BS: Universal Medicine in the USA.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 03 Oct 07 - 08:20 PM

In Canada they are called generic drugs. For those people who have health plans for drug coverage, unless specifically prescribed, the folks who cover the cost will pay the cost of the generic.

Subject: RE: BS: Universal Medicine in the USA.
From: GUEST,petr
Date: 03 Oct 07 - 07:41 PM

on that point McGrath, its worth noting what the drug companies in Africa re; malaria drugs.. when Gates foundation and other philanthropists started funding malaria research and drug programs
suddenly the price of anti-malarial drugs skyrocketed..
(and in general there wasnt much research into it by the drug companies since its the worlds poor who are most affected and they dont have the money)

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 03 Oct 07 - 07:11 PM

That was me.

Subject: RE: BS: Universal Medicine in the USA.
From: Kent Davis
Date: 03 Oct 07 - 06:48 PM

MORE THREAD CREEP, but again it may be useful,
katlaughing and others,

Many hospitals have programs which will discount all or part of your bill, depending on your income. It might be worth asking about. At our hospital it is called "Ohio Free Care". Hospitals also frequently offer discounts to anyone who pays cash. I think our cash rate is about 80%.
For the future, you might look into high-deductible insurance. Some of my patients have it and are well-satisfied. Premiums are much lower. Ideally, one would keep an amount equal to the deductible in a savings account. They will not cover pre-existing conditions.
On another but related topic, the high cost of prescription drugs, remember that medicines are like many other goods in that each incremental increase in quality raises the price dramatically. You want good medicine, but not necessarily the very best. For example, in our area, the very best medicines to lower cholesterol costs about $70 a month or more, depending on the dosage. However, Giant Eagle pharmacy sells an almost-as-good generic for $4 a month. The diabetes medicine Actos can run over $600 for a three-month supply, but metformin, another diabetes medicine is about $12 for a three-month supply at Wal-Mart and K-Mart. The same price differences are true for blood pressure medicine, anti-depressants, antibiotics, etc. TELL your doctor if you are willing to accept an almost-as-good medicine. Sometimes there is no inexpensive alternative, but ususally there is.
Kent

Subject: RE: BS: Universal Medicine in the USA.
From: bobad
Date: 03 Oct 07 - 06:34 PM

Exactly.

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 03 Oct 07 - 06:31 PM

"I'm all right, Jack" is how we put it here.

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 03 Oct 07 - 06:16 PM

Huh. So is it then "I've got mine and fu#k the rest of you"?

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 03 Oct 07 - 06:13 PM

Not really. There is already more than enough money being spent on health to give the USA a universal health service that would be admired by the world.

"The United States continues to spend significantly more on health care than any country in the world. In 2005, Americans spent 53 percent per capita more than the next highest country, Switzerland, and 140 percent above the median industrialized country, according to new research from the Johns Hopkins Bloomberg School of Public Health."

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 03 Oct 07 - 05:49 PM

It's difficult to put billions into Universal Health Care when you use that money for bombs. Sometimes it's just that simple.

Subject: RE: BS: Universal Medicine in the USA.
From: bobad
Date: 03 Oct 07 - 04:48 PM

There's No Way Like The American Way

Subject: RE: BS: Universal Medicine in the USA.
From: GUEST,mg
Date: 03 Oct 07 - 04:30 PM

A service now provided for people who have nothing by people who now have nothing. While we wait for the perfect system, people die, starve, wander the streets. mg

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 03 Oct 07 - 02:59 PM

A second class medical service for second class people...
..............................................

I'm not really sure that "opponents of universal health care" is really a fair way of putting it. Most of the doubters seem to think it'd be a good idea, but it would just be impossible, because Americans could never manage to run something like that without screwing it up, unlike everyone else.

I think they are needlessly underestimating their country's ability to get things right, when it sets its mind to it. I'm sure when America actually gets round to it it'll come up with a system that other people will admire and even wish to emulate.

Subject: RE: BS: Universal Medicine in the USA.
From: GUEST,mg
Date: 03 Oct 07 - 02:38 PM

Here is part of my plan:

Called the Ex-Con Clinics

1. Ex-prisoners have very hard times getting jobs (and housing).
2. They can be, sometimes are, and definitely should be, getting job training and credentials whilst in prison.
3. There are very unserved parts of the population, incluidng other ex-prisoners, drug users, homeless, mentally ill etc.

Kill a few birds with one stone. Train the prisoners, set up free or very low cost clinics and have some mobile and fixed clinics for the destitute run by ex-cons. Supervised of course by highly qualified professionals, nurses, doctors, administrators. Extra security on board. Extra special precautions around drugs, child welfare etc. Perhaps total video monitoring of every single interaction. Extreme security where drugs are concerned. Obviously not placing violent or sex offenders. Full disclosure that the medical providers are former whatevers.

mg

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 03 Oct 07 - 01:44 PM

Remember when the Pentagon/Militar was charging for tailet seats at something like $5000?

Subject: RE: BS: Universal Medicine in the USA.
From: Peace
Date: 03 Oct 07 - 01:22 PM

Yeah. And that amounts to "Mr Firth, take two of these with water right now. [gulp] Thank you Mr Firth."

That took all of 20 seconds. At $12 for that, I'm making $2160 an hour. Good business to be in.

Subject: RE: BS: Universal Medicine in the USA.
From: Don Firth
Date: 03 Oct 07 - 01:18 PM

In the lengthy post on the other thread that I mention above (HERE, if you care to read it), I talk about three weeks I spent in a hospital in Feb-Mar of 2000.

