Health care?

[Chuckanut]

The fact that Italian men live about three years longer on average than American men says more about Italian life and culture than their health care system. We must remember that Italy does not have the epidemics of crime, drugs, and alcohol that we do here in the states, and their cities are not the war zones that ours are.

Sees to me it is a real stretch to think that the above accounts for the difference between 7% of GNP and 15% of the GNP. Perhaps preventative care is more available in Italy to lower income people. That would also be a factor.

 

[Chuckanut]

The fact that Italian men live about three years longer on average than American men says more about Italian life and culture than their health care system. We must remember that Italy does not have the epidemics of crime, drugs, and alcohol that we do here in the states, and their cities are not the war zones that ours are.

On second thought, I guess I need to change my life style. Less criminal activity, and more wine and women. Tough medicine but I will make the sacrifice.

 

[Brat]

However, what is common among all the countries that have universal coverage regardless of single payer or competing insurance companies is that the government sets price controls, and all health insurance companies have to be non-profit.

Back in the day Blue Cross was non-profit.

 

[ERD50]

What could possibly go wrong with this thread?

It's different this time?

I am personally in favor of universal health coverage but think the US would be better served using a universal private insurance system and there are several countries who have this type of system in place.

+1.

Nice to hear it from someone who has 'walked the walk' and has perspective from both sides.

-ERD50

 

[obgyn65]

I am not sure what's the interest in asking such a divisive question. It is unlikely we find a consensus on this website.

Anyone for single payer system like Canada?

Everybody is covered, less stress?

 

[Midpack]

I am not sure what's the interest in asking such a divisive question. It is unlikely we find a consensus on this website.

I can't think of many issues of more importance to retirees than future health care cost/security. Fortunately it has been discussed here several times without devolving into political conflict...though without consensus as you've noted. Still worth comparing "facts" if nothing else? I would love to see someone provide hard evidence that US private health care is worth the huge premium we pay, though we can't collectively afford the current cost anyway.

 

[marko]

On second thought, I guess I need to change my life style. Less criminal activity, and more wine and women. Tough medicine but I will make the sacrifice.

I want to live in Greece: free health care, 30 hour work week, retire at 55 (I'll take a half pension!!), lounge around eating good food and drinking ouzo...live long and live well!

Let the grand kids pay for it!!

 

[Buckeye]

I'm sure many older folks can't keep up with the bills, it's hard enough for us younger folks.

Some while back we would get fliers from our company insurance firm, BCBS, asking us to help them keep costs down by checking all the bills against the Explanation Of Benefits (EOB) forms we'd get. However, it is impossible to do so since the EOB's don't list the individual tests and procedures that have been performed. There was one occaision when I had to pay much more than normal on a co-pay for a new crown and when I talked to our company rep she looked into it and saw that it had been mis-coded and the EOB was wrong. If the EOB would list the codes at the minimum, or at best decscribe each line item, it would help a lot.

I always try to check the EOB's but as you describe above, they are a bit cryptic and lack detail. By accident? I think not.

 

[Buckeye]

I am not sure what's the interest in asking such a divisive question. It is unlikely we find a consensus on this website.

It's not very interesting, or informative, if everyone agrees. There's a lot of smart people on this board and, whether I end up agreeing with them or not, I learn from their input.

To me, the "divisiveness" makes the journey interesting and informative on the way to the possible destination of consensus.

 

[l2ridehd]

The biggest reason our health care system is so much more expensive is the legal system. And yes someone will jump on this and say TORT is only 2% of our health care cost. And yes that is almost true. What is does take into consideration is the high cost of Mal-practice insurance and the added cost that EVERY doctor creates by doing so many extra tests to avoid the perception that he made a mistake. Those costs are difficult to measure but have been estimated by some very smart people to be 40% of our total health care cost.

And as to the premise that we have the best health care, a lot of people travel to the US for specialist care. Very few if any travel to the UK or Canada or Norway or anyplace else for specialist care.

The issue of 45 million people with limited care needs to be resolved. However I believe there are better answers then a single payer system.

 

[marko]

The biggest reason our health care system is so much more expensive is the legal system. And yes someone will jump on this and say TORT is only 2% of our health care cost. And yes that is almost true. What is does take into consideration is the high cost of Mal-practice insurance and the added cost that EVERY doctor creates by doing so many extra tests to avoid the perception that he made a mistake. Those costs are difficult to measure but have been estimated by some very smart people to be 40% of our total health care cost.

Absolutely!!! Here's another: a doctor friend told me that he had to hire 3 people just to do the insurance forms etc.

Until the 'mandates' talk began, he'd been thinking of not taking insurance, charging a modest fee ($75) and making more money than if he had to pay people to keep track of insurance claims.

 

[MichaelB]

The biggest reason our health care system is so much more expensive is the legal system. And yes someone will jump on this and say TORT is only 2% of our health care cost. And yes that is almost true. What is does take into consideration is the high cost of Mal-practice insurance and the added cost that EVERY doctor creates by doing so many extra tests to avoid the perception that he made a mistake. Those costs are difficult to measure but have been estimated by some very smart people to be 40% of our total health care cost.

