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Our society and many others are founded on Wealth has its Privileges. And it most surely does. We won't change that. What is horrible though, is when some people are squeezed out of the system so that corporations can get what they want.
I think we should have panels that look at heart transplants for instance. There are 2000-2200 heart transplants available every year for 100,000 people that need them. The current system DOES discriminate in favor of those who can cough up insurance and out-of-pocket money for those scarce organs. But should they go to a 70+ year Dick Cheney?
I like to use the comparison of not health outcomes, but social outcomes of someone dying. If a 35 year old working male with a family of four needs a heart transplant, shouldn't he get priority over a 70+ individual? Particularly if the older gentlemen has provided well for his family in the event of his demise. In the 35 year old's case, maybe it's a middle class family which will then have to go to the government till for social security survivor benefits, maybe for food stamps, all of which further drain society.
Again, it goes back to rationing and how we ration. Age should be an ABSOLUTE determining factor. I'm 66, and not in the best of health myself. Should I insist that society aid me in stretching out a difficult life, or ask that they provide me at very little cost, the medications to ease me through the end of life. But we spend an inordinate amount of money on keeping end-of-life people alive for a few more weeks or months.
It's a tough call, but unless we get the gonads to publicly make those decisions, the current system will continue to drown more and more of us. And NO, this is not a call for "death" squads. It's a call to keep life alive for the living.
The greatest health care system in the world is nothing, if you can't afford to utilize it.
That's the problem we are dealing with in this country. Insurance determines access to the system and quality of care.
I could care less if we are doing the most advanced, high tech procedures in the world if we are allowing a large segment of the population to go without antibiotics and preventive care.
You speak like someone who has no trouble affording the best and what you want is for all of us to get out of your way so that you can have it. I hope you will also spare us any long and irrelevant lectures about the "dangers of socialism".
I said no such thing. If you're going to respond to my points, please try to respond to points I made rather than ones you made up.
My point is that providing everyone with the best care available to a broader group of people is a more worthy goal than downgrading the level of care for some people in the name of "fairness" so that everyone gets the same poorer service.
Fairness in and of itself is not the goal. Wider distribution of better care is.
Our society and many others are founded on Wealth has its Privileges. And it most surely does. We won't change that. What is horrible though, is when some people are squeezed out of the system so that corporations can get what they want.
I think we should have panels that look at heart transplants for instance. There are 2000-2200 heart transplants available every year for 100,000 people that need them. The current system DOES discriminate in favor of those who can cough up insurance and out-of-pocket money for those scarce organs. But should they go to a 70+ year Dick Cheney?
I like to use the comparison of not health outcomes, but social outcomes of someone dying. If a 35 year old working male with a family of four needs a heart transplant, shouldn't he get priority over a 70+ individual? Particularly if the older gentlemen has provided well for his family in the event of his demise. In the 35 year old's case, maybe it's a middle class family which will then have to go to the government till for social security survivor benefits, maybe for food stamps, all of which further drain society.
Again, it goes back to rationing and how we ration. Age should be an ABSOLUTE determining factor. I'm 66, and not in the best of health myself. Should I insist that society aid me in stretching out a difficult life, or ask that they provide me at very little cost, the medications to ease me through the end of life. But we spend an inordinate amount of money on keeping end-of-life people alive for a few more weeks or months.
It's a tough call, but unless we get the gonads to publicly make those decisions, the current system will continue to drown more and more of us. And NO, this is not a call for "death" squads. It's a call to keep life alive for the living.
This is true. It is a very tough issue to define the line between providing unnecessary care and hastening death.
I think it's just sweet that rich Canadians have the option of traveling to the US for their healthcare, with Dr Collins help (gratis or for a fee?) while everyone else waits in line for months, but what options will they have if our system is transformed into theirs, as many have proposed? Where will Premier Williams go then?
This is what the fairness argument always boils down to, doesn't it? Some have it better than others, so let's ruin it for them, and everything will be crappy for everyone, but fair.
I have an insurance, it's better than most, and I wait for at least a month for my infrequent appointments. Had I been a Canadian Prime Minister my wait time would have shrunk to nothing. Wealth and Status has its privileges, USA, Canada or Cuba. I think it's misleading to portray American health care as much faster and much more responsive than that of Canada. For us mortals (with good insurance plans) it's a few weeks (at least), for those without insurance it's months and years and they may very well meet their funeral director first.
Physicians do not set prices for laboratory services. They cannot even send you to a specific laboratory, unless for some reason it is the only one that does the test you need.
As far as I recollect I was given all sorts of paperwork to take to that particular lab belonging to the same health care network as a nurse practitioner who condescended to spending 10 minutes or so on an uninsured patient. When I took DirectLab tests to an urgent care clinic (they do NOT want uninsured either) nurses made round eyes at me asking whether I'm a doctor who can order those tests. It was a revelation for them that one doesn't have to pay a tribute to medical doctors and networks to order those tests.
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Also, the AMA does not determine how many medical school slots and medical residency slots are available. Medical school enrollment is increasing, but it is Congress that will have to act in order to increase the number of practicing physicians, since a 1997 law caps the number of residency slots.