While I was there, my regular doctor checked to see that there would be no interaction problems with the prescription drug that I take regularly (blood pressure) and the stuff they were giving me at the hospital, then told me to keep taking it. My wife brought me my pills from home. A couple of people at the hospital had a hissy-fit about my "self-medicating," even if I had been told to by my regular physician. They wanted to confiscate my pills and then dole them out to me. With my regular doctor's support, I insisted that they back off!

One of the nurses (bless her pea-pickin' heart—on several occasions—for putting patient welfare before hospital regulations; I would nominate her for sainthood!) informed me that, had I given in, they would have charged me about $12.00 a day to give me my own pills!

A nickel here, a nickel there. . . .    Ain't it grand how the money rolls in?

Don Firth

Subject: RE: BS: Universal Medicine in the USA.
From: katlaughing
Date: 03 Oct 07 - 10:08 AM

art, my daughter did just that for me when I went into the hospital with congestive heart failure and no insurance. They were very hostile and reduced the bill only by about 1%, leaving me with a bill of over $13,000 which I am paying off $50 per month.:-<

Subject: RE: BS: Universal Medicine in the USA.
From: artbrooks
Date: 03 Oct 07 - 08:46 AM

Don, I once had a boss (who had excellent health insurance, BTW) who demanded an itemized bill for each period of care. She found, for example, that she had been billed for such things as $12.50 per day for the tissues next to her bed. The insurance paid, no questions asked, whatever their "reasonable and customary" negotiated rate was.

I don't personally believe that those who are uninsured pay for the care of those who are, but that's certainly where much of the profit margin comes from. If I were advising someone who was uninsured, I'd say to get that itemized bill first and then sit down with the billing office to discuss a reduction.

Subject: RE: BS: Universal Medicine in the USA.
From: katlaughing
Date: 03 Oct 07 - 12:18 AM

Oops, I misread your posting a little bit, Don. Just to clarify: I am sure hospital bills ARE padded; probably why they are open to negotiations with insurance companies, which could also be a big reason for why they are padded. Still the uninsured wind up paying for all of the padding.

Subject: RE: BS: Universal Medicine in the USA.
From: katlaughing
Date: 02 Oct 07 - 11:51 PM

Don, the uninsured usually wind up paying more, in my experience, than folks do who have insurance. That is, the insurance companies negotiate lower rates with the service providers and wind up not paying full-price. A self-pay, as I was for several years, is expected to pay full price because they have no one allowed to bargain for them.

There is more about it HERE.


More about hospital charges HERE, if you scroll down. Also, from there, obvious the uninsured are not spending much time in hospital:

Together, Medicare and Medicaid are billed for more than half (58 percent) of all hospitalizations. Private insurers are billed for 35 percent while uninsured hospitalizations account for about 5 percent of hospital stays. The remaining 3 percent of hospitalizations are billed to other insurers or the expected payer cannot be determined.

Subject: RE: BS: Universal Medicine in the USA.
From: Don Firth
Date: 02 Oct 07 - 10:52 PM

Here is an excerpt from a fairly lengthy post on the "thread with the controversial title" that spawned this thread (this isn't controversial?).

Along with my manual wheelchair, I have a power wheelchair. It can move at a good, swift jogging pace, it has a 25-mile range on a full charge, and with it, I can go a lot of places that I couldn't otherwise, including riding the city busses (which are equipped with wheelchair lifts). A couple of months ago, the batteries had to be replaced. It takes two 12-volt deep-cycle batteries. The charge to have Care Medical (where I bought the chair) replace the batteries was $500 ($220 per battery, plus $60 for installation).

I asked the technician who was installing the batteries "Why so much?" "Well," said the tech, "the batteries are classed as medical equipment, and they figure some insurance company is going to pay for them anyway."

I checked the labels on the batteries and called my nephew, who works for an auto supply store that, among other things, sells batteries. He said, "Those are standard marine batteries, like for a power boat. You can get them at any battery store. They should cost about 50 bucks apiece, max! Next time your chair needs batteries, fer gawdsake, call me!"

We know that Americans pay a lot more—a lot more—for prescription drugs than people in other countries do. A fair number of Americans who live near the Canadian border find that, even including the cost of the trip, they can get the same prescription drug for less in Canada than they can at their local pharmacy. And I've compared prices for manual wheelchairs with prices for good quality bicycles, which, apart from the design, contain more parts and are generally a bit more complex than a wheelchair. Wheelchairs are much more expensive, for no manufacturing or parts reasons that I can detect, than a considerably more complex bicycle. Why?

I think the Care Medical technician I mentioned above provided the answer.

This raises the question of how much in the way of medical bills, especially ones charged to insurance companies, are heavily padded?

Don Firth

Subject: RE: BS: Universal Medicine in the USA.
From: John Hardly
Date: 02 Oct 07 - 09:39 PM

"The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America."

Gee, what an even-tempered, moderate, objective statement to add to a discussion.

Nope, that won't shut down discussion. That's "pretty good".

Subject: RE: BS: Universal Medicine in the USA.
From: bobad
Date: 02 Oct 07 - 09:17 PM

From Emma's link on another thread:

"The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America."

http://select.nytimes.com/2007/07/16/opinion/16krugman.html?_r=4&adxnnl=1&oref=slogin&adxnnlx=1190367339-/20RYgCrVnWKw4gQ1yB+qw&oref=slogin

Subject: RE: BS: Universal Medicine in the USA.
From: McGrath of Harlow
Date: 02 Oct 07 - 08:36 PM

"Pretty good" counts as pretty effusive in England.

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!!!!!!!!!!!!!!!!!

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: 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: 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: 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: 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 - 07:43 PM

More than $73 dollars.

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.

http://www.nchc.org/facts/cost.shtml

What's 15% of $2 trillion?

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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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: 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 - 02:08 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: 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: 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: 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: 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 - 01:26 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