Pros And Cons Of Healthcare

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04-09-2004, 11:27 PM
vidcc

As requested (and not in the talk club because someone had a close call :D )

There has been a lot of dueling from both sides of the pond as to who has the best system of healthcare, social payed by tax or private paid by the individual.
We all know that both systems have benefits and both have down sides. Social has the advantage of free healthcare for all at point of service (it's not free because it's payed by tax, before the point is raised) However it has problems of being overstretched and could be run more efficiently. There is a lot of beurocratic red tape that clogs it down and as time passes there will more people retired than working and taxes will have to be raised to meet the extra costs.
My parents live in the Uk and my father has heart problems...he has to wait anything upto 3 months to see the specialists then more waiting for appointments for tests...then more waiting for the results then more waiting to see the specialist to decide the next course of action ( he had an operation...it was cancelled 3 times because of lack of beds)

The private system in the USA has the advantage of no waiting for treatment and most hospitals and clinics are as modern as they can be.....The downside is that it cost big time. Insurance premiums are rising fast and the drug companies charge more here than anywhere in the world. healthcare is not cheap because of competition, rather as expensive as the market can handle. The medical profession is also a powerful lobby in government, the drug companies spend millions each year lobbying our congress to protect their own interests and they are very good at doing so.
I am fortunate enough that i am able to afford full healthcare plans for my family, but millions in the USA can't. Companies are cutting down on benefits to save money and health insurance policies are often very basic.
2 years ago a friend of mines son was badly injured in a car crash (it was his sons fault). With all the treatment he has needed in the recovery the co payment the insurance requires has passed the $100,000 mark and there is still a long way to go. Now there are certain safety nets but they are limited.
On the other side of the fence some areas have a shortage of doctors because of malpractice lawsuits. People that have to pay big time for a service are more likely to sue for the slightest thing and in reaction Malpractice insurance for the doctors has become unrealistically expensive.

What i would like to see is government dealing on the cost of drugs to make them more affordable as they do in Europe and also have contracted medical treatment..the hospitals bid for contracts to treat. This would still keep the American ethic (we do it already with military contracts) but could provide the same high standard of healthcare to all citizens regardless of financial standing.
Of course this would never happen in the USA because there is too much money being made. I am not against profit but i am against profiteering. Another reason is that it would require taxation to achieve it and tax is the dirtiest word in the American vocabulary ( even if they actually saved money because they didn't need health insurance) It also doesn't help that each state is seperate and we seem to like it that way.
As i say it's about pros and cons. Both systems have ups and downs....is there anywhere in the middle that could just use the ups?
04-10-2004, 02:26 AM
hobbes

I think a great start would be the abolishment of lawsuits against doctors. In many countries such is the case, and the doctors there practice no differently.

Lawsuits lead to petty litigation (In the Rio Grande Valley in Texas over 50% of all practicing physicians have a lawsuit pending), deprive health care in rural communities (rural docs cannot afford the malpractice for child birth so people sometimes must travel 100s of miles to give birth), and leads to severe over-utilization of resources. Doctors order thousands of dollars worth of tests because their "training and judgemnet" is not longer good enough in a court of law. So Doctors order expensive tests by some ridiculous protocol to rule out everything under the sun.

Lawsuits also cause intense job dissatisfaction to the doctors themselves, they tend to look at patients as a threat, not an opportunity to heal.

In a case in Florida, an ER doctor ordered an x-ray of himself because he had a cough. He kept the film himself, put it in his pocket and never showed it to the radiologist. When he died of the lung cancer he missed 2 years later, the family successful won a lawsuit against the hospital for missing his diagnosis. This case is extraordinary, but the reality is that insurance companies will often settle out of court with people just to avoid the cost of a lengthy trial. Whether the doctor is in the right or not is irrelevant, it is about cost management. Imagine being a doctor, who has done everything right, who now must explain every year how he is a bad doctor to the State Board and why he is listed in a book of "naughty doctors".

There are too damn many lawyers and to compensate for this they have created a niche of medical malpractice. The back of the "Yellow Pages" I am holding is covered with ads from these fuckwits.

Sure "bad doctors" would find a way to screw people over without lawsuits, but these same people are doing it now anyway and the decent docs out there are paying for it.

