Government Health Care

[Snipe]

From The New York Times....


Those Who Pay for Private Care Are Testing Britain’s Public Health System (http://www.nytimes.com/2008/02/21/world/europe/21britain.html?pagewanted=2&ei=5088&en=d488f4fca56dcc71&ex=1361250000&partner=rssnyt&emc=rss)

February 21, 2008
By SARAH LYALL

LONDON — Created 60 years ago as a cornerstone of the British welfare state, the National Health Service is devoted to the principle of free medical care for everyone. But recently it has been wrestling with a problem its founders never anticipated: how to handle patients with complex illnesses who want to pay for parts of their treatment while receiving the rest free from the health service.

Although the government is reluctant to discuss the issue, hopscotching back and forth between private and public care has long been standard here for those who can afford it. But a few recent cases have exposed fundamental contradictions between policy and practice in the system, and tested its founding philosophy to its very limits.

One such case was Debbie Hirst’s. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist’s support, she decided last year to try to pay the $120,000 cost herself, while continuing with the rest of her publicly financed treatment.

By December, she had raised $20,000 and was preparing to sell her house to raise more. But then the government, which had tacitly allowed such arrangements before, put its foot down. Mrs. Hirst heard the news from her doctor.

“He looked at me and said: ‘I’m so sorry, Debbie. I’ve had my wrists slapped from the people upstairs, and I can no longer offer you that service,’ ” Mrs. Hirst said in an interview.

“I said, ‘Where does that leave me?’ He said, ‘If you pay for Avastin, you’ll have to pay for everything’ ” — in other words, for all her cancer treatment, far more than she could afford.

Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.

Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.

“That way lies the end of the founding principles of the N.H.S.,” Mr. Johnson said.

But Mrs. Hirst, 57, whose cancer was diagnosed in 1999, went to the news media, and so did other patients in similar situations. And it became clear that theirs were not isolated cases.

In fact, patients, doctors and officials across the health care system widely acknowledge that patients suffering from every imaginable complaint regularly pay for some parts of their treatment while receiving the rest free.

“Of course it’s going on in the N.H.S. all the time, but a lot of it is hidden — it’s not explicit,” said Dr. Paul Charlson, a general practitioner in Yorkshire and a member of Doctors for Reform, a group that is highly critical of the health service. Last year, he was a co-author of a paper laying out examples of how patients with the initiative and the money dip in and out of the system, in effect buying upgrades to their basic free medical care.

“People swap from public to private sector all the time, and they’re topping up for virtually everything,” Dr. Charlson said in an interview. For instance, he said, a patient put on a five-month waiting list to see an orthopedic surgeon may pay $250 for a private consultation, and then switch back to the health service for the actual operation from the same doctor.

“Or they’ll buy an M.R.I. scan because the wait is so long, and then take the results back to the N.H.S.,” Dr. Charlson said.

In his paper, he also wrote about a 46-year-old woman with breast cancer who paid $250 for a second opinion when the health service refused to provide her with one; an elderly man who spent thousands of dollars on a new hearing aid instead of enduring a yearlong wait on the health service; and a 29-year-old woman who, with her doctor’s blessing, bought a three-month supply of Tarceva, a drug to treat pancreatic cancer, for more than $6,000 on the Internet because she could not get it through the N.H.S.

Asked why these were different from cases like Mrs. Hirst’s, a spokeswoman for the health service said no officials were available to comment.

In any case, the rules about private co-payments, as they are called, in cancer care are contradictory and hard to understand, said Nigel Edwards, the director of policy for the N.H.S. Confederation, which represents hospitals and other health care providers. “I’ve had conflicting advice from different lawyers,” he said, “but it does seem like a violation of natural justice to say that either you don’t get the drug you want, or you have to pay for all your treatment.”

Karol Sikora, a professor of cancer medicine at the Imperial College School of Medicine and one of Dr. Charlson’s co-authors, said that co-payments were particularly prevalent in cancer care. Armed with information from the Internet and patients’ networks, cancer patients are increasingly likely to demand, and pay for, cutting-edge drugs that the health service considers too expensive to be cost-effective.

“You have a population that is informed and consumerist about how it behaves about health care information, and an N.H.S. that can no longer afford to pay for everything for everybody,” he said.

Professor Sikora said oncologists were adept at circumventing the system by, for example, referring patients to other doctors who can provide the private medication separately. As wrenching as it can be to administer more sophisticated drugs to some patients than to others, he said, “if you’re a doctor working in the system, you should let your patients have the treatment they want, if they can afford to pay for it.”

In any case, he said, the health service is riddled with inequities. Some drugs are available in some parts of the country but not in others. Waiting lists for treatment vary wildly from place to place. Some regions spend $280 per capita on cancer care, Professor Sikora said, while others spend just $90.

In Mrs. Hirst’s case, the confusion was compounded by the fact that three other patients at her hospital were already doing what she had been forbidden to do — buying extra drugs to supplement their cancer care. The arrangements had “evolved without anyone questioning whether it was right or wrong,” said Laura Mason, a hospital spokeswoman. Because their treatment began before the Health Department explicitly condemned the practice, they have been allowed to continue.

The rules are confusing. “It’s quite a fine line,” Ms. Mason said. “You can’t have a course of N.H.S. and private treatment at the same time on the same appointment — for instance, if a particular drug has to be administered alongside another drug which is N.H.S.-funded.” But, she said, the health service rules seem to allow patients to receive the drugs during separate hospital visits — the N.H.S. drugs during an N.H.S. appointment, the extra drugs during a private appointment.

One of Mrs. Hirst’s troubles came, it seems, because the Avastin she proposed to pay for would have had to be administered at the same time as the drug Taxol, which she was receiving free on the health service. Because of that, she could not schedule separate appointments.

But in a final irony, Mrs. Hirst was told early this month that her cancer had spread and that her condition had deteriorated so much that she could have the Avastin after all — paid for by the health service. In other words, a system that forbade her to buy the medicine earlier was now saying that she was so sick she could have it at public expense.

Mrs. Hirst is pleased, but up to a point. Avastin is not a cure, but a way to extend her life, perhaps only by several months, and she has missed valuable time. “It may be too bloody late,” she said.

“I’m a person who left school at 15 and I’ve worked all my life and I’ve paid into the system, and I’m not going to live long enough to get my old-age pension from this government,” she added.

She also knows that the drug can have grave side effects. “I have campaigned for this drug, and if it goes wrong and kills me, c’est la vie,” she said. But, she said, speaking of the government, “If the drug doesn’t have a fair chance because the cancer has advanced so much, then they should be raked over the coals for it.”

And this is from the New York Times, an advocate of socialized medicine.

I probably highlighted too much, that whole article is a stunning indictment of Government health care.

[Snipe]

And we do already provide some top rate Government health care..

Soldiers Face Neglect, Frustration At Army's Top Medical Facility (http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html)

'It Is Just Not Walter Reed'
Soldiers Share Troubling Stories Of Military Health Care Across U.S (http://www.washingtonpost.com/wp-dyn/content/article/2007/03/04/AR2007030401394.html)

YES WE CAN!

WE ARE THE CHANGE THAT WE SEEK!

