The good old USA and medical costs

[getoutearly]

To tell you the truth, I didn't ponder over it for too long. Fairly obvious - to me only maybe - that the litigious time we are living in is driving a lot of costs up, health care only being one of them. But, the lawyers are doing well.

One definition of Politics: The often internally conflicting interrelationships among people in a society

my drink's getting low...

[cute fuzzy bunny]

Fair enough. You were a bit persistent in the beliefs, so I wanted to give you a fair shake at offering up the thought process and data that led to your opinion. Maybe there was something I was missing or a line of thinking that would change my opinion.

I looked some more; lowest data from a well published source says that malpractice runs .56% of the total medical costs of the US; high end was 2%. Lowest data estimating "defensive care", ie doctors ordering extra tests to avoid being wrong, at roughly 2%; high end is 4%.

So this is a 2.56% to 6% of the total medical "bill" problem.

Most of the study information I found shows that these costs might actually be declining year on year over the last 3 years.

Most of the study information I found concluded that the biggest problem with malpractice costs was the 2-5% of doctors who create 50-55% of the malpractice claims. Apparently the 'system' fails almost completely in policing and resolving "problem doctors". So perhaps the lawyers are less the culprit here in this minority issue, but hack doctors fellow "peers" doing a catch and release with them when they're hooked.

So it seems this "problem" is unlikely to be a big or the biggest "problem" with health care costs. Not because of politics or relationships or agendas, but simply the data. In the relative absence of data based opinions to the contrary, I sort of have to go with the evidence.

Where I last worked, it was common to call people acting badly and being idiots as "politics", so I have a wan opinion of the word.

[LRS]

Maybe it's the three glasses of wine I just had, but I am pissed as hell: are we only entitled to the human rights we can PAY for? I dunno--I think health care is the right of every American and not just the privileged few who can pay full price. Now that some cancer drugs are being priced at $100,000 for a year's supply (see last week's news), how many of you have "earned" the "privilege" of surviving cancer?

[sgeeeee]

Quote:

Originally Posted by getoutearly . . . One definition of Politics:* The often internally conflicting interrelationships among people in a society. . .

I don't know what that means, but I don't think this discussion has been that political.

When we argue about whether or not Cheney was drunk when he shot his friend, that's political. We have no real data either way. Maybe he just exercised poor judgement. Maybe he had purely altruistic reasons for the way he handled the situation. Our beliefs about what happened are colored by our predjudices.

When we argue about the motives of Ted Kennedy or George Bush when they've done something stupid, that's political. None of us really knows Ted or George or what their motives are. Our political beliefs tend to make us believe in the honor of the figure we agree most with.

But this discussion has been about whether the US has the best health care system and about whether it is a good bargain or expensive. While no data can specifically address those questions, a great deal of data that relates to those issues has been collected and presented in this thread. It all seems to point to the same answers. How is that political?

Maybe I've missed something in this thread or in my reading of other news sources. If there is data that contradicts the data we've seen here? Is there anything beyond gut feeling (political bias?) or anecdotal evidence (political rationalization?) that indicates that the US does have a superior medical system or that our medical system is a bargain?

[Martha]

I apologize for mixing my politics with a discussion of the facts. Unfortunately the two get intertwinned. The facts indicate to me a situation that are contrary to my personal beliefs about what a society should be like.

There is considerable factual data cited on this board which indicates that US healthcare is expensive and not available to all. Legitimate questions have also been raised concerning the quality of our medical care system given where the US sits in contrast to other developed countries with respect to longevity. No one has raised any contrary data.

We also have discussed why the costs in the US may be high. Only opinions, not data, have been advanced that a primary driver is lawyers and malpractice. I don't and never have practiced personal injury law. Figures were presented which indicate that this is a small part of the total cost. Nevertheless, the cost of malpractice insurance is an issue in many parts of the country. And if doctors feel they are ordering unnecessary tests, this is an issue that should be addressed. But in the scope of things, this appears to be a small issue and if controlling lawsuits is presented as a solution to the healthcare problem by politicians, I questions their motives.