Our healthcare system is in a state of emergency. If you are broke, you get your care for free. If you have a medical condition, you are uninsurable. If you are uninsurable and have a job and get sick, the hospital bill will break you.
04-10-2004, 02:40 AM
Busyman

"Abolishment" of lawsuits?

So 'bad doctors' would have no repercussions for making a horrible decision?

We need screening for all lawsuits not abolishment.

If a decision makes an obvious boneheaded decision that causes dain bramage to a newborn, he should be liable.

There are good malpractice lawsuits hobbes. (there are doctors on illicit drugs for god's sake)

Your proposal is to throw them all out because most are unwarranted.

You left out a solution to hold these bad doctors liable.
04-10-2004, 03:27 AM
hobbes

Quote:

Originally posted by Busyman@10 April 2004 - 03:40
"Abolishment" of lawsuits?

So 'bad doctors' would have no repercussions for making a horrible decision?

We need screening for all lawsuits not abolishment.

If a decision makes an obvious boneheaded decision that causes dain bramage to a newborn, he should be liable.

There are good malpractice lawsuits hobbes. (there are doctors on illicit drugs for god's sake)

Your proposal is to throw them all out because most are unwarranted.

You left out a solution to hold these bad doctors liable.

Absolutely not, it is the job of the American Medical Association to police itself, as it is in the best interest of the medical field to weed out those who would undermine it's credibility. Integrity, credibility, and confidentiality are the sacred cows of the medical field, because doctors want you to throw yourself trustingly into their arms and say, "do whatever you need to make me better", and not for one second fear that you are being fleeced by some white-coated used car dealer. The AMA is the one who creates the "bad doctor book", not the courts/legal system. These are the guys to whom you have to answer to every year.

If you're going to be black listed, this should come from patient/family complaints that are motivated by neglect/incompetence, not out of a desire for monetary gain. If the monetary gain is ousted, then only those who feel that they have a real complaint will take the necessary time to file charges.

I already discussed the huge number of frivilous lawsuits, but in those where big money is involved and the case goes to trial, the doctor gets screwed again.

Before the jury we wheel the plaintiff who has had some bad shit happen to him and the jury can see this. The prosecutor is ideally out to prove "overt neglect", not bad luck or even a bad decision, but the truth is that the jury makes the decsion based on, "Well, he is paralyzed, and doctors are rich, so why don't we just give him a break". This is the sad reality. Have you ever been on a jury, it is scary to listen to what happens in the deliberation room.
04-10-2004, 11:34 AM
Rat Faced

Much as this thread is useful, i think my initial post was mis-interpreted.

I had asked how the USA was spending twice the GDP as the UK (13.8% v 7%) on health, and ALSO had to pay for Healthcare in the form of private insurance.

If you take that into perspective, the USA economy is half of the worlds economy; ie immeasurably larger than the UK's, whilst the population is only 5- 6 times as large I believe.

This means that the amount the US government spends on Health should be giving you a Free Health Service far better than anyone elses BEFORE Private Medical Insurance is taken into account.

I wasn't asking which system was better; i was pointing out that someone, somewhere, was being ripped off.

There is nothing wrong with Private medicine as is the US system. We have it here too, we dont have to go through the NHS. However the insurance premiums I would pay for Private Medical Insurance here are far cheaper than the equivalent over there.

This is a reverse of the usual situation.

Most things on the shelves are half the price of the UK or cheaper in the USA (offset by the fact that our salaries are larger, so as % of income its probably about the same)

As to law suits, in the UK I believe its the Hospital that gets sued and the Hospital refers the Dr to the apropriate Medical Authorities to see if they were negligent. Unless its an open and shut case of negligence no-one wants to be seen to be sueing a Hospital, as they are already under funded.

This appears to be changing as the "Sue Everyone" mentality is also moving across the Atlantic, however suing because an operation left a scar (I heard about some US case for that, believe it or not) would be laughed out of court. Our Lawyers would be happy to try though, im sure.

If we lynched the Lawyers, most problems would be solved.
04-10-2004, 04:05 PM
vidcc

Rat ...yes you did make that point but i am trying to get the ultimate answer because in so many other topics both sides have flamed the others system. :D

In response to your question though, you have already answered it..being ripped off. (i kind of touched on it myself in the first post
just one example

Why does the government pay so much for so little?

