I'll believe its a crisis when peoples start acting

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BackInTex
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Re: I'll believe its a crisis when peoples start acting

#51 Post by BackInTex » Mon Jul 27, 2009 12:46 pm

silverscreenselect wrote:
I'm not saying you didn't deserve treatment. However, unless you (or your employer) is an expert at it, you would have a hard time deciphering just what is and is not covered under a particular policy, and there's often a lot of wiggle room for insurance companies to decide just how much should be covered. And by then it's too late for you to do anything about it.

The bankruptcy courts are filled with people who found out too late that their insurance coverage wasn't what they needed to cover what actually happened to them. And that's not counting those that wind up in the morgue because they can't get treatment at all.
My employer is self-insured so they do know what is covered. And I pre-cerfified everything, so I knew going in what was covered.

I don't have my own doctor following me around like Obama does, but I have pretty good coverage. And though I know I didn't get it all on my own, I contributed a lot to where I'm at, as did we all (not all contrbuted to where I'm at but to where we are individually).
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Re: I'll believe its a crisis when peoples start acting

#52 Post by silverscreenselect » Mon Jul 27, 2009 12:52 pm

BackInTex wrote: I paid for the medical insurance. I've been paying for over 25 years. Counting the money my employers paid on my behalf (considered wages to me) they insurance companies are probably still way ahead of the game.
That's how insurance is SUPPOSED to work. Most people pay relatively modest premiums and receive less in actual dollars than they pay out. The others suffer large losses, far more than they paid in premiums and get paid out of what the others paid into the system.

If you have homeowners insurance, unless you house has burned down, the insurance companies are "way ahead" of the game on you too.

If you want a good read on why private health insurance is inherently more expensive than universal government insurance, read this:

http://www.ianwelsh.net/how-insurance-w ... insurance/
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Re: I'll believe its a crisis when peoples start acting

#53 Post by hf_jai » Wed Jul 29, 2009 6:18 pm

I'm gonna re-order your response a little, only for clarity. I don't think it will change your meaning. Let me know if you think it does, because it will probably mean I misunderstood what you were saying.
BackInTex wrote:
hf_jai wrote:You think you have made it all by yourself,
I've never said or thought that.
hf_jai wrote:And I know you will never see your success as anything but the result of your own efforts. Which is sad.

That's twice in on post you've said that. You must really think that zings me. And that is sad (and incorrect).
Not at all. I wasn't trying to "zing" you. At least not consciously. I was reacting to your statement, "I would never ever feel that others should be required to support me or anyone in my family, in any way, what so ever, just becase I live in the same country. Period."

I see statements of this sort all the time from conservatives and libertarians (and conservatives who think they are libertarians). For that reason, I was taking it at face value and treating it as somewhat of an absolute, but if I read too much into it, I apologize. You see, when I do hear or read something like this, I am always quite literally shocked that so many people today seem to think they owe society nothing because they receive nothing from society. It just ain't so. I am also always glad that our forebears didn't see things that way, or we might all be speaking German. Or Russian. Or English... oh wait. :)
hf_jai wrote:You would not be able to deliver those goods or services without an infrastructure paid by their taxes and built by their labor.
What about the food they ate, the clothes they wore, the homes they lived in, the vehicles they took to and from work? Guess you think we should provide those as well, yet it wouldn't be socialism?
First off, I believe that ALL government is socialism. That's what we have government for: the betterment of society. I also think people like to use the word "socialism" to scare other people, and it probably works so well because of the whole Cold War thing, but they ignore the socialism that we already have, or refuse to see it as socialism.

Remember, I believe in reinstating the draft. The ULTIMATE socialism. And ironically, an idea that many conservatives support.

But the way I see it, all of human existence is a balancing game between the needs of the one vs. the needs of the many. And BOTH are important, because both the individual and society as a whole have value in their own right.

A good leader in the military finds the happy medium between getting his/her subordinates to act as a team, and preserving enough of their individuality that they retain the incentive and initiative to achieve and find innovative solutions to problems. Too much emphasis on the team and the unit is only a mob or a bunch of ants that will never really excel at the tasks before it, and is quite likely to act wrongly if the situation changes or the pressure becomes too great. But too much individuality and the unit will be incapable of performing the most basic tasks that require a team to achieve.

