[ksilty]

Originally Posted by spacenurse

Who is paying for the uninsured?

You and I are.......

[pickledpepperRN]

Originally Posted by spacenurse
Who is paying for the uninsured?

Originally Posted by ksilty

You and I are.......

If so why not figure out how to do so efficiently?
Safe, effective, therapeutic health care for everyone?

[MBANurse]

Originally Posted by spacenurse

If so why not figure out how to do so efficiently?
Safe, effective, therapeutic health care for everyone?

Spacenurse;
I have to wonder why you believe that government can provide care and set up a program that will cover all citizens within the United States.

I would like to see cost assessments and what they base their conclusions on. I will seek out assessments and studies that predict the cost of such programs.

I know that the NHS annual budget is 90 billions pounds which is about...90 billion British pounds = 176.27400 billion U.S. dollars.

http://www.nhscareers.nhs.uk/details...lt.aspx?Id=796

And they only cover about 57 million people. The United states has approximately 6 times the number of people 6*176 billion = equals over a trillion dollars a year. This does not include anystart up costs. One trillion each and every year; taxes will have to be raised and the rationing of care will still occur.

The only one of things that you listed that would be covered is "for everyone." effiecent and effective would be left out flapping in the breeze.

[pickledpepperRN]

■ National healthcare expenditures — $2 trillion (2005). Healthcare is 16% of the GDP
(2005), expected to rise to 20% by 2015 (Modern Healthcare, Dec. 18, 2006). Healthcare
costs doubled from 1993 to 2004, according to the Centers for Medicare and Medicaid
Services (Washington Post, Jan. 10, 2006)

■ One-fifth of all Americans, 48.8 million individuals, were in families spending more than
10% of their family income on healthcare in 2003, an increase of 11.7 million persons
since 1996. Of these, 18.7 million (7.3%) were spending more than 20% of family income,
a figure normally associated with home ownership. The percent of middle-income
Americans (22.7%) spending over 10% of their income on healthcare was almost identical
to the percent of low-income Americans (23.7%) on healthcare (JAMA, Dec. 13, 2006).

■ Half of all personal bankruptcies are caused by illness or medical bills. The number of
medical bankruptcies has increased by 2200% since 1981 (Health Affairs, February, 2005).
Two-thirds of people with a medical bill or debt problem went without needed care due to
cost (Commonwealth Fund, Aug. 2005).

■ Nearly 30% of low and middle-income households with credit card debt cite medical debt
as a contributing factor; 69% of those had a major medical expense in the previous three
years (Borrowing to Stay Healthy: How Credit Card Debt Is Related to Medical Expenses,
Demos, The Access Project, January, 2007)

■ The potential economic value to be gained in better health outcomes from uninterrupted
coverage for all Americans is estimated to be between $65 and $130 billion each year.
(Institute of Medicine, June 17, 2003)

■ Over 30% of every healthcare dollar is spent on administrative overhead in private
insurance compared to just 3.2% in Medicare administrative costs (Institute for Health
and Socio-Economic Policy)

■ About one-third of medical spending is now devoted to services that don’t appear to
improve health or the quality of care, meaning the U.S. wastes more than $650 billion per
year (IHSP), more than is being spent on the war in Iraq (John Abramson, Harvard Medical
School, column, Los Angeles Times, Nov. 3, 2006).

■ From 2000 to 2005, health insurance premiums rose by 73%, compared to an aggregate
increase in workers’ income of just 15%. (Chicago Tribune, Jan. 31, 2006) Premiums rose
three times faster than wages and inflation in 2005 (UC Berkeley Center for Labor research
and Education, Dec. 2006).

http://www.guaranteedhealthcare.org/...ayer_top10.pdf

[LilyMB]

"yes it is... ANY VERSION of "From each according to his ability; to each according to his need" is a form of socialism whether you want to call it that or not. Any time that you take the dollars that I have worked my tail off for and distribute them via programs such as this... in whatever form... it is socialism/communism."

I would like to point out that we live in a mixed economy. You ride on public roads, kids go to public schools, the FAA monitors air traiffic, you depend on public police departments, public judicial systems, public fire departments, public libraries. etc. We depend on government regulations to ensure the safety of the planes we fly and the cars we drive. Need I go on? Nothing works perfectly, but I really wouldn't like to live without any of the above.

