Socialized Medicine

[lets-retire]

Well the ground work happened faster than I expected. In the stimulus package there are provisions for government bureaucrats to dictate what treatment is the best and which treatments will be provided, instead of letting practicing doctors dictate treatment. It isn't a far step for the government to actually start providing the treatment. Oh boy, I can't wait for the long lines and poor treatment. I should have stayed in the military where at least I can be compensated for substandard treatment.

<Rant off>

 

[W2R]

I am concerned about these provisions as well, since I am FI and only working in order to obtain lifetime medical coverage. When I get it, I'd like my doctor to be in charge of what treatments I do or don't receive!

I believe the differences between the House bill and the Senate version still have to be ironed out, so I am hoping (but not expecting) that these parts of the bill will be removed.

 

[OAG]

IMO the only way it will be completely removed is that the three GOP Senate votes decide to have it removed i.e., threaten to not vote for it when it come back to the Senate. According to what I read this provision was written by former Senator Daschle; and maybe some help from the Secretary of State. I think it will stick in some form and probably more like the Senate version. The start of rationed Medical Care.

 

[deepc]

Yeah, it's a real drag to go to the pharmacy and pick up medicine on just a signature. To make an appointment for an eye exam, see the doctor, and get your glasses mailed to you in two weeks.

And don't you hate it when your kid's annual school physical, immunizations, and wellness visits are all free?

Not to mention the spouse's high blood pressure (caught on a routine physical) that's treated with the latest meds (all free) and followed up on regularly? Or the time she put a knife through her hand, went to the local civilian ER, and the Navy doctor actually came to the ER at 8pm at night to see how she was doing?

This has been my experience with military medicine over the past couple years, and over the previous thirty it was no different. Now that I'm working in an ER myself, and see the challenges people with no insurance face, the use of the ER as a routine care clinic, and the amount of worry that having no health care coverage causes, I absolutely do not understand these arguments against "socialized medicine." If that's what we had in the military, it seems to work pretty well to me.

 

[Leonidas]

My two greatest concerns over health care reform are (a) how much is it going to cost us, and (b) what are we going to have to give up.

Betsy McCaughey, who got slammed back in the 90's for being inaccurate in her arguments against the Clinton health care plan, wrote a commentary for Bloomberg recently on this. I haven't read HR 1, and I don't vouch for her accuracy on this, but she raises some points that are scary:

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council.

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.

I don't think your average American is going to be happy with that sort of thing. Given the power that the older voters in this country carry at the polls, if these provisions exist under the proposed laws and regulations, I think there could be a strong backlash against people who voted for this.

http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs

 

[REWahoo]

Lets-retire, is the information in this opinion piece what you are referring to?

Bloomberg.com: Opinion

"Tragically, no one from either party is objecting to the health provisions slipped in without discussion. These provisions reflect the handiwork of Tom Daschle, until recently the nominee to head the Health and Human Services Department.

Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version)."

 

[Rustic23]

This may border on Soap Box, but the health care related items in the Stimulus Bill will not be removed unless those with Democratic Senators and Congressmen hear from their constituents.

Tom Daschle was quoted as saying that health care changes would be hard to get through congress and the best way was to slip them in to large budget bills to get them past. This is a statement that no currently elected official could get away with making. It is a classic example of 'the ends justifies the means', a dangerous course of action for any government!

I would also like to ask the members of this forum that support Health Care reform. 'Is this what you have in mind?'

 

[dex]

Now that I'm working in an ER myself, and see the challenges people with no insurance face, the use of the ER as a routine care clinic, and the amount of worry that having no health care coverage causes, I absolutely do not understand these arguments against "socialized medicine." If that's what we had in the military, it seems to work pretty well to me.

The largest difference is that health coverage is a benefit for those in the military; just like those in the private sector.

With your logic if you saw "the amount of worry that having no":
car - provide it
housing - provide it (we try)
food - provide it (we try)
education - provide it (we try)
health care - provide it (we try - are people turned away from the ER - I don't know)

The fallacy in the thinking is - no health ins; then the only option is the same health care for all. Why not other options such as private insurance for those that want it and can afford it and a means tested group policy that people would have to pay for?

The discussion is being limited by those who have only their agenda they want to promote it.

 

[ziggy29]

This may border on Soap Box, but the health care related items in the Stimulus Bill will not be removed unless those with Democratic Senators and Congressmen hear from their constituents.

