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Old 07-24-2007, 09:57 PM   #61
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Thanks, Soon.

You're correct about the rewards being proportional to the altruism one is committed to. In a way, those like myself have been subsidized by taxes and contributions to enable us to care for the indigent without personal penalty so it's not all as charitable as it might have sounded. And there are plenty in private practice who render no-pay care to the poor in limited amounts.

Anyhow, care for all segments can be done well and should be done universally in my view. The current system is shameful and embarrassing.
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Old 07-24-2007, 10:23 PM   #62
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Oh, Lord! I've spent a meaningful chunk of my career caring for those at the bottom of society (probably numbering in the thousands), often due to mental illness, addictions, alcoholism plus the occasional freeloader.

Success stores? Give me some time...I may be able to come up with one or two. A few times I've been able to game the system creatively to benefit a patient here and there, but otherwise... naaah, sorry, can't come up with many succes stories.

Major university teaching hospitals have a proud heritage of caring for the poor because the faculty physicians were often on salary and had little directly at stake for non-payment. But that has been changing, and not for the better; there is more emphasis on "productivity" every year.
Rich - you have made my point for me. In America, philanthropic physicians such as yourself will still care for the poor even if they have no means. However, in countries where people are placed on waiting lists, they are unable to "jump the queue" unless they have lots of money and can come to America for services that they do not want to wait for. Even if the physician wants to help, if there is no room at the hospital or no funded rooms, the charitable physicians hands are tied. At least, in America, people can turn to charity for help, even if they can't afford services. In other countries, it's just to bad if you don't have the means to jump out of the waiting queue (I guess....unless they can find a charitable organization that will give them the money to come to America for services).....but once America adopts a single payor system and we start experiencing shortages and waiting queues, then where will people go?

This is for soon to retire... soon - I have no objections to providing coverage for those who slip through the cracks....major medical coverage..or bankruptcy protection (with some personal responsibility for deductibles and pre-deductible expenses. Medicare for all (Canadian system), IMO, is not a good solution.
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Old 07-24-2007, 11:16 PM   #63
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Healthcare for all is not about you or I, it is about coverage for everyone in this country. There is no reason that the citizens of this country should be held hostage by the insurance companies. We can afford and we should provide healthcare for everyone - it is the moral and decent thing to do.

There are more important things in life than profit or capitalism.

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Old 07-25-2007, 01:50 AM   #64
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Luckily, it looks like Wisconsin has it all figured out.

OpinionJournal - Featured Article

In part . . .

"This exercise is especially instructive, because it reveals where the "single-payer," universal coverage folks end up. Democrats who run the Wisconsin Senate have dropped the Washington pretense of incremental health-care reform and moved directly to passing a plan to insure every resident under the age of 65 in the state. And, wow, is "free" health care expensive. The plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes. It represents an average of $510 a month in higher taxes for every Wisconsin worker (emphasis added)."

Obviously, the answer is to not be a worker. Or, if you are a worker, to leave Wisconsin.

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Old 07-25-2007, 07:44 AM   #65
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Healthcare for all is not about you or I, it is about coverage for everyone in this country. There is no reason that the citizens of this country should be held hostage by the insurance companies. We can afford and we should provide healthcare for everyone - it is the moral and decent thing to do.

There are more important things in life than profit or capitalism.

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Bestash - I am in 100% agreement with you. There are more important things in life than capitalism or profit. In a perfect world NO ONE should ever suffer. That's how I would like to see things happen too, but that would be idealistic and also unrealistic! The question is...IMO....by which means will the least amount of people suffer? In a single payor system, IMO, waiting queues will HURT more people (particularly people suffering from chronic, painful, apparently "non-emergent" illnesses than in a for-profit system where access and quality are always there - somewhere (whether it be through paying on your own, insurance or charity).

In one of the videos I posted, a woman was suffering from a bladder probelm. She needed somekind of electrode placed on her bladder to help her empty it regularly. The single payor system called the surgery "elective", because it was non-emergent. The waiting time for the surgery was 3 years. The surgeon told her he could only do 12 of these surgeries per year, and his hands were tied. He couldn't help her earlier even if he wanted to. She did not have enough money to "opt out" of the system. The woman suffered from so much pain and infections, that the condition became emergent, and she had to have her bladder removed. Now she has a hole in her abdomen and a bag. This kind of thing is unheard of in America. In America, even if she were poor, she would have been able to get treatment, most likely through charity or pro-bono.