An effective government (or more accurately, the aggregate of social institutions) also has to hit the happy medium between encouraging and motivating the individual to create and innovate, but it must also protect the larger social group from which those individuals spring and from which they receive support for their collective needs.

As for providing food, clothes, housing, vehicles... I don't have a problem with that, whether you call it socialism or not. If people need those things and there is no way they can afford them (or otherwise legally get them for themselves), then someone is going to have to provide them. Otherwise everybody suffers. But what is so unusual about that? During the Great Depression (the First Great Depression) there were government work projects to keep people from starving and going homeless. After WWII, we had the GI Bill to provide housing to the men returning from overseas and starting families. In some industries, there used to be "company towns" which provided housing, and usually goods and services to the workers and their families. There have always been subsidies to keep prices down for essentials like milk and bread. Then there's that draft thing....
...But without them, they could not produce any more than they could if they couldn't read.
And that's my point. It's just a matter of where you draw the line. Some things make more sense to do collectively. Public schools. Utilities. And imo, healthcare. But one is no more socialist than the other. They are ALL socialism, but that doesn't make them bad. And it doesn't automatically mean eliminating free market capitalism from the equation either. It just means finding the right balance.
I understand "for the common good". An educated workforce. A safe country. A shared and reliable infrastructure. [Making sure others' kids are innoculated against communicable diseases? O.K. Sold.] Giving me a new hip, Grandpa a triple by-pass, or Dad his monthly Viagra is not for the common good.
Why not? Aren't you a valuable contributor to society? If you don't have the new hip you need, won't your productivity be hindered just as much as the guy who never learned to read because the school failed or wasn't there at all? I think we could legitimately argue about Grandpa's triple by-pass or Dad's Viagra, but to me it makes sense that there is a greater value of not having society make those kinds of quality of life decisions. The cost savings of doing so would be relatively small, esp compared to what it might say about us as a society if we do not.
hf_jai wrote: No one is talking about involving the government in medicine or medical care. Only in the system of paying for them.
You are simply delusional if that is what you think. If you control the money, you are involved.
Ok, I'll give you this one. "Involving" was a poor choice of words, both imprecise and probably inaccurate. The point I was trying to make is that ALL of the current proposals concern socialized access to healthcare, not socializing the care itself, and your word choice did not make that distinction. That is, no one afaik is proposing a system like England where the government actually employs the doctors and requires that people go see the doctors that they employ. That is a BIG difference.

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Re: I'll believe its a crisis when peoples start acting

#54 Post by silverscreenselect » Thu Jul 30, 2009 3:48 am

BackInTex wrote: My employer is self-insured so they do know what is covered. And I pre-cerfified everything, so I knew going in what was covered.
First, personally, I'm glad you or anyone was able to get medical care taken care of. No one should be cast adrift when they need it the most which is what happens to a lot of people facing expesive treatment.

However, you can't tell me that before you took this job, you gave them a laundry list of everything that you or your family members might have happen to them medically and found out in advance that those ailments would be covered. Even if your employer is self-insured, they usually have a stop-loss excess insurer that steps in for claims over a particular amount, and the terms of that policy dictate what coverage people have in catastrophic situations. Plus, your employer's health coverage won't matter a whole lot if they go out of business or you get laid off.

There's a lot of people out there who are underinsured, and they usually don't know about it until it's too late to do anything about it. You might have been able to get by without a hip replacement by putting up with some discomfort (and there's a lot of people who wind up being forced to choose remaining partially disabled because they can't afford the surgery or treatment to repair what's wrong), but there's some conditions that you literally can't survive without being treated for.