Tom Daschle was quoted as saying that health care changes would be hard to get through congress and the best way was to slip them in to large budget bills to get them past. This is a statement that no currently elected official could get away with making. It is a classic example of 'the ends justifies the means', a dangerous course of action for any government!

I would also like to ask the members of this forum that support Health Care reform. 'Is this what you have in mind?'

It may be Soap Boxy, but don't let it be said that the health insurance conundrum isn't about FIRE. There's almost nothing the government is debating that is MORE central to the quest for FIRE given that health insurance is the 800-pound gorilla of achieving FIRE.

I think the [-]spending[/-] stimulus bill is, in some ways, a trojan horse for increased government provision of health care.

There's an old saying that if you suddenly put a frog in a pot of very hot water, it jumps out and gets out of the pot. But if you very slowly turn up the heat such that the frog doesn't know it's being boiled to death, it stays in the pot.

And so it is with much of what government does. People tend to be very resistant to sweeping changes that cause massive displacement of the status quo. But with enough "tinkering around the edges" over a number of bills and a number of years, pretty soon you've collectively made some massive reforms.

I suspect that is what Daschle is saying to Congressional Democrats -- you won't get your reforms by putting the frog into a boiling pot, but over time you may get most of it by slowly turning up the heat.

As for what the forum members want, that surely differs, but I'd say a fairly common desire is to find a way to make health insurance reasonably affordable even for those with pre-existing conditions that make getting private insurance impossibly expensive. There could be several different ways to get there, though, some of them ideologically at odds with other ways.

 

[dex]

There's an old saying that if you suddenly put a frog in a pot of very hot water, it jumps out and gets out of the pot. But if you very slowly turn up the heat such that the frog doesn't know it's being boiled to death, it stays in the pot.

And so it is with much of what government does. People tend to be very resistant to sweeping changes that cause massive displacement of the status quo. But with enough "tinkering around the edges" over a number of bills and a number of years, pretty soon you've collectively made some massive reforms.

This is so true. Just imagine if someone like Thomas Jefferson, Teddy Roosevelt, JFK or Malcom X came to life and looked at the USA today. They wouldn't recognize, the politics or people.
It kinda reminds me of this commercial - remember it?

YouTube - Pollution: Keep America Beautiful - Canoe

 

[lets-retire]

I'm referring to title XIII section 3001 of the stimulus package that states, health care IT will reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information, provides appropriate information to help guide medical decisions at the time and place of care, improves efforts to reduce health disparities.

All of these do have innocuous sides, however, how can simply having an IT system reduce health disparities? Only by requiring health care for certain groups of people or limiting care for other groups of people. How can having an IT system prevent duplicative care? Only by restricting the care provided. How can having an IT system prevent inappropriate care? Only by dictating what care is given.

My point of view is if you are receiving care (earnestly trying to get help not fishing for drugs or attention) and just had a test you would most likely tell the doctor that you just had that test. If the doctor still feels the test must be redone then it is redone, it won't matter whether you tell them or the computer system tells them. The only way an IT system can guide medical decision is by telling the doctor what to do. If the doctor is worth a darn they will already know what to do without treatment being mandated by some government computer.

As I stated in my original post this is the ground work for socialized medicine. I believe when the expected savings are not realized more restrictive statutes will be put into place.

 

[lets-retire]

deepc--I'm glad you have had success with your military medical. Unfortunately I had 32 year experience with it and have not seen the good side yet. I had several medical issues while in the military and until I got out was unable to have them fixed. Once out I discovered several issues that if properly treated by the military I would not have suffered the after effects I currently get to enjoy.

 

[TromboneAl]

there are provisions for government bureaucrats to dictate what treatment is the best and which treatments will be provided, instead of letting practicing doctors dictate treatment.

I fixed this for you:

...there are provisions for government bureaucrats to dictate what treatment is the best and which treatments will be provided, instead of letting[-] practicing doctors[/-] your insurance provider dictate treatment.

 

[lets-retire]

I fixed this for you:

...there are provisions for government bureaucrats to dictate what treatment is the best and which treatments will be provided, instead of letting[-] practicing doctors[/-] your insurance provider dictate treatment.

I have yet to have my insurance company deny any recommended treatment from a doctor.

 

[TromboneAl]

It kinda reminds me of this commercial - remember it?

I think of that commercial each time I pass a big Native American casino that has taken over a beautiful natural location. I picture the guy from the canoe standing in the casino, with all the bells, beeps, flashing lights, and smoke; he has a tear in his eye.

