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Old 02-14-2012, 08:05 AM   #121
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Originally Posted by Birchwood View Post
Said Midpack: reduce health care by 17%, cover all Americans, No income tax increase, and we still spend more per capita than other countries!

I just can't see that happening, and few comments.
1. Where does she propose the reduction in health care will come from-medicare?
2.When you cover more people, you need more revenue, thus taxes increases. Private corporation? I read GE did not pay any taxes ExxonMobil? C mon! Romney pays only 14.9%
3. American medicine is different compared to other countries. It is very procedure oriented. This is very expensive and lobby always find a way to have it approved for billing. There is little money to be made for prevention.
4. We Americans are also so egocentric and selfish. We are for reforms but when we get sick- we'll all want to go to the Mayo clinic for the latest
and most expensive procedures even if it works well close by.
5. It does not matter what reform we do, if we supersize our food, not exercise, smoke, use illicit drugs, drink too much alcohol, drive fast, health care is going to get expensive. Without cooperation of people result is nil.
6.If you look closely at other socialized medicine, they have a tendency to
exaggerate their results, but there is no way out for some. People are stucked with the socialized system, and there is little option if they are
unhappy with the system. (Sweden, Norway, England).
7. BTW, I just read there was just a nationwide strike of doctors in Germany, doctors abusing their patients in Sweden, etc. So nobody is perfect.
With all due respect, we've already answered the actual questions you've posed here and in your earlier posts, but you don't seem to be reading them, and you don't offer any hard evidence to support your personal opinions.
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Old 02-14-2012, 12:42 PM   #122
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Thanks for the effort James7, but you may have misunderstood my question. I'm well aware that the Swedish medical system has plenty of advanced medical technology. The articles you posted are further examples of this. But I'm struggling to understand how outside "private pay" patients fit into socialized systems, such as Sweden's. The answer seems to be, as others have mentioned above, the socialized systems have a private component to them operating in parallel with the socialized component.

EDIT:

In looking through the articles james7 kindly provided, there was a mention of how an "outsider" is given access to care in the Swedish socialized system. The article was about a Vermont woman who required a windpipe transplant and the Italian doctor (in Switzerland) who provided it. From that article:

That makes it clear why the Swedish system is so appealing to young, beautiful girls who have had a beautiful past.

Well, thank you for the thanks!! LOL

Yes, most socialized systems of health care do have a private component as does the UK, but I think more important in your discussion of the Swedish system is not the private component that provides health care, but the world renouned research facilities that have been able to pioneer lifesaving procedures. We Americans have been told many times by those advocating against universal health care in the US that one of the great strengths of our present system is our research facilities, both in medical procedures and in lifesaving drugs, and that if we go the universal, one payer, socialized route, this groundbreaking research will disappear overnight. Who knows, maybe it will disappear under the socialized plan that is being proposed in the US. After one has heard this argument so many times, it ceraintly seems strange to see medical research alive and well in the most socialized of countries.

I love Sweden and everything about it, including their women (been there many times), but I'll take a US girl anyday!! LOL
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Old 02-14-2012, 12:56 PM   #123
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On the topic of the availability of insurance in Mass. Can anyone list places to move to in Mass. that have a lower cost of living than the big cities? A town of 50,000 to 100,000 would be a nice starting point. IF you have any cost data points like housing to add that would be great. I am not familiar at all with that state but will probably need to be. I am only 47 and I see a move there in the future as the most likely way to stay in the States going forward.

I have also considered a move to MA with health care/insurance being one of the reasons. Of course I also like cold weather, Boston, the beaches of the Cape, and the New England lifestyle. As far as I know, there is no requirement to become a Patriot or Red Sox fan.