YES WE CAN!

[spazzrico]

That is probably one of the most poorly worded survey questions I have ever seen. I realize that it follows the spirit of the article, but it is quite leading and you basically end up with a predetermined answer.

[The Artist]

I personally enjoy the assumption that if the government is in charge of healthcare, then it will automatically be exactly like other healthcare systems that have problems. You can't beat that one.

[PM Thor]

That is probably one of the most poorly worded survey questions I have ever seen. I realize that it follows the spirit of the article, but it is quite leading and you basically end up with a predetermined answer.

X2. Can you get a more anti-Obama "YES WE CAN" tag to the poll please Snipe?

How about "In Hussein We Trust" or something like that?

[Muskie]

SNIPE.... you've got to quit cutting pasting entire articles! Quote a paragraph or so and then provide the link please.

Thanks.

It was an interesting article though. Not saying i back it or anything though.

[Snipe]

SNIPE.... you've got to quit cutting pasting entire articles! Quote a paragraph or so and then provide the link please.

Thanks.

It was an interesting article though. Not saying i back it or anything though.

Will do. I apologize.

[Snipe]

X2. Can you get a more anti-Obama "YES WE CAN" tag to the poll please Snipe?

How about "In Hussein We Trust" or something like that?


For the record you just brought up his middle name. I think that is dirty pool!

You can't mention his middle name without being a racist and a bigot. And now if you say "Yes We Can" you are anti-Obama. Could you just take a highlighter to my dictionary so I know in the future what words I can use?

[Snipe]

That is probably one of the most poorly worded survey questions I have ever seen. I realize that it follows the spirit of the article, but it is quite leading and you basically end up with a predetermined answer.

I thought it did follow the spirit of the article quite nicely. It was also a simple and direct question. I am not sure what you are looking for. In other countries with socialized medicine (like the United Kingdom) the governement is indeed in charge of everyone's health care. I am not making that up.

[Snipe]

I personally enjoy the assumption that if the government is in charge of healthcare, then it will automatically be exactly like other healthcare systems that have problems. You can't beat that one.

As I enjoy your assumption that if the governement is in charge of health care we won't have the same problems as other countries that have government health care. Would it not make sense to look at other systems? Isn't the National Health Service of the United Kingdom a "model system" when it comes to government health care?

[Muskie]

Will do. I apologize.

No problem... i just hate getting letters about copyright infringement. ;)

[The Artist]

As I enjoy your assumption that if the governement is in charge of health care we won't have the same problems as other countries that have government health care. Would it not make sense to look at other systems? Isn't the National Health Service of the United Kingdom a "model system" when it comes to government health care?

Please point out where I made the assumption. I look forward to your lack of a response.

[spazzrico]

I thought it did follow the spirit of the article quite nicely. It was also a simple and direct question. I am not sure what you are looking for. In other countries with socialized medicine (like the United Kingdom) the governement is indeed in charge of everyone's health care. I am not making that up.

The question implies that bureaucrats will be in charge of medical decisions, not doctors. This is somewhat disingenuous. Obviously no system is perfect and the article clearly points out a flaw in the British system. But to suggest that some paper pusher will be in charge of all that goes on with your body is overstepping. Besides, that is basically what we have now. Insurance companies routinely deny basic treatment (and preventative treatment) to patients at will who have no recourse. Insurance companies look for any reason to deny claims. And of course they do, they are companies whose purpose is to make a profit for their investors. Which begs the question of which is more important, proper care for patients or profits for investors.

I know this is a weird example, but look at that show "Little People, Big World". They are dwarves and as such, no insurance company will cover them. And believe me there are plenty more example. Now how can we support any system that leaves out a significant portion of the population based on the fact that they were born with certain medical issues. That is what a for-profit system gets you.

A universal system at the very least guarantees that everyone will be taken care of, not just those that have been lucky enough to be born healthy, in the right section of town, or have potentially thrown themselves into massive debt so that they can get a degree leading to a decent job that provides health insurance.

[Snipe]

I personally enjoy the assumption that if the government is in charge of healthcare, then it will automatically be exactly like other healthcare systems that have problems. You can't beat that one.


As I enjoy your assumption that if the governement is in charge of health care we won't have the same problems as other countries that have government health care.


Please point out where I made the assumption. I look forward to your lack of a response.

I guess you didn't. We are in agreement then. If Government is in charge of health care we will have the same problems as other countries that have government health care. I assumed you thought otherwise. I apologize.

[Snipe]

The question implies that bureaucrats will be in charge of medical decisions, not doctors. This is somewhat disingenuous. Obviously no system is perfect and the article clearly points out a flaw in the British system. But to suggest that some paper pusher will be in charge of all that goes on with your body is overstepping. Besides, that is basically what we have now.

It is disingenuous to imply that bureaucrats will be in charge of medical decisions, but you conceed that we are in a system where it is already happening. That is quite a circle of logic you have there. Who would decide what is covered and what is not? Isn't the answer obvious? The governement would.

I am not being disingenuous.

And if insurance companies did not make a profit, you simply wouldn't have insurance companies at all. That means you wouldn't have health care plans or the options the market currently makes available to us all.

Everyone needs a home. What is more important, a place to live for an American citizen or profits for home builders and real estate agents and the real estate investors?

Everyone needs food. What is more important, feeding hungry people or profits for farmers, supermarkets, distributors, restaurants, their lawyers, accountants and investors?

Without a home and food people can starve or freeze to death. Would you put their lives in front of investors? You can make a case that the government should run everything.

I just wonder where you are going to get the investors that aren't interested in profit. You also need to know that profit is not a dirty word. I bet it isn't when you get one in your 401K. Look closely at your funds and see if you are invested in 'Big Phrama' or the health insurance industry. I hope you aren't gaining at the expense of someone's health care.

[Kahns Krazy]

Given the current state of Government involvement in healthcare, it is quite reasonable to assume that any expansion of that involvement would make the problems worse.

The federal government takeover of previously state funded prescription drug plans has done nothing but add 2 extra layers of buracracy and cost to a program that not many considered broken before. Oh, and the government isn't doing crap. It's all outsourced to the private sector. I would hate to think what would happen if they dipped their fingers into all healthcare.

[The Artist]

I guess you didn't. We are in agreement then. If Government is in charge of health care we will have the same problems as other countries that have government health care. I assumed you thought otherwise. I apologize.

Rats! Wrong again!

Will such a system be as great some some left-winged dems are suggesting? - probably not.

Will such a system be as terrible as some right-winged repubs are suggesting? - probably not.

THOSE are my assumptions.

[boozehound]

I have no problem with Government Health Care in theory. However, the US government is the very epitome of inefficiency and waste. Health care costs are rising as it is, they would go through the roof if the government took over.

We Americans have a different attitude towards life than many Europeans. In France, for example, they would think that it is insane to spend $250k+ per year to keep an 80 year-old with medial problems alive. In America, we don't look at it that way. I will be the first to admit that I would probably feel differently if my parent or grandparent was old and in poor health, but we spend a lot of money extending the life of the elderly for relatively short amounts of time. If you are 90 and your organs are failing, you are not going to get better. However we will spend over $1MM keeping that person alive for another year, despite the fact that they have no quality of life. Again, I would probably feel differently if that person was a loved one, but I'm just calling it like I see it. Health care costs will continue to rise until we hit a crisis level.