In the 21st century, the wealthiest, most powerful nation in the world should be able to provide medical care for its citizens when other civilized industrial nations like Canada, Britain, and France have been able to do so.
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Re: I'll believe its a crisis when peoples start acting

#55 Post by wintergreen48 » Thu Jul 30, 2009 7:45 am

silverscreenselect wrote:In the 21st century, the wealthiest, most powerful nation in the world should be able to provide medical care for its citizens when other civilized industrial nations like Canada, Britain, and France have been able to do so.
And yet why is it that US hospitals along our northern border are typically packed with Canadians seeking medical care?
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Re: I'll believe its a crisis when peoples start acting

#56 Post by themanintheseersuckersuit » Thu Jul 30, 2009 8:45 am

Suitguy is not bitter.

feels he represents the many educated and rational onlookers who believe that the hysterical denouncement of lay scepticism is both unwarranted and counter-productive

The problem, then, is that such calls do not address an opposition audience so much as they signal virtue. They talk past those who need convincing. They ignore actual facts and counterargument. And they are irreparably smug.

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Re: I'll believe its a crisis when peoples start a

#57 Post by Bob78164 » Thu Jul 30, 2009 8:51 am

wintergreen48 wrote:
silverscreenselect wrote:In the 21st century, the wealthiest, most powerful nation in the world should be able to provide medical care for its citizens when other civilized industrial nations like Canada, Britain, and France have been able to do so.
And yet why is it that US hospitals along our northern border are typically packed with Canadians seeking medical care?
Cite, please. --Bob
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Re: I'll believe its a crisis when peoples start a

#58 Post by smilergrogan » Thu Jul 30, 2009 9:22 am

Bob78164 wrote:
wintergreen48 wrote:
silverscreenselect wrote:In the 21st century, the wealthiest, most powerful nation in the world should be able to provide medical care for its citizens when other civilized industrial nations like Canada, Britain, and France have been able to do so.
And yet why is it that US hospitals along our northern border are typically packed with Canadians seeking medical care?
Cite, please. --Bob
Here's some evidence (albeit 10 years old) that they are not:

http://content.healthaffairs.org/cgi/co ... ll/21/3/19

"Almost 40 percent of the facilities we surveyed [hospitals and clinics in Buffalo, Detroit, and Seattle] reported treating no Canadians, while an additional 40 percent had seen fewer than ten patients (Exhibit 1). Fifteen percent of respondent sites reported treating 10–25 Canadian patients, and only about 5 percent reported seeing more than 25 during the previous year (generally 25–75 patients; none reported more than 100). These findings were fairly consistent across the service categories."

Maybe some of the Canadians who post here could share their experiences and impressions.

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Re: I'll believe its a crisis when peoples start acting

#59 Post by themanintheseersuckersuit » Thu Jul 30, 2009 10:28 am

Suitguy is not bitter.

feels he represents the many educated and rational onlookers who believe that the hysterical denouncement of lay scepticism is both unwarranted and counter-productive

The problem, then, is that such calls do not address an opposition audience so much as they signal virtue. They talk past those who need convincing. They ignore actual facts and counterargument. And they are irreparably smug.

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Re: I'll believe its a crisis when peoples start acting

#60 Post by hf_jai » Thu Jul 30, 2009 11:15 am

themanintheseersuckersuit wrote:Here is one Canadian experience
I don't see what this has to do with the issue. Lots of US hospitals run out of room in their specialized medicine wards, if they have them at all, and so transfer patients to other hospitals. That's all that was done in this case. The problem is that the parents are no longer authorized to cross the border without a passport thanks to tightened homeland security requirements.

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Re: I'll believe its a crisis when peoples start a

#61 Post by wintergreen48 » Thu Jul 30, 2009 12:46 pm

smilergrogan wrote:
Bob78164 wrote:
wintergreen48 wrote:
And yet why is it that US hospitals along our northern border are typically packed with Canadians seeking medical care?
Cite, please. --Bob
Here's some evidence (albeit 10 years old) that they are not:

http://content.healthaffairs.org/cgi/co ... ll/21/3/19

"Almost 40 percent of the facilities we surveyed [hospitals and clinics in Buffalo, Detroit, and Seattle] reported treating no Canadians, while an additional 40 percent had seen fewer than ten patients (Exhibit 1). Fifteen percent of respondent sites reported treating 10–25 Canadian patients, and only about 5 percent reported seeing more than 25 during the previous year (generally 25–75 patients; none reported more than 100). These findings were fairly consistent across the service categories."

