McGrath: A guaranteed way to further screw it up (our healthcare system) is to turn it over to bureaucrats.

DougR

Subject: RE: BS: Universal Medicine in the USA.
From: artbrooks
Date: 02 Oct 07 - 01:55 PM

Since there is no proposal to turn the system over to bureaucrats, other than the proposal set up by opponents of the imaginary proposal, there seems to be no real threat of such a proposal being implemented.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 02:00 PM

The most difficult thing to see is why people would be opposed to Medicare.

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 02:08 PM

A guaranteed way to further screw it up (our health care system) is to turn it over to bureaucrats. And that's a good reason to do look into ways or organising a comprehensive health system that wouldn't do that.

But isn't your present health service largely run by bureaucrats already?   "An official who is rigidly devoted to the details of administrative procedure." Sounds familiar? For example accountants and other deskbound people working in insurance companies and hospitals.

Subject: RE: BS: Universal Medicine in the USA.
From: artbrooks
Date: 02 Oct 07 - 02:13 PM

Peace, the basic problem with Medicare is that rates are set by Act of Congress, on a national basis, and don't reflect the different costs in different parts of the country. Where I live, in Albuquerque, New Mexico, there is no problem at all in finding a doctor that accepts Medicare rates. The situation varies from place to place, since the cost of doing business (office rent, staff salaries, equipment costs, living expenses, etc.) is not the same nation-wide.

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 02:23 PM

That rerally sounds rather a daft way of doing it. You're a federal republic, so why not have that kind of thing done at a state level?

Doing it that way really does sound like you've got a system designed by people who don't really want it to work.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 02:26 PM

Canada, due to its size, has the same difficulty. BUT, we are dealing with it. Pneumonia in Alberta is the same as pneumonia in Quebec. I'd figure the same in the US. Comes down to a matter of will I think. The problems are surmountable.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 02:31 PM

"You're a federal republic, so why not have that kind of thing done at a state level?"

Curiously, it has to do with our development as a political state. The most liberal among us are the most against State's Rights and the most in favor of homogeneous States in the name of fairness. And at the same time, it is those who deem "fairness" in those terms that most want our medical care socialized.

That's one of the reasons that I really hope some good conservative minds can enter into the develpment of a better system before it's too late. We will socialize. It's inevitable.   And I'd like some reasonably good business sense in the mix before it's too late.

Subject: RE: BS: Universal Medicine in the USA.
From: Don Firth
Date: 02 Oct 07 - 03:06 PM

A quick mention to Peace:   I think there may be a bit of confusion of terms. I wasn't aware until just a bit ago that the Canadian health care system is referred to as "Medicare."

In the United States, "Medicare" is the word that is used when referring to health care reserved for people over age 65 (or is it now 67?) who are receiving Social Security benefits (and part of which, the SS recipient must pay for out of their monthly SS check). "Medicaid" is for very low-income people. Both Medicare and Medicaid pay some to health care providers, but barely adequately. And as noted above, many private physicians refuse to take Medicare and Medicaid recipients because they pay so little, and there is a mountain of paperwork involved. Incidentally, in most states, both Medicare and Medicaid are administered, not by government bureaucrats, but by private insurance companies under contract to the state government.

So much for the contention that it's "government bureaucrats" who render a system unwieldy.

####

I haven't had a chance to research this yet, so if someone has the skinny on it, perhaps you can parse it for us.

There are "health care costs" and then there are "health care costs." I think most people consider the amount of their income that they have to pay for health insurance (either directly, or deducted from their paycheck by their employer—plus the employer's contribution, which, in reality, also comes out of the employee's paycheck) as "health care costs." Often this amounts to a couple thousand dollars a year, sometimes even more. Add all of that together, and it comes to many billions of dollars placed into the hands of insurance companies.

Now. When we refer to "health care costs," are we referring to the money paid to insurance companies in health insurance premiums plus money paid directly to health care providers by patients? Or are we referring to the money that is actually paid to the health care providers, by both insurance companies and by patients directly?

I think that needs to be clarified when we talk about "health care costs."

What prompted me to wonder about this is that within recent weeks, there has been a flurry of commercials on the radio and television in this area against Referendum 67, slated to appear on the Washington State ballot in the next election.

From the Seattle Times:    "Under the new law [Referendum 67], courts can approve triple damages if an insurance company is found to have unreasonably denied coverage or payment of claims."

This law was proposed as a result of an "abnormal" number of denials of payment by insurance companies, often despite what the contract and the sales literature says the insurance company covers. Basically, Referendum 67 is an attempt to get the insurance companies to honor their promises, with a punitive charge of triple damages if a court determines that they are in default.

Insurance companies are pouring vast amounts of money into a campaign to defeat the referendum. The ads are claiming that the referendum is being proposed by "unscrupulous trial lawyers" and "ambulance chasers" in search of huge fees, and using a further scare-tactic of claiming that if the law is passed, it will cause insurance rates to skyrocket.