The further west one goes from Boston on the Mass Pike/I-90, the more the cost of living goes down. The college towns of Western Mass could be the perfect place, however, the winters there can be brutally cold. You also might want to look southwest of Boston, near the RI line. A good friend of mine who relocated to this area from the area southwest of Boston a couple of years ago says that the economy there has been hit very hard by the foreclosure crisis.
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Old 02-14-2012, 01:04 PM   #124
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6.If you look closely at other socialized medicine, they have a tendency toexaggerate their results, but there is no way out for some. People are stucked with the socialized system, and there is little option if they are unhappy with the system. (Sweden, Norway, England).
I can only talk about the English NHS. In that system there is constant evaluation by the government and other research organizations. It seems to be a national obsession. But most people are entirely satisfied with the NHS. Some people have private insurance as part of an employer package or pay for it themselves so they can use the private system in the UK. This is sometimes done when people don't want to wait for a non-critical operation. So if you have the money you have lots of options. If you don't you get world class care at no cost, with maybe a bit of inconvenience caused by waiting lists.

The NHS can be described as a socialized system as the Government uses taxes to pay the hospitals and doctors, but it's one of the very few such systems. Most are closer to Obamacare than they are to the UK system. They use highly regulated non-profit private insurance systems
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Old 02-15-2012, 08:19 AM   #125
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Well, it's a good thing that Japan invented the MRI.

Oh, wait.

Gee, I wonder how the medtech inventors recover the cost of the R&D from their technological advances... and the expense of experimental & heroic medical care on what we would call "hopeless" patients (excepting of course the ones that are related to us). And all of the litigation expenses that have gone into developing "the patient's bill of rights".

I'm not trying to claim that American healthcare is perfect. But it's sure expensive out there on the bleeding-edge frontier of tech. And what happens if the surgeons or techs in those other countries screw up and cripple or kill you a little? How come we never read those anecdotal stories here?

Many Americans think military Tricare is such a great deal for active-duty servicemembers... until they realize they can't choose their doctor, they can't get appointments in a timely manner, they have little confidentiality and no privacy, and no litigation rights. But it's free!
We're obviously getting gouged. It's certainly blatant in the case of pharmaceuticals, where the exact same drugs are cheaper in Canada or Mexico or the rest of the world. Big Pharma unapologetically says that US prices subsidize their R&D (which itself is a questionable proposition, since a lot of their drugs come out of NIH and other govt. funded research) for the rest of the world.

Not to mention they spend more on advertising than R&D to begin with.

So it's not surprising that the producers of medical technology may also impose discriminatory pricing on Americans relative to people in other countries.

Doctors and hospitals are probably making a lot more money than their counterparts in other countries.

Of course, each of these segments of health care have big lobbying operations, which have trained politicians to sow fear of "socialized medicine" and "govt. takeover" of health care.

Remember the prescription care benefit and how Pharma lobbyists drafted that law, which included prohibitions against govt. agencies negotiating volume discounts of drugs.

There's not too much mystery why costs are higher here. The vested interests have successfully ingrained the idea into enough of the populace that health care should be profitable in and of itself, that it isn't a right but something which should be earned and paid for.
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Old 02-15-2012, 08:40 AM   #126
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I have always thought that there are many facets to the issue of high health care costs in the US. Here's another example. In both my family doctor and my dentist offices, I saw about the same number of clerical workers as the number of health care professionals, i.e. nurses or PA and the doctor himself. Obviously, they need many paper pushers to deal with Medicare and the private insurance companies. And then, on the other end, who knows how many are employed by the government and the insurance companies to haggle back and forth with the health care providers. Meanwhile, do the patients know if the charges are correct, or do they even care how much certain procedures cost?
There was a famous Harvard Medical School study a few years ago which estimated that at least 25% of our total health care spending goes to processing insurance claims. We're talking half a trillion per year or more.

Doctors have to hire full-time staff to process insurance payments, as different insurers use different codes for the same conditions. Even then, many doctors have to spend a big chunk of their time handling the insurance claims as well.

Oddly though, during the whole health care debate, it was pointed out that the total revenues of all health insurance carriers was a small fraction of total health care spending, under 10% IIRC. But then the processing of the insurance takes a lot of time and money.
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Old 02-15-2012, 08:51 AM   #127
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Just wondering how many of these "great" national health systems (Canada, UK, etc etc) have been indirectly 'subsidized' by the US system.