Maybe some of the Canadians who post here could share their experiences and impressions.
I am surprised that the numbers are that low, but that does not mean that the numbers are not correct, they may indeed be that low (although this does appear to be the result of a 'voluntary' survey, in which case you have potential for self-selection in respondents, which could skew the results; and of course it does only survey three cities, although I must admit that two of them-- Buffalo and Detroit-- are cities which I had thought would have higher numbers).

But that sort of begs the question: given that these people-- however few they may be-- have to pay full freight in the US hospital for care that they should be able to receive for free in Canadian hospitals, why are there ANY Canadians in those hospitals (other than, perhaps, Canadian tourists who have sudden medical emergencies while in the US, and who require immediate treatment and cannot therefore be transported across the border)? I really would wonder why even a single Canadian would choose to cross the border to pay for medical care that he or she is entitled to receive for free at home?
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Re: I'll believe its a crisis when peoples start acting

#62 Post by Bob Juch » Thu Jul 30, 2009 12:51 pm

I got the bill from the hospital (not including the doctors) for my retinal detachment repair. It is over $20,000! Now of course their contract with Aetna will reduce that and I won't have any copayment at all.

Just imagine if they really got away with charging that much to everyone!
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Re: I'll believe its a crisis when peoples start a

#63 Post by hf_jai » Thu Jul 30, 2009 1:07 pm

wintergreen48 wrote:But that sort of begs the question: given that these people-- however few they may be-- have to pay full freight in the US hospital for care that they should be able to receive for free in Canadian hospitals, why are there ANY Canadians in those hospitals (other than, perhaps, Canadian tourists who have sudden medical emergencies while in the US, and who require immediate treatment and cannot therefore be transported across the border)? I really would wonder why even a single Canadian would choose to cross the border to pay for medical care that he or she is entitled to receive for free at home?
I don't think there's any doubt that Canadians frequently wait for routine and elective care. That's a trade-off they've made. I remember when I was diagnosed with my breast cancer, and was talking to other women on the bored about the importance of not putting off their mammograms. I think it Saucy who said she called for an appointment and was given one six or nine months out. I had been able to walk in, same day, for my initial test. But it doesn't always work that way. I have had to wait as long for appointments with specialists before, and even occasionally with my primary physician whom I've been seeing for over 10 years.

Point is, pretty much the only Canadians you see coming to the US are those who have a lot of money. Well, people in the US who have a lot of money have no problem seeing anybody they like here too. I think it's a bogus argument against the Canadian system The majority of people in Canada are satisfied with their system and the quality of their care. Far more so than the majority of people in the US are. Would Canadians like to be able to afford to pay for their doctors bills out of pocket? Well who the hell wouldn't. But that's not the way it is, in either country.

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Re: I'll believe its a crisis when peoples start a

#64 Post by wintergreen48 » Thu Jul 30, 2009 2:55 pm

hf_jai wrote:I don't think there's any doubt that Canadians frequently wait for routine and elective care. That's a trade-off they've made. I remember when I was diagnosed with my breast cancer, and was talking to other women on the bored about the importance of not putting off their mammograms. I think it Saucy who said she called for an appointment and was given one six or nine months out. I had been able to walk in, same day, for my initial test. But it doesn't always work that way. I have had to wait as long for appointments with specialists before, and even occasionally with my primary physician whom I've been seeing for over 10 years.

Point is, pretty much the only Canadians you see coming to the US are those who have a lot of money. Well, people in the US who have a lot of money have no problem seeing anybody they like here too. I think it's a bogus argument against the Canadian system The majority of people in Canada are satisfied with their system and the quality of their care. Far more so than the majority of people in the US are. Would Canadians like to be able to afford to pay for their doctors bills out of pocket? Well who the hell wouldn't. But that's not the way it is, in either country.
Choosing to wait six to nine months for a mammogram or other test may or may not be a good choice to make (If 'something' were developing during that period, and that 'something' grew during that delay to the point that it could no longer be dealt with, I guess it would be a 'bad choice,' but otherwise, probably neutral; except that if we were certain that nothing was developing, we wouldn't need the test at all...) And whether or not it is a good choice, if people want to make that choice, or choose to defer any other test or treatment, that's fine with me.

