Health care shmelf care

jmpoet

Invader
Anybody besides me understand that we are all being screwed and ripped off?  Because health care insurance prices continue to go up with zero government oversight?  Because we are told our health care will be rationed under the governments eye, when in actuality, the rationing under private health care has already been proven deadly for years now.  (IE:  No, you can't have health care insurance!  You're too sick!)

Insert sob story here - there are too many to count:  Out here in Cali, , about early 2008 or so, a young woman was very ill, needed a liver transplant.  Cigna (my health insurance company by coincidence) actually made it on the news because people were standing with placards and marching and protesting outside their offices because they refused to cover her transplant, which was recommended by her doctors -- they did have a liver available.  Cigna Health Insurance (a cold piece of work if ever there was one) said they refused the transplant because she would not have lived that much longer with or without it.  She died.  She was 17-18 years old at the time.  They are probably still in litigation with the family. 

That is called rationing health care by a 'death panel' for lack of a better term, not on a government board, but a panel employed by a health care insurer to cut their costs, and decrease their risks.

All the costs of this type of litigation is passed on to the consumer through higher insurance costs.  Litigation is by far more expensive than a liver transplant. 

Also, anytime someone walks into an emergency room who cannot pay, the costs get passed along to the taxpayer.  Public hospitals rarely operate in the black, they are often in debt, and that cost gets passed along to the taxpayer.

When someone says how will we pay for health care, I say, we already are, guys!  But no one has given you or me the fineprint to read about what really happens to tax money as related to health care in America.

I do not think what's going through Congress can help us.  They've compromised us into the dust bin yet again, and fed corporate pharmaceutical and health care insurance interests yet again. 

And all we have is some lousy vote, which isn't much compared to millions of dollars in lobbying money being spent to create roadblocks for everything that might be a good idea.  Funny how legislation in America is paid for and sponsored by lobbyists, and much of it isn't in the public interest.

Someone on another post has mentioned the cost.  Actually the cost of the debate thus far could have covered a few million people for their lifetime and that of their progeny.

The healthcare and pharmaceutical industries spend probably together around a hundred million dollars a year on lobbying, if not more.  How much did they spend defeating Clinton's health care initiative?  They could have covered a few more million people, for life.

Everything costs, but honestly, the only health insurance card you should need here is your social security card.  It's too bad nothing is that simple.
 
jmpoet said:
I do not think what's going through Congress can help us.  They've compromised us into the dust bin yet again, and fed corporate pharmaceutical and health care insurance interests yet again. 

We don't know exactly what's going through Congress yet. There are now 5 plans from committees that have to be combined into one bill both House and Senate can agree on. This is still going to be a long and bloody fight, since the Senate won't pass a public option, while Pelosi insists the House will.

The Baucus plan is a killer though, as is any plan with both requirement for everyone to buy insurance + no public option to keep costs down. The government is on the edge of legally requiring everyone to buy insurance that even the government admits is broken. Buy crap, pay out the nose for it, or go to jail.

As a mod, I'm on the fence about merging this with the US Politics thread. This is a big enough issue, maybe it deserves its own thread. We'll wait and see what the other mods think.
 
Well, some were commenting on health care in the Barack Obama & the Nobel thread, so I thought that everyone might want to open up the discussion a little more. 

I did see the US Politics thread and have read some of it to keep up, but my rant didn't seem to belong.  :)  Whatever you guys would like to do.

Maybe nobody will add to this cause I wrote so much of a book, as usual.  Well, I'm not a Twitterer, that's for sure.

You know, I realize there will be several bills coming in for a vote but I'm afraid also.  Baucus is a stooge for industry.  Many of those in Congress take campaign contributions from heallth care lobbyists, but he is one of the worst.  It's pretty similar to good old fashioned nepotism, letting someone run a committee when his interests and that of the legislation being written supposedly for the public good are compromised and in direct conflict.
 
