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View Poll Results: How Should Americans' Health Care be Paid For?
Keep the status quo 4 2.72%
The Health Care Act, or something similar 4 2.72%
Individual responsibility with minimal, if any, government involvement 19 12.93%
A tax-funded, comprehensive government health plan 54 36.73%
A government plan for catastrophic illness/injury, plus optional supplemental coverage 22 14.97%
Hybrid—a government plan pays a set amount; the remainder is paid by supplemental coverage or out of pocket 14 9.52%
Underwritten policies for catastrophic coverage + national risk pool + HSA + tort reform 22 14.97%
Other (please explain) 8 5.44%
Voters: 147. You may not vote on this poll

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Old 12-20-2010, 04:40 PM   #41
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But ask yourself, would you be an average patient? A treatment may cure some patients, but only a few of them, so that the "average patient" lives only a few weeks longer. This sort of formulation in terms of the "average patient" conceals that in refusing to fund a treatment which extends the life of this statistical artifact by only a small amount may deny some patients a curative treatment.

And I think that if the patient can pay for this treatment they should have the right to do so...
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Old 12-20-2010, 04:50 PM   #42
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And I think that if the patient can pay for this treatment they should have the right to do so...
That's very generous of you.
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Old 12-20-2010, 04:57 PM   #43
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+1

Universal health care sounds great on paper, but I can't see how it could ever be paid for with unlimited benefits. A line has to be drawn somewhere, the real debate is where?
In the UK, the basic doctor visits and pharmacy are covered, Chronic illness is treated, Serious life threatening problems are treated immediately.

The rationing starts with elective health care procedures that are not critical to life (example Knee Replacement). They will get the procedure, but there is a queue and one will have to wait their turn. Even with that, it is not years.

To go to the head of the line for elective procedures, one can purchase supplemental insurance. Many companies provide it to employees as a benefit.


I talked with some people about this issue when we were over there. They said much of the U.S. election rhetoric was exaggerated. Of course there were some early issues and problems to work through... like any complex system.

Those Brits told me it was working just fine.

BTW the people I talked to were mainly professionals... well educated and compensated.... the people who might actually be on the short end of the stick in such a system.


After those conversations, I was convinced that much of the rhetoric was scare tactics to try to derail any effort to address the problems.
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Old 12-20-2010, 04:58 PM   #44
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In the UK, the basic doctor visits and pharmacy are covered, Chronic illness is treated, Serious life threatening problems are treated immediately.

The rationing starts with elective health care procedures that are not critical to life (example Knee Replacement). They will get the procedure, but there is a queue and one will have to wait their turn. Even with that, it is not years.

To go to the head of the line for elective procedures, one can purchase supplemental insurance. Many companies provide it to employees as a benefit.


I talked with some people about this issue when we were over there. They said much of the U.S. election rhetoric was exaggerated. Of course there were some early issues and problems to work through... like any complex system.

Those Brits told me it was working just fine.

BTW the people I talked to were mainly professionals... well educated and compensated.... the people who might actually be on the short end of the stick in such a system.


After those conversations, I was convinced that much of the rhetoric was scare tactics to try to derail any effort to address the problems.
The UK also has a 20% VAT and $8/gallon gas...
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Old 12-20-2010, 05:03 PM   #45
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I have dealt with cancer patients for many years through an online ovarian cancer support group I run. The treatments are difficult and there are often permanent side effects - peripheral neuropathy is common, among others.

I find there are different ways of thinking about it - the ones who want to see their children graduate high school (or get married, or see their grandchild born) are highly motivated to get treatment no matter what, for example. There are women whose families won't acknowledge that the cure is worse than the disease, and so the women continue treatment despite seriously compromised quality of life. And luckily some do well. But there always seems to be a point when the treatments are too much, hospice is called in, and the patient dies comfortably (for the most part).

For myself, knowing what I know about chemo and radiation - and having no children - I'm not sure I would do anything but spend money on travel and have a wonderful time while I could do it, if I knew I only had a few months left.
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Old 12-20-2010, 05:10 PM   #46
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The UK also has a 20% VAT and $8/gallon gas...
Yes they do. But that is not all due to health care.

But we spend more than other developed nations per capita!

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In 2006, per-capita spending for health care in Canada was US$3,678; in the U.S., US$6,714
Since this was about Canada vs US cost, I did not see the exact figure for the UK... But there is a Bar Chart... The US spends about double the amount per person compared to the the UK.

Comparison of the health care systems in Canada and the United States - Wikipedia, the free encyclopedia
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Old 12-20-2010, 05:17 PM   #47
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In the UK, the basic doctor visits and pharmacy are covered, Chronic illness is treated, Serious life threatening problems are treated immediately.

