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Re: The good old USA and medical costs
Old 02-16-2006, 05:10 PM   #21
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Re: The good old USA and medical costs

WSJ has an article today on medicaid and the struggles states are having with Medicaid cuts. Many states are cutting a number of people off of their medicaid rolls, even if they are disabled. In Missouri a family of three can earn no more than $3504 a year to qualify for Medicaid. Families with a disabled family member are also facing increased barriers to getting Medicaid for the disabled family member.

The WSJ says the biggest driver of Medicaid costs is the "long-term care for a relatively small number of elderly and disabled beneficiaries. About 4% of Medicaid recipients account for half the program's expenditures." This is according to the Kaiser Family Foundation.

So, my grandneice incurs 2 million of medical expenses and others get cut off and get nothing.

This is a big freaking problem.

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Re: The good old USA and medical costs
Old 02-16-2006, 05:16 PM   #22
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Re: The good old USA and medical costs

Oh, one more thing. In Missouri the Legislature has decided to end Medicaid in 2008 and has established a commision to come up with a replacement. The commission has proposed tax credits to small employers who offer health insurance, and incentives for people to buy nursing home insurance. Won't help people like my grandniece and her mother, who is having to care for her full time and as a result lost her job. She would have used up her lifetime healthcare limits anyway.

I think we need to separate health insurance from employment.

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Re: The good old USA and medical costs
Old 02-16-2006, 06:42 PM   #23
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Re: The good old USA and medical costs

Quote:
Originally Posted by dylar
We spend more and get less. Have a look at any of this information and tell me our system is the best. OECD 2005 Health Care Data
Yep...all you need to do is look at the mortality tables in the first-world countries that have "socialized" health care and compare it to the USA...if I remember correctly, despite spending more than other other country per capita, we still come in something like 10th or 11th in longevity...if we truly had the "best health care in the world", we also have the longest average lifespans...and we don't.
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Re: The good old USA and medical costs
Old 02-16-2006, 07:11 PM   #24
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Re: The good old USA and medical costs

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Originally Posted by dylar
We spend more and get less. Have a look at any of this information and tell me our system is the best. OECD 2005 Health Care Data
I have posted these stats over and over. Most forum members go blind when they see it, deaf when they hear it. Miust be part of the "America- Love it or leave it" syndrome.

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Re: The good old USA and medical costs
Old 02-16-2006, 08:52 PM   #25
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Re: The good old USA and medical costs

Wow, had no idea I would touch such a nerve!!* Sorry about that.*

CFB, I agree that the end o f life costs are a big factor , and we don't exactly take good care of ourselves (I can't throw any stones there).*

I do think (and, I don't have any "statistics" to quote to back this up - unfortunatley, I've got a damn job that takes up too much of my time - trying to remedy that though....) that it is the lawyers that are driving a lot of the end of life costs and the doctor's need to CYA on every issue.* The docs can't pull the plug for fear of lawsuits.*

Also, I think we are our own worst enemy,* in that we have gotten so complacent, with health insurance picking up the lions share of our health care costs.* If we had to pay for more of it out of our own pocket, we would not go to the doctor every time johnny had a sniffle, and would not demand antibiotics on every other visit to the clinic.*

(It's kind of like the (one possible) solution to rising taxes:* do away with paycheck withholding, and make people write that check to Uncle Sam every month or two weeks.* See how long it would take to have a tax revolt on our hands...)

Anyway, sorry about starting this thread.* Although I didn't really.* I just couldn't let the comment slide...

disclaimer: I haven't run this through the spell check, and am typing with the keyboard on my lap, so no telling what the spellchecker police will say!
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Re: The good old USA and medical costs
Old 02-16-2006, 09:04 PM   #26
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Re: The good old USA and medical costs

Quote:
Originally Posted by farmerEd
Yep...all you need to do is look at the mortality tables in the first-world countries that have "socialized" health care and compare it to the USA...if I remember correctly, despite spending more than other other country per capita, we still come in something like 10th or 11th in longevity...if we truly had the "best health care in the world", we also have the longest average lifespans...and we don't.
Hmm, not sure I agree that there is a one to one (or even a 1 to 100)correlation between having the best health care, and having the longest longevity. Granted, it will take you off of the bottom of the list.