By that I mean the US pharma cos (who spend billions on drug research...and expect a payback), US med-tech cos, (who again spend billions and expect a payback), US trained research/doctors, etc etc. Leading edge tech/pharma -most developed here-- costs a lot of money and the costs of healthcare reflect that...paid for by you and me.

BUT! At the same time, the nationalized systems are also beneficiaries as they get the tools, drugs, information and techniques that were developed here in the US (again, at our expense) become available to them as well.

So, can a fair comparison be made when a lot of the infrastructure/innovation/(heavy lifting) in other countries is actually being paid for by someone else? I wonder if the UK had to re-invent all their current resources from scratch how good their system would be.

Might be a bad example, but it's sort like the bat-boy showing off his World Series ring.

Jus' sayin'
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Old 02-15-2012, 08:51 AM   #128
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There was a famous Harvard Medical School study a few years ago which estimated that at least 25% of our total health care spending goes to processing insurance claims. We're talking half a trillion per year or more.

Doctors have to hire full-time staff to process insurance payments, as different insurers use different codes for the same conditions. Even then, many doctors have to spend a big chunk of their time handling the insurance claims as well.

Oddly though, during the whole health care debate, it was pointed out that the total revenues of all health insurance carriers was a small fraction of total health care spending, under 10% IIRC. But then the processing of the insurance takes a lot of time and money.
Everything I've read says administrative costs are one of the reasons (of many) we pay so much more for health care in the US. Coordinating among so many providers, insurance companies, employers, etc. isn't efficient. And many other countries have or are moving to online medical records which helps considerably. Here's just one US vs Canada illustration re: health care admin costs, shocking IMO...and necessary

US health care costs are higher because of administrative waste - Something Not Unlike Research
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Old 02-15-2012, 09:04 AM   #129
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A lot of the major pharmaceuticals are in fact based in Europe. But they dip into US funded research and certainly make a big chunk, if not most of their profits in the US market.
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Old 02-15-2012, 10:37 AM   #130
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Just wondering how many of these "great" national health systems (Canada, UK, etc etc) have been indirectly 'subsidized' by the US system.

By that I mean the US pharma cos (who spend billions on drug research...and expect a payback), US med-tech cos, (who again spend billions and expect a payback), US trained research/doctors, etc etc. Leading edge tech/pharma -most developed here-- costs a lot of money and the costs of healthcare reflect that...paid for by you and me.
Pharma is not a good example to choose to make your point as the French, Swiss, German and UK pharma industry is enormous. So the US profits from all that European innovation too.

IMHO such arguments are made as a last resort to try to rationalize a US system that is expensive and inefficient.

But even if it were true that the US spends so much more that the rest of the world on innovation and then the rest of the world benefits, why doesn't the US recoup it's research investment in royalties and sales of medical hardware and drugs and deliver medical care at a cost that is competitive with the rest of the world?
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Old 02-15-2012, 10:49 AM   #131
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As the previous poster noted: "...A lot of the major pharmaceuticals are in fact based in Europe. But they dip into US funded research and certainly make a big chunk, if not most of their profits in the US market...", I say 'follow the money'...somebody has to pay for it and it may as well be us!!

I wasn't trying to make an argument for the current system but just trying to point out that a lot of the smugness coming from the national systems isn't fully warranted.

At the same time, we need only to look at the current events in Greece to see how crippling the cradle to grave benefit approach can become.
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Old 02-15-2012, 11:05 AM   #132
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At the same time, we need only to look at the current events in Greece to see how crippling the cradle to grave benefit approach can become.
Greece is tiny. Financially less than 2% of the GDP of the Eurozone. It is only news because it was allowed to join the Euro even though it didn't meet the standards required. If it was still on the Drachma it would have imploded with such a small financial pop it may not have even made the main news networks.

It is not Healthcare (<3% GDP compared to >16% in the USA) that has caused the Greek economy to be in such bad shape but a combination of things. (this thread is about universal healthcare, right?)

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Health care in Greece is provided by the state through a universal health care system funded mostly through national health insurance, although private health care is also an option. According to the 2011 budget, the Greek healthcare system was allocated 6.1 billion euro, or 2.8% of GDP.
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Old 02-15-2012, 11:12 AM   #133
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I wasn't trying to make an argument for the current system but just trying to point out that a lot of the smugness coming from the national systems isn't fully warranted.