The rationing starts with elective health care procedures that are not critical to life (example Knee Replacement). They will get the procedure, but there is a queue and one will have to wait their turn. Even with that, it is not years.

To go to the head of the line for elective procedures, one can purchase supplemental insurance. Many companies provide it to employees as a benefit.


I talked with some people about this issue when we were over there. They said much of the U.S. election rhetoric was exaggerated. Of course there were some early issues and problems to work through... like any complex system.

Those Brits told me it was working just fine.

BTW the people I talked to were mainly professionals... well educated and compensated.... the people who might actually be on the short end of the stick in such a system.


After those conversations, I was convinced that much of the rhetoric was scare tactics to try to derail any effort to address the problems.

Since I worked on London for mega for a bit over a year.... (back in 2000).. my experience is a bit different than what you state... almost all of the people that I met (also professionals) seemed to have negative things to say about their system... most people who had something minor would not even go to the doctor since it would be weeks before they could get an appointment....

I had a lady come visit over here and while here got a bad case of strep... we were visiting Disney and I said 'lets go to the doctor and get you looked at'... she could no believe that we called and had an appointment in less than one hour... the doc ran some test etc.. gave a shot, got some prescriptons and we were out of there... lucky for her she had bought travel insurance so it was paid for...


One of the other things they have going for them.... you can get a LOT of drugs over the counter there that you can not here... I could buy my allergy steroid spray over the counter... here, I have to go to the doc to get a prescription... my sister (a nurse) was surprised what you can get over there...
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Old 12-20-2010, 05:31 PM   #48
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Since I worked on London for mega for a bit over a year.... (back in 2000).. my experience is a bit different than what you state... almost all of the people that I met (also professionals) seemed to have negative things to say about their system... most people who had something minor would not even go to the doctor since it would be weeks before they could get an appointment....

I had a lady come visit over here and while here got a bad case of strep... we were visiting Disney and I said 'lets go to the doctor and get you looked at'... she could no believe that we called and had an appointment in less than one hour... the doc ran some test etc.. gave a shot, got some prescriptons and we were out of there... lucky for her she had bought travel insurance so it was paid for...


One of the other things they have going for them.... you can get a LOT of drugs over the counter there that you can not here... I could buy my allergy steroid spray over the counter... here, I have to go to the doc to get a prescription... my sister (a nurse) was surprised what you can get over there...

My conversations took place just prior to the election.... not 10 years ago.

They said there were some problems that had to be ironed out.

I have no illusions... I am sure their system is not perfect. For that matter, it may not be a good fit for America. But they seemed to be happy and healthy.

On that note, ever meet anyone who didn't have a complaint? For that matter, ever see a complex system that couldn't use some improvement?


I hear a lot of complaining here in the US.... and it is getting louder as prices spiral upward.... and that is from the people that have coverage.

Those who do not have coverage really have something to complain about!
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Old 12-20-2010, 05:40 PM   #49
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If you think health care in the US is expensive now, wait until it's free...
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Old 12-20-2010, 05:51 PM   #50
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If you think health care in the US is expensive now, wait until it's free...
Whooooouooo! I'm so scared.
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Old 12-20-2010, 05:51 PM   #51
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So you'd be in favor of some sort of committee that was empowered to deny life-extending care to individuals under some conditions. What criteria would you like to see in place to begin this process? Perhaps we can make that slope less slippery.
I would be in favor of any entity that would allow you to feel comfortable with the feedback that the cost of your care would exceed the value to the cultural greater good.

I would agree with any criteria that would allow individuals to view themselves as part of a larger, more important picture rather than an individuals with overriding demands.

Coming to terms with our own mortality is daunting. What has helped me to gain a perspective for myself is the the concept of value: how much is the attempt to deny/delay my nature worth? Death is inevitable. I had better be prepared to offer something really big in return in order for the expense to be worth it.

My very strong preference is to be much more aggressive in dealing with pain. In my very humble opinion.....pain is the enemy....not death. Hospice programs "get" that....and with supportive medical directors, try and allow pain to abate along enough for individuals to truly live for whatever time they may have.

In my opinion....after over 30 years as a registered nurse working in every layer of health care.....the American system is not just broken. It is corrupt. Everyone means well.....but the simple concept of our nature being what it is has been lost...and we have become a society that insists that attempting to live forever is our right.
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Old 12-20-2010, 06:05 PM   #52
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As many posters have said, an individual should be able to pay for his own treatment, no matter how much it costs. On the other hand, if the public is to pay for it, then we should realize that health care is a limited resource, just like anything else, and we will have to look into its use for maximum benefits to our society.