This is a true story. I've got a good friend who has lots of relatives that live in England. He tells me that, in the public clinics and primary care facilities, at the end of the day, the physician will literally walk out of his office, look at his watch, and then look at the people in the waiting room. He'll say, "I'm sorry, I've met my quota for the day, and cannot take any more patients".. Then, he'll just walk out....leaving people who had appointments to come back another day, EVEN IF THEY ARE SICK. Mind you, these are people who had appointments. This is just ONE of the consequences of a single payor system. If these people don't have access to private care or can't afford it, then, they just have to wait.
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Old 07-25-2007, 08:37 AM   #66
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Luckily, it looks like Wisconsin has it all figured out.
It represents an average of $510 a month in higher taxes for every Wisconsin worker (emphasis added)."
Let's take a family with a single wage earner. $510/month is $6120 per year. The average health insurance cost for a family in the US is $11,000 per year. So the average single earner family saves $4880 per year. Double earner families, assuming they each pay the same, would pay $12240 a year, or $103 per month more to provide health care for everyone. Doesn't sound like a reason to quit work or leave the state. And by the way, that $103 per month extra will likely be equalized after one more year of health insurance increase.
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Old 07-25-2007, 08:57 AM   #67
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This is for soon to retire... soon - I have no objections to providing coverage for those who slip through the cracks....major medical coverage..or bankruptcy protection (with some personal responsibility for deductibles and pre-deductible expenses. Medicare for all (Canadian system), IMO, is not a good solution.
Well, that's a start. Could we do a little better than rely on pro bono or the "family and friends" plan? I've said before, I don't know what the answer is, and I am not advocating single payer one way or the other. All I'm saying is, give health care a chance.

As far as the endless waiting times you keep bringing up, I don't want those. If those are a problem in Canada or anywhere else, we can do better. We don't have to copy another system's problems, we should learn what works and what doesn't, and as someone else said, leapfrog to the best system in the world. Used to be a time we had the confidence to think we could do better than anyone else. Now we seem to be in the mode of gee, wish we could do what those other guys do, if only we had the money or the profits. That's bullcrap and I'm not buying it.

BTW, the US military health system services over 100,000 patient visits per day. It is free, has little or no deductibles, and has enough doctors and hospitals that waiting times are not an issue. I wait maybe 1-2 weeks to see a doctor, 2-3 weeks to have a test (sooner if urgent), and maybe 2-3 months for elective surgery. Urgent cases are seen the same day or in days. Can we use that as an example instead of these horror anectdotes that you bring up about Canada?

Is the military health system perfect? Far from it, we had a thread on it in this forum not too long ago. But it works. And when a wheel squeaks, as in the recent Walter Reed case, it gets oiled, people get reassigned, and the problem gets fixed. After every visit with a specialist I get asked to fill out an anonymous survey as to the quality of care. And if I need to I can pick up the phone to complain to an ombudsman, to the hospital commander, or to my congressman. In 40 years of using this system I've had to make maybe 2 calls to complain.

And you know what? That is a system operated by the US Gummint paid for by US taxpayers.
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Old 07-25-2007, 08:57 AM   #68
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Luckily, it looks like Wisconsin has it all figured out.

OpinionJournal - Featured Article

In part . . .

"This exercise is especially instructive, because it reveals where the "single-payer," universal coverage folks end up. Democrats who run the Wisconsin Senate have dropped the Washington pretense of incremental health-care reform and moved directly to passing a plan to insure every resident under the age of 65 in the state. And, wow, is "free" health care expensive. The plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes. It represents an average of $510 a month in higher taxes for every Wisconsin worker (emphasis added)."

Obviously, the answer is to not be a worker. Or, if you are a worker, to leave Wisconsin.
Not necessarily defending the Wisconsin plan, but if the money now spent by corporations and individuals for insurance premiums is eliminated/shifted, maybe the extra tax bill is somewhat of a wash...
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Old 07-25-2007, 09:09 AM   #69
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Agreed that the WSJ article is little light on info...I really dont think health care reform on the state level is really going to do much...WI has had problems with indigent from other states moving in because of higher welfare payments in the past....What are people supposed to do during the 1 year "waiting period"....and these payroll proposals dont help business....It should be up to the business what they want/can afford to pay in benefits...

There are also competing proposals in WI for a more HSA type insurance for most people....and a subsidy for the "poor"....