I suppose the issue of access is a political issue. I have very strong personal beliefs that we as a country should provide healthcare to all its citizens. I am very disturbed about medicaid cuts. That the price of providing multimillion dollar care to one baby results in other people getting no care. I believe healthcare for all citiizens should be right up there with defense of the country and education of its citizens, and social security. Therefore, I reacted strongly to the post which said "why do people get off thinking they have a right to what I have worked hard to get'? But I do apologize for my strong reaction. Unfortunately, my reaction probably served only to cause some people to question the factual content of my posts.

[Eagle43]

In case you haven't seen this, here is a site discussing national health care.

One of the problems with national health care is the desire of the bureaucrats to eliminate any competitors.* I believe Hillary's plan had some aspect of this.* In Canada there is a ongoing controversy about that very thing.* This would be tantamount to the U.S. Postal Service eliminating FEDEX.* Since I've been poor, I know that some form of government assistance is necessary for a lot of people.* The questions are:* How much will it cost? How will it be paid for?* and Will Competition be outlawed?

As to the ongoing discussion about longevity tables, We're just fat and lazy. Our kids sit in front of tvs and computers. Most of the adults would drive to the mail box, if we could. National Health Care won't fix that.

[Martha]

Quote:

Originally Posted by Eagle43 Since I've been poor, I know that some form of government assistance is necessary for a lot of people. The questions are: How much will it cost? How will it be paid for? and Will Competition be outlawed?

Insurance and competition is a big issue. The problem with the insurance concept is that insurance is for future risks, not current problems. Therefore, insurance companies don't want to cover people who are already sick. Or the insurer will charge a price most cannot afford to pay. HIPAA helped somewhat with this problems, but it doesn't regulate rates and it only protects people who move from group to group plan or group to individual plan. Some states have found their own solutions in the way they regulate the insurance industry, though none of the solutions have provided universal coverage.

I have a hard time believing that we can eliminatehealth insurance companies in this country. However, we might need to subsidize insurance costs for low income people and sick people. Just allowing market forces to function won't work because insurance companies will want only to cover healthy people. Minnesota does a pretty good job of dealing with these issues through its current system. It has a risk pool that is fairly affordable for uninsurable people. It has subsidized insurance for those who cannot afford insurance. I believe Minnesota has a greater percentage of people covered by insurance than any other state.

I also tend to think that we need to separate insurance from employment. One of the reason's HIPAA was enacted was that people with preexisting conditions were trapped in their job because they could not get coverage elsewhere. HIPAA made it far easier for people going from job to job, but it is of limited help if you have no job at all or your employer doesn't provide health insurance.

[cute fuzzy bunny]

Quote:

Originally Posted by ((^+^)) SG I don't know what that means, but I don't think this discussion has been that political. When we argue about whether or not Cheney was drunk when he shot his friend, that's political. We have no real data either way. Maybe he just exercised poor judgement. Maybe he had purely altruistic reasons for the way he handled the situation. Our beliefs about what happened are colored by our predjudices. When we argue about the motives of Ted Kennedy or George Bush when they've done something stupid, that's political. None of us really knows Ted or George or what their motives are. Our political beliefs tend to make us believe in the honor of the figure we agree most with. But this discussion has been about whether the US has the best health care system and about whether it is a good bargain or expensive. While no data can specifically address those questions, a great deal of data that relates to those issues has been collected and presented in this thread. It all seems to point to the same answers. How is that political? Maybe I've missed something in this thread or in my reading of other news sources. If there is data that contradicts the data we've seen here? Is there anything beyond gut feeling (political bias?) or anecdotal evidence (political rationalization?) that indicates that the US does have a superior medical system or that our medical system is a bargain?

Actually cheney admitted to having "just one beer", although who the hell ever said or heard that and it was true?

Other than that, you said what I thought and didnt say. See? Sometimes the cute and fuzzy bunny really is a nice guy

[Nords]

Quote:

Originally Posted by (Cute Fuzzy Bunny) Actually cheney admitted to having "just one beer", although who the hell ever said or heard that and it was true?

I thought the delay in reporting to the press was because the staff was waiting for Cheney to sober up and put down the shotgun...

[cute fuzzy bunny]

Well if it wasnt standard operating procedure for a well to do person who crashes their car while drunk to be 'tucked away' by their lawyer until turning themselves in the next day, I guess nobody would grab onto the analogy. Substitute gun for car. Substitute meaningless "leaving the scene" fine for a little talk show blabbing.