If we are going to continue offering the quality of health care we currently offer, to anybody who needs it, we may as well Nationalize the health care system. Unfortunately I don't think that the health care issue has a very viable solution at this time.

[Kahns Krazy]

Rats! Wrong again!

Will such a system be as great some some left-winged dems are suggesting? - probably not.

Will such a system be as terrible as some right-winged repubs are suggesting? - probably not.

THOSE are my assumptions.

Do you have any experience with any form of government funded healthcare - Medicare, Medicaid, etc? I'm curious how you can say it won't be that bad.

[Snipe]

I have no problem with Government Health Care in theory. However, the US government is the very epitome of inefficiency and waste. Health care costs are rising as it is, they would go through the roof if the government took over.

We Americans have a different attitude towards life than many Europeans. In France, for example, they would think that it is insane to spend $250k+ per year to keep an 80 year-old with medial problems alive. In America, we don't look at it that way. I will be the first to admit that I would probably feel differently if my parent or grandparent was old and in poor health, but we spend a lot of money extending the life of the elderly for relatively short amounts of time. If you are 90 and your organs are failing, you are not going to get better. However we will spend over $1MM keeping that person alive for another year, despite the fact that they have no quality of life. Again, I would probably feel differently if that person was a loved one, but I'm just calling it like I see it. Health care costs will continue to rise until we hit a crisis level.

If we are going to continue offering the quality of health care we currently offer, to anybody who needs it, we may as well Nationalize the health care system. Unfortunately I don't think that the health care issue has a very viable solution at this time.

It is insane to spend $250k a year to keep an old person alive who has no quality of life. Especially when you factor in that the cost is passed along to future generations. That $250,000 represents real resources. The concept of opportunity cost tells us that spending $250k there means you don't have those resources to spend somewhere else.

In many developed countries, life expectancy at birth is higher than the United States. Once we hit 80 years old though, we have the highest life expectancy in the world (http://content.nejm.org/cgi/content/abstract/333/18/1232).

And with the baby boom generation those costs are going to be piling up. It is like a huge intergenerational transfer of wealth to our aged baby boomers from both our current workers and future generations.

Halting that cost would be a great benefit of Government health care. They could do cost/benefit analysis and deny treatment. Another way of constricting costs is to set budgets and ration health care. This leads to waiting lists, and many people die on them and that saves money. And you end up with a two-tiered system like Britian. Some people will be able to afford private health care, while others will be stuck with government health care. Kind of like public vs. private schools.

[The Artist]

Do you have any experience with any form of government funded healthcare - Medicare, Medicaid, etc? I'm curious how you can say it won't be that bad.

I can say it because it remains to be seen. I think people are making an unfair assumption that whatever we come up with will be exactly like the other systems and therefore share all the problems of the other systems. Maybe it will, maybe it won't. I think it's a stretch to say it definitely will.

I'm hopeful that we'll be able to look at the problems with the other systems and try to avoid them.

I guess the only thing I really know is that I'm damn sure the healthcare system in this country needs to be reformed, and I'm having trouble imagining how it could be worse than it currently is.

Doesn't Obama's plan give people the option of the public healthcare or private healthcare (private includes provided by employers, from what I've heard him say)? I don't know it well enough to know if you can "mix and match".

That sounds to be at least a partial solution and solve some of the problems in the stated article. However, I'm not even going to pretend to be knowledgeable enough to know whether or not this would present other issues.

[Snipe]

Rats! Wrong again!

Will such a system be as great some some left-winged dems are suggesting? - probably not.

Will such a system be as terrible as some right-winged repubs are suggesting? - probably not.

THOSE are my assumptions.

I am right there with you. It won't be great like the lefties think, but it does have some benefits that the righties don't admit to, like the cost savings of rationing care and denial of service through cost/benefit analysis. And the well to do will still be able to get real health care anyway.

[PM Thor]

For the record you just brought up his middle name. I think that is dirty pool!

You can't mention his middle name without being a racist and a bigot. And now if you say "Yes We Can" you are anti-Obama. Could you just take a highlighter to my dictionary so I know in the future what words I can use?

Nope, I won't play Snipe. I just find it quite amusing that you used the term "Yes We Can" in an obviously derogatory swipe at Obama, I just continued that assumption by taking the next step by referring to his middle name, simply as you did in another thread. Oh hey did you know that if Obama gets elected, he won't put his hand on the Bible at the swearing in ceremony? You might as well throw out that kind of tripe already and get it over with.


Blech.

All of this political gamesmanship is really not a healthy thing.

[blobfan]

A universal system at the very least guarantees that everyone will be taken care of, not just those that have been lucky enough to be born healthy, in the right section of town, or have potentially thrown themselves into massive debt so that they can get a degree leading to a decent job that provides health insurance.

I think that's a false assumption. My understanding is the universal health care only guarantees that everyone will eventually get basic care. That appears to be the reality in Britain and nothing I've heard about the current US proposals makes me think I'm wrong.

Someone floated the idea about keeping older people alive in spite of their quality of life. What about young people? A year or so ago the Enquirer ran a series of stories about local people having trouble getting health coverage. One was a teen that needed 500k a year in medicine to treat his hemophilia because all other meds left him too ill to go to school, even though they kept him alive. Another was a toddler that was born so premature the doctors wanted to let her die. The mother insisted they try to save her. She now has severe developmental and physical problems, including needing a device that pumps food directly into her stomach, all totalling almost $1M a year.

How do you handle these situations? Is it more fair if government health care turns down the request than if a private insurer does? Should these kids be covered? Does it matter that it's unlikely neither child will ever earn enough to return the money to society?

I admit, I'm against a nationally funded health care system. In general, I think our government gives too much without requiring a minimum of personal accountability in return. I'm open to anyone that can give me a good argument for why it would work, though. My heart would love to see every last human taken care of but my mind believes it is not possible.

[spazzrico]

It is disingenuous to imply that bureaucrats will be in charge of medical decisions, but you conceed that we are in a system where it is already happening. That is quite a circle of logic you have there.

In the system I am referring to, Insurance adjusters decide who is covered. I'm willing to bet most of the people who answered yes in this poll really wouldn't be too fond of that either, but yet that is the system we have.


And if insurance companies did not make a profit, you simply wouldn't have insurance companies at all. That means you wouldn't have health care plans or the options the market currently makes available to us all.

That's just it, the market hasn't made health care plans available "to us all".

I've got more to say later, but I need to leave.

[boozehound]

Blob, I agree with you and Snipe that too much money is spent on people with no quality of life, but could you imagine someone preposing that we let people die because it is not cost effective to keep them alive? The country would never go for it. It would be absolute career suicide for any politician to take that stance, and few, if any, of their colleagues would support them. It definitely makes the most sense, but is it feasible? I think that we will continue to spend way too much money to keep anyone and everyone alive as long as possible, no matter how poor their quality of life is. We won't do anything about it until it reaches absolute crisis levels and threatens to bankrupt the country. With the aging population that won't take too long.

