U.S. healthcare expensive, inefficient (1 Viewer)

[RazorOye]

not every hospital that you go to under Canadian health care is like Charity Hospital - that's a terrible generalization

blackadder described it much more accurately

for the every day, minor things - it's great.

The reason a lot of Canadians go to the US is because the upper tier of health care is expensive if you go private or it means long wait times if you go through the government.

But if the need is urgent, you get moved up in priority.

Case in point:

I needed a CT-Scan on my neck and they judged that while the need was not immediate or life threatening, I should be given priority because it was potentially serious. Two days later I was getting that scan and didn't pay a thing.

I also was recommended for a colonoscopy because I've turned 30 and my family has a history of colon polyps, ulcers, etc... Well, the referral was made in February but the first opening for someone who didn't need the colonoscopy urgently was July. So that's a several month wait.

If I wanted a colonoscopy now, I could get one but I would have to go the private route. Which is expensive.

So there are obviously good and bad.

I've been under both health care systems and I prefer the Canadian. Granted, I have not had anything seriously needed so I've been lucky in that regard.

But to describe the hospitals as Charity Hospitals is a joke. I've gone to hospitals in downtown Toronto that are every bit as impressive and technologically advanced as those in the Houston medical center.

You could also argue that a lot of Americans seek treatment in Canada because the US system is so limiting and restricted, in terms of medicine and treatments.

 

[sandiego_dre]

RazorOye - judging from those I have spoken with, including Europeans and Canadians, that's generally the perspective of people living in universal health care countries. It's amazing that it is so widely criticized by Americans who have never experienced it.

Perhaps Americans are skeptical and apathetic by nature. If someone isn't able to make huge sums of money by getting over on someone else, there must be something wrong with it.

 

[blackadder]

We need to de-regulate the market and let it work. The market is very creative. Even on it's most imperfect day, it beats the hell out of government. When the market gets it wrong, a limited number of people are hurt- those with direct and perhaps indirect exposure to the specific issue. Enron is a good example. Qwest is another.

On the other hand, when government gets it wrong, we all lose. Taxpayers get soaked. And those who rely on services now provided by government suffer miserably, are robbed of their dignity, and lose the essence of their freedom.

I agree with this about 95% of the time if you are talking about the provision of goods and services people really want.

As far as health care goes, in a perfect world I'd rather see it decoupled from the profit motive. I'd rather not have someone ask me if I can pay before they treat me for a life threatening injury or illness. I find that a little galling. It's not like I wanted to get sick or hurt.

Once you are sick or hurt, you need the assistance. I'm pretty sure most of us would rather not be involved with doctors or hospitals if we had our choice: it means something is wrong. It's not something most of us would be interested in outside perhaps giving birth to your children. Nobody who is mentally sound wishes to be sick or hurt and therefore in need of a doctor.

As things are, you get soaked either way. Doctors/Insurance or the government. Can't win for losing.

My family has been exposed to a lot of quackery, and a lot of unecessary "tests" and excessive prescriptions. Probably should have been a malpractice suit filed by grandparents against one doctor, but they wouldn't pull the trigger on that. So, I am admittedly a little biased against the doctors and insurance companies.

 

[RazorOye]

As far as health care goes, I'd rather see it decoupled from the profit motive.

lus-un2:

 

[Taurus]

Ever dealt with the VA medical system? Are you sure you would want the government running the entire medical system? Seriously. We already have a model and it's not a very pretty picture.

Once upon a time though, government did a few things right. Grand Coulee, the interstate highway system, etc. Government is capable of it, we just have to hold them accountable.

/lookthemdudesisgettinmarried!

 

[BullDawg]

I agree with this about 95% of the time if you are talking about the provision of goods and services people really want.

As far as health care goes, in a perfect world I'd rather see it decoupled from the profit motive. I'd rather not have someone ask me if I can pay before they treat me for a life threatening injury or illness. I find that a little galling. It's not like I wanted to get sick or hurt.

Once you are sick or hurt, you need the assistance. I'm pretty sure most of us would rather not be involved with doctors or hospitals if we had our choice: it means something is wrong. It's not something most of us would be interested in outside perhaps giving birth to your children. Nobody who is mentally sound wishes to be sick or hurt and therefore in need of a doctor.

As things are, you get soaked either way. Doctors/Insurance or the government. Can't win for losing.