[ladelfina]

Quote:

Will Competition be outlawed?

not gonna happen in the good old U.S. of A. *

In Italy (and I assume Canada, Switzerland, Japan and just about every other developed country with a public system) one is certainly free to buy additional private health insurance and either use that or pay out-of-pocket to visit private physicians and clinics.

From what people tell me (and I have both doctors and patients in the family here), it's not so much a matter of quality as of convenience and wait times. If you are on the list for a non-emergency test you may have to wait weeks. You're always free, though, to get the same test sooner for cash at a private lab if you so choose.

I have to strongly second Martha in her disdain for Rustic23's comment:

Quote:

why do people get off thinking they have a right to what I have worked hard to get?

A huge number of Americans pay their fair share of taxes yet find themselves without healthcare coverage. THEY have a bigger beef than Rustic23. The patchwork systems of 50 states regulating insurance along with the huge overhead of hundreds upon hundreds of insurance providers and hospitals has way more to do with escalating costs than does malpractice. This kind of 'competition' is INefficient and is literally killing us.

How can people be worried about 'competition' and 'choice' when they are apparently too blind to see that neither is operative in the current system anyway!?!? In Massachusetts, for example, you cannot buy catastrophic coverage even if you decide that's best for your situation.. just can't buy it no how no way.

Just do the basic math of public vs. private: Kaiser Permanente buys a pill for a dollar but to make a profit for their shareholders they have sell it for $1.20. The gov't. could probably buy the pill for .90 and after overhead still give it to you for a buck.. at the very least they don't have to be paying multi-million dollar exec salaries and pleasing shareholders.. If people feel like they're 'paying too much' or that 'there's not enough to go around', cutting out the middleman should net you an extra 20% right off the bat, ..no? *(Before you even get into reduced costs of doctors dealing with myriad insurance forms and those kind of savings..)

My Republican sister says, "why should I trust the government with my health care?" I say, "why should I trust an insurance salesman or anyone with a profit motive with my health care?.. he only gains if I lose..!"

--
now quit talking about Cheney, 'cause it's just distracting us from the UAE thing

[cute fuzzy bunny]

I'll bet cheney has good health care...

[sgeeeee]

Quote:

Originally Posted by (Cute Fuzzy Bunny) I'll bet cheney has good health care...

I wonder how much the policy that comes with a helicopter costs?

[ladelfina]

Quote:

I'll bet cheney has good health care...

He's got the best kind there is.. someone else is paying for it.. namely you and me!

I wanna know what the annual costs are of having doctors and ambulances follow him wherever he goes.

[cute fuzzy bunny]

Hmm...I've heard of 'ambulance chasers', what do you call ambulances that chase YOU?

[Alan]

Quote:

Originally Posted by ladelfina not gonna happen in the good old U.S. of A. * In Italy (and I assume Canada, Switzerland, Japan and just about every other developed country with a public system) one is certainly free to buy additional private health insurance and either use that or pay out-of-pocket to visit private physicians and clinics. From what people tell me (and I have both doctors and patients in the family here), it's not so much a matter of quality as of convenience and wait times. If you are on the list for a non-emergency test you may have to wait weeks. You're always free, though, to get the same test sooner for cash at a private lab if you so choose.

When I lived in England back in '83 I had a foot problem that was extremely painful meaning I had wear open-toe sandals at work etc. *I had to wait for 18 months to have the required surgery. *However, I always believed that if something was life-threatening, things would be different. *Since then I have had a number of family members with some really serious health problems who can't afford private and have to wait many months or years to get treatment. *The most recent is my sister's husband who was having balance problems and then dizzy spells. *It took 2 years before he had an MRI on his head, where they found a very large tumor wrapped around his brain stem, and they operated within days. *They couldn't take it all of course and after tests found some cancer cells so expected it to continue to grow slowly. *He has been pretty sick since then and 10 days ago had the first MRI since his operation 18 months ago. *The tumor has been growing again and the doctors debated about going in again for a trim and tuck but decided it would probably keep for 12 months. *However they have told him that the waiting list for the MRI scanner is 18 months so they won't see him again until then, unless he gets much worse (they also assured him that death will be painless when it comes). *He is 48 with 2 girls, 2 grandchildren and another due in 6 months. *We have often thought about going back to England when we retire because that is still where the vast majority of our family live, but the National Health care system is broken, and while we can afford the insurance in the USA there is no doubt in our my minds that it is worth it. (We moved here in 1987)

[ladelfina]

Alan, I am so sorry to hear about your brother-in-law. I guess I am, as you were, 'whistling in the dark'.