 

[ziggy29]

I think of that commercial each time I pass a big Native American casino that has taken over a beautiful natural location. I picture the guy from the canoe standing in the casino, with all the bells, beeps, flashing lights, and smoke; he has a tear in his eye.

Until he gets his cut of the profits from the tribe. And then he grins.

(And yes, I'm 1/4 Indian and on a tribal roster, and from time to time we do get a check from the tribe for casino profits. Not huge, usually $100-200 once every year or two, but better than a sharp stick in the eye. Unfortunately, I'm not Pequot or else I'd already be FIRE'd.)

 

[jug]

As for military medicine, via VA, I never used them as they were inconvenient or too much of a hassle to get to.

However a friend who worked for NYS used the VA, when he had a very good NYS employee plan, for his intactable high blood pressure, and was given meds which made him fall asleep each day at his desk. I don't think his pressure came down too much either.

He finally was coaxed to go to a Hypertension specialist using NYS benefits and was given estensive testing, and was given new medication. The man literally changed overnight. His BP normalized, he didn't sleep at his desk, he was energized, new lease on life.

Sometimes you have to look around. I live in Vegas, the medical care here can get you killed. 6 People, perhaps more have contracted hepatitis C going to a clinic run by a maniac who reused syringes used for anestetic during routine colonoscopies. The state was slow to act, and after a year, it seems no criminal charges have been levied.

This is where common sense comes in, if you have the coverage and are ill or need an exam, examine what is going on with you, if it smells bad, leave town, get on a plane, at least where I live and go somewhere else. If you have no coverage, and no money, demand service and watch everything they do. If you need treatment, you will probably get it, and they can't bleed blood out of a rock.

Keep in mind, health insurance is actually insurance against someone taking away whatever wealth you have accumulated in the event of prolonged illness. Thus insure yourself for the big stuff and don't worry about the nickel and dime stuff.

If you have nothing, then take every government program you can get and demand excellent treatment.

jug

 

[ziggy29]

Keep in mind, health insurance is actually insurance against someone taking away whatever wealth you have accumulated in the event of prolonged illness. Thus insure yourself for the big stuff and don't worry about the nickel and dime stuff.

This is the "true" insurance model, which is often at odds with how health care has been delivered in recent decades. Self-insuring the small stuff with a deductible is what keeps premiums affordable. If homeowners insurance paid for every $100 repair, every broken window and every paint job with no deductible, it would be very, very costly. So we eat the relatively small stuff out of pocket and pay a lot less for premiums.

That may or may not be what we want in health care, but if it's not -- if we want all the small stuff to be paid out without deductible -- maybe it shouldn't be called "insurance."

 

[FinanceDude]

Whenever I think of socialized medicine, I think of a VA hospital, and I get nightmares.........

 

[lets-retire]

jug--Good points. In fact, every six months I drive the DW over 600 miles round trip to see a specialist, because the ones around our house are questionable at best. I would go with the higher deductable policy, because what you say makes sense, but I can get a better policy for about $260 more per year. I would spend that much and more for the DW's doctors visits.

 

[Martha]

I have yet to have my insurance company deny any recommended treatment from a doctor.

I have had this happen twice and my sister also has had this happen. Of course, they don't deny treatment, only payment.

 

[Martha]

Whenever I think of socialized medicine, I think of a VA hospital, and I get nightmares.........

Things have changed at the VA. Now it is pointed to as a good example of care and followup.

 

[Rustic23]

Martha, are you talking about the Bethesda VA Hospital that several years ago was in the news? Is that the model of care? I have no doubt it was cleaned up. However, the horror stories still come from other VA hospitals around the country that are not in the news.

 

[FIREd]

I favor a hybrid system: national healthcare insurance as a default (premiums commensurate with incomes) with the option to opt out in favor of private health insurance for those who want it and can afford it.

I lived for 20+ years with socialized medicine, and it was run efficiently and seamlessly from a patient prospective. The "government" is less likely to deny payment for treatment received, in my experience, than a for-profit insurance company which has a financial incentive to deny payment if at all justifiable.

 

[OAG]

As already was pointed out Insurance companies never deny treatment only payment. They could care less what you have done; they only care what they pay for. The difference that I see coming is the GOVERNMENT is going to care what you have done and I guess they can if they will be paying for it. I guess you will always have the option to pay for it yourself and go where you want to have it done on your personal tab. But if you cannot afford to pay for it OOP, then I guess you just do not get it!