But what right do you have to make that choice for me? I cannot help but think of the most compelling argument on the pro-choice side of the abortion debate in the US, which runs along the lines that a medical decision (such as the decision to have an abortion) should be left solely to the patient and the patient's doctor, and should NOT be left to the state nor to any third party; but here, you seem to be suggesting that it is OK for the state or some third party (someone other than the patient and the patient's physician) to decide when or if a particular procedure will be performed. That makes me a little uncomfortable.
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Re: I'll believe its a crisis when peoples start a

#65 Post by hf_jai » Thu Jul 30, 2009 5:03 pm

wintergreen48 wrote:
hf_jai wrote:I don't think there's any doubt that Canadians frequently wait for routine and elective care. That's a trade-off they've made. I remember when I was diagnosed with my breast cancer, and was talking to other women on the bored about the importance of not putting off their mammograms. I think it Saucy who said she called for an appointment and was given one six or nine months out. I had been able to walk in, same day, for my initial test. But it doesn't always work that way. I have had to wait as long for appointments with specialists before, and even occasionally with my primary physician whom I've been seeing for over 10 years.

Point is, pretty much the only Canadians you see coming to the US are those who have a lot of money. Well, people in the US who have a lot of money have no problem seeing anybody they like here too. I think it's a bogus argument against the Canadian system The majority of people in Canada are satisfied with their system and the quality of their care. Far more so than the majority of people in the US are. Would Canadians like to be able to afford to pay for their doctors bills out of pocket? Well who the hell wouldn't. But that's not the way it is, in either country.
Choosing to wait six to nine months for a mammogram or other test may or may not be a good choice to make (If 'something' were developing during that period, and that 'something' grew during that delay to the point that it could no longer be dealt with, I guess it would be a 'bad choice,' but otherwise, probably neutral; except that if we were certain that nothing was developing, we wouldn't need the test at all...) And whether or not it is a good choice, if people want to make that choice, or choose to defer any other test or treatment, that's fine with me.

But what right do you have to make that choice for me? I cannot help but think of the most compelling argument on the pro-choice side of the abortion debate in the US, which runs along the lines that a medical decision (such as the decision to have an abortion) should be left solely to the patient and the patient's doctor, and should NOT be left to the state nor to any third party; but here, you seem to be suggesting that it is OK for the state or some third party (someone other than the patient and the patient's physician) to decide when or if a particular procedure will be performed. That makes me a little uncomfortable.
I'm not advocating for the Canadian system. I'm merely pointing out that the majority of Canadian citizens seem to be satisfied with it. I will admit I would probably be satisfied to wait for a mammogram IF the alternative were not getting one at all, which is the case for all too many people. That said, if you were a Canadian and chose not to wait, you would be free to fly to the US to get the test done. The only limitation on that choice would be whether you could afford it, which is precisely the limitation that is placed on people in this country.

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Re: I'll believe its a crisis when peoples start a

#66 Post by Thousandaire » Thu Jul 30, 2009 11:04 pm

hf_jai wrote: I'm not advocating for the Canadian system. I'm merely pointing out that the majority of Canadian citizens seem to be satisfied with it. I will admit I would probably be satisfied to wait for a mammogram IF the alternative were not getting one at all, which is the case for all too many people. That said, if you were a Canadian and chose not to wait, you would be free to fly to the US to get the test done. The only limitation on that choice would be whether you could afford it, which is precisely the limitation that is placed on people in this country.
And if the U.S. had the same system as Canada, where would such people go then?

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Re: I'll believe its a crisis when peoples start a

#67 Post by hf_jai » Fri Jul 31, 2009 10:17 am

Thousandaire wrote:
hf_jai wrote: I'm not advocating for the Canadian system. I'm merely pointing out that the majority of Canadian citizens seem to be satisfied with it. I will admit I would probably be satisfied to wait for a mammogram IF the alternative were not getting one at all, which is the case for all too many people. That said, if you were a Canadian and chose not to wait, you would be free to fly to the US to get the test done. The only limitation on that choice would be whether you could afford it, which is precisely the limitation that is placed on people in this country.
And if the U.S. had the same system as Canada, where would such people go then?
Do you honestly believe that people with enough money will not always be able to get whatever medical care they want? Even back in the day when abortions were seriously illegal, I never heard of a rich person who couldn't get one if they wanted it.