At the same time, we need only to look at the current events in Greece to see how crippling the cradle to grave benefit approach can become.
I fully agree about excessive spending and your point about Greece is well taken as far as general spending is concerned not as far as it's healthcare system as it's a far smaller %age of GDP than the US spends and everyone is covered. My point is that America spends twice as much as most other countries on healthcare and gets half the value, it is worse than Greece. If America were to adopt one of the systems from abroad it would save money and probably cover more people too.
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Old 02-15-2012, 11:16 AM   #134
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Ok, ok, ok.

Not to go further off topic, but I do remember when Bush was spending < 3% GDP in Iraq...a lot of people claimed that was going to bankrupt us.

But, point taken. Thanks!

Still wish I was back living in Greece again though: free healthcare, good food and nice weather....good living until the tear gas start flying.
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Old 02-15-2012, 11:19 AM   #135
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Ok, ok, ok.

Not to go further off topic, but I do remember when Bush was spending < 3% GDP in Iraq...a lot of people claimed that was going to bankrupt us.
.
Totally off topic.
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Old 02-15-2012, 12:02 PM   #136
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Totally off topic.
Of course.

Sorry.
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Old 02-15-2012, 04:31 PM   #137
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Viewed an interview with this gentleman this morning (Dan Rather's program on HDNet). For those of you who contend we can't reduce health care costs while increasing quality of health care. The details are readily available...
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Candid Advice From a Health Care Visionary
Dr. Donald Berwick, who was the administrator of the agency that runs Medicare and Medicaid (alas only 17 months), has been speaking out.
Berwick began his career as a pediatrician at Harvard Community Health Plan; in 1983 he became the plan's first Vice President of Quality-of-Care Measurement. In that position, Berwick investigated quality control measures in other industries such as aeronautics and manufacturing and considered their application in health care settings. From 1987-1991, Berwick was co-founder and Co-Principal Investigator for the National Demonstration Project on Quality Improvement in Health Care, designed to explore opportunities for quality improvement in health care. Based on this work, Berwick left Harvard Community Health Plan in 1989 and co-founded the IHI (Institute for Healthcare Improvement).
He also found signs everywhere that hospital systems, specialty medical societies, patient safety programs, health insurers, employers, labor unions and various states are already taking steps to improve the quality and lower the cost of health care. He said there is still plenty of room for savings in a complex system where, he estimates, 20 percent to 30 percent of all health spending — or more than $1 trillion a year — may be “waste” that does nothing to help patients.
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Old 02-15-2012, 04:50 PM   #138
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Viewed an interview with this gentleman this morning (Dan Rather's program on HDNet). For those of you who contend we can't reduce health care costs while increasing quality of health care. The details are readily available...
I've heard him on NPR a couple of times. He's a Harvard academic with a long list of degrees from Harvard College, the Kennedy School and the Medical School. He has advocated introducing some of the methods used in the NHS and other foreign systems. This all makes him sound impressive and pragmatic to me, but many will not be as enamored of his background or approach.
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Old 02-15-2012, 05:27 PM   #139
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I've heard him on NPR a couple of times. He's a Harvard academic with a long list of degrees from Harvard College, the Kennedy School and the Medical School. He has advocated introducing some of the methods used in the NHS and other foreign systems. This all makes him sound impressive and pragmatic to me, but many will not be as enamored of his background or approach.
Just one of the many ways he's been misquoted/out of context...which has indeed led (unfairly) to your last sentence.

We have got to get past making judgements based on sound bites, though it's prevalent these days.
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Old 02-15-2012, 06:41 PM   #140
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Just one of the many ways he's been misquoted/out of context...which has indeed led (unfairly) to your last sentence.

We have got to get past making judgements based on sound bites, though it's prevalent these days.
I'm not sure I know where I was incorrect. In the interviews I heard he talked about cost savings and how foreign schemes might be applied to the US.

I think this is a good idea, as will many others, but many won't agree
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