_sabotage_ wrote:Player,
Do you feel that receiving the 38th best healthcare while paying the most money for it is reasonable?
Of course not..
and if you think I do, go back to some of the first pages of this thread. You will see that several of us pointed out, early on, many, many options. Also, I never said that the Healthcare Reform act was fantastic. I have always been disappointed in it. What I have said is that it is a bit better than what WE had... that is the only real question congress debated.
_sabotage_ wrote:I had my son in China. We had a private room in a private hospital without insurance. He ended up spending two weeks in ICU a couple days after his birth. Total cost, under US$2k.
You were lucky, and American with a good job. Many Chinese could not afford that. Also, you have to pre-pay in China, even in an emergency. People die or go past the point of easy repair/cure while family are rounding up money to pay. I think our system is far from the best, but is still much better than that in China.
_sabotage_ wrote:I am for socialized medicine to the extent that it covers those who can't get coverage. On the other hand, do you think there is something which can be done about the exorbitant cost of healthcare in the US? I have often heard that by paying the doctors so much we attract the best doctors. Is this true? Who are our competitors for all the best doctors and how much are they paying them and how many do they need? According to wikipedia, the only countries with similar GDPs and even remotely similar populations are Japan and Germany. But combined, they only have 2/3s of the US's population. So where are these doctors going to go? In a quick search, German doctors get an average of 155k a year and Japanese, 96k a year. Doesn't seem like the market is too large elsewhere even discounting language barriers.
We got into this earlier in the thread.
Healthcare is not something that can be ruled by the free market fully, because it lacks key elements. People in emergencies rarely have the option to just go choose another doctor or facility. Even when people have time to investigate, don't really have the ability to make fully their own medical decisions. (despite the internet hype to the contrary!) We must rely on doctors. Because of this, we must rely on a system that ensures good quality. Because people cannot really make free choices, the market is not free.
Each of those countries to which you referred has a very different system. One country often mentioned early in this thread is France. They have a system I remember liking, though I cannot remember all the details of why right now. Yet... if you listen to Phattscotty and Nightstrike, the examples THEY kept bringing up were just errors in the UK and Canada, and not the successes, just he biggest problems. They never, ever, compared those problems honestly and equally to those in our system. There is no such thing as one type of "socialized medicine". There is no real definition of "socialized medicine", it is more of a political term people use to debate whatever side they wish. So, anyway, saying that ou "like socialized medicine" for people who cannot afford it.... that just means nothing.
if you want to look at why our healthcare system is expensive, you have to consider a lot of complex problems. The first and primary point is that medicine offers a lot, LOT more than it did even 20 years ago. Our insurance system was set up at a time when appendectomies and tonsillectomies were major surgeries. Of course its more expensive to cure cancer and to rebuild people "broken" in car accidents than it was to cure the measles and lance ears.
Beyond that, folks talk about lawsuits. That is very, very true. The cost of malpractice insurance is a HUGE expense. But, its not as simple as blaming "greedy lawyers". One reason people wind up suing is that all too often its the only way they can get the money to obtain the care they need. With better, more universal coverage, the need to sue goes way down. That kind of cost relationship is being ignored too often in this debate.
The basic idea of insurance is important and fundamentally good. I have fire insurance on my house, hope I never have to use it, but still pay that monthly permium. Why? Because if I did not have it and my house were to burn, my kids and I would have nowhere to go, nothing to fall back upon. I don't consider myself a "loser" because my house failed to burn! I don't begrudge the fact that my premiums went, in part to the family across town that lost their house. (hmm... I might begrudge that guy downtown... lol, no seriously, not really). I am very happy that my house did not burn!!!
That is no different than with medical insurance. The primary difference is that while most people's houses never burn, most people do get sick, eventually. If you are very lucky, it won't happen until you are old .. and covered by Medicare, which was instituted by-the-way because insurance companies at the time did not want to cover all those naturally more ill seniors. So, those bills must be paid. By combining, pooling the costs, the individual cost of that insurance is brought down, just like the individual cost of my fire policy is nowhere near as great as rebuilding my house.
I DO have problems with the way our system was instituted. I don't want employers in my medical business, so I don't like that it is employers who offer insurance, BUT.. for all that business complains about that now, it was set up that way because it benefited the businesses, not individuals! But, the main problem is that in the past, insurers were able to charge premiums, collect billions of dollars (combined) from largely healthy people and then they could turn around and just dump a lot of policyholders when they got truly sick. THAT is the major "fix" this law makes. The law also limits the amount of profit insurance companies can now collect, so even though they are still allowed to get profits, at least its not unlimited as it was before.
Ultimately, to truly keep costs down, we need to do several things.
First, we have to look more seriously at limits to coverage. You are correct when you say that not everything can or should be covered. To pick an example I see, maybe giving a 90 year old dementia patient aggressive chemotherapy is not a good choice. I mean, the poor person doesn't even understand what is happening, just sees that they feel bad when they go see a particular doctor and doesn't really understand why its required! Why put them through it? On the other hand, I have seen doctors spend hours on the phone trying to track down the best treatment for a toddler with a major issue.
One real problem is that because our doctors are so highly trained and oriented to "save lives", they often spend too much time, effort and medicine on dying patients, particularly elderly patients. "Letting go" is hard. For a doctor, letting a patient die can seem a lot like failure. Yet.. death is very much a part of life. I am not talking about euthanasia here. I am talking about things like deciding not to put a frail 94 year old dementia patient on aggressive chemotherapy with nasty side effects. Or, allowing a patient who can no longer swallow, who has to drink things the consistency of honey and who can only eat mashed food and who still tends to choke, even with help... maybe if that patient stops breathing, maybe the nurse should try some basic measures to help, but not go so far as to hook up tubes, start CPR. Maybe that person has lived their life and is ready to "move on".
_sabotage_ wrote:Ok, so then we need to pay more for the best equipment right? Why then are we ranked 38th if we have the best doctors and best equipment? Is it because of the people who can't get access to healthcare? Maybe. On the other hand, would you prefer a doctor who was more interested in helping you or more interested in the money they make?
I am all for healthcare reform in the US, but mandating compliance, raising the already high cost and limiting choice doesn't seem to be the solution. Wouldn't it be wise to try to be like Singapore? 6th best in healthcare and 38th in spending? Or are we too exceptional or greedy to look to other systems?
I would say you are just misjudging the system, the problems, Obamacare, and my opinion about the solutions.
We have great equipment for 2 reasons. Part of it is that companies stand to gain big profits. BUT - - the fact is that a lot of research is actually done by the government, not private entities. Research is a hard thing to quantify, because its not as simple as saying "this scientist did all this research, did not find the solution and therefore failed/that scientist got the solution and succeeded". Finding that something won't work is just as important, is just as much real science and credible science as finding the thing that does work. And, it takes a lot of false starts to get to success. Also, many times even if the original answer was not found, side questions might result. We all benefit in many ways from the research that lead to man walking on the moon.
Mandating compliance? that's about integrity. If you mean requiring certain certifications and the like, well.. its like I said earlier. We all don't have time to go out and learn how to do appendectomies on our kids. We have to trust that if we take them to an emergency room and let a stranger in scrubs operate on them, they will know what they are doing. Requiring certification is not a perfect guarantee, but it works pretty well.
If you mean requiring certain levels of coverage... it makes no sense to allow insurance companies to take profits by offering something that gives no real protection. What the limits and requirements should actually be is certainly debatable, but that limits need to be applied is not.
Per other systems... Americans have been brainwashed to think anything containing the words "socialism" or "socialized" are bad.
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