Besides, your question is grossly hypothetical. No one has proposed replicating the Canadian system here. Even single payer proponents would allow for direct payment to doctors, hospitals etc for those who can afford it, and supplemental insurance for those who cannot. Just as Medicare does now.

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Re: I'll believe its a crisis when peoples start a

#68 Post by Thousandaire » Fri Jul 31, 2009 10:32 am

hf_jai wrote:
Thousandaire wrote:
hf_jai wrote: I'm not advocating for the Canadian system. I'm merely pointing out that the majority of Canadian citizens seem to be satisfied with it. I will admit I would probably be satisfied to wait for a mammogram IF the alternative were not getting one at all, which is the case for all too many people. That said, if you were a Canadian and chose not to wait, you would be free to fly to the US to get the test done. The only limitation on that choice would be whether you could afford it, which is precisely the limitation that is placed on people in this country.
And if the U.S. had the same system as Canada, where would such people go then?
Do you honestly believe that people with enough money will not always be able to get whatever medical care they want? Even back in the day when abortions were seriously illegal, I never heard of a rich person who couldn't get one if they wanted it.

Besides, your question is grossly hypothetical. No one has proposed replicating the Canadian system here. Even single payer proponents would allow for direct payment to doctors, hospitals etc for those who can afford it, and supplemental insurance for those who cannot. Just as Medicare does now.
The point is, why can't rich people get such treatment in Canada? The reason is their system squelches innovation and makes certain treatments unavailable no matter how much money one has. If the U.S. had single payer that would happen here too.

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Re: I'll believe its a crisis when peoples start a

#69 Post by hf_jai » Fri Jul 31, 2009 11:23 am

Thousandaire wrote:
hf_jai wrote:Do you honestly believe that people with enough money will not always be able to get whatever medical care they want? Even back in the day when abortions were seriously illegal, I never heard of a rich person who couldn't get one if they wanted it.

Besides, your question is grossly hypothetical. No one has proposed replicating the Canadian system here. Even single payer proponents would allow for direct payment to doctors, hospitals etc for those who can afford it, and supplemental insurance for those who cannot. Just as Medicare does now.
The point is, why can't rich people get such treatment in Canada? The reason is their system squelches innovation and makes certain treatments unavailable no matter how much money one has. If the U.S. had single payer that would happen here too.
Your second statement is untrue, and based on an untrue premise in the first. It's not a matter of rich people being denied treatment in Canada. It's a matter of whether they have to wait for it, or go somewhere else for it (the latter a function of Canada's geography and demographic distribution at least as much as their health care system). And the REASON they have to wait is NOT that their system squelches innovation; that MAY be a result, but there is no empirical evidence to back it up.

Furthermore, there is NO reason to think that single payer in the US would have the same impact as the Canadian system because THEY ARE NOT THE SAME THING. Medicare is single payer. So is TriCare for military retirees and active duty dependents. Neither one prohibits the patient from going outside the system if they choose to and if they can afford it (I have a TriCare supplemental policy myself, and will probably be getting a Medicare supplement for Mr Jai when he retires from the railroad). There is ZERO reason to think that another US single payer system, or expansion of the existing one, would be any different.

Finally, let's not forget that single-payer is currently off the table, so we're still having only a hypothetical discussion. It really has no bearing on the health care reform being debated in Congress.

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Re: I'll believe its a crisis when peoples start a

#70 Post by Thousandaire » Fri Jul 31, 2009 11:21 pm

hf_jai wrote:
Thousandaire wrote:
hf_jai wrote:Do you honestly believe that people with enough money will not always be able to get whatever medical care they want? Even back in the day when abortions were seriously illegal, I never heard of a rich person who couldn't get one if they wanted it.