Please, don't play naive. Congress is very sensitive to business interest groups lobbying on behalf of their industries. Essentially Congress just rubber stamps industry "suggestions" provided proper "incentives". One could see medical industry interests behind each and every quoted sentence you provided.
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You can also blame Medicare, Medicaid, and insurance company reimbursement for the high prices charged self pay patients. The reimbursement from third party sources may not be enough for some docs to stay in practice.
It doesn't make sense. Here priorities of the service most private practices and health networks have - Insured, Medicaid/Medicare, Uninsured paying cash. If what you typed would be true then those who pay cash would be #2 which is clearly not the case. As bad as medicare is (according to you), it's "better" than spending time on a cash patient with limited financial resources, even if he pays upfront now doctors know they cannot milk him for as long/much as they can milk medicare etc.. "Opportunity" cost. Economics 101.
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You are also free to interpret lab tests on your own. Just be aware that wise doctors do not treat themselves or their own families. It's hard to be objective when you are related to the patient. Of course, since you consider prescriptions to be trivial, why do any tests at all?
Yup, I have my mother almost collapsing from high blood pressure in the front of a pharmacy window, they wouldn't sell her drugs without prescription, the drugs that she knows help her. Periodically you must pay homage to doctors in order to buy drugs that you know work. Medicine is an art, doctors fix you by trial and error. If you cannot afford doctors, wouldn't it be better to allow you to do trial and error on yourself? Who knows, you could be better at that than 5 minutes/$300 doctors. It's an art that is not outside of the mental capacity of the unlicensed mortals. Don't get me wrong, I'm for licensing, but if you cannot afford licensed professionals, self-help and unlicensed doctors should be an option. It's better than do nothing.
Every year they "catch" people who practice medicine without license and proper education. Overwhelming majority of those who are caught did a good job (or better)as licensed doctors until bureaucracy finally caught up with them.
Again, if it's a business jungle, let it be a jungle, if you can afford licensed doctors fine, if you can't afford them, state should not kill you in the course of protecting licensed doctor's turf.
As far as I recollect I was given all sorts of paperwork to take to that particular lab belonging to the same health care network as a nurse practitioner who condescended to spending 10 minutes or so on an uninsured patient. When I took DirectLab tests to an urgent care clinic (they do NOT want uninsured either) nurses made round eyes at me asking whether I'm a doctor who can order those tests. It was a revelation for them that one doesn't have to pay a tribute to medical doctors and networks to order those tests.
But, in the end, you chose your own lab, did you not?
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Please, don't play naive. Congress is very sensitive to business interest groups lobbying on behalf of their industries. Essentially Congress just rubber stamps industry "suggestions" provided proper "incentives". One could see medical industry interests behind each and every quoted sentence you provided.
And who elects the people in Congress? If you want more residency slots, let them know.
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It doesn't make sense. Here priorities of the service most private practices and health networks have - Insured, Medicaid/Medicare, Uninsured paying cash. If what you typed would be true then those who pay cash would be #2 which is clearly not the case. As bad as medicare is (according to you), it's "better" than spending time on a cash patient with limited financial resources, even if he pays upfront now doctors know they cannot milk him for as long/much as they can milk medicare etc.. "Opportunity" cost. Economics 101.
Physicians are free to determine which patients they will accept in their practices. If those in your area are declining to accept self pay patients, it is probably because of experiences in which those patients do not pay their bills. Insurance and Medicare will not pay for care for which there is not a documented need, so it would be difficult to "milk" patients.
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Yup, I have my mother almost collapsing from high blood pressure in the front of a pharmacy window, they wouldn't sell her drugs without prescription, the drugs that she knows help her. Periodically you must pay homage to doctors in order to buy drugs that you know work. Medicine is an art, doctors fix you by trial and error. If you cannot afford doctors, wouldn't it be better to allow you to do trial and error on yourself? Who knows, you could be better at that than 5 minutes/$300 doctors. It's an art that is not outside of the mental capacity of the unlicensed mortals. Don't get me wrong, I'm for licensing, but if you cannot afford licensed professionals, self-help and unlicensed doctors should be an option. It's better than do nothing.
As I said, most doctors do not treat themselves. I am interested in how you propose to treat yourself by "trial and error" for something like hypertension. How do you decide what to try?
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Every year they "catch" people who practice medicine without license and proper education. Overwhelming majority of those who are caught did a good job (or better)as licensed doctors until bureaucracy finally caught up with them.
Some examples, please?
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Again, if it's a business jungle, let it be a jungle, if you can afford licensed doctors fine, if you can't afford them, state should not kill you in the course of protecting licensed doctor's turf.
The licensure is there to protect patients, not turf.
You consider seeing a doctor as "paying homage" and "paying tribute." I see them because I value their education and expertise.
Apparently you feel you can do as good a job as someone with four years of medical school follwed by three or more years of residency. Somehow I doubt that.
But, in the end, you chose your own lab, did you not?