I just have one thing (left) to say.  There are two problems with American health care that I can see: pharmaceuticals and insurance.  As I've stated in the US Politics thread, why is Obama not reversing the government endorsed and enforced monopoly that pharmaceutical companies currently have?  Because they contributed to his campaign.

I'm not sure how insurance runs, but if it is anything like car insurance in Ontario, it can't be good.
 
I have to be honest, I'm pretty much as fence sitter as a presidential candidate- I don't know the right path.  I think the decision to have 'universal health care' (or whatever name you want to put on that face) is one that can't be easy.  It, to me, is like choosing between a capatilastic economy and a socialist one (yes, I realize there are more differences than that-- i'm generalizing).  The thing that most people tend to forget is that, as of now, health insurance is a privelage, not a right.  And, it is a business, not a food kitchen.  Just because a person wants to have health insurance, because they are sick, doesn't mean they should have it-- why would an insurance company do that?  That's like buying a car saying "sell it to me for $5k, instead of the $35k it costs you...".  Its not a cool thing, but they have to make enough on premiums to cover the coverage-- its not a bottomless vat of cash.  Now, I'm not saying it isn't out of control; it is a crazy system, and there isn't much for bargaining the price down (yes, unlike a car).  However, we are playing under current rules in our capatalistic society.  I have stated this before, but what happens when we get this bill passed?  Currently, I am 'self insured' medically-- I'm healthy, and I choose to not participate in risk sharing (my premiums would go to pay for the sick dude, so it doesn't benefit me).  So, lets say that they pass the bill, and I have free health insurance-- then my taxes go from 25% a year to 45% a year... and I still don't need to see the doctor.  So, I'm giving up an extra 20% a year to cover the guy that is making $7 an hour at McDonalds, cause he didn't want to work a full 40.  Then, just like social security, I find out in 7 years, they have spent all the money that I gave them.  So, I have lost the money, and I have lost the ability to get health care.  And, to make matters worse, Pfizer has shut its doors, because there is no more profit in finding a cure to whatever ailement they could have found the cure for.  Yes, that is extreme, and it is kinda cold sounding, but, again, Pfizer isn't in this business because they have a soft spot for people that can't get an erection-- they want to make money, because our economy said 'Hey, have a dream, find something that you like, are good at, or whatever, work your ass off, and make some bucks at it.' 

It does need an overhauling, it does need some 'oversight'... and I have said before, I don't like the 'death panels' that are out there.  But, having the gov't control health care isn't any better than having them own a car mfg.  Congress is pretty good at making laws, cause they went to school to learn to be atty's-- that doesn't necessarily make them good business men, or health care experts. 

This may sound like a rant; I'm not totally against a universal health care system-- I just want it done correctly, and I'm willing to wait for it.
 
Wasted CLV said:
capatilastic

Wasted CLV said:
capatalistic

Sorry, had to quote these, because they sounded funny. :)

But I seriously wonder if things will turn out that bad for you. Please post it in a couple of years and we'll see if these dark omens will become reality.

And universal health can work, at least it does in other countries. If it's done well of course. I'd say, take inspiration from the Dutch model, because ours is the best of Europe for the second year in a row.

The following was said last November and I doubt there's much reason to change this:
Intriguingly, HCP President Johan Hjertqvist urged the future Obama administration in the US to take their cue from the Dutch in healthcare reform: "It is justified to say that the Dutch have the best healthcare system in Europe. When the Obama healthcare policy team looks at Europe for inspiration, it seems to be the right system to study."

So, if you guys are interested to see how this system works, do check the link.
 