I think there is a bit of personal responsibility with taking care of yourself. No matter how good the healthcare, if you don't take care of yourself, you're not going to live as long as someone who does. And there are countries whose citizens seem to have a healthier lifestyle. Doesn't mean I'd necessarily want to live there but..

By the way, the country with the highest longevity is China/Hong King. For some reason, I do not think they have the best health care - of course I do not have any statistics to back that up...
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Re: The good old USA and medical costs
Old 02-16-2006, 09:39 PM   #27
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Re: The good old USA and medical costs

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Originally Posted by getoutearly
Hmm, not sure I agree that there is a one to one (or even a 1 to 100)correlation between having the best health care, and having the longest longevity.* Granted, it will take you off of the bottom of the list.*
Lie expectancy at age 60 is probably the very best metric for healthcare quality. For one thing, it can't be fudged.

You could make all sorts of long shot assertions, such as, "Americans are so messed up lifestyle wise, (etc.) that even with our immensely superior healthcare, nevertheless a Mexican at age 60( with essentially no healthcare) has a greater life expectancy."

Ya, sure, you betcha!

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Re: The good old USA and medical costs
Old 02-16-2006, 09:47 PM   #28
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Re: The good old USA and medical costs

Quote:
Originally Posted by HaHa
Lie expectancy at age 60 is probably the very best metric for healthcare quality. For one thing, it can't be fudged.

You could make all sorts of long shot assertions, such as, "Americans are so messed up lifestyle wise, (etc.) that even with our immensely superior healthcare, nevertheless a Mexican at age 60( with essentially no healthcare) has a greater life expectancy."

Ya, sure, you betcha!

Ha
Think I lost your point somewhere in there. Maybe it's just late...
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Re: The good old USA and medical costs
Old 02-17-2006, 12:03 AM   #29
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Re: The good old USA and medical costs

More is spent on advertising drugs (probably on TV commercials for erectile disfunction and toenail fungus alone!) than on medical legal judgments.

No, I don't remember where I read that, and it's late and I'm going to bed. Tomorrow I need ot help my brother persuade the hospital and insurance company to lower his $30,000 bill for surgery and a one night stay (that;s just the hospital bill, the surgoen and anethesiologist are thousands more).. Back problems are excluded from his individual policy. I'm gonna try playing the hospital volunteer card. At least he got the use of his arm back--a nerve was so badly pinched in one of his neck disks that he lost both use and feeling in his right hand and arm until the surgeon fixed it, bless his heart.
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Re: The good old USA and medical costs
Old 02-17-2006, 03:17 AM   #30
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Re: The good old USA and medical costs

The Economist couple weeks back did an article on the state of health care in the US., Besides noting what other posters have already mentioned (spending twice per capita the OECD average), they reckoned that America is a lot closer to "socialized medicine" already than anyone would like to admit.

Adding together all publicly-financed health care (Medicare, Medicaid, VA, etc.) they came up with 45% of all US health care spending. Then they pull the interesting trick of including tax breaks to businesses for health-care/insurance write-offs and come up with a total of 60% US health care spending shouldered already by the government (i.e., taxes, i.e., "us"). In fact, the public spending in the US on health care today is exactly the same %age of GDP as it is in Switzerland, Japan, and Britain, except there they are covering everyone!

The share of workers getting health ins. through their employers has gone from almost 70% in the late 1970s, to about 50% today (again, according to The Economist).

As this trend continues, the US will end up with a de facto socialized system anyway.. It's just that no one has enough guts/power to stand up to the lobbies and enough credibility to be able to convince America that a universal health care plan could work in the US without turning us into 'commies'. So people will keep getting left out of the system.
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Re: The good old USA and medical costs
Old 02-17-2006, 04:28 AM   #31
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Re: The good old USA and medical costs

Quote:
Originally Posted by getoutearly
Yeah, Canada, France, Italy, UK, etc* those are great examples of what socialized medicine can do.* That's why they all head over here if they really get sick.* I guess you could say the same thing about our health care as you could about our judicial system; It's the worst in the world, except for all the others...

Besides, what's wrong with our health care system has nothing to do with our health care (THE best in the world); it has everything to do with the ambulance chasing lawyers...