Also, it is MUCH more complicated to say what each person's share of the cost is....right now there is budget shifting of medicaid (with hidden taxes on stuff like landfill tipping going to medicaid in our state)
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Old 07-25-2007, 09:14 AM   #70
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Healthcare

We're going to have to grow up as a nation before real changes are made in the healthcare system. What we have experienced in the post WWII period is cost-shifting, which accellerated after Medicare in 1966. Everyone want the best healthcare but they want someone else (government, employers) to bear the cost. For heaven sakes, the auto workers get exercised if they have to pay a dime out of pocket. The change will come when big business puts its foot down. We're seeing GM, Ford, Chrysler say that they can pay health benefits and compete. We going to all have to realize that we will have to pay for what we want and not expect someone else to do it.
A one size fits all system won't work here. We need to realize that healthcare is both a right and a commodity. A certain level of healthcare will always be available to everyone-it justs needs to be provided in better places than emergency rooms. But for those who have the money and are willing to pay, they will get direct access to a physician of their choice, sophisticated tests and procedures, etc. That part of the system will be more consumer driven. HG
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Old 07-25-2007, 09:32 AM   #71
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Luckily, it looks like Wisconsin has it all figured out.

OpinionJournal - Featured Article

In part . . .

"This exercise is especially instructive, because it reveals where the "single-payer," universal coverage folks end up. Democrats who run the Wisconsin Senate have dropped the Washington pretense of incremental health-care reform and moved directly to passing a plan to insure every resident under the age of 65 in the state. And, wow, is "free" health care expensive. The plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes. It represents an average of $510 a month in higher taxes for every Wisconsin worker (emphasis added)."

Obviously, the answer is to not be a worker. Or, if you are a worker, to leave Wisconsin.

Keep in mind this is just an opinion from the WSJ opinion page. There are a number of proposals being floated around in Wisconsin, none of which are likely to be passed. There is plenty to dislike about the proposed plan, but there is also plenty to like. Some analysis shows that the cost is a wash. It is all academic because the chance of this plan passing is nil.
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Old 07-25-2007, 09:33 AM   #72
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Let's take a family with a single wage earner. $510/month is $6120 per year. The average health insurance cost for a family in the US is $11,000 per year. So the average single earner family saves $4880 per year. Double earner families, assuming they each pay the same, would pay $12240 a year, or $103 per month more to provide health care for everyone. Doesn't sound like a reason to quit work or leave the state. And by the way, that $103 per month extra will likely be equalized after one more year of health insurance increase.

Yes, the average cost is $11,000/yr, but for most people (approx 95% of working americans, the large majority of that cost is paid for by their employer. So, if they have to pay the extra taxes, they are going to feel it!

The point of most of my posts is that if you implement a single payor system, you eventually end up with waiting queues. Theres no way around it. One way or another rationing will occur. It occurs in America via the free market (the haves and the have nots). In other countries, it occurs because of shortages (of money, suppliers of care, etc.). So, basic economics shows us that on either extreme, there are major problems.

In the middle, there HAS to be some kind of cutoff point for people to get gov't aid. In America's hybrid system, politicians keep trying to figure out where that cutoff point needs to be, but there are always a certain number of people who can't qualify for Medicaid and also either can't afford health insurance or lack the financial smarts to figure out how to work the cost of healthcare into their budget.

On the other hand, if you implement a single payor system with the ability to "opt out" into a private system, most people will not be able to afford private care, so you still end up with inequality (the haves get better service, and the have nots get to wait their turn).....not the kind of solution that most who lean to the left would agree to.....two-tiered systems don't sit well on that side of the fence.

For some reason, the majority of Americans think that the grass is greener on the other side...proably because of all of the negative media attention about our system and all of the hype about Michael Moore's SICKO movie....notice that the media give ZERO attention to the problems with the other kind of systems.....because of the hype, I truly fear that Americans will elect a congress/president that will be heavily in favor of a single payor type system. Even if we elect a moderate President, the camel's nose will already be under the tent, and, IMO, it will only be a matter of time before we implement a single payor system. I think America will probably always have some kind of private system available (unless the extremists eventually outlaw that, like in Canada, to prevent the haves from getting something more than the have nots), but in all likeliehood, even if we do keep a private system in place, the majority of people would not be able to afford to "opt out".
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Old 07-25-2007, 09:40 AM   #73
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Yes, the average cost is $11,000/yr, but for most people (approx 95% of working americans, the large majority of that cost is paid for by their employer. So, if they have to pay the extra taxes, they are going to feel it!