Besides, your question is grossly hypothetical. No one has proposed replicating the Canadian system here. Even single payer proponents would allow for direct payment to doctors, hospitals etc for those who can afford it, and supplemental insurance for those who cannot. Just as Medicare does now.
The point is, why can't rich people get such treatment in Canada? The reason is their system squelches innovation and makes certain treatments unavailable no matter how much money one has. If the U.S. had single payer that would happen here too.
Your second statement is untrue, and based on an untrue premise in the first. It's not a matter of rich people being denied treatment in Canada. It's a matter of whether they have to wait for it, or go somewhere else for it (the latter a function of Canada's geography and demographic distribution at least as much as their health care system). And the REASON they have to wait is NOT that their system squelches innovation; that MAY be a result, but there is no empirical evidence to back it up.

Furthermore, there is NO reason to think that single payer in the US would have the same impact as the Canadian system because THEY ARE NOT THE SAME THING. Medicare is single payer. So is TriCare for military retirees and active duty dependents. Neither one prohibits the patient from going outside the system if they choose to and if they can afford it (I have a TriCare supplemental policy myself, and will probably be getting a Medicare supplement for Mr Jai when he retires from the railroad). There is ZERO reason to think that another US single payer system, or expansion of the existing one, would be any different.

Finally, let's not forget that single-payer is currently off the table, so we're still having only a hypothetical discussion. It really has no bearing on the health care reform being debated in Congress.

Oh, really?

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silverscreenselect
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Re: I'll believe its a crisis when peoples start a

#71 Post by silverscreenselect » Sat Aug 01, 2009 7:01 am

A public option that is competitively priced to the existing health insurance system will run into huge deficits due to adverse selection. Namely, a lot of the people who don't have insurance now are bad risks who are going to have a high level of claims and they can't be covered at the same price as everyone else.

One that is priced on an actuarially sound basis is going to be exceedingly expensive and those who don't have insurance currently in many cases won't be able to afford the public option either.

I have yet to understand why people think they won't be able to choose their own doctor on a single payer. Right now, your medical insurance to a large extent controls who you can and can't use for a doctor anyway. If your doc isn't on the list for your plan, you either pay through the nose or get a doctor who is.

Under single payer, with the exception of a few high level physicians who can get by on a boutique practice, almost everyone else will be under the plan. You won't have access to a handful of people you couldn't have afforded anyway, but you will have access to nearly everyone else.

Also, a lot of the tests that people are concerned about having to wait for are ordered by doctors to pad their fees. It's like a restaurant pushing its overpriced desserts on customers. If there's definite indications someone has a severe problem, he or she can get a test done quickly, in Canada or any place else. However, if doctors can only get a fixed amount for their basic services, they try to find anything and everything else to do so they can pad that amount. They blame it on the trial lawyers (I have to do this to avoid malpractice), but it's really their own desire to get more money.

After my heart problems ten years ago, I had some rather thorough tests done which I felt were warranted. Then when I switched doctors a few years later due to the orignal guy's retirement, the new one insisted that I should get a complete physical, despite the fact I'd had no problems or symptoms in the interim. Mrs. SSS insisted I go, so I did. The physical was supposed to take all morning, but after about an hour, I saw it was just every test under the sun, very little of which was related to anything that I had shown any possible indication of. I walked out, not wanting to waste any more of my time and the insurer's money (which eventually is my money anyway). I haven't had any problems since.
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Re: I'll believe its a crisis when peoples start a

#72 Post by BackInTex » Sat Aug 01, 2009 8:02 am

silverscreenselect wrote: Also, a lot of the tests that people are concerned about having to wait for are ordered by doctors to pad their fees. It's like a restaurant pushing its overpriced desserts on customers. If there's definite indications someone has a severe problem, he or she can get a test done quickly, in Canada or any place else. However, if doctors can only get a fixed amount for their basic services, they try to find anything and everything else to do so they can pad that amount. They blame it on the trial lawyers (I have to do this to avoid malpractice), but it's really their own desire to get more money.