We have a safety net for those that can't afford medical treatment (you have to qualify )...it's called medicare. Congress has repeatedly refused to deal on the prices charged by the medical field and therefore the tax payer pays top dollar ( as i said there is a very powerful lobby to keep prices and profit high. We already deal with contractors for military contracts to get the best price but the lobby for the medical companies has hypnotised our congress into thinking it would be against the american way to do it for healthcare.
We are at the mercy of private industry which need to make a profit....and they make that profit well...anyone with a Drug company in their portfolio will always get a nice return.
04-10-2004, 04:58 PM
Rat Faced

I agree, the US citizens are paying way over the top for Drugs, however that only accounts for approx 10% of US Government spending on Healthcare.

Quote:

Nor does it help the millions of working people not eligible for Medicare coverage. As health-care spending keeps rising, (9.3% in 2002, according to the trade journal Health Affairs, the largest increase in 11 years) and employers tighten their coverage to cut costs, consumers have grown more resentful of what they are paying at the drugstore.
While prescriptions represented only 10.5% of total health-care costs in the U.S. in 2002, they amounted to 23% of out-of-pocket costs for the consumer.
Americans spent $162.4 billion on prescription drugs in 2002, up from less than $100 billion a decade ago.

If we discount every cent the US Government pays for Medicare drugs then, the GDP falls to 12.3%.

I say again, that is still almost twice the GDP of countries that provide Universal Free Health Care (including Drugs).

Where is the money going?

Obviously not to the American citizens..they still have to pay :blink:
04-10-2004, 05:26 PM
vidcc

that was just about the cost of drugs......

medicare is charged top $ for medical services as well and as stated before a doctor will send you for all the tests under the sun, not always, but often...and the tests cost top $ which is all billed back to medicare.
I can't account for every cent spent, there must be waste in red tape as well, but you get the picture ?
04-10-2004, 07:08 PM
hobbes

Rat,

It is the lawyers, who have created a entire section of law dealing with personal injury, which introduce incredible waste into the system.

They turn a routine visit to the ER which could have been handled with a bandage and a pat on the back, into extensive laboratory and radiologic evaluation to objectively document everything.

Lawyers have a very helpful role in protecting our assets and have done a good job in discovering nursing homes which are collecting oodles of money and abusing their patients. You must understand that nursing homes are run by "business men", not doctors. But in regard to ambulance chasing, they are nothing but leeches.

http://www.graphicsguy.org/gallery/v..._samtd2003.jpg

Do you like the name, "Welmaker", give me a break, how nauseating. That advertisment cover the entire back cover of the Yellow Pages, which is in every household in San Antonio.

These people come onto TV soliciting viewers to sue anyone and everyone. They don't wait to be contacted, they actively encourage lawsuits.

Imagine if doctors were to start a media blitz?

"Do you have a small cancer which might be curable if you get a whole body CT scan now? Can you afford not to you know? Can your family?" /cut scene to girl crying at Daddys funeral.
04-10-2004, 07:20 PM
vidcc

Quote:

Originally posted by hobbes@10 April 2004 - 11:08
Imagine if doctors were to start a media blitz?

"Do you have a small cancer which might be curable if you get a whole body CT scan now? Can you afford not to you know? Can your family?" /cut scene to girl crying at Daddys funeral.

we already kind of get that with prescription drug adverts on the TV...."if you get ******* (symptoms) ask your doctor if ****** is right for you" so your point is kind of scary :o :D
04-10-2004, 07:25 PM
hobbes

Quote:

Originally posted by vidcc+10 April 2004 - 20:20--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (vidcc @ 10 April 2004 - 20:20)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-hobbes@10 April 2004 - 11:08
Imagine if doctors were to start a media blitz?

"Do you have a small cancer which might be curable if you get a whole body CT scan now? Can you afford not to you know? Can your family?" /cut scene to girl crying at Daddys funeral.

we already kind of get that with prescription drug adverts on the TV...."if you get ******* (symptoms) ask your doctor if ****** is right for you" so your point is kind of scary :o :D [/b][/quote]
Drug companies are not doctors and anyway most of the ads say "if you feel like shit, ask your doctor if this drug may help", not "take this drug or you might just drop over dead".