[Gary]

"They tell us it's too expensive to cover the uninsured, but they don't mention that every time an American without health insurance walks into an emergency room, we pay even more. Our family's premiums are $922 higher because of the cost of care for the uninsured.

We pay $15 billion more in taxes because of the cost of care for the uninsured. And it's trapped us in a vicious cycle. As the uninsured cause premiums to rise, more employers drop coverage. As more employers drop coverage, more people become uninsured, and premiums rise even further.

But the skeptics tell us that reform is too costly, too risky, too impossible for America.

Well the skeptics must be living somewhere else. Because when you see what the health care crisis is doing to our families, to our economy, to our country, you realize that caution is what's costly. Inaction is what's risky. Doing nothing is what's impossible when it comes to health care in America.

It's time to act. This isn't a problem of money, this is a problem of will. A failure of leadership. We already spend $2.2 trillion a year on health care in this country. My colleague, Senator Ron Wyden, who's recently developed a bold new health care plan of his own, tells it this way:

For the money Americans spent on health care last year, we could have hired a group of skilled physicians, paid each one of them $200,000 to care for just seven families, and guaranteed every single American quality, affordable health care. "

The time has come for universal healthcare. Hear your nation calling.

Yes, we can.

[Fred Garvin]

What ER's is Spass visiting? I wasn't aware they were turning people away. I was in an ER two weeks ago. Btw, The Rebublic of Mexico says hi.

I always resent the comment that people don't really die on waiting lists. That it is a Republican Fear and Smear tactic. My brother in law is from Vancouver. His dad died while waiting an eternity for cancer treatment. Believe me, it happens. It turns out you can keep costs down if people die before undergoing treatment.

[Fred Garvin]

Also, I just spoke with Helen and she wants to know if dental is covered.

[XUglow]

Also, I just spoke with Helen and she wants to know if dental is covered.

Good call, Fred. I thought Helen died waiting for proper dental care. It is good to know that she is as real now as she was back then.

I don't know. I lived in the UK for a while, and most of my employees had private insurance. It was very inexpensive, and the reason for the low cost is that catastrophic events were handled by the public health system. "Well" care wasn't bad either. The English are punctual, so if your appointment was at 4 pm on Wed., they saw you at 4 pm on Wed. I never went to the doctor myself when I was over there, but my dad felt poorly on one visit and went to the local hospital. They just took his SSN, treated him as if he were an English patient, and released him when he was better. He paid nothing. He was impressed with the doctor and the treatment he was given.

[Stonebreaker]

Aside from the military, exactly what function does our government run well?

[blobfan]

"They tell us it's too expensive to cover the uninsured, but they don't mention that every time an American without health insurance walks into an emergency room, we pay even more. Our family's premiums are $922 higher because of the cost of care for the uninsured.

How will universal health care change this behavior? People are still going to go to the ER rather than plan ahead for well care. The problem is people's behavior, not funding. Again, it comes down to people taking responsibility for themselves.

Even assuming we could figure that out, in the US, only cities like San Francisco will be able to do universal health care effectively. It's the geography, composition of population, and access to transportation. I'd wager that currently, lack of public transportation is a bigger obstacle to health care than lack of affordability. I believe ambulance's are abused by people that can't get to regular appointments. I know Cincinnati tried to limit them a few years ago but couldn't figure out how to do it without jeopardizing the lives of people that really needed assistance.

[GuyFawkes38]

It's a really difficult situation (in my opinion between the Present and Long-term).

In the Present/short-term, it would be vastly better to have universal coverage. The poor of the country would no longer have to go to the ER. Our amazing medical system can be distrubted more effectively and efficiently to all.

Long term, Universal coverage looks bleaker. The lack of competition decreases inovation.

Those in favor of universal coverage scream, "what lack of inovation? we have people suffering right now who deserve coverage".

I'm sympathetic to that arguement.

But I disagree. Inovation is central to the progress in the medical field for the past 30 years. As someone who has studied the issue for many years, I can't disagree more with any attempt to limit competition.

And Doctors/Nurses/and Hospital Administrators agree with me in the surveys.

[GuyFawkes38]

I deleted this post.

[GuyFawkes38]

"Well the skeptics must be living somewhere else. Because when you see what the health care crisis is doing to our families, to our economy, to our country, you realize that caution is what's costly. Inaction is what's risky. Doing nothing is what's impossible when it comes to health care in America.


I might be repeating myself from my previous post.

Your arguement does make sense (and I do love Obama and have contributed to his campaigne).


But, through my experience of working at a hospital, your quote doesn't ring true. Indeed, through national regulation, all hospital employees HAVE TO TREAT PATIENTS EQUALLY (via JAYCO).

I know your probably thinking, "that doesn't really happen".

But it does. Doctors and Nurses have every incentive to treat all patients equally. Hospital Administrators have every incentive not to interfer with this.

Medicaid picks up the remaining balance.

Anyways, it frusterates me when foreigners claim that US hospitals refuse care. THAT DOES NOT HAPPEN.

THAT'S COMPLETELY FALSE. As it is right now, the US system is much better than the UK or any other foreign health care system.

[danaandvictory]

Aside from the military, exactly what function does our government run well?

National parks and the interstate highway system are two services that come to mind immediately that I would never trust for-profit industry to handle alone.

This Norquist anti-government crap is just as obnoxious to me as the nanny state. As always, the truth lies somewhere in the middle.

[Snipe]

I just find it quite amusing that you used the term "Yes We Can" in an obviously derogatory swipe at Obama, I just continued that assumption by taking the next step by referring to his middle name, simply as you did in another thread. Oh hey did you know that if Obama gets elected, he won't put his hand on the Bible at the swearing in ceremony? You might as well throw out that kind of tripe already and get it over with.


Blech.

All of this political gamesmanship is really not a healthy thing.

I didn't know that he won't put his hand on the Bible. Why is that? Has any President ever not done that? What are his reasons?

As far as the term "Yes We Can" being an obviously derogatory swipe at Obama, that is his campaign theme. I like Obama. He has said "Yes We Can" a hell of a lot more than I have. I shouldn't be denied from saying what he does. If Obama says "YES WE CAN!" it is one thing. If I repeat it you have "political gamesmanship" that is not a healthy thing? I don't even know what that means. Obama wasn't the first person to chant "YES WE CAN", and he won't be the last. Granted, he is very good at it, maybe one of the best ever. I love "YES WE CAN". I love it every time I see it.

YES WE CAN!

WE ARE THE CHANGE THAT WE SEEK!

YES WE CAN!

[PM Thor]

I was being facetious about Obama not putting his hand on the Bible, it's one of those random anti-Obama things floating around on the internet.

As for the "Yes We Can" thing.

It's about context. Obviously, you have your opinion made up on the subject of universal healthcare, which is fine. Just don't try to hide your disdain for the left with veiled attacks on them. I mean, look at the first line in this original post.

"Are you in favor of the Government being in charge of everyone's health care?"

That is an assumption that either Clinton or Obama healthcare programs will force everyone to have a governmental healthcare program, which simply is not true. I digress though.