Wasted CLV said:
I have to be honest, I'm pretty much as fence sitter as a presidential candidate- I don't know the right path.  I think the decision to have 'universal health care' (or whatever name you want to put on that face) is one that can't be easy.  It, to me, is like choosing between a capatilastic economy and a socialist one (yes, I realize there are more differences than that-- i'm generalizing).  The thing that most people tend to forget is that, as of now, health insurance is a privelage, not a right.  And, it is a business, not a food kitchen.  Just because a person wants to have health insurance, because they are sick, doesn't mean they should have it-- why would an insurance company do that?  That's like buying a car saying "sell it to me for $5k, instead of the $35k it costs you...".  Its not a cool thing, but they have to make enough on premiums to cover the coverage-- its not a bottomless vat of cash.  Now, I'm not saying it isn't out of control; it is a crazy system, and there isn't much for bargaining the price down (yes, unlike a car).  However, we are playing under current rules in our capatalistic society.  I have stated this before, but what happens when we get this bill passed?  Currently, I am 'self insured' medically-- I'm healthy, and I choose to not participate in risk sharing (my premiums would go to pay for the sick dude, so it doesn't benefit me).  So, lets say that they pass the bill, and I have free health insurance-- then my taxes go from 25% a year to 45% a year... and I still don't need to see the doctor.  So, I'm giving up an extra 20% a year to cover the guy that is making $7 an hour at McDonalds, cause he didn't want to work a full 40.  Then, just like social security, I find out in 7 years, they have spent all the money that I gave them.  So, I have lost the money, and I have lost the ability to get health care.  And, to make matters worse, Pfizer has shut its doors, because there is no more profit in finding a cure to whatever ailement they could have found the cure for.  Yes, that is extreme, and it is kinda cold sounding, but, again, Pfizer isn't in this business because they have a soft spot for people that can't get an erection-- they want to make money, because our economy said 'Hey, have a dream, find something that you like, are good at, or whatever, work your ass off, and make some bucks at it.' 

It does need an overhauling, it does need some 'oversight'... and I have said before, I don't like the 'death panels' that are out there.  But, having the gov't control health care isn't any better than having them own a car mfg.  Congress is pretty good at making laws, cause they went to school to learn to be atty's-- that doesn't necessarily make them good business men, or health care experts. 

This may sound like a rant; I'm not totally against a universal health care system-- I just want it done correctly, and I'm willing to wait for it.

Oh good gawd, Wasted, people go on about capitalism because they think America is the get-rich-quick society.  We've been taught to believe this bull but it's all brainwashing from a young age.  Few actually get rich.  Most only just do okay.  But look at the truth of the country, not the propaganda about what America is supposed to be. 

Like the whole thing of it being a free country, right?  No, it way is not free, bro.  The middle class bears the brunt of the tax-paying while the wealthy scoot their money away in tax shelters overseas.  But then we are told, and you believe, that health care, along with clean air, clean water, and good roads and bridges are not a right, but a priviliege.

To go to a doctor when you are sick, or for preventative care before you get sick, is a right, so is clean air and clean water, and yes our taxpaying dollars should also take care of the infrastructure in this country, which is falling apart. 

It's a right to see our taxpaying dollars used for the good of the people in this country (instead of another fighter plane for the Pentagon that costs $100 million dollars each) and for government to be accountable for such expenditures, preferably through systems that will negotiate the lowest prices --  But what do things cost?  Am I being ripped off when my health insurer raises our rates again next year for the umpteenth time?  How would I know what fair cost is when there is nothing to compare it too, and when there is no law protecting me as a consumer if I try to shop around for health care?

And while as a consumer, I have very few ways to protect myself from overpaying for health care, top executives in the health care industry make millions in bonuses every year, there's you're 'bottomless vat of cash' so obviously what they charge for a premium does a little more work than just pay for a person's health care.

And obviously our health care isn't going to win any prizes.  I wish we did things like the Netherlands, Forostar!  I wish corporate interests were not so entrenched in the US that the practicality of a human being's health care became impossible.

If you don't have some kind of health care, Wasted, and you have an accident or you get sick, who will pay?  The taxpayers will pay, ultimately, because you may not decide to pay the bill yourself, and for a simple broken bone, you're looking at probably tens of thousands of dollars.  I know that my sinus operations cost about $17, 000 each, both were covered though, and two guys from work both had appendectomies, cost: somewhere around $100,000.  Can you afford anything like this?  Hospitals turn to state and local governments to pay bills, that's how they survive, when people do not pay their bills. So taxpayers ultimately support the system in all different ways, in all different directions, no matter how you look at it.
 