About humane treatment, I think few would mind paying for a surgery to save even a homeless person from dieing of a ruptured appendix. Such an operation, I believe, is now routine and has a good chance of success.

On the other hand, an expensive cancer treatment with, say 50% chance of success, would be better used on a 30-yr old than an 80-yr old. Some might say that, but, but, but there might be a chance the 80-yr old can get to live to 82 with the treatment. True, but we still have to draw the line somewhere. It is for the survival of society that we have to do that. Again, an individual should be allowed to expend all his personal assets to pursue whatever treatment he desires.

I just hope that if and when I face the condition as described by a nurse in this dire situation (that I posted the link in an earlier post) that my family would make the right decision and let me die with as little pain and with as much dignity as possible.
Her “large tumor” was so grotesque it is difficult to describe. She had visible growths resembling giant warts extending in a solid mass from her backside, around one hip, and covering one side of her belly from her navel to her groin. There were blackened, necrotic (dead) areas scattered throughout and other sections festered, oozed and bled. The smell was horrific... Although she had been prescribed oral pain medications, rolling and cleaning her still was physically agonizing for her... An earlier scan of her chest and abdomen had shown widespread metastatic disease in her lungs and tumor growth in her groin that pressed on a main artery. She had intractable anemia that transfusions relieved but would not cure.
Doctors and nurses generally know when a patient's condition is hopeless. We have made many medical advances, but there is a limit to what humans can do. We do not live forever! And in the case described above, I am not a doctor but it appears to me the patient could only be healed by God appearing by her bedside.
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Old 12-20-2010, 06:06 PM   #53
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From each according to his ability, to each according to his needs.
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If you think health care in the US is expensive now, wait until it's free...
I think we already have enough bumper stickers, thanks.


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And if I were in a mental state to be able to make the decision, I would absolutely decide to stop seeking medical treatment based on cost. At some point, I would not want to leave my family penniless, when the odds were against me, and I might not have much quality time left anyhow. If it's somebody else's money, sure - why not? Maybe that is what is immoral?

-ERD50
In order to evaluate this situation, I try to do as you have done -- reduce the variables to a minimum, see how it looks and then expand the variables.

Thus, I first ask myself what I would do in the following situation: I am clearly dying, but there are machines and drugs that could keep me alive for another week. However, in order to do that, my children will be forced to give up every asset they own to pay for it, which will lead to their eventual starvation and death. In such situation, I would hope that I could muster the strength of character to say "I'm not going to be any more ready to go next week than I am now, and I would prefer that my children not starve, so I won't get the treatment." I think most parents would say the same.

Now, expand the variables. Since I don't have any children, I am really talking about having other people's children bear the cost of my continued week of life. And what if it just meant that they couldn't buy a big screen TV? And what if it were a month or a year? And what if the outcome were entirely uncertain? What about only a 10% chance of life extension? 20%? etc.

The situation can quickly become very complex and convoluted. But at heart, it is the same question -- how much should I burden my children to extend my own life? At some point, given technological advances in medical care, we will be unable to avoid making these decisions, individually and as a society. I hope that we can be both rational and compassionate when we finally do address the issue.
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Old 12-20-2010, 06:11 PM   #54
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... she could no believe that we called and had an appointment in less than one hour... the doc ran some test etc.. gave a shot, got some prescriptons and we were out of there...
Not exactly a typical experiencing over here. Most folks in America would also have a hard time believing it would be possible to get an appointment that quickly.
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Old 12-20-2010, 06:20 PM   #55
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Since I worked on London for mega for a bit over a year.... (back in 2000).. my experience is a bit different than what you state... almost all of the people that I met (also professionals) seemed to have negative things to say about their system... most people who had something minor would not even go to the doctor since it would be weeks before they could get an appointment....
Well, yes. Fewer doctor visits implies a reduction in medical expenses, which IS the goal.

Mission accomplished.
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Old 12-20-2010, 06:23 PM   #56
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Yes they do. But that is not all due to health care.

But we spend more than other developed nations per capita!


Since this was about Canada vs US cost, I did not see the exact figure for the UK... But there is a Bar Chart... The US spends about double the amount per person compared to the the UK.