After that, you use the term "Yes We Can" as one of the answers, where most people who follow the political scene know exactly what you were refferring to with that. It wasn't even a good attempt at expressing your dislike for Obama either. Spin it how you want, try to pick apart this post however you want. It's obvious how you feel, I for one get it. I just want you to know that the continual attacks that you make on the left get old quickly, at least for me. But hey, have at it I guess. It's always easier to criticize, belittle, and undercut someone you don't agree with over discussing the issues anyway right?

[Fred Garvin]

Thor's post above was written by Deval Patrick.

[PM Thor]

Fred that is funny, considering that I am mostly likely not going to vote for a democrat in this election, based on the Iraq/Afghanistan issue.

Look, I am just trying to find a middle ground here, that's all. Do I agree with the left on many issues? Hell no. With the right on many issues? Nope.

But these kinds of threads that are divisive won't turn people onto your "side". In fact, I think most people are getting sick of the attacks, the "us" vs "them" attitude that both sides are taking.

I am in no way a democrat. I just hate seeing the willingness of either side to attack the other. Maybe I should just ignore it altogether.

[Fred Garvin]

Thor, it was a joke. I think you might be overanalyzing things a bit.

[PM Thor]

I will admit, I am swinging wildly right now, windmill style, just hoping to connect with some dayton fan...

[kmcrawfo]

As some of you know I am a physician. Let me preface my comments with a little background of my knowledge base with government run healthcare...

I have worked in completely government run healthcare systems in the Air Force and VA hospital system.

I have also worked in an essentially government run system in two County Hospitals (Wishard in Indianapolis and Grady in Atlanta).

I have my own practice in Indiana, where I work on weekends that I am not in my Air Force clinic.

If you call me for an appointment at my private clinic, I can see you the next day. I can order any drug you want. I can get an MRI within 72 hours (the same day if it is urgent). I can do a biopsy/surgery and get you the pathology results in 24-48 hours. If you have a skin cancer, and need surgery I can do it that same day, if requested.

In the Air Force it usually takes me 6-8 months to get an MRI. You can only get an appointment with me if you are active duty and it takes months. Lab results take weeks to get back. There is no incentive to see patients because I get paid the same whether I see 6 or 60 in a day. The government decides which drugs I can and can't give you and how much you can get.

The VA is even worse, where 30-40% of the requests I recieved for consults were denied because we were overwhelmed with requests for visits and could not meet demand.

The County Hospitals are believe it or not, even worse.... Multiply everything above x 10.

I have many close friends who work/live in Canada and the UK. The Healthcare systems are disastrous. In the UK, if you have money you completely avoid the government hospitals and go to private hospitals. In Canada, where it is illegal to have a private system most people come to the US, until recently.

Brian Day, M.D opened a private hospital which is state of the art and insures its own patients. The Canadian Government told him he had to close it, and the case went all the way to the supreme court, which sided with DAy and stated that the Canadian system was "Inhumane and that Access to a Waiting list does not mean access to care." Brian Day was voted president of the Canadian Medical Association, and has opened more hospitals.

If you want to see what government run healthcare would be like, go to your local county hospital or VA.

The bottom line is that if you are healthy and don't need healthcare and government run system is great. The problem is that if you need a hip replacement, heart cath, Gallstone surgery in a government system the wait is months to years.

Anyone who advocates this is pulling wool over your eyes. Our system has its faults, but less government involvement, not more is what it needs.

It is difficult to name any system the government has every run and done a good job, and now people want to hand over healthcare. Give me a break.

The first thing docs will do (the good ones anyway) if a government system goes into play (and reimbursements are cut) is opt out. Thereby creating a cash only private sector. This sector will actually provide fast, good care as I have detailed above. The remaining docs will be overwhelmed and provide worse care.

The result.... The with Money will be better or the same care.... Those without will get even worse care than they get now.

Look, this is an immensly complicated topic which can not be appropriately discussed in a message forum, but please do some research and don't believe what pundits or politicians tell you about the boon s of universal healthcare. If you let a system like that go into place it will only hurt the poor. The "rich" will not be affected because they will opt out of the crap system.

[joebba]

As some of you know I am a physician. Let me preface my comments with a little background of my knowledge base with government run healthcare...

I have worked in completely government run healthcare systems in the Air Force and VA hospital system.

I have also worked in an essentially government run system in two County Hospitals (Wishard in Indianapolis and Grady in Atlanta).

I have my own practice in Indiana, where I work on weekends that I am not in my Air Force clinic.

If you call me for an appointment at my private clinic, I can see you the next day. I can order any drug you want. I can get an MRI within 72 hours (the same day if it is urgent). I can do a biopsy/surgery and get you the pathology results in 24-48 hours. If you have a skin cancer, and need surgery I can do it that same day, if requested.

In the Air Force it usually takes me 6-8 months to get an MRI. You can only get an appointment with me if you are active duty and it takes months. Lab results take weeks to get back. There is no incentive to see patients because I get paid the same whether I see 6 or 60 in a day. The government decides which drugs I can and can't give you and how much you can get.

The VA is even worse, where 30-40% of the requests I recieved for consults were denied because we were overwhelmed with requests for visits and could not meet demand.

The County Hospitals are believe it or not, even worse.... Multiply everything above x 10.

I have many close friends who work/live in Canada and the UK. The Healthcare systems are disastrous. In the UK, if you have money you completely avoid the government hospitals and go to private hospitals. In Canada, where it is illegal to have a private system most people come to the US, until recently.

Brian Day, M.D opened a private hospital which is state of the art and insures its own patients. The Canadian Government told him he had to close it, and the case went all the way to the supreme court, which sided with DAy and stated that the Canadian system was "Inhumane and that Access to a Waiting list does not mean access to care." Brian Day was voted president of the Canadian Medical Association, and has opened more hospitals.

If you want to see what government run healthcare would be like, go to your local county hospital or VA.

The bottom line is that if you are healthy and don't need healthcare and government run system is great. The problem is that if you need a hip replacement, heart cath, Gallstone surgery in a government system the wait is months to years.

Anyone who advocates this is pulling wool over your eyes. Our system has its faults, but less government involvement, not more is what it needs.

It is difficult to name any system the government has every run and done a good job, and now people want to hand over healthcare. Give me a break.

The first thing docs will do (the good ones anyway) if a government system goes into play (and reimbursements are cut) is opt out. Thereby creating a cash only private sector. This sector will actually provide fast, good care as I have detailed above. The remaining docs will be overwhelmed and provide worse care.

The result.... The with Money will be better or the same care.... Those without will get even worse care than they get now.

Look, this is an immensly complicated topic which can not be appropriately discussed in a message forum, but please do some research and don't believe what pundits or politicians tell you about the boon s of universal healthcare. If you let a system like that go into place it will only hurt the poor. The "rich" will not be affected because they will opt out of the crap system.

Wow. This may be one of the best posts ever seen on this board.

[GuyFawkes38]

I agree that government run health care systems work poorly.

But it would be nice to somehow disconnect health care and employment.

Even as a staunch libertarian, I admire the nordic countries where small businesses don't have to be burdened with insane health insurance cost. More risks can be taken without the fear of not having health insurance.

In the Nordic countries, at least, the market place works better because employers don't have to worry about insurance costs.

[Fred Garvin]

crawford, are you a dermatologist?