So, one question I would ask is this:  How much have you paid in premiums?  Was it enough to pay the $17k?  And, yes, I know exactly how much broken bones cost.  I paid 10K for my daughters arm, and around 3-4k for each of my son's.  And pay I did.  And, no, the tax payers don't always pay for the debts that un-insureds don't pay.  The people that pay their bills (me and insurance companies) pay those amounts.  Doctors pad their bills by an extra 25% and more, to account for the people that they know won't pay the bills.

Now, as to the 'rights' we have as citizens; I don't know how it is that all these things are rights for us.  Right to free speech?  Yep.  Freedom of religion?  you betcha.  Right to keep and bear arms-- sure thing.  However, just because we want health care, preventative medicines, clean water and the like, it doesn't make it a right. 

Back to your comparison of fair cost:  if the health care coverage the company pays is greater than the premiums you pay in, its a bargain.  Don't believe that once the gov't gets ahold of your extra 20% a year, that it is going to be cheaper than the premium you pay now.  I'm always amazed when a person gets insurance, pays $100 a month, then after 8 months has a $15k claim, then gets upset at their premiums going up.  Its no different than auto insurance; you have an accident and your auto premiums go up-- you have a house fire and your homeowners ins goes up.  People can't look at health insurance the same way as other insurance, tho it is the same setup. 
 
I don't know what you'd be paying for a family.  I'm thinking somewhere around $300 bucks a month, or maybe $3000 a year, with a halfway decent carrier.  I don't know, it could be more.  I don't have kids. I think insurance would pay for itself if something big happens.

But not too many people would want to make those expenditures that you did out of pocket because they simply don't have the money.  and what happens if you didn't have the money for some long term illness?  Not wishing that on anyone.  But the hospitals or doctors would sue, and you, or anyone stuck with big bills from medical emergencies, could lose their home, all their savings.  Having no insurance is a disaster waiting to happen.

Sure those sinus surgeries I had were $17,000 each, that's $34,000, plus I had thyroid cancer years ago.  I wouldn't have been able to afford the cost of the surgery to remove the cancer and the following radiation treatment.  I've never seen that much money in my life, and yeah that was a minor cancer too.  So, i'd have to admit, I've gotten the money out of my premiums over the years.  I'm the kind of patient they hate, probably.  I cost too much.  And since I've had cancer before I'm sure the health care insurer wouldn't want me around at all as a client. If I didn't have insurance through work, it would be tough for me to get insured on my own.

I think that the greater problem here is the bottom line cost of everything.  How do I know a sinus surgery costs so much?  Some other country maybe it would have been half that cost. There's got to be more accountability here, more oversight for healthcare costs because it just can't keep going up.  It's an impossible situation.

But given the taxes we pay in this country, I'd say that I do have a right to clean water and air (look at it this way - why does a corporation have the right to dump poisons into the atmosphere and into the water systems of this country?) as do all the children growing up in this country.  Health care is a right -- how in a civilized country do you just let people die if there is the medical technology to save them? How can you say the medical technology is only meant to save the lucky few?  I don't think that's what our country would want to be seen as doing, using its economic might to cater to the fortunate ones.  I want my tax money to be spent in a way that will increase the greater good to everyone living here.  To me, that means taking care of the basics.
 
Wasted, we've had the discussion about taxes already, but here's my thought on the subject: the US's socialized health care (Medicare and Medicaid) already uses more of your tax money as a percentage than we Canadians pay.  Canadians pay 10.1% of their taxes on health care; Americans spend 16% of their taxes on health care.  That's why getting costs under control is important.  Medicare is sucking the cash out of the government, because health care costs are just more than they are in the rest of the world.