Comparison of the health care systems in Canada and the United States - Wikipedia, the free encyclopedia
Which implies that even a 20% VAT and $8/gallon gas would not be enough to have the same type of system in the US. Cost control is the key, but it's not going to be cut in half overnight either.
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Old 12-20-2010, 06:28 PM   #57
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The situation can quickly become very complex and convoluted. But at heart, it is the same question -- how much should I burden my children to extend my own life? At some point, given technological advances in medical care, we will be unable to avoid making these decisions, individually and as a society. I hope that we can be both rational and compassionate when we finally do address the issue.
That's why I personally think it is important to meet with a doctor and put together a living will that specifies when 'enough is enough', while I can think clearly about the issues, and am not already so far along 'the process' that I cannot clearly express my wishes.

One of the nice, but often overlooked items in the recent health care legislation modifies Section 1861(s)(s) of the Social Security Act to permit Medicare providers to have this discussion about end of life care with their patients. This was the bit that Rep. John Boehner said would "start us down a treacherous path toward government-encouraged euthanasia." (There is a possibility that he may have been exaggerating a bit.)
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Interesting Topic - Poll Results Surprise Me
Old 12-20-2010, 07:43 PM   #58
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Interesting Topic - Poll Results Surprise Me

This is a favorite topic of mine. I've spent hours writing elected officials, debating the pro and con. The answer seems obvious to me. I realize it's a complex topic and it's likely there is not a simple, one size fits all method of addressing health care and health care insurance. Yes, they are two different topics. While many interchange the phrases health care with health insurance they are separate.

I have not taken time to read the entire thread but I will come back to it when time permits. As I said above the answer seems obvious. In my mind at least part of the obvious answer is we all (as invidviduals) must realize that when you spend other people's money (OPM) you don't spend it as wisely as when you spend your own hard-earned money. Therefore, I am clearly on the side of less governement involvement. That being said, I think the government needs to establish a framework to make a health care and health care insurance system work well for most if not all citizens. Let me stress that government only provides the framework - less is better - let the individual decide how much insurance to purchase - let the individual decide if they want a high deductible or a low deductible. Let the individual decide if they want insurance to cover out of pocket expenses.

So what's up with the nearly 43% of you that voted (as of 12/20/2010) for a tax-funded, comprehensive government health plan? You actually want to redistribute your money (i.e. taxes) to the governement so they can waste it on programs like Medicare and Medicaid? Those programs (like most government programs) have become so convoluted they don't make sense.

I'm a compassionate person... I can understand society has obligations... but a tax-funded, comprehensive government health plan. Maybe I gotta go back and read the thread. Maybe this is a joke. It's a joke right?

If you voted for a tax-funded, comprehensive government health plan in the above poll please take time to read the article September 2009 article in The Atlantic by David Goldhill.

How American Health Care Killed My Father - Magazine - The Atlantic
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Old 12-20-2010, 08:47 PM   #59
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So what's up with the nearly 43% of you that voted (as of 12/20/2010) for a tax-funded, comprehensive government health plan? You actually want to redistribute your money (i.e. taxes) to the governement so they can waste it on programs like Medicare and Medicaid? Those programs (like most government programs) have become so convoluted they don't make sense.
Well, ya gotta remember, there's a bunch of those damn old people that hang out here. Those greedy ole pharts paid into Medicare for 40-50 years in many cases, and actually expect to collect some benefits from the program.

Yeah. Shocking how the government would waste all that money they collected on some old people, when they could be losing it in unreconciled transactions (24.5 billion in 2003), or spending $108 million on unused airline tickets, or dumping $8.5 billion into overpayments of Earned Income Tax Credits.

(Between me and my employers, I have $244,758 in Medicare. That's enough to cover a $1500 a month medical policy for over thirteen and a half years. If y'all decide Medicare is wasted on old people, I'd like that money back, please. kthxbai.)
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Old 12-20-2010, 08:50 PM   #60
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I just read through the Atlantic article above.

Nearly 30 years ago, my former employer, a large aerospace company, was already alarmed by the rising cost of health care. It organized and pushed for health care reform at the state level. It has been a while, and I do not remember all the details, but one of the objectives was to make the hospital charges more transparent, and to have the customers, i.e. the patients, understand the cost of the service that they were getting.

That proposition was voted down. The health care customers simply did not care; they believed that the cost was not directly borne by themselves, and the measure would simply restrict the availability of care that they would get. This was back when we did not have any copay, and the insurance premium was still dirt cheap.

About the article, a friend of mine in his 60s said something similarly regarding his experience. His father was a blue collar worker, and did not have insurance. Yet, he never had problems going to a doctor if he needed to. The payment was in cash, and it was never that big a deal to his father. As the article pointed out, when there were fewer middle men between the service provider and the consumer, and the consumer was more informed to shop for better deals, the costs would be lower.
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