[Snipe]

As some of you know I am a physician. Let me preface my comments with a little background of my knowledge base with government run healthcare...

I have worked in completely government run healthcare systems in the Air Force and VA hospital system.

I have also worked in an essentially government run system in two County Hospitals (Wishard in Indianapolis and Grady in Atlanta).

I have my own practice in Indiana, where I work on weekends that I am not in my Air Force clinic.

If you call me for an appointment at my private clinic, I can see you the next day. I can order any drug you want. I can get an MRI within 72 hours (the same day if it is urgent). I can do a biopsy/surgery and get you the pathology results in 24-48 hours. If you have a skin cancer, and need surgery I can do it that same day, if requested.

In the Air Force it usually takes me 6-8 months to get an MRI. You can only get an appointment with me if you are active duty and it takes months. Lab results take weeks to get back. There is no incentive to see patients because I get paid the same whether I see 6 or 60 in a day. The government decides which drugs I can and can't give you and how much you can get.

The VA is even worse, where 30-40% of the requests I recieved for consults were denied because we were overwhelmed with requests for visits and could not meet demand.

The County Hospitals are believe it or not, even worse.... Multiply everything above x 10.

I have many close friends who work/live in Canada and the UK. The Healthcare systems are disastrous. In the UK, if you have money you completely avoid the government hospitals and go to private hospitals. In Canada, where it is illegal to have a private system most people come to the US, until recently.

Brian Day, M.D opened a private hospital which is state of the art and insures its own patients. The Canadian Government told him he had to close it, and the case went all the way to the supreme court, which sided with DAy and stated that the Canadian system was "Inhumane and that Access to a Waiting list does not mean access to care." Brian Day was voted president of the Canadian Medical Association, and has opened more hospitals.

If you want to see what government run healthcare would be like, go to your local county hospital or VA.

The bottom line is that if you are healthy and don't need healthcare and government run system is great. The problem is that if you need a hip replacement, heart cath, Gallstone surgery in a government system the wait is months to years.

Anyone who advocates this is pulling wool over your eyes. Our system has its faults, but less government involvement, not more is what it needs.

It is difficult to name any system the government has every run and done a good job, and now people want to hand over healthcare. Give me a break.

The first thing docs will do (the good ones anyway) if a government system goes into play (and reimbursements are cut) is opt out. Thereby creating a cash only private sector. This sector will actually provide fast, good care as I have detailed above. The remaining docs will be overwhelmed and provide worse care.

The result.... The with Money will be better or the same care.... Those without will get even worse care than they get now.

Look, this is an immensly complicated topic which can not be appropriately discussed in a message forum, but please do some research and don't believe what pundits or politicians tell you about the boon s of universal healthcare. If you let a system like that go into place it will only hurt the poor. The "rich" will not be affected because they will opt out of the crap system.


Wow. This may be one of the best posts ever seen on this board.

I would have to agree. Thank for your first hand insight into the system. It is an eye opener.

[Snipe]

I agree that government run health care systems work poorly.

But it would be nice to somehow disconnect health care and employment.

Even as a staunch libertarian, I admire the nordic countries where small businesses don't have to be burdened with insane health insurance cost. More risks can be taken without the fear of not having health insurance.

In the Nordic countries, at least, the market place works better because employers don't have to worry about insurance costs.


I agree with you. I think that everyone should have a health savings account. If the market was more involved in the system it would help it to be more efficient and bring down costs. You would also get better care.

[GuyFawkes38]

I agree with you. I think that everyone should have a health savings account. If the market was more involved in the system it would help it to be more efficient and bring down costs. You would also get better care.


I like the idea of health care savings accounts. Of course, if left to some peoples own management, some might not fund their account when they are healthy.

So it seems like you would need to have some sort of penalty to those who refuse to fund their account.

[Old School]

Tell 'er MediCare is a waste of money and you're cuting her off.

Tell her you hate her pies, too.

[GuyFawkes38]

I'm passionately against Medicare.

I always come out looking like an ageist jerk when I debate Medicare with my friends. but I will go on anyways.

I have two major points against Medicare:

1. A lot of the procedures given to the senior citizens will do them absolutley no good. But medicare pays all and doctors have every incentive to give senior citizens every procedure possible.

2. Morally, medicare doesn't make sense. If anything, we should have much more pity for those who get sick in their 20's and 30's than those who get sick in their 70 and have lived a full life.

Also, those who get sick in their 20's and 30's have had little opportunity to save money. The opposite is true with those who get sick in their 70's.

Yet those in their 20's and 30's pay for the bill of the person in the 70's.

Medicare makes me sick.

[Old School]

<<Yet those in their 20's and 30's pay for the bill of the person in the 70's.>>

So ... we're going to write a check to refund all those septuagenarians' FICA contibutions?

[GuyFawkes38]

<<Yet those in their 20's and 30's pay for the bill of the person in the 70's.>>

So ... we're going to write a check to refund all those septuagenarians' FICA contibutions?


I don't know about that. But I do believe that we should start pulling funding from Medicare.

It makes no sense why we fund health care for senior citizens rather than children or anyone else.

The problem is that people feel bad for older people. I don't understand.

WE SHOULD FEEL MUCH WORSE FOR THE 25 YEAR OLD WHO GETS CANCER THAN THE 75 YEAR OLD. AND IT MAKES MORE SENSE TO ASSIST THE 25 YEAR OLD RATHER THAN THE 75 YEAR OLD.

[Old School]

Just put everyone on MediCare. There. We're done.

Fair is fair.

[kmcrawfo]

...........................

[kmcrawfo]

crawford, are you a dermatologist?

Garvin... Yes. I am a dermatologist.

[Old School]

Yes Sir, dermatology is my speciality.

and duct tape.

[Fred Garvin]

Garvin... Yes. I am a dermatologist.

The reason I ask is because my brother in law is a dermatologist who did his residency while in the Air Force. He was stationed in Alexandria, La at the base the Flying Tigers originated from.

[Fred Garvin]

and duct tape.


This place was great when it was an Old Stool free board.

[GuyFawkes38]

This place was great when it was an Old Stool free board.


Old School hasn't "gone postal". But yes, Old School is very annoying. I don't doubt that it's tough to be a moderator.

[xu2006]

This is a somewhat interesting article given the discussions being held in this thread.

http://www.nytimes.com/2008/02/21/world/europe/21britain.html?ex=1361336400&en=79cdc5e5158e4873&ei=5124&partner=permalink&exprod=permalink

[Raoul Duke]

I wish Old School hadn't joined this board.

And I'm a doctor of gonzo medicine.

[Kahns Krazy]

I am so sick of the freaking politicos already.

Everyone I see is on a platform that includes "affordable" health care. What the French Toast does that mean? i can afford the coverage I currently have. I could afford a lot more if I sold my house and stopped saving for retirement. Does that mean that the cost of my healthcare is going to increase?

I don't understand why people consider premium healthcare a right. If you choose not to take care of yourself (I haven't), you then have another choice. You can pay through the nose to try to fix it, or live with the consequences.

If I eat nothing but vodka and skittles for 10 years, should I still be entitled to free health care?