My family has been exposed to a lot of quackery, and a lot of unecessary "tests" and excessive prescriptions. Probably should have been a malpractice suit filed by grandparents against one doctor, but they wouldn't pull the trigger on that. So, I am admittedly a little biased against the doctors and insurance companies.

ba...I hear you and to an extent agree. There's one particular "doctor" who will one day loath the day he ever set eyes on anyone in my family. I just have to bide my time at this point. On the other hand, there are many, many good, honest, caring, and extremely hard working doctors. I have no problem with them enjoying the fruits of their labor...if they even get to that point.

Some doctors, like my uncle on the Gulf Coast, don't get to. He's trying to reopen his practice that was wiped out by the hurricane. Since his home is sitting somewhere in the Gulf, he and my aunt were forced to re-mortgage their original home...which had been paid off for 15-20 years. And since the majority of his patients are the elderly and poor, my aunt is getting ready to start a new career in her 50s.

I also know we have doctors on this board who, as far as I can tell, are quite dedicated to their profession and those entrusted to their care.

IMHO, if anyone is to blame it's the insurance companies and those who file frivolous malpractice suits.

 

[blackadder]

ba...I hear you and to an extent agree. There's one particular "doctor" who will one day loath the day he ever set eyes on anyone in my family. I just have to bide my time at this point. On the other hand, there are many, many good, honest, caring, and extremely hard working doctors. I have no problem with them enjoying the fruits of their labor...if they even get to that point.

Some doctors, like my uncle on the Gulf Coast, don't get to. He's trying to reopen his practice that was wiped out by the hurricane. Since his home is sitting somewhere in the Gulf, he and my aunt were forced to re-mortgage their original home...which had been paid off for 15-20 years. And since the majority of his patients are the elderly and poor, my aunt is getting ready to start a new career in her 50s.

I also know we have doctors on this board who, as far as I can tell, are quite dedicated to their profession and those entrusted to their care.

IMHO, if anyone is to blame it's the insurance companies and those who file frivolous malpractice suits.

I'm not saying otherwise. I'm just focused on the bad apples. And, as I admit, I have seen a run of pretty bad luck with doctors. That's just the way it worked out for me personally.

Not trying to make a blanket statement and sorry if I came off that way.

Given the cost of medical school and the long greuling hours, doctors indeed ought to be very well compensated. It's just hard to tell when "tests" are really needed, addtional office visits really required and how much you should legitimately be billed. How do you tell when you are getting soaked?

 

[RazorOye]

seems to me, though, that the doctors you are talking about who are passionate about their patients and their well-being are not driven by profit

I've been to doctors who try and cram as many bodies into one day as possible. I've been to doctors who have spent nearly an hour with me - one even going down to his car to pick up literature for me and it was in a lot that was a few minutes down the road in toronto.

I feel like the quality of care I recieve differs between the two. So I guess, like blackadder, I'm thinking of those 'bad apples' who are entirely profit driven and, like the insurance companies, care nothing for the individual.

 

[Pure Energy]

The real issue began when employers began to offer medical insurance as an employee benefit. The reason this happened is because the tax structure penalized higher salaries with a higher marginal tax rate. To counter this disincentive to more income, Unions asked Employers to offer medical insurance instead of higher wages. The practice of offering health insurance proliferated and became the norm as Employers competed for workers.

The problem with health insurance as an Employee benefit is the Consumer has absolutely NO incentive to use restraint when exercising this benefit. Imagine if instead of medical insurance employers provided free auto insurance. So regardless of the number of claims, accidents or tickets you'd get the same price as someone with a spotless driving record who never made a claim. Eventually, auto insurance rates would go up for safe drivers who made no claims and be artificially low for high risk drivers. This is what is happening for medical insurance, co-pays are increasing, the Employees portion of the premium is increasing, the restrictions and the rules governing the plan are increasing and more difficult to understand every year.

We have a bad front-end for an otherwise good medical system. We need to reform the sytem. We need to consider a single-payer model, bringing medical care under government regulation along the lines of that for public utilities, socialized medicine, and other alternatives because we have a dramatic problem with costs.

 

[Pure Energy]

No. It's honestly not better. I've seen this first hand through my f-i-l's cancer ordeal that lasted from late fall till earlier this year. He died waiting on an appointment to get scheduled for a consultation to figure out what course of treatment to be scheduled for.