Ok, enough of the soap box; coudn't help myself.
Quote:
Originally Posted by getoutearly
I think there is a bit of personal responsibility with taking care of yourself. No matter how good the healthcare, if you don't take care of yourself, you're not going to live as long as someone who does. And there are countries whose citizens seem to have a healthier lifestyle. Doesn't mean I'd necessarily want to live there but..

By the way, the country with the highest longevity is China/Hong King. For some reason, I do not think they have the best health care - of course I do not have any statistics to back that up...
I neither support nor oppose "socialised" versus "private" medical provision, but there are some points and comments here that require reply.

First, Europeans do not go to the US when they are very sick. That is a ludicrous notion. Some very specific treatments, or particular advancements are at some time or other best found in the US. Hence people worldwide will seek them out, come to the US and PAY for that treatment. US is not however the leader in all medicall fields and better treatments and the earliest breakthoughs are, proportionally, found elesewhere in the developed world. Where the US does lead the world however, is in sports related treatments and surgeries, due to the exceptional lengths that professional athletes and their teams will go to get fit and playing again as quickly as possible. I'll wager that the money spent by the average football team on health care per year would pay for world class early years health care for about half the kids currently born in the US to parents without medical cover.

As for the US having THE BEST (OP's emphasis) health care in the world, I would cavaet that by saying it is the best for the very wealthiest; it is probably the best for a large but dimishing number of people in the middle, but is closer to third world for the increasing number of people at the bottom. By contrast, the "socialised" healthcare provided the rest of the developed world may not always hit the pinnacles of advanced treatment and breakthrough that the US sometimes does, but ACROSS THE ENTIRE POPULACE it provides a standard of care far better TO EVERY ONE of it's citizens than the US does. I would hazard a guess that taken holistically, somewhere like Sweden, Germany or Switzerland probably attains the highest aggregate standards in Europe, with Australia/NZ being very high also.

As for health generally, there seems an empirically compelling argument for the position that US healthcare spending is disproportionately high because Americans want and need a lot of medical attention due to their relatively unhealthy lifestyles (as a whole population). Compared to Asia, where health levels are far higher due to healthier diets and attitudes to ones own health. As for longevity, diet and genetics plays a large part. I would guess that a lot of Asian countries would beat the US in longevity statistics were it not for a disproportionate number of their population dying younger not from ill health per se, but from contractible disease and the direct and indirect consequences of natural disasters.

Howard's original question : "Why are Americans not demanding that they be provided with Health Care along the lines of every other civilized nation in the world??" - the obvious answer appears to be that they don't want it. If they did, as a population they would get it. Politicians would be voted in on a health platform. as it is, I doubt any US politician would be elected with such a policy in his manifesto. If they would, they would be in by now.

Here's athought. Pay "European" level taxation on fuel (petrol/gas) and you could have the finest universal system of health care provision. Just a thought.

Very last point. I didn't know that Hong Kong had the highest statistical longevity in the world, but it doesn't suprise me. A diet high in fresh fish, rice and fresh vegetables is a good start. every morning, the small parks, playgrounds and streets are full of the retired and elderly excercising, stretching and practicing Tai Chi. From my window as type right now, I can see at least 50 seniors walking along the sea front, jogging or doing Tai Chi. In the morning, that number will be closer to 200 and that is just in my small block.


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Re: The good old USA and medical costs
Old 02-17-2006, 08:02 AM   #32
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Re: The good old USA and medical costs

Quote:
Originally Posted by getoutearly
I do think (and, I don't have any "statistics" to quote to back this up - unfortunatley, I've got a damn job that takes up too much of my time - trying to remedy that though....) that it is the lawyers that are driving a lot of the end of life costs and the doctor's need to CYA on every issue. The docs can't pull the plug for fear of lawsuits.
Walk me through the information you've heard (I dont need you to point out references), experiences you've had and other salient points that led you to draw this conclusion.
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Re: The good old USA and medical costs
Old 02-17-2006, 08:44 AM   #33
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Re: The good old USA and medical costs

Get Out -

You are really leaving out a huge part of the equation and no pun inteneded - obese/overweight Americans. We, by nature, will point our finger at anything but ourselves - the doctors, the lawyers, the government, the drug companies, the HMOs, yada yada - it all adds up. But when you have a country with a lot of overweight/obese people (an "epidemic" according to the media ), you have high health care costs. Your equation looks like you are leaving out quite a bit but it is just your opinion.