As a former employer who provided health insurance for employees, I would take the savings from having to pay those big premiums and see that the employee came out even by increasing their pay.

However, the big problem is with employers who do not offer health insurance. In that case there is no savings to pass along to employees.

I would prefer to finance health care through the income tax system or similar system and not through a payroll tax where the burden fall just on employers/employees.
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Old 07-25-2007, 10:22 AM   #74
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However, the big problem is with employers who do not offer health insurance. In that case there is no savings to pass along to employees.
Ding ding ding...
And that's an increasing number. As much as 30% in some cities.
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Old 07-25-2007, 10:28 AM   #75
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An the increasing number is almost entirely from small employers, who are less able to afford increasing taxes.
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Old 07-25-2007, 11:11 AM   #76
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Since I'd like to retire before age 65, I am concerned about health care during those years before medicare kicks in. DW and I have health conditions that are not serious but don't fit the underwriting standards of insurance companies. (Another problem is not being entirely candid about medical problems on the application, because although you may be accepted, you'll have a claim denial if they find it later.) Why doesn't the government underwrite the care of chronically ill patients, who consume a lot of health care dollars? I believe this is the case now for everyone with end stage renal failure (dialysis) regardless of age. This would help insurance companies underwrite risk better and keep their costs down. The quid pro quo would be that the companies could not "cherry pick" customers. All they could be is charge more by age, which seems fair. The govt. should assign a case manager to every seriously chronically ill patient to see that these people had the most appropriate, but not necessarily the most expensive, case available. And why, as a society, do we require that people who are obviously dying be treated with expensive drugs and interventions? It reflects our unwillingness to face death and the greed of the health insurance injury and trial lawyers. (think John Edwards, the cerebral palsy king).
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Old 07-25-2007, 11:17 AM   #77
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Why doesn't the government underwrite the care of chronically ill patients, who consume a lot of health care dollars?
Does this question mean that you would be in favor of the gov't giving free care only to sick people who can't qualify for insurance, while the rest of Americans pay the taxes to support the program AS WELL as buy their own insurance since they can qualify?....or, should we all just skip buying insurance, and then just wait till we can't qualify, knowing the gov't would pay for our care.
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Old 07-25-2007, 11:20 AM   #78
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Since I'd like to retire before age 65, I am concerned about health care during those years before medicare kicks in. DW and I have health conditions that are not serious but don't fit the underwriting standards of insurance companies.
So just keep working until you're 65, or use the "friends and family" plan. What are you, un-American? Here's a link to HR 676, the proposed bill that's causing panic in the insurance industry that it might pass with this Congress or with the next Pres.
H.R. 676 - Home

John Conyers has a good summary of it in his site.
Congressman John Conyers, Jr. Federal Information Page

I'm neither advocating or criticizing this specific bill, just pointing it out.
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Old 07-25-2007, 11:31 AM   #79
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So just keep working until you're 65, or use the "friends and family" plan. What are you, un-American? Here's a link to HR 676, the proposed bill that's causing panic in the insurance industry.
H.R. 676 - Home
Soon - this is exactly the kind of plan that frieks me out. Here's a quote from the article:

"18,000 people die every year in Ameica because of no health insurance. We must act NOW! Please help..."

Has anyone done any research to find out exactly how many people within single payor systems die while on a waiting list or suffer needlessly? I've posted several videos depicting just a few cases, but what are the real numbers? I've looked and looked, but I can't find any published data. The Fraser Institute, an advocate of private healthcare systems in Canada, has stated that the Canadian gov't is very squemish about publishing the numbers, because they know it will make their system look bad in the eyes of the public. I can't find numbers from any other countries either. How many billion people are in America? Isn't something like 4 billion?...and only 18,000 people die because they don't have health insurance! That is an incredibly low percentage of the overall population!

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Old 07-25-2007, 12:07 PM   #80
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[quote=gozzie;539333. And why, as a society, do we require that people who are obviously dying be treated with expensive drugs and interventions? It reflects our unwillingness to face death and the greed of the health insurance injury and trial lawyers. (think John Edwards, the cerebral palsy king).[/quote]

We don't require people who are dying to be treated that's what living wills and hospice are for . I don't think it's the greed of the insurance or the lawyers sometimes it's just the ( and I don't mean to offend anybody ) physicians inability to give up on a hopeless situation especially if it's a younger person .So they will order test after test and treatment after treatment until they finally give up or the family says enough .
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