I once held your views, because we've all been scared by the big boogie of communism, and rightly so. I've been to a communist country years ago, and a former communist country a couple of years ago, and we do NOT want that system of government.

However, be that as it may, we DO have a mixed economy right now, and part of the reason our economy is doing so badly is that our companies have to compete GLOBALLY with other companies that do not have to play healthcare costs for their employees. One reason - yes - but a fact, nevertheless. We are the ONLY industrialized nation in the world without a sane healthcare plan for its citizens.

The FACT is that citizens in other countries pay much less than their American counterparts for healthcare. Each country does it differently; some are worse than others. I wouldn't want the UK plan - which is socialized medicine - because the government actually employs the health personnel. I would prefer a system like France, where everyone pools their money in order to have giant healthcare/risk management pools. Most clinics, hospitals, doctors, nurses, etc. DON'T work for the government, but they are reimbursed by what amounts to a large insurance company - the healthcare division of their government. In that way, competition is still a factor in driving one of the world's best healthcare systems. In fact, the WHO rates France as having the best healthcare system in the world.

Here in the U.S. we see one insurance CEO making the same amount of money as thousands of hospital employees, and that includes all staff, including those big money-making surgeons! No wonder our health care is so expensive! Then there's the layers and layers of beurocracy within the insurance companys, hospitals and doctors' offices. And then there's the stockholders of the insurance companies. Imagine if this money was actually spent on healthCARE. What a concept!

Furthermore, I don't think you know how vulnerable you are, even when you do have healthcare. My mother had cancer, and here are some of the tricks used to deny payment:

1) Simply deny the claim. Deny the claims for so long, that the patient starts to worry about her credit rating and pays the darn bill herself.

2) Deny that the procedure was ever pre-certified with the insurance company. My mother is fighting thousands of dollars worth of bills because the insurance company insists that the lab wasn't pre-certified. The surgeon was pre-certified, the hospital was pre-certified, but the insurance company insists that the lab was not pre-certified. (Surgeon insists lab was pre-certified.) I'm talking about thousands of dollars of money that the insurance company is refusing to pay, and that my parents are legally responsible for. (This includes several procedures including needle guided biopsies, and surgical biopsies of cancerous tissue removal and nodes.)

I could go on and on, but either people understand that stuff like this happens every day, or they don't. You may think you have taken care of you and yours, but think again. You can get screwed by your insurance company when you have coverage, dropped by your insurance company, or denied coverage by any insurance company. Got IBS? Tough luck. Had cancer? Tough luck. Your spouse has diabetes? Tough luck. Your kid has juvenile RA? Tough luck.

You know what really sucks? My dad is stuck at his present job because my mom now has a pre-existing cancer condition.

And how about this: my sister was very ill during college, but if she dropped out of college, my parents would have lost her insurance coverage.

DOES this method of healthcare insurance make any sense when you REALLY think about it? Just when you need it, you don't have it? You pay for insurance for years, and then you can be dropped just when you need it? It makes no sense if we're talking about healthcare, but it makes perfect sense if we're talking about insurance company profits. (Insurance companies exist for one reason - profit for their stockholders.) Hey, I'm not against profit. I'm all for profit, but when profit stands in the way of your health after you've paid into an insurance company for decades, there is a problem. A big problem. A problem that you have no control over.

Have you ever watched a friend go to work day after day because they will lose their insurance coverage if they quit their job? Would you like to watch one of your parents work until they are almost dead because they can't afford the COBRA payments to pay for their cancer treatments?

Think carefully what we have done in this country: we have tied healthcare to employment for most people. This doesn't make any sense. It just seems to make sense to you because you are accustomed to it.

And about those waits in Canada. Canada insures its citizens by province. Some provinces have little to no wait time for "certain" procedures, while others do. The great thing about this is that wait lists are published, so that those in charge of the provinces are motivated to do something about it. When my mother had cancer here in a large urban area, she had very short wait times - days to maybe three weeks for certain procedures. When my grandmother had cancer, she waited much, much longer. Why? Because she's in a rural area with less technology and fewer specialists. The situation is similar in Canada.