Looks like he wasn't alone.

http://www.boston.com/news/nation/articles/2007/02/11/told_to_wait_a_marine_dies/
http://www.ledger-enquirer.com/254/story/33336.html
http://www.sctimes.com/apps/pbcs.dll/article?AID=/20070511/NEWS01/105100067/1009

It didn't stop them from handing out huge bonuses though.
http://www.chron.com/disp/story.mpl/ap/politics/4806357.html
http://tennessean.com/apps/pbcs.dll/article?AID=/20070504/NEWS02/705040446/1009/NEWS

I understand your disappointment with the VA. I was in a Hotel Fitness Center a few weeks back and was speaking to the women on the Elliptical next to me and she was telling me she worked for the VA Hospital. Her side of the story is no one realized the overwhelming number of injured soldiers they would have to provide care to due to the War in Iraq.

Even is this is correct, it doesn't change the lack of medical attention. However, if it is correct, the fault would lie primarily with Senior Management of the VA (whoever that is) and not with the Clinicians and clericial staff attempting to provide service to more Patients than they are equipped to handle.

 

[BullDawg]

I understand your disappointment with the VA. I was in a Hotel Fitness Center a few weeks back and was speaking to the women on the Elliptical next to me and she was telling me she worked for the VA Hospital. Her side of the story is no one realized the overwhelming number of injured soldiers they would have to provide care to due to the War in Iraq.

Even is this is correct, it doesn't change the lack of medical attention. However, if it is correct, the fault would lie primarily with Senior Management of the VA (whoever that is) and not with the Clinicians and clericial staff attempting to provide service to more Patients than they are equipped to handle.

I agree the Senior Management failed at planning. However, I've personally watched the "rank and file" VA employees and how they treat veterans. By in large it's disgusting. I was nearly arrested by VA security in Birmingham. Why? I observed a VA employee berate a near deaf WWII vet who was asking for help. The elderly gentleman was confused and needed assistance. The VA employee talked down to him like he was dirt. I stepped in and helped the veteran get his bearings and then unleashed on the VA employee. The only reason security couldn't and wouldn't arrest me was I somehow maintained enough to not say anything overtly threatening.

And yes, I did file a complaint against the employee...knowing it wouldn't do a bit of good.

 

[Eeyore]

I would imagine that if fraud could be minimized the health-care system would be manageable but nobody wants to stop it. There is too much benefit on both sides.

Here is an example.

I got a bill from a local hospital for a bunch of tests that my wife had done a while ago. One of the tests on the bill was a pregnancy test ($130). My wife had a hysterectomy about seven years ago. Everything was ripped out with the exception of one half of an ovary. It would take an act of God for her to get pregnant. I disputed the bill. The hospital claims that the test was necessary. While the bill was being disputed the hospital took me to collections which now shows on my credit report.

Charging for tests and procedures that may or may not have been necessary or even actually done is fraud. Would they give me a pregnancy test? What would be the difference? It would take an act of God for me to get pregnant too.

How many situations like this are there? How much do these situations increase the cost of doing business?

 

[blackadder]

I would imagine that if fraud could be minimized the health-care system would be manageable but nobody wants to stop it. There is too much benefit on both sides.

Here is an example.

I got a bill from a local hospital for a bunch of tests that my wife had done a while ago. One of the tests on the bill was a pregnancy test ($130). My wife had a hysterectomy about seven years ago. Everything was ripped out with the exception of one half of an ovary. It would take an act of God for her to get pregnant. I disputed the bill. The hospital claims that the test was necessary. While the bill was being disputed the hospital took me to collections which now shows on my credit report.

Charging for tests and procedures that may or may not have been necessary or even actually done is fraud. Would they give me a pregnancy test? What would be the difference? It would take an act of God for me to get pregnant too.

How many situations like this are there? How much do these situations increase the cost of doing business?

It's rampant.

The thing they have going for them is that the average person is outmanned: You can barely read the bill and make sense of the medical jargon. It's intimidating. It's hard to challenge something when you don't even really undertand what it is. And if they give you a BS answer, do you know enough to call BS on it???

There's that, and then they've got you over a barrel because you are often in a worried state about your own health or the health of a loved one. You just want things to get better, so you are distracted or distraught. Perfect time to slip things in the bill. You're busy worrying and not at the top of your game with haggling against the system...