And who elects the people in Congress? If you want more residency slots, let them know.
Please, don't play "democracy" on me, I don't even know what hole those congress runners jump from. I don't know who decided to spin those people off and why. All I have a choice between two or more people of the same background, status, goals, views etc. that unknown to me forces decided to push to the public trough. Please, don't tell me that I'm responsible for everything because I have such a wonderful "choice" which is no choice at all in the larger sense. Most congressmen come from law, business and medicine, they have nothing in common with me. They sure don't want to extend to me their free & excellent health care. All they want - a cushy corporate job for themselves and their relatives, to get that they must not bite the feeding hands of big business, including big pharma & medicine.
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Physicians are free to determine which patients they will accept in their practices.
And I'm free to suffer/die in pain if I'm not worthy of their services. Ok, if I'm not worthy than to the hell with all license requirements, let me handle things that I can possibly handle, let me use unlicensed people I'm willing to bet on. It doesn't really take a medical genius to find blood pressure pills and dosage that work with your body and so on.
If you refuse care and, at the same time, use your state granted/enforced monopoly to ensure that I have no care of any kind, that's evil and immoral. Hippocratic oath my hairy butt. Especially considering that despite alleged hardships most doctors/nurses/administrators do quite well financially (way better than average populace) and have job security for life. Most of them go into medicine for money. And denying me access to care I can afford is how that money is made.
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If those in your area are declining to accept self pay patients, it is probably because of experiences in which those patients do not pay their bills.
Offer of $ upfront doesn't make any difference. They know very well that average individual cannot afford those outrageous prices for too long. So they just summarily dismiss them all, opportunity costs of a medicare patient is less despite the constant beatching about losing money on medicare patients.
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Insurance and Medicare will not pay for care for which there is not a documented need, so it would be difficult to "milk" patients.
Milking a patient have nothing to do with "undocumented" needs. You can treat a Medicare patient all way to his/her grave. You can profitably treat an uninsured for as long as he has $, see difference? Thus, a medicare patient is a predictable milking cow unlike an uninsured of the unknown financial means.
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As I said, most doctors do not treat themselves.
Most doctors have fancy expensive cars in their garages, your point?
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I am interested in how you propose to treat yourself by "trial and error" for something like hypertension. How do you decide what to try?
Same way doctors decide. Look what side-effects are the least desirable and pick a medicine that doesn't have those side-effects. Start from low dosage, listen your body. It doesn't really take a medical wizard.
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Some examples, please?
There are plenty of examples. Most striking part is that unlicensed doctors are at least as good as licensed, otherwise why hunt those doctors down using undercover agents? If an unlicensed doc is that bad, he'd get no patients, a few corpses and bloodthirsty relatives.
As she had in Peru, Marcos extracted teeth, filled cavities, and treated gum infections. Patients found her by word of mouth; they often haggled over prices but almost always paid cash. For a while, her practice thrived. But late last year, when she unwittingly offered to treat the toothache of an undercover agent, all of that came to an abrupt end.
The licensure is there to protect patients, not turf.
Even those patients that licensed doctors don't want to see/treat?
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You consider seeing a doctor as "paying homage" and "paying tribute." I see them because I value their education and expertise.
You must have insurance and $ to value them with. Lose either and come back to tell us about your ongoing worship of their education and expertise.
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Apparently you feel you can do as good a job as someone with four years of medical school follwed by three or more years of residency. Somehow I doubt that.
No, I don't. I feel that me playing doctor and/or seeking unlicensed help I can afford is better than no doctor at all.
Last edited by RememberMee; 11-26-2012 at 08:48 PM..
No government, perhaps, (though i'm not convinced even that is true) but individuals, including plenty of Canadians and government officials come to the US for medical treatment.
If the criteria is how attractive a system is to medical tourists, the US probably scores bottom in the world. 80 000 people come to the US for treatment every year. Very few indeed from Canada. More than a million leave for the same in a year. It is one of the biggest humiliations of a system by citizens voting with their feet ever seen.
That does not count the millions filling their prescriptions in Canada and Mexico of course.
Anyway, why would any government ever be attracted to the US model? It is so expensive that Americans pay more in taxes for government health care than citizens of the UK, Sweden, France, Japan etc. And in those countries, having paid taxes, everyone gets the option of government health care. In America, paying more only covers 1/3 of the population.
Doctors of the past were practicing medicine because they wanted to help people. These days, if you ask most kids why they have decided they want to be doctors, they will tell you so they can make lots of money, and help people. .
You have it backwards. Adjusted for inflation, doctors in the past made way more money and had a lot fewer hassles.
Tell these fictional young kids you ask these questions to find a different profession - they can make a lot more money in business/finance or law with a lot less stress and responsibility.
If the criteria is how attractive a system is to medical tourists, the US probably scores bottom in the world. 80 000 people come to the US for treatment every year. Very few indeed from Canada. More than a million leave for the same in a year. It is one of the biggest humiliations of a system by citizens voting with their feet ever seen.
This is very interesting. Would you please share your source(s) for this information? Thank you.
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