I'm truly troubled to hear of such long wait times for an MRI! I had read in the article I cited earlier that some countries have more MRI machines per person than the US, but I don't think Britain was mentioned.

In Italy my MIL has just come off the second of two knee replacements. She only had to wait a month or two.. probably depends on regional availability and demand here.

Certainly, especially after reading your story, it's hard to be a 'cheerleader' for socialized medicine, but I still do think of the millions of Americans who have no insurance whatsover; they would not have had the MRI at all, nor would they have had the operation.

I have a close friend in the US who is living with brain tumors (she had her first operation about 25 years ago, not long after I first met her), so I know it is a very long and rocky road. She has had to go through the "wait and see how big it gets" scenario, as well. She's had excellent care so far, since she is covered by her employer's insurance. However, the tumors' continued growth and her operations and treatment leave her ever more deaf. When her deafness reaches the point where she is no longer able to do her job, where will she go? How will she be able to pay with no job and no insurance? What insurer would take her even if she had the wherewithal to pay a high monthly premium?

It's a conundrum.

I do wish you and your brother-in-law and his family all the best.

[MRGALT2U]

Quote:

Originally Posted by ladelfina Alan, I am so sorry to hear about your brother-in-law. I guess I am, as you were, 'whistling in the dark'. I'm truly troubled to hear of such long wait times for an MRI! I had read in the article I cited earlier that some countries have more MRI machines per person than the US, but I don't think Britain was mentioned. In Italy my MIL has just come off the second of two knee replacements. She only had to wait a month or two.. probably depends on regional availability and demand here. Certainly, especially after reading your story, it's hard to be a 'cheerleader' for socialized medicine, but I still do think of the millions of Americans who have no insurance whatsover; they would not have had the MRI at all, nor would they have had the operation. I have a close friend in the US who is living with brain tumors (she had her first operation about 25 years ago, not long after I first met her), so I know it is a very long and rocky road. She has had to go through the "wait and see how big it gets" scenario, as well. She's had excellent care so far, since she is covered by her employer's insurance. However, the tumors' continued growth and her operations and treatment leave her ever more deaf. When her deafness reaches the point where she is no longer able to do her job, where will she go? How will she be able to pay with no job and no insurance? What insurer would take her even if she had the wherewithal to pay a high monthly premium? It's a conundrum. I do wish you and your brother-in-law and his family all the best.

I've had some MRIs. I only use the "open" type as I am
slightly claustrophobic. Anyway, the last time I could have gotten
in at several locations within 24 hours. In fact, I had more trouble
scheduling to be able to get there as quickly as they could take me.
Never ever any trouble with a wait for an MRI.

JG

[cute fuzzy bunny]

So were they able to locate a brain?

Was it where I think it is?

[Alan]

Quote:

Originally Posted by ladelfina I'm truly troubled to hear of such long wait times for an MRI! I had read in the article I cited earlier that some countries have more MRI machines per person than the US, but I don't think Britain was mentioned.

Thank you for your words of support. My family is in the NE of England, which is where this particular family drama is unfolding. My wife's family lives in Manchester and a few years ago her brother was desperately in need of an MRI on his back as he was heading towards paralysis of his lower body. He was born with part of his lower spine missing and had several surgeries as a small boy. He was now a successful lawyer in his mid 30's and obviously things were getting much worse. He had a few months to wait, and had to travel to Liverpool for the nearest available MRI machine, which was amazing considering the size of Manchester. All turned out well in this case. As a result of the MRI they went back in and did some more surgery to make him much better.

Medicare may well be facing some tough times financially in the coming years but it has a long way to go before it faces the types of issues plaguing the NHS in Britain.