Prescription drugs, for example, are costing 3-4x as much in the States as they do in Canada.  How much do you think that costs the federal government each year, considering the majority of all prescription drugs sent out in the USA are to seniors?  And that's just one example.  Single-payer systems have traditionally reduced health costs.  In the US, I don't think this will be the case; I believe it's more likely that you'll need a strictly regulated private insurance industry...which will also reduce the costs.
 
Oh, you are right, we have spoken of taxes and costs-- I've probably come off sounding really cynical about the government, taxes, and health care.  I know there is a huge mess out there, starting with health care costs.  Mostly, what I am wanting is for the gov't to take it slowly, rather than quickly-- there is this desire out there to have government health care NOW and that will solve our problems.  However, without reigning in health care costs first, its going to fail-- badly.  I know, I have seen, how doctors have different scales for charging fees, based on who the health provider is-- my local doctor charges me one fee, for having no coverage, another fee for insureds, and yet a third fee for medicare/medicade.  Milking?  probably.  Some doctors won't take medicare/medicade, because the fees they are allowed to charge are less than what they can charge to privately insured clients.  Its messed up, and it needs work, but a universal health care system won't fix it if the 'base' isn't worked over first. 

Now, having said that, I also don't want to see the gov't just roll in and tell physicians what they can charge.  There is a reason that some doctors cost more than others-- they should!!  The more time, money, energy, and genious that a person has in their field should be rewarded.  If I need stitches, the local doctor and $60 bucks is fine.  However, for when my daughter broke her arm and split her growth plate, I had no problem driving 2 hours away to find the best doctor to operate and fix it.  I'd have saved a good $3k to stay local, but this way, it was fixed right. 

So, for me, its a giant mess that needs to be fixed from the bottom up.  What I don't know-- and, no I haven't bothered to look-- is why our meds are so much higher than other countries.  I can understand why our physicians can charge more, but I don't know why meds cost so much here vs. 'out there'. 
 
The biggest reason, as I understand it, why health care costs are so huge is because of the 47 million Americans without health care coverage and the 80% of American bankruptcies that are caused by people who have insurance that doesn't cover everything.  To simplify, let's run a scenario.

Wasted, SMX, Perun, LC, and jmpoet live in the United States.  Wasted, SMX, Perun, and LC have insurance.  jmpoet does not.

jmpoet becomes sick and goes to the hospital, and has $10,000 of treatments performed on her.  jmpoet cannot pay for the $10,000 but qualifies for Medicaid.  The government pays this $10,000.

Wasted becomes sick and goes to the hospital and has $10,000 of treatments performed on him.  Wasted's insurance pays for the $10,000.  Wasted's premiums may change a bit but otherwise everything is OK so far.

SMX becomes sick and goes to the hospital, and has $10,000 of treatments performed on him.  However, his insurance has a cap of $5,000 per year.  SMX is now responsible for paying the extra $5,000 himself.  However, he has the money, so it's okay.

Perun becomes sick and goes to the hospital, and has $10,000 of treatments performed on him.  However, his insurance has a cap of $5,000 per year.  Perun doesn't have the money to pay for it, so he borrows the extra $5,000 from the bank.  That's okay.

LC becomes sick and goes to the hospital, and has $10,000 of treatments performed on him.  However, his insurance says he has a pre-existing condition and pays for nothing.  LC has no credit and no money.  He declared bankruptcy.  The hospital is out $10,000.

jmpoet becomes sick and goes to the hospital and has $10,000 of treatments performed on her.  She has no insurance but is covered by Medicaid.  The hospital needs to make up for LC's missing $10k so they charge the government $12,500 because "costs have increased".

Wasted becomes sick and goes to the hospital and has $10,000 of treatments perfomed on him.  His insurance covers it.  The hospital bills his insurance $12,500 because of rising costs.  His premiums rise up more because his health care expenditure has increased.

SMX becomes sick and goes to the hospital and has $10,000 of treatments performed on him.  His insurance covers the first $5,000.  The hospital bills him $7,500 because costs have increased.  He still has the money and it's okay, but he's pissed off.