[kmcrawfo]

The reason I ask is because my brother in law is a dermatologist who did his residency while in the Air Force. He was stationed in Alexandria, La at the base the Flying Tigers originated from.

When did he leave the Air Force? I have been in derm with them since 2003, so if he has been in during the last 4-years I might know him. I didn't realize we had a derm in Alexandria. I know there are a couple dermatologists at Keesler AFB in Biloxi, MS.

I was stationed at Andrews AFB in DC for 2-years, and I am getting ready to leave Atlanta in couple months to be stationed at Scott AFB just outside of St. Louis for my last 2 years of service before separating and working full-time in Indiana.

It has been a good run, but I look forward to my non-military life and settling down with my family.

[XUglow]

I heard this morning that 9 million fewer families are insured in the US now than there were in 2000. Anyone else like me running a business where your employee health plan is running through the roof? It is hard for me to imagine a situation where I don't provide health insurance for my employees, but I am sure that I will be shocked yet again in March when I get quotes for the next 12 months of coverage.

[Kahns Krazy]

I heard this morning that 9 million fewer families are insured in the US now than there were in 2000.

Ahhh, statistics. Without visibility to the data, this could just be a result of more employers pushing employees away from 'family' plans when the spouse is eligible.

That is an example of why I hate this whole debate.

[XUglow]

Ahhh, statistics. Without visibility to the data, this could just be a result of more employers pushing employees away from 'family' plans when the spouse is eligible.

That is an example of why I hate this whole debate.

Uh, nope. We are talking about totally uninsured through any means. The data comes from the US Census Bureau. Feel free to look it up yourself so that you have some "visibility" into the data. Just in 2006 alone, the last year of the data on the web, the number of uninsured persons went from 44.8 million to 47 million.

http://www.census.gov/Press-Release/www/releases/archives/income_wealth/010583.html

[Snipe]

Does that data include illegals?

[Kahns Krazy]

Uh, nope. We are talking about totally uninsured through any means. The data comes from the US Census Bureau. Feel free to look it up yourself so that you have some "visibility" into the data. Just in 2006 alone, the last year of the data on the web, the number of uninsured persons went from 44.8 million to 47 million.

http://www.census.gov/Press-Release/www/releases/archives/income_wealth/010583.html

Thanks for the source. That data indicates that the number of insured persons increased in 2006 by 800,000 persons.

Also, if you read the study, you'll find the following:
1) The study itself admits that insurance coverage is underreported.
2) A person who is insured for 364 days but has a 1 day lapse in coverage during the year is counted as "uninsured". This would include a number of people who change jobs and work the Cobra loophole that allows retroactive coverage if necessary. By that yardstick, I have been 'uninsured' at 2 different points in my life.
3) The number of uninsured grew by 2.2 million people. Of that, 1.4 million of them make $75,000 or more, and another 0.6 million make $50,000 or more. That sounds like people who are willing to pay their own way if necessary, and represents 91% of the 'new' uninsured.

Do you think that paints the same picture as the sensationalized highlights? In your words, "Uh, nope."

[Kahns Krazy]

Snipe, the report does not discuss the legality of the aliens, but it does identify foreign born non-citizens. In that category, the uninsured rose from 9.4 million to 10.2 million.

[XUglow]

Thanks for the source. That data indicates that the number of insured persons increased in 2006 by 800,000 persons.

Also, if you read the study, you'll find the following:
1) The study itself admits that insurance coverage is underreported.
2) A person who is insured for 364 days but has a 1 day lapse in coverage during the year is counted as "uninsured". This would include a number of people who change jobs and work the Cobra loophole that allows retroactive coverage if necessary. By that yardstick, I have been 'uninsured' at 2 different points in my life.
3) The number of uninsured grew by 2.2 million people. Of that, 1.4 million of them make $75,000 or more, and another 0.6 million make $50,000 or more. That sounds like people who are willing to pay their own way if necessary, and represents 91% of the 'new' uninsured.

Do you think that paints the same picture as the sensationalized highlights? In your words, "Uh, nope."

"Uh, nope." was responding to your possible suggestion of the reason for the 9 million differnce only. I knew it was census data. To me, the sensationalism of the data is that the 9 million increase in uninsured is individuals and not families. That is a big difference. (I heard it on NPR... consider the source.)

There was an 800,000 increase in insurance, but there was also a 3M increase in the population which accounted for the 2.2M increase in uninsured. Please let me know where you get that goofy number that 1.4M people of this 2.2M increase make over $75K.

The study does say that the number is underreported, but the numbers for 2000 to 2006 are probably equally underreported, so the delta would still be significant.

[Fred Garvin]

When did he leave the Air Force? I have been in derm with them since 2003, so if he has been in during the last 4-years I might know him. I didn't realize we had a derm in Alexandria. I know there are a couple dermatologists at Keesler AFB in Biloxi, MS.

I was stationed at Andrews AFB in DC for 2-years, and I am getting ready to leave Atlanta in couple months to be stationed at Scott AFB just outside of St. Louis for my last 2 years of service before separating and working full-time in Indiana.

It has been a good run, but I look forward to my non-military life and settling down with my family.


It has been at least 15 years since he left for private practice. He's been in Greer, SC ever since. I thought about e-mailing him an article from last week's Cincinnati Enquirer that talked of a derm shortage in the area. It spoke of months long waiting lists.

I'm not sure if he did his residency in Alexandria. He was in San Antonio after that and I'm thinking that is where he was longest. He loved the entire culture of the Air Force.

Good luck in St.Louis.

[blobfan]

Quote all the statistics you want but it doesn't tell us much about the underlying problem. Without discovering the cause, any plan to fix it will be ineffective over the long term. Why is the cost of health care going up? Aging population? Over treatment? Insufficient well care practices? Abuse of emergency treatment?

Does our existing system really cover what it should? Is it right for insurance to cover quality of life care for the same cost others pay for subsistence? Should ED drugs and expensive IVF be paid for by all or only those willing to pay for premium coverage? Should doctors have the power to refuse treatment to people unlikely to survive or do we let families push for continued high cost treatment? What's an acceptable chance of survival to continue coverage? 10%? 50%?

Do we start offering services based on how much responsibility individuals take for their own health? Should someone pay more for coverage if their diabetes is due to obesity?

These are just some of the difficult questions that need addressed. I'm afraid national health care is being offered as a panacea but will simply be a short-term band-aid, like so many other ideas proposed by politicians. Offering so-called free or affordable health care is a great vote getter when you don't discuss the real costs of the program.

[GuyFawkes38]

Blobfan, to me, a lot can be accomplished by liberalizing the healthcare market (especially on the labor side).

I have a lot of respect for doctors and nurses. They work hard and are brilliant. BUT, through the AMA (the Doctors guild), a lot of restrictions are put in place which create expensive labor costs (all in the name of assuring quality...I guess I'm cynical, but I think it has a lot to do with keeping salaries high).

And I'm all for limiting care, especially for the elderly (that sounds kind of evil, but I think I give a rational explanation ealier on this thread on Medicare).

[Fred Garvin]

There was an article recently-I think it was excerpted in The Enquirer- about overuse of antibiotics and about these extremely resistant bugs.(I refuse to call them "superbugs".)