Quote:
As for health generally, there seems an empirically compelling argument for the position that US healthcare spending is disproportionately high because Americans want and need a lot of medical attention due to their relatively unhealthy lifestyles (as a whole population).
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Re: The good old USA and medical costs
Old 02-17-2006, 08:57 AM   #34
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Re: The good old USA and medical costs

Quote:
Originally Posted by getoutearly


I do think (and, I don't have any "statistics" to quote to back this up - unfortunatley, I've got a damn job that takes up too much of my time - trying to remedy that though....) that it is the lawyers that are driving a lot of the end of life costs and the doctor's need to CYA on every issue. The docs can't pull the plug for fear of lawsuits.
If the family agrees to pull the plug, I haven't seen doctors fail to do so because of fear of lawsuits.

I don't think fear of lawsuits drive up end of life costs. Fears of lawsuits may create a tendency to order unnecessary tests. Maybe.

Malpractice premiums in many areas are too high. In my part of the country, malpractice premiums are fairly reasonable. In my part of the country it is rare for people to sue their doctors, or lawyers, for malpractice.

Quote:
Also, I think we are our own worst enemy, in that we have gotten so complacent, with health insurance picking up the lions share of our health care costs. If we had to pay for more of it out of our own pocket, we would not go to the doctor every time johnny had a sniffle, and would not demand antibiotics on every other visit to the clinic.
I used to have a secretary like that. Every time her kid had a cold they went to the doctor.

I wonder though how much this really drives up the cost of health care. Doctors generally don't get much money above any copays for these types of visits.

I tend to think far more money is wasted on the bureacracy of forms.
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Re: The good old USA and medical costs
Old 02-17-2006, 09:10 AM   #35
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Re: The good old USA and medical costs

Quote:
Originally Posted by wildcat
Get Out -

You are really leaving out a huge part of the equation and no pun inteneded - obese/overweight Americans. We, by nature, will point our finger at anything but ourselves - the doctors, the lawyers, the government, the drug companies, the HMOs, yada yada - it all adds up. But when you have a country with a lot of overweight/obese people (an "epidemic" according to the media ), you have high health care costs. Your equation looks like you are leaving out quite a bit but it is just your opinion.
There is a trend try to charge more for health insurance if people do not do or try to do things to improve their health. For examples, in some states insurance companies can charge smokers more. In other places, smokers are charged more unless they go through smoking cessation programs.

It will be interesting to see how this developes and if it expands to other lifestyle issues besides smoking.


Treatment of chronic diseases that last for years can be very expensive. Some are due to failure to care for yourself and some are due to the fact that more people are getting older and living longer. We could do a lot to promote preventive care. Sidewalks. Bicycle lanes. Deductible gym memberships. Neighborhood public health nurses. Etc.
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Re: The good old USA and medical costs
Old 02-17-2006, 09:21 AM   #36
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Re: The good old USA and medical costs

And once again, preventative care has a lot more value than throwing money at something after its gone too far.

I think it was well summed up by an MD my wife works with: "I can get all the insurance approvals I want to cut off diabetics limbs once they cant be saved, but I have to fight tooth and nail to get them the preventative care paid for that would easily avoid it ever coming to that".

I wonder if the insurance companies figure that if they spend money on preventative care, then its already out of their pocket...if they dont do it, maybe you'll go to another insurer, fall from the insurance ranks, or simply die before they have to spend much money on you. Apparently they've done their homework and the numbers work out in favor of limiting preventative care.

On the other hand, I also read an article recently that said that much preventative care doesnt work. They made a pretty good case as to why the box stock annual physical and blood test probably wont catch most serious problems early enough to do any good, athough they admitted the dialog with the doctor was probably fairly beneficial.

Apparently they havent talked to any of my doctors, who never stop moving on their way through the door until they go back out it less than 5 minutes later.
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Re: The good old USA and medical costs
Old 02-17-2006, 10:32 AM   #37
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Re: The good old USA and medical costs

A couple of "factoids" to put US health and medical provision to THE WHOLE POPULATION into persepective (facts kindly provided my colleague, who happens to be American and an excellent researcher) - all from various official US statistical sources OR the NYT)


• The World Health Organization "ranked the countries of the world in terms of overall health performance, and the U.S. [was] ... 37th." In the fairness of health care, we're 54th. "The irony is that the United States spends more per capita for health care than any other nation in the world"* Pay more, get lots, lots less.

