This is Why Healthcare for Profit is Wrong

[frogger]

The reason my brother MUST be on Medicaid despite having family to help etc is because no private insurance will touch him. He was born with Down Syndrome so it's not like he could get insurance before the condition existed so I understand where you are coming from but even all of those funds are delegated to the state programs so states manage them. He also has to limit work hours which stinks. The loss of productivity from the hoop jumping to be able to get health insurance at all is sad, not to mention quality of life issues. 

[Garga]

 

2 hours ago, Paige said:

Clean water and proper sanitation are good for everyone. Public rest areas on the highway are good for everyone.  The police and military are good for everyone. And access to healthcare is something we should see as a need for general public safety and national security. 

Hear, hear!

[ktgrok]

6 hours ago, SereneHome said:

I didn't respond the first time you quoted me.  And I really won't respond this time except to say that while you might be a popular member on here - you come off as insulting and condescending and entirely intolerable to any views other  than your own and I have less than zero interest in having any kind of discussion with you.

Obviously, you can quote whoever you want, but you will be wasting your time if you waiting for any kind of response from me.

I'm not here, so maybe I can explain that no, the ER is not available for everyone/everything. If you have cancer, they will not treat you. An ER isn't going to do dialysis or get you a heart transplant or do anything other than stabilize you. 

A former coworker had what was suspected to be cancer of the thyroid, but she didn't have insurance and couldn't afford a biopsy, let alone treatment, and no where would do a payment plan. You had to have money up front. Another had symptoms that were indicative of MS, but again, no insurance and can't cash pay for the MRI that would diagnose it. 

The ER won't do biopsies or cancer treatment or a workup to check for MS, and the specialists won't see you without cash in hand or insurance. Leaving...no options. In both these situations early diagnosis and treatment could have life altering effects. But because they don't make enough money, they may die. 

So don't go around saying that the ER or bankruptcy are solutions. They are not. 

[SereneHome]

1 hour ago, Ktgrok said:

I'm not here, so maybe I can explain that no, the ER is not available for everyone/everything. If you have cancer, they will not treat you. An ER isn't going to do dialysis or get you a heart transplant or do anything other than stabilize you. 

A former coworker had what was suspected to be cancer of the thyroid, but she didn't have insurance and couldn't afford a biopsy, let alone treatment, and no where would do a payment plan. You had to have money up front. Another had symptoms that were indicative of MS, but again, no insurance and can't cash pay for the MRI that would diagnose it. 

The ER won't do biopsies or cancer treatment or a workup to check for MS, and the specialists won't see you without cash in hand or insurance. Leaving...no options. In both these situations early diagnosis and treatment could have life altering effects. But because they don't make enough money, they may die. 

So don't go around saying that the ER or bankruptcy are solutions. They are not. 

OK, so I went back to re-read what I was responding to.  You said that you are OK with some waste as long as people are not dying bc of lack of healthcare.  I told you upfront that I don't know much about people dying from lack of care. 

So two thoughts popped into my head -  if someone needs an immediate care, there is an  ER.  And if  someone who had a lot of bills due to health care costs and can not afford to pay them off, they can declare BK. 

That was it.  I didn't  "go around" saying much more than that.  I didn't say those were great solutions.  I didn't say that I think that alleviates any kind of need for change in our healthcare system. 

[SKL]

I have always said our healthcare system needs reform.

I just don't trust our government to run it.

Personally I'd probably be fine - my kids and I don't have any serious health issues.  But I do believe many people would suffer much more than they suffer now.

Our government is not comparable to other governments.  Maybe some countries' governments do this right (more or less), but I have no faith in ours.  Just about every major legislation in recent decades intended to help people has failed and often hurt people.  All while costing a ton of money.  There is no reason for me to believe it would be different with health care.

The US government has not earned our trust IMO.

 

[SKL]

1 hour ago, Ordinary Shoes said:

I have an example of major legislation in recent decades that was intended to help people that absolutely revolutionized our healthcare system and probably saved millions of lives. 

Medicare

Medicare has been a huge success. Yes, there are problems but it covers, in a very efficient manner, millions of Americans. It's more efficient than any other payor in the US. 

It's also responsible for all of the kinds of advances in healthcare. Before the institution of Medicare, most sick people (people over 65) lacked the resources to pay for treatments for ailments like cancer or heart disease. Medicare provided funding for the elderly and created a market for healthcare services. It's absolutely no coincidence that there have been huge strides in healthcare technology in the last 50 years. Do you think we would have seen the developments we've seen if there had been no way to pay for chemotherapy for most people with cancer? 

Another huge benefit of Medicare is that the law specifically forbid segregation in Medicare participating providers. Overnight that ended segregation in hospitals throughout America. 

If you look at all of the measures (quality and cost), Medicare does a much better than any other private payor in the US. It's even more efficient than the private payor administering Medicare Advantage plans. 

So explain again why the US government, already proven to administer the most efficient healthcare administration system in the country, should not be trusted when it comes to healthcare? 

 

 

Medicare was enacted in 1965.  The workings of our federal government have changed a great deal since then.