Perun becomes sick and goes to the hospital and has $10,000 of treatments performed on him.  His insurance covers the first $5,000 but he is billed for $7,500.  Perun is at his credit limit.  He declares bankruptcy.  The bank is out $5,000 and the hospital is out another $7,500.

LC becomes sick and goes to the hospital and has $10,000 of treatments performed on him.  LC is now on medicaid since he's officially poor.  The hospital is now out a total of $12,500, and so they charge the government like $15,000.

You can see where it goes from here.  Costs balloon, all because LC's insurance declared they wouldn't cover him.  Or Perun's got a yearly cap on insurance.  These limitations force more emphasis onto other insurance plans or the government to make up the shortfalls.
 
OK, That part I did/do understand-- and have seen in person.  The part that I really don't understand is how a, for instance, blood pressure pill can cost $10 in the States, and $3.50 in Canada.  Now, I have heard of stuff coming out of other countries that don't contain the same ingredients (heard of viagra coming out of Panama that had concrete powder in it for color).  But, the claim is that meds can be bought in Canada for less.  I know that we have a time frame (7 years I think) for new meds to be marketed before generics can be used-- allowable for the company to recoup the cost of creating the pill.  So, why is the same pill less in Canada?
 
The exact same theory applies to pills as well.  In addition, the pharmaceutical companies won't allow their drugs to be mfg'd by third party companies, which means that they control the amount on the market...thus increasing the cost.
 
So, a pill in Canada is not the same pill as in the US?  Lets say, cialis-- does Canada have that exact pill, and is it less?  Or do you have a pill that is 'similar' and far less expensive. 
 
I don't think you can purchase Cialis in Canada.  But many drugs are manufactured as "no-name" brands by third parties.  IE, company A develops a drug and has a patent for it.  Company A sells the rights for the patent to Company B, who produces the same drug without the name, usually with a profit sharing arrangement.  That way there's the "brand name" drug and the "no name" drug.  Not all drugs do this, especially new ones are very expensive still, but most common drugs aren't.

In the US, companies hold onto their patents, making tiny changes so they retain the sole rights to the formula, this sort of thing doesn't grant an extension on the patent in Canada.
 
Ah, ok, that makes sense.  So when the original patent runs out, Canada can have that pill produced as a generic; a med that is introduced today should cost the same there as here.
 
It will cost less due to insurance ballooning as previously discussed (who do you think pays for the majority of most medications), but yes, the costs will be closer in that situation.
 
LooseCannon said:
The exact same theory applies to pills as well.  In addition, the pharmaceutical companies won't allow their drugs to be mfg'd by third party companies, which means that they control the amount on the market...thus increasing the cost.

George W. Bush received X-amount of dollars in lobbying from Phrma to continue the closed door policy to drugs from other western nations/companies.  I don't recall what the law was exactly, but this allowed them to control the market with higher prices, just like you said.  Obama is doing same by accepting lobbying money and by not wishing to touch this part of health care in his reform bill.  This is part of the 'base' problem that Wasted is talking about I think.  Allowing further competition probably would need changes in FDA rules and regulations, and patent laws. 

I see no rational reason why these pharmaceutical patent laws are so strict.  A lot of medicine that is used in the USA is not necessarily developed in the USA, but yet is imported and the said legal monopoly of Phrma prevents others to compete -- period.

"By eliminating the federal law that gives these manufacturers a monopoly over prescription drug importation, competition will end the discriminatory prices, and the cost of prescription drugs will plummet in the United States at no expense to the taxpayer."

Source.  Notice that not much has changed since this article was written.

Another sobering thought: "At a time when millions of Americans are unable to afford the enormously high prices of prescription drugs, the drug companies constitute the most profitable industry in America - enjoying over $27 billion in profits last year."

I'm not sure where the author got these stats, but I'm convinced that it is a staggering number. 

Allow generic brands and allow drugs from other western countries.  The FDA can't think that Canadian manufactured drugs are somehow harmful, can they?

That should help the pharmaceutical part of health care. 
 
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