Two local insurance companies, Safeco and Pemco, are declining to join the campaign, saying that they consider the law to be fair, and that the campaign to defeat the referendum is being financed by a number of large out-of-state insurance companies.

So, again:    How much of America's health care costs go to insurance company profits and how much actually goes to pay health care providers?

Don Firth

Subject: RE: BS: Universal Medicine in the USA.
From: DougR
Date: 02 Oct 07 - 03:39 PM

I think the major problem with Medicare in the US is too many decisions regarding healthcare are made by federal beauracrats instead of patients and physicians. If a universal federal plan is ever adopted I can just imagine how more screwed up the system will become. We certainly don't have a problem free system in the US, but I think it's the best medical care system in the world. Otherwise why would there be so many Canadians coming south for medical care? I would not oppose a federal program designed to insure healthcare for the truly needy and cannot afford one, but I would also anticipate that it would not be a very well run program.

DougR

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 04:25 PM

"We certainly don't have a problem free system in the US, but I think it's the best medical care system in the world."

Why is that, Doug?

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 06:33 PM

No one is saying that American doctors aren't pretty good and American medical facilities aren't great. But how much help is that for millions of Americans who can't afford them?

"I would also anticipate that it would not be a very well run program." Another case of "Only in America"? Don't write yourself down and assume you Americans aren't just as competent as anyone else, when you set your mind to it.

I'm sure if you did that it really could become "the best medical care system in the world."

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 07:27 PM

"No one is saying that American doctors aren't pretty good and American medical facilities aren't great."

wow.

Subject: RE: BS: Universal Medicine in the USA.
From: pdq
Date: 02 Oct 07 - 07:28 PM

"How much of America's health care costs go to insurance company profits and how much actually goes to pay health care providers?"

The figure of 15% has been thrown around, so that may be right. Sounds reasonable, and remember, that is overhead and profit, not just profit..

When you consider that a tax dollar you send to Washington comes back to your home town as about 28¢, I don't think anyone is getting gouged here. Still, 20% of the US population is unhappy with their care, or lack of it. New ideas are needed.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 07:31 PM

"Still, 20% of the US population is unhappy with their care, or lack of it. New ideas are needed."

Well said.

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 07:37 PM

Well, if the richest country on the planet didn't have some good doctors and some great medical facilities it'd be pretty weird, wouldn't it, John?

Subject: RE: BS: Universal Medicine in the USA.
From: bobad
Date: 02 Oct 07 - 07:38 PM

By several measures, health care spending continues to rise at the fastest rate in our history.

In 2005 (the latest year data are available), total national health expenditures rose 6.9 percent -- two times the rate of inflation (1). Total spending was $2 TRILLION in 2005, or $6,700 per person (1). Total health care spending represented 16 percent of the gross domestic product (GDP).

U.S. health care spending is expected to increase at similar levels for the next decade reaching $4 TRILLION in 2015, or 20 percent of GDP (2).

In 2006, employer health insurance premiums increased by 7.7 percent � two times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $11,500. The annual premium for single coverage averaged over $4,200 (3).

Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.

What's 15% of $2 trillion?

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 07:43 PM

More than $73 dollars.

Subject: RE: BS: Universal Medicine in the USA.
From: pdq
Date: 02 Oct 07 - 07:45 PM

Back to the WHO report...

"The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems..."

"The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds."

Again, the report used five categories to evaluate each health care system, so the ranking of "37th" has little to do with the actual operating room performance or therapy or any other guage of medical talent. It is about "fairness" and "financing" and "respect for patient dignity" and, er, you get the point.

We have the finest health care in the world, just not everybody is able to receive it.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 02 Oct 07 - 07:48 PM

"We have the finest health care in the world, just not everybody is able to receive it."

We have the second-best health care in the world, and everybody IS able to receive it.

Subject: RE: BS: Universal Medicine in the USA.
From: Emma B
Date: 02 Oct 07 - 07:51 PM

"The overall performance of the United States health care system was ranked 37th by the World Health Organization (WHO) in 2000, but the same report assessed Americans' overall health at 72nd among 191 member nations included in the study."

posted 30 Sep 07 - 08:57 PM

Subject: RE: BS: Universal Medicine in the USA.
From: pdq
Date: 02 Oct 07 - 07:55 PM

"What's 15% of $2 trillion?"

Not a valid concept since 'health care managed by insurance companies who are for-profit' is only one of may methods of management. The last office visit I made, the doctor sent me a bill. I sent him a check.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 08:09 PM

Yeah, MofH, we've got some "pretty good" doctors. Don't be so darn effusive next time.

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 08:10 PM

...oh yeah. I forgot. House is actually a Brit affecting an American accent. That changes everthing. What was I thinking?

100!!!!!!!!!!!!!!!!!