Research by McKinsey, linked a number of times in previous threads on this subject, does not support this conclusion. Do you have any data or studies that do?

And as to the premise that we have the best health care, a lot of people travel to the US for specialist care. Very few if any travel to the UK or Canada or Norway or anyplace else for specialist care.

Some feel indicators like average life expectancy are better measures of overall health care.

The issue of 45 million people with limited care needs to be resolved. However I believe there are better answers then a single payer system.

please share your ideas on how to address this challenge.

 

[Midpack]

The biggest reason our health care system is so much more expensive is the legal system. And yes someone will jump on this and say TORT is only 2% of our health care cost. And yes that is almost true. What is does take into consideration is the high cost of Mal-practice insurance and the added cost that EVERY doctor creates by doing so many extra tests to avoid the perception that he made a mistake. Those costs are difficult to measure but have been estimated by some very smart people to be 40% of our total health care cost.

And as to the premise that we have the best health care, a lot of people travel to the US for specialist care. Very few if any travel to the UK or Canada or Norway or anyplace else for specialist care.

The issue of 45 million people with limited care needs to be resolved. However I believe there are better answers then a single payer system.

While malpractice is significant, from what I've read it's not the biggest reason, arguably higher admin costs are. But it's not one single reason anyway, here's just one summary Why Is Health Care So Expensive? Let Us Count the Conspirators | Moneyland | TIME.com

And I researched the 'lots of people travel to the US' for health care angle too. Indeed people (some wealthy) do, but the numbers are "relatively small, even infinitesimal" compared to health care system usage within other developed countries. I'd welcome hard evidence to the contrary. Furthermore, we've all read stories of US citizens traveling to other countries for major procedures and prescriptions because they can't afford them here. That was unheard of only a few generations ago. What does that say about private US health care?

Again, I'd love to be shown hard evidence (vs opinion or out of date "facts") where we get value commensurate with the huge premiums (50-100%) we pay vs the rest of the world. There are far more knowledgeable folks here and I am not a doctor, but my Dad was an orthopedic surgeon and I dealt with health care providers as an employer for decades. I am very concerned about the cost of healthcare in the US, the cost trend is not sustainable.

 

[farmerEd]

Not only do I support the idea, I think it is inevitable. I just can't see the math working any other way.

 

[Buckeye]

My husband plays tennis a couple times a week with international snowbirds from Germany, France, Canada and the Netherlands. Politics, including healthcare, come up in their Friday coffee klatch. They consider our lack of available healthcare for those who can least afford it barbaric.

 

[james7]

I want to live in Greece: free health care, 30 hour work week, retire at 55 (I'll take a half pension!!), lounge around eating good food and drinking ouzo...live long and live well!

Let the grand kids pay for it!!

At least the last part of your dream will come true without you moving anywhere. Your grandkids will be paying for our national debt.

 

[Chuckanut]

I want to live in Greece: free health care, 30 hour work week, retire at 55 (I'll take a half pension!!), lounge around eating good food and drinking ouzo...live long and live well!

Let the grand kids pay for it!!

I would hope we can find some compromise between the two extremes. One mentioned above, and the other, our current system, which makes health care very iffy for many people. My 2 cents.

 

[ERD50]

I am not sure what's the interest in asking such a divisive question. It is unlikely we find a consensus on this website.

In this country, not so very long ago, slavery, and then Civil Rights was a very divisive question, w/o consensus.

I guess those people like Abraham Lincoln and other abolitionists and those that followed should have just kept quiet. Don't want to ruffle any feathers, no, just keep that head deep in the sand. Everything will be better that way.

Now, I agree that the OP question was far too open-ended. But that's another matter.

They consider our lack of available healthcare for those who can least afford it barbaric.

Actually, healthcare is available for those who can least afford it.

I'm not defending our system, I think it is really screwed up and needs change. But distortions don't help. Now, if you can afford it, it can put you in the poor house. That's a problem, but it's not what you stated, but I suspect those Euro-friends of yours believe it to be true. Have they seen sick people on the sidewalk that would not be treated by us barbarians?

-ERD50

 

[Alan]

And as to the premise that we have the best health care, a lot of people travel to the US for specialist care. Very few if any travel to the UK or Canada or Norway or anyplace else for specialist care.

There are plenty of folks who travel to specialists in countries with Universal Health care. Many sports pros go to specialists in different European countries depending on their problem. (They also go to specialists in the USA).

We have some good friends who traveled to Nantes, France for surgery. She had a condition called Pudenal Nerve Entrapment for which surgery was available in Houston but was not covered by their HI company at the time as it was still classed as experimental. (They live in Louisiana). After trips to Houston for tests to confirm the diagnosis they faced a $25k bill for surgery or they could could go to Nantes where they could have it done privately by the surgeon who pioneered this particular surgery. The total cost of the surgery and hospital stay was <$5k so they both went to Nantes and spent about 10 days there. It still took awhile for recovery but she is doing great and they came to stay with us in England for 2 weeks last year and they did lots of driving on their own, plus some walking trips with us.