Anyway, It summarized a recent study about antibiotics used on patients with extreme dementia in nursing homes.

A lot of patients in nursing homes get pneumonia and they treat with antibiotics. That's all well and good. It gets interesting when you start talking about a patient who has Alzheimers. Alzheimers is a fatal illness and is classified as such. A patient with Alz can contract pneumonia, be treated with antibiotic and have their life prolonged.

That seems like quite a sea change. Dying of pneumonia is a lot more dignified than dying of Alzheimers. The study mentions that people once referred to pneumonia as "the old person's friend." You comforted them and let them go.

The plot really thickens when you start affecting others:

Then comes this quote: "This extensive use of antimicrobials and pattern of antimicrobial management in advanced dementia raises concerns not only with respect to individual treatment burden near the end of life but also with respect to the development and spread of antimicrobial resistance in the nursing home setting," The results support "the development of programs and guidelines designed to reduce the use of antimicrobial agents in advanced dementia."

Good gawd, these nursing homes sound like germ farms. I think I'd rather be on an airplane after a SARS outbreak. I'd go to a nuring home for rehabilitation but that's about it. When I go they are dragging me out the front door feet first.

[PM Thor]

Same thing could be said about hospitals Fred. Those places breed illness.

[XUglow]

Do we start offering services based on how much responsibility individuals take for their own health? Should someone pay more for coverage if their diabetes is due to obesity?


In essence, this is the system that we have today. I get quotes from health care brokers each year for next year's coverage. They gather data from all of my employess and hand it to the actuaries and come back with rates for my coverage. (If I want to slice my health insurance bill, I need to hire nothing but young males.) My highest cost employee is a 60 year old black woman that is slightly over weight with slightly elevated blood pressure. It would probably run her about $1000 per month to self-insure. I doubt she could afford that amount if she had to come up with the money on her own.

The health insurance companies do "reward" us if my older employees join and regularly attend hospital sponsored workouts called Silver Sneakers. The health insurance company pays for the classes and gives us a break on payments. Obviously, that is money well spent for them.

[The Artist]

I was worried you were going to hate on the actuaries. THEN we'd have a problem.

[Kahns Krazy]

"Uh, nope." was responding to your possible suggestion of the reason for the 9 million differnce only. I knew it was census data. To me, the sensationalism of the data is that the 9 million increase in uninsured is individuals and not families. That is a big difference. (I heard it on NPR... consider the source.)

There was an 800,000 increase in insurance, but there was also a 3M increase in the population which accounted for the 2.2M increase in uninsured. Please let me know where you get that goofy number that 1.4M people of this 2.2M increase make over $75K.

The study does say that the number is underreported, but the numbers for 2000 to 2006 are probably equally underreported, so the delta would still be significant.

Well, you "Uh noped" like you knew your number was solid, and it turns out that it is wrong in more than one way. First, as long as the population is increasing, there is a pretty substantial difference between "9 million fewer with insurance" and "9 million more uninsured". Your (NPR's) statement would indicate that there are, at a minimum, 18 million fewer insured persons in this country than there were in 2000. In fact, the truth is that there are 12 million more insured persons in this country vs. 2000 (249.8 million vs. 237.8 million from 2000). So I was wrong about the possible source, but it really doesn't count when you were wrong about the fact in question.

As far as where I get the "goofy" number, it comes from "Table 6.People With or Without Health Insurance Coverage by Selected Characteristics :2005 and 2006.", located on page 21 of the U.S.Census Bureau's report: Income,Poverty,and Health Insurance Coverage in the United States:2006. If you are aware of a less goofy source of data, I'd be more than happy to challenge the data.

Finally, it is no accident that whoever picked that soundbite for NPR chose 2000. Compared to 1998, there are 2.7 million more uninsured in 2007, but that actually represents a decrease in percent of total population from 16.3% to 15.7%.

So, I've totally discredited the NPR soundbite. Does that mean there isn't a heathcare cost and insurance issue? Absolutely not. Just that you should always be wary of the agenda of the person giving you statistics, and that if you are going to quote them, you should understand them first.

And to your original point, statistics don't mean sh*t when you're trying to provide decent coverage to your employees.

[XUglow]

As far as where I get the "goofy" number, it comes from "Table 6.People With or Without Health Insurance Coverage by Selected Characteristics :2005 and 2006.", located on page 21 of the U.S.Census Bureau's report: Income,Poverty,and Health Insurance Coverage in the United States:2006. If you are aware of a less goofy source of data, I'd be more than happy to challenge the data.


KK, I think that if you examine the numbers on that table more closely, you will see why I called them "goofy". Using the absolute numbers and percentages, the number of persons living in households that make $75K or more went from 102.4M to 109.2M. The number of persons in to $50K to $75K range went from 58.8M to 58.7M. The number of persons in households from $25K to $50K went from 72.9M to 72.6M. The number of persons in households below $25K went from 59.7M down to 56.2M. These numbers do add up to 293.9M in 2005 and 296.7M in 2006.

The $75K crowd increased 6.8M. The number of insured increased 6.1M, so the delta is 700K that are uninsured. The $50K crowd dropped 100K in population. The number of insured droped 1.1M, so this group increased the uninsured ranks by 1M. The 25K crowd went from 72.9M to 72.6M. The number of people dropped 300K, but the number of insured dropped abour 950K, so this group added 650K to the uninsured ranks. The sub-25K group went from 59.7M down to 56.2M. That is a drop of 3.5M people with a drop of 3.2M insured meaning there are 300K more insured than before. The bottom line is that we added about 2.8M people and increased the number of insured by only 800K. That is not a good thing.

NPR is pretty good at correcting misinformation. I sent them an email with what I found, and they have responded that they are researching the numbers and certainly will set the record straight. They did say that the numbers I heard were provided by a guest and that they had no way to refute or substantiate his claims at the time. He was an Obama supporter, and I am "sure" that the year 2000 was totally chosen at random.

[Kahns Krazy]

Are you mixing numbers from 2 different tables? I can't find the numbers (specifically the 102.4M and 109.2M) you are referencing.

I was looking at the part of the table that shows the following information about the gross number of uninsured:


Household Income 2005 2006 Increase
Less than $25,000 14,452 13,933 (519)
$25,000 to $49,999 14,651 15,319 668
$50,000 to $74,999 7,826 8,459 633
$75,000 or more 7,886 9,283 1,397
Total 44,815 46,994 2,179


Part of the discrepancy could come out of the fact that "institutionalized" persons are not included in the population for the health insurance portion. This is rather peculiar as it ignores the Nursing Home population.

[XUglow]

Using simple math... they give the number and percentage. Dividing one by the other gives the total.

[Kahns Krazy]

They give you the number. Using a rounded percentage (especially ones as low as 7.7 and 8.5) is likely giving you an incorrect total population number.

The chart shows that the population of $75k+ increased by 7.5 million, not 6.8 million. I don't get your exercise of trying to recalculate numbers they provided.

Using simple math only provides you with a range. The data says that 7,886,000 represents 7.7% of the total population. From this, you can only determine that the population is somewhere between 101.8 million and 103.1 million, not that it is in the exact middle of that range.