Watch SICKO if you haven't seen it. I'm not a fan of Michael Moore, and it's pretty easy to recognize the propoganda in the film, but at the same time, there's a lot of truth in it that Americans need to face.

[♪♫ in my ♥]

Originally Posted by clee1

All valid points; but it is NOT a public problem - it is an individual problem.

I beg to differ. When it's 1 person or 10 people, it's an individual problem. When it's 45,000,000 people or 15% of our population, it's a public problem.

Originally Posted by clee1

The problem with our healthcare system NOW is insurance companies...

Yep, exactly. That's why we need to get rid of the profit motive in medical insurance and adopt a single-payer plan. I've got no problem if that's contracted out to a non-profit entity rather than created as a government bureaucracy. Probably better that way.

[ksilty]

Originally Posted by clee1

Very valid points, Granny.



Let's face it folks; the whole shebang is all about $$$$. Doctors, lawyers, insurance companies, HCF administrators and CEOs, and politicians - they all want their slice of the pie, regardless of who else gets screwed in the end.

I believe we have two major challenges to cost-efficient healthcare delivery. The first is the need for Tort Reform. So much money is wasted because providers fear lawsuits. We should all be realizing a sense of gradification from the good we all do, but we have been reduced to whining, negative paranoia waiting for the next personal injury attorney to appear. Until we can do our jobs without fear of reprisal, we will continue to complain and burn out.
The second problem is a bit more sensitive, yet closely related to the first. I ask myself every day if we are not keeping people alive just for the sake of proving we can do it. My dear 94 year-old aunt died last month, and her last year was a rough one. I saw her through one inpatient stay after another for diagnostics that brought her pain and discomfort. Apart from her physical complaints, she had dementia and knew none of us. I was finally able to convince my uncle that he should let her go. He admitted her to hospice and she died 3 days later. I loved my aunt, but I think she lost her will to live 5 years ago, but was afraid to say so. What purpose is served to spend thousands of dollars on a MRI to R/O brain tumor? At 94, she was entitled to forget who we are........

[ksilty]

Originally Posted by ♪♫ in my ♥

Yep, exactly. That's why we need to get rid of the profit motive in medical insurance and adopt a single-payer plan. I've got no problem if that's contracted out to a non-profit entity rather than created as a government bureaucracy. Probably better that way.

I worked for one of the biggest nonprofits in US healthcare and I have to say, it was still about the money. Bottom line, someone has to pay the bills - need infrastructure, need latest equipment, need manpower, need to pay for those who can't. Then if you run a University, need to pay for the school and the research. Need money, money, money, and I can't fault them for that....

[ksilty]

Originally Posted by spacenurse

If so why not figure out how to do so efficiently?
Safe, effective, therapeutic health care for everyone?

I have Tricare and I have no complaints about my care. The DOD hires Tricare to administer healthcare to eligible beneficiaries. I am capitated to a local Naval Hospital, but am referred to civilian docs as needed. I pay nothing for the meds I get on base and $9./month for those I get in town because they are not formulary. It is no frills, I cannot go to my PCP and demand a MRI because I have a sinus infection, and I don't expect to be given antibiotics for every sniffle. They don't scrimp where care is necessary - I need ear surgery and they are sending me to one of the best ENT surgeons on the East Coast. For this, my husband and I pay $240/year. Could they deliver this care to the entire country? Never.... For one thing, the DOD has deep pockets and understands the need to keep the workforce and their families healthy. Then there are those millions who think they need a MRI to diagnose a sinus infection. Who would be able to say no without sending folks scrambling to their Congressperson?

[♪♫ in my ♥]

Originally Posted by ksilty

I worked for one of the biggest nonprofits in US healthcare and I have to say, it was still about the money. Bottom line, someone has to pay the bills - need infrastructure, need latest equipment, need manpower, need to pay for those who can't. Then if you run a University, need to pay for the school and the research. Need money, money, money, and I can't fault them for that....

Of course it takes money, lots of it. Yes, cost containment is crucial to any entity.

The issue is whether you want to add the profit motive on top of that. Any for-profit entity puts their shareholders first. Their shareholders demand not just a return on their investment but a growing return.

Also, I was specifically addressing the payer side of the equation, not the provider side. There, too, though, I believe that they should be not-for-profit.