The UK, in particular London, is a popular destination for patients seeking treatment. In the past I've read of a US HI company on the East Coast offering to send heart patients to London for bypass surgery, paying for a 2nd person to travel with them including the cost of several nights stay. I think it was Guy's Hospital, that has a world re-nowned Heart center, that was the destination.


Medical Tourism

The United Kingdom is one of the most active of medical tourism destinations, especially London.

 

[youbet]

Still worth comparing "facts" if nothing else?

I'd like to see that happen........ Just once........

 

[Midpack]

I'd like to see that happen........ Just once........

I see it here often enough, but not always...

 

[james7]

There are plenty of folks who travel to specialists in countries with Universal Health care. Many sports pros go to specialists in different European countries depending on their problem. (They also go to specialists in the USA).

We have some good friends who traveled to Nantes, France for surgery. She had a condition called Pudenal Nerve Entrapment for which surgery was available in Houston but was not covered by their HI company at the time as it was still classed as experimental. (They live in Louisiana). After trips to Houston for tests to confirm the diagnosis they faced a $25k bill for surgery or they could could go to Nantes where they could have it done privately by the surgeon who pioneered this particular surgery. The total cost of the surgery and hospital stay was <$5k so they both went to Nantes and spent about 10 days there. It still took awhile for recovery but she is doing great and they came to stay with us in England for 2 weeks last year and they did lots of driving on their own, plus some walking trips with us.

The UK, in particular London, is a popular destination for patients seeking treatment. In the past I've read of a US HI company on the East Coast offering to send heart patients to London for bypass surgery, paying for a 2nd person to travel with them including the cost of several nights stay. I think it was Guy's Hospital, that has a world re-nowned Heart center, that was the destination.


Medical Tourism

You are absolutely right. An American man just came back from Sweden for lifesaving surgery that is performed nowhere else in the world. The cost was $450,000 and he is still trying to pay it off. Sweden has a socialised health system with long waiting times for surgery, and sometimes even emergency treatment, but they also have world renouned research institutions providing groundbreaking treatments for various illnesses.

 

[youbet]

You are absolutely right. An American man just came back from Sweden for lifesaving surgery that is performed nowhere else in the world. The cost was $450,000 and he is still trying to pay it off. Sweden has a socialised health system with long waiting times for surgery, and sometimes even emergency treatment, but they also have world renouned research institutions providing groundbreaking treatments for various illnesses.

I tried to find more info about this but couldn't. The WIKI article Alan listed didn't mention Sweden. It raises interesting questions. Did this private pay American cause any Swedes to wait longer for their similar surgeries? Did the Swedes charge a "mark-up" over what the cost to their socialized system actually was? How does the average Swede on the street feel about Americans, or others, receiving services from their socialized system while they have long waiting times?

I can understand how "outsiders" fit into the health care systems of capitalistic, private-pay systems like ours. It's harder to imagine how one would fit into a socialized system as a private pay "outsider."

I'd appreciate comments from folks who know.

 

[Animorph]

I tried to find more info about this but couldn't. The WIKI article Alan listed didn't mention Sweden. It raises interesting questions. Did this private pay American cause any Swedes to wait longer for their similar surgeries? Did the Swedes charge a "mark-up" over what the cost to their socialized system actually was? How does the average Swede on the street feel about Americans, or others, receiving services from their socialized system while they have long waiting times?

I can understand how "outsiders" fit into the health care systems of capitalistic, private-pay systems like ours. It's harder to imagine how one would fit into a socialized system as a private pay "outsider."

I'd appreciate comments from folks who know.

Sounds like he contributed $450k to their socialized system. And would Swedes even be eligible for this procedure under their program, or would they have to pay for it outside of the system?

 

[nun]

The American system delivers excellent care and outcomes at a vey high cost. However, many cannot afford insurance or are refused access to good coverage because of pre-existing conditions This becomes a big issue for ER'ers who have to find insurance on their own before Medicare starts.

I live in MA where we have Romneycare and I'm glad that I can retire early and be guaranteed that I will be able to buy good coverage for $340 a month no matter what pre-existing I have. Of course as a UK citizen I also have the option to move to the UK and use the NHS at no cost and that's the option I'll probably choose.

As I have experience of both systems I can talk about the benefits and failing of both. The UK system delivers excellent care at half the cost of the US. There are waiting lists and some procedures won't be done that would be done in the US because their efficacy isn't proven in the opinion of the NHS. But US insurance companies also deny procedures too and I'd argue that they are a lot more arbitrary.

I grew up in the UK and much prefer the UK system. Most foreigners who come from countries with Universal Care are sorry for Americans, and are amazed that they fight so hard to keep a system the performs so poorly.

It's easy to quote examples of poor outcomes from all systems. For the US it would be the millions with no insurance and who don't go to the doctor because they are afraid of the cost or the family that has a massive bill for their daughters cancer treatment. I'm the UK it would be someone waiting for a year for a hip replacement or not getting a new breast cancer drug. But to believe that a system is the "best in the world' in the face of evidence to the contrary and the opinions of those that have other systems sounds as if hubris might just reduce you lifespan. It's certainly costing America a lot of money.