It has its problems.  But those problems would be exponentially worse if we expanded it to cover the entire country right now.

Edited September 16, 2018 by SKL

[Frances]

14 minutes ago, SKL said:

Medicare was enacted in 1965.  The workings of our federal government have changed a great deal since then.

It has its problems.  But those problems would be exponentially worse if we expanded it to cover the entire country right now.

While it may have been enacted in 1965, it is currently serving more people than ever before. So why would the problems be exponentially worse if it were expanded to serve the entire country? One of the few complaints I hear about it is some specialists refusing to take it, especially in popular retirement areas. If it becomes the primary game in town, it’s going to be a lot harder for doctors to refuse it. And also everyone would know exactly what is and isn’t covered by it.

Edited to add that my dad would not have lived for ten relatively healthy years with cancer without it. And my mom, who has several serious life long health conditions, would absolutely not be alive today without it.

Edited September 16, 2018 by Frances

[Lady Florida.]

On 9/15/2018 at 6:37 PM, StellaM said:

 

Hear hear!

(And no, that's not because Murphy is 'popular' but because she's right).

Yes, this. 

[frogger]

It has been very difficult for my father to find a doctor now that he is over 65. For awhile there was an extreme shortage of doctors willing to take Medicare at all. The amount of paperwork and regulations was very burdensome. The last two years have been very busy so I have not kept up like I would like to but I believe there was a change(in my state) to force doctors to take a certain percentage of Medicare patients and once they reached that minimum they could then turn away any new medicare patients.  Some doctors were actually losing money on their medicare patients. They had to hire people specifically for dealing with medicare patients paperwork on top of that.

 

I wouldn't use Medicare as an example to people in costly states because those states are the ones who would notice the discrepancies. The doctors prices being undercut, the refusal to accept new patients, and the ensueing shortages. 

 

[TechWife]

Medicare was the best insurance my parents ever had. They had no problems finding doctors and received excellent care.

Medicare has changed over the years. They moved from a fee for service model to a value based purchasing model in recent years.  Gone are the days when providers received a set fee for a service with Medicare - now there is a somewhat convoluted formula that bases reimbursement on clinical outcomes, patient experience, safety, and efficiency/cost reduction. Hospitals & providers that perform well receive more money in reimbursement than hospitals that perform poorly.

I wish I had time to explain more, but this is a major change that went into effect in recent years.

[scholastica]

2 hours ago, TechWife said:

Medicare was the best insurance my parents ever had. They had no problems finding doctors and received excellent care.

Medicare has changed over the years. They moved from a fee for service model to a value based purchasing model in recent years.  Gone are the days when providers received a set fee for a service with Medicare - now there is a somewhat convoluted formula that bases reimbursement on clinical outcomes, patient experience, safety, and efficiency/cost reduction. Hospitals & providers that perform well receive more money in reimbursement than hospitals that perform poorly.

I wish I had time to explain more, but this is a major change that went into effect in recent years.

It actually started under the second Bush administration. It was strengthened during the Obama administration. It's just a very slow-moving process with different facets to the formula introduced over time. It's also exceedingly unfair to hospitals that serve in poorer areas. Their scores are affected by the poverty of the people they serve.

[threewishes]

19 hours ago, SKL said:

I have always said our healthcare system needs reform.

I just don't trust our government to run it.

Personally I'd probably be fine - my kids and I don't have any serious health issues.  But I do believe many people would suffer much more than they suffer now.

Our government is not comparable to other governments.  Maybe some countries' governments do this right (more or less), but I have no faith in ours.  Just about every major legislation in recent decades intended to help people has failed and often hurt people.  All while costing a ton of money.  There is no reason for me to believe it would be different with health care.

The US government has not earned our trust IMO.

 

But big business has earned your trust? I can't see how things can get much worse. The cost of basic healthcare in America is highly prohibitive for many Americans. Even those who have insurance often can't afford the deductibles. Imagine how much harder it is to get well from an illness or accident if you are constantly stressed over how you are going to pay the medical bills. Our "system" is going to burst just like the housing bubble in 2008, but at the cost of many lives. I am more than happy to let the government have a go if it means that I don't have to take second and third jobs to pay for medical care. 

[frogger]

4 hours ago, TechWife said:

Medicare was the best insurance my parents ever had. They had no problems finding doctors and received excellent care.

Medicare has changed over the years. They moved from a fee for service model to a value based purchasing model in recent years.  Gone are the days when providers received a set fee for a service with Medicare - now there is a somewhat convoluted formula that bases reimbursement on clinical outcomes, patient experience, safety, and efficiency/cost reduction. Hospitals & providers that perform well receive more money in reimbursement than hospitals that perform poorly.

I wish I had time to explain more, but this is a major change that went into effect in recent years.

Isn't the main reason the changes were implemented though was to keep costs down? This then caused supply problems.

 

Currently, we have a ton of special interest groups using and manipulating the government who currently controls the health care market.  Arguing ideaologies won't fix anything. One thing that would reduce costs tremendously would be to have a more straightforward health care system regardless of which way we go.