• "The U.S. and South Africa are the only two developed countries in the world that do not provide health care for all their citizens" Excuse me, but since when is South Africa a "developed" country? Anyway, that's the company we're keeping.

• Lack of health insurance coverage causes 18,000 unnecessary American deaths a year. (That's six times the number of people killed on 9/11.) (NYT, Jan. 12, 2005.)

• The United States is 41st in the world in infant mortality. Cuba scores higher (NYT, Jan. 12, 2005).

getoutearly, still convinced the US is #1 ?
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Re: The good old USA and medical costs
Old 02-17-2006, 10:49 AM   #38
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Re: The good old USA and medical costs

Quote:
Originally Posted by Honkie
A couple of "factoids" to put US health and medical provision to THE WHOLE POPULATION into persepective (facts kindly provided my colleague, who happens to be American and an excellent researcher) - all from various official US statistical sources OR the NYT)


• The World Health Organization "ranked the countries of the world in terms of overall health performance, and the U.S. [was] ... 37th." In the fairness of health care, we're 54th. "The irony is that the United States spends more per capita for health care than any other nation in the world"* Pay more, get lots, lots less.

• "The U.S. and South Africa are the only two developed countries in the world that do not provide health care for all their citizens" Excuse me, but since when is South Africa a "developed" country? Anyway, that's the company we're keeping.

• Lack of health insurance coverage causes 18,000 unnecessary American deaths a year. (That's six times the number of people killed on 9/11.) (NYT, Jan. 12, 2005.)

• The United States is 41st in the world in infant mortality. Cuba scores higher (NYT, Jan. 12, 2005).

getoutearly, still convinced the US is #1 ?
Honkie
I don't know where you got your facts...Rush Oxytocin Limbaugh says that people from other countries that offer SOCIALIZED healthcare ALL come here to the USA to get the best health care in the world..thats my story and I'm sticking to it...no matter what the facts are [/sarcasm]
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Re: The good old USA and medical costs
Old 02-17-2006, 10:50 AM   #39
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Re: The good old USA and medical costs

Just some facts... *First from Insurance Information institute *http://www.iii.org/media/hottopics/i...ce/medicalmal/

Quote:
In early January 2005, Towers Perrin released its U.S. Tort Costs: 2004 Update. The study found that over the 28 years since 1975, when they were first identified separately, medical malpractice cost increases have outpaced other tort areas, rising at an average of 11.8 percent a year, compared with 9.2 percent for all other tort costs. In 2003 medical malpractice costs, at almost $27 billion, cost each American an average $91 a year. This compares with $5 a year in 1975.
Then from CFB* on February 16, 2006, 12:43:26 PM *

Quote:
...overall healthcare in the US reached 1.7 trillion and is estimated at 1.8 trillion in 2004...(with source noted)
So in 2003 Malpractice costs were $27B in a medical sector that in 2004 is $1,800B; *given some inflation for 2003 to 2004 I'd have to estimate Malpractice as a less than 2% part of the medical sector in the USA. *I'd conclude that Malpractice is one of the lower contributors to the US medical costs, and encourage those concerned to find the real culprits. *I'd start by looking at the costs of the forms processing between the Dr's offices and the insurance companies for a real eye-opener, as highlighted by CFB earlier.

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Re: The good old USA and medical costs
Old 02-17-2006, 11:06 AM   #40
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Re: The good old USA and medical costs

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Originally Posted by farmerEd
I don't know where you got your facts...Rush Oxytocin Limbaugh says that people from other countries that offer SOCIALIZED healthcare ALL come here to the USA to get the best health care in the world..thats my story and I'm sticking to it...no matter what the facts are [/sarcasm]
Maybe your man Rush is one of the following 20%............


• Twenty percent of Americans think the sun orbits the Earth. Seventeen percent believe the Earth revolves around the sun once a day (The Week, Jan. 7, 2005).

Or maybe he just thinks the world revolves around him......
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