After my heart problems ten years ago, I had some rather thorough tests done which I felt were warranted. Then when I switched doctors a few years later due to the orignal guy's retirement, the new one insisted that I should get a complete physical, despite the fact I'd had no problems or symptoms in the interim. Mrs. SSS insisted I go, so I did. The physical was supposed to take all morning, but after about an hour, I saw it was just every test under the sun, very little of which was related to anything that I had shown any possible indication of. I walked out, not wanting to waste any more of my time and the insurer's money (which eventually is my money anyway). I haven't had any problems since.
O.K. So what you are saying is that women should not get mamograms until they feel a lump. People shouldn't ever get a colonoscopy until they start pooping blood.

That will save us a lot of money. Especially when they do get the tests and are deemed terminal. Just paying for hospice will be much much cheaper, though I'm not sure hospice care is in the plan.

I think you may have something there.
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Re: I'll believe its a crisis when peoples start a

#73 Post by silverscreenselect » Sat Aug 01, 2009 8:29 am

BackInTex wrote: O.K. So what you are saying is that women should not get mamograms until they feel a lump. People shouldn't ever get a colonoscopy until they start pooping blood.
There's a general consensus on what tests are and are not needed. If something should be done on a periodic basis like a mammogram, there's no reason it has to be done the same day or week that a patient visits the doctor. If Mrs. SSS visits a doctor for her checkup on January 1 and gets a mammogram on June 1 every year, then she's gotten the same level of treatment as if she had them the same day.

And I know you're going to say, well what if there was a problem that wasn't diagnosed etc. etc. Well what if there's a problem that a Jan 1 mammogram wouldn't have caught but a June 1 mammogram did catch? It all evens out.

Quite frankly, if patients had to foot the full bill for "routine" tests, they would spend a lot more time asking doctors if a particular test was really needed and would wind up ordering a lot less of these tests.

If better planning allows for more efficient scheduling of routine periodic tests, in cases in which there is no indication of an immediate problem, that's a sign of good, efficient management, not bad medical care.
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Re: I'll believe its a crisis when peoples start a

#74 Post by BackInTex » Sat Aug 01, 2009 8:43 am

silverscreenselect wrote:If better planning allows for more efficient scheduling of routine periodic tests, in cases in which there is no indication of an immediate problem, that's a sign of good, efficient management, not bad medical care.
You get no argument from me, there.

Most medical procedures, as with anything medical or not, would be less expensive on an individual basis if done en mass. But the total cost probably would go up. So while a person now getting the routine care would see their cost go down, those not getting it now would see their cost would go up (from zero to whatever it becomes, whether it is cost to them or us). I know that is not what you are saying above, but it is what a lot of the people supporting the medical bill are saying (whether they realize it or not).

Back to your comments. Not all, and probably not most, doctors order tests to pad their wallets. Doctors do not get a cent (at least the ethical ones) from tests they prescribe if that test is done at another facility. My FIL is a testaholic. Not to get money, he just has genuine concern for his patients and if he can identify or eliminate something he will.
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Re: I'll believe its a crisis when peoples start a

#75 Post by BackInTex » Sat Aug 01, 2009 8:47 am

silverscreenselect wrote:After my heart problems ten years ago, I had some rather thorough tests done which I felt were warranted. Then when I switched doctors a few years later due to the orignal guy's retirement, the new one insisted that I should get a complete physical, despite the fact I'd had no problems or symptoms in the interim. Mrs. SSS insisted I go, so I did. The physical was supposed to take all morning, but after about an hour, I saw it was just every test under the sun, very little of which was related to anything that I had shown any possible indication of. I walked out, not wanting to waste any more of my time and the insurer's money (which eventually is my money anyway). I haven't had any problems since.
If you think your doctor is testing for income and not for your best interest, you should get a different doctor. However, many if not most people who die of a sudden heart attack havent' had any problems. Thus, they were never tested and didn't know they had a problem.
..what country can preserve it’s liberties if their rulers are not warned from time to time that their people preserve the spirit of resistance? let them take arms.
~~ Thomas Jefferson

War is where the government tells you who the bad guy is.
Revolution is when you decide that for yourself.
-- Benjamin Franklin (maybe)

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