What I find strange about some drug ads is that they never tell you just exactly what the drug is for. They never mention during the ad what is for, sour stomach, anxiety, depression, who knows?

Doctors are doing nothing to scare people, lawyers are filling the TV set and printed media with their "call to sue". There is no comparison.
04-10-2004, 11:48 PM
Rat Faced

Ah, so im right.

If we Lynch the Lawyers everthing will fall into place.

Seems that is the answer to most of the western worlds problems ;)
04-11-2004, 12:24 AM
vidcc

Quote:

Originally posted by Rat Faced@10 April 2004 - 15:48
Ah, so im right.

If we Lynch the Lawyers everthing will fall into place.

Seems that is the answer to most of the western worlds problems ;)

not sure if it will work.....but it's worth a try :lol:
04-11-2004, 12:39 AM
hobbes

Quote:

Originally posted by vidcc+11 April 2004 - 01:24--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (vidcc @ 11 April 2004 - 01:24)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Rat Faced@10 April 2004 - 15:48
Ah, so im right.

If we Lynch the Lawyers everthing will fall into place.

Seems that is the answer to most of the western worlds problems  ;)

not sure if it will work.....but it's worth a try :lol: [/b][/quote]
What do you call 10,000 dead lawyers at the bottom of the ocean?

A good start.
04-11-2004, 04:18 AM
{SHELL%SHOCKED}

Obesity leads to increased medical problems that come on spontaneously like heart attack and stroke. Those unplanned medical procedures for saving life's cost many times more than preplanned medical procedure like for example angioplasty to increase blood flow in clogged arteries instead of on the spot open heart by pass.
04-11-2004, 07:23 PM
vidcc

Quote:

Originally posted by {SHELL%SHOCKED}@10 April 2004 - 20:18
Obesity leads to increased medical problems that come on spontaneously like heart attack and stroke. Those unplanned medical procedures for saving life's cost many times more than preplanned medical procedure like for example angioplasty to increase blood flow in clogged arteries instead of on the spot open heart by pass.

i can't deny your statement, however obesity and it's side affects is not unique to the USA so it would be included in both systems.
We are looking at the pros and cons of each system of healthcare
04-11-2004, 08:00 PM
{SHELL%SHOCKED}

Quote:

Originally posted by vidcc+11 April 2004 - 19:23--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (vidcc @ 11 April 2004 - 19:23)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-{SHELL%SHOCKED}@10 April 2004 - 20:18
Obesity leads to increased medical problems that come on spontaneously like heart attack and stroke. Those unplanned medical procedures for saving life's cost many times more than preplanned medical procedure like for example  angioplasty to increase blood flow in clogged arteries instead of on the spot open heart by pass.

i can't deny your statement, however obesity and it's side affects is not unique to the USA so it would be included in both systems.
We are looking at the pros and cons of each system of healthcare [/b][/quote]
Yah, that was more less a theory why the US spends a larger percentage of the GDP on health care, that's a result of having immediate spontaneous medical care supplied by the free market profiteering medical corporations. In countries were were medical care is more "socialized" or distributed uniformly from class to class or blind to socioeconomic status. A lot of medical care is not spontaneous or hard money "bribes" can't get you to the front of the line, individuals are more inclined to practice preventive medical care opposed to emergency medical care, using the "Heart Attack" example a patient caused that health crises that was years in the making in "Most" cases but not all.
04-11-2004, 10:16 PM
Biggles

To me the main pro of a tax based system is that it is open to all and there are no exclusions should one develop an illness.

An insurance based system by definition involves an insurance company. These tend to limit their risks by not insuring those with poor health, dangerous hobbies and/or work etc.,

At the end of the day an insurance premium is no different to taxation - it is money you can't spend on anything else.

The difference in spending in the UK and the US is two fold.

Firstly, as has been pointed out, buying branded drugs is expensive (where possible the NHS uses generic ones) and..

Secondly, we have not bit the bullet and spent the amount needed to get up to speed with other NHS's in Europe; such as Germany and France. There needs to be a rise in taxation to do this, but "no increase" has become a sacred cow in the UK worshipped by al parties.

I have looked at private insurance and it is damned expensive - a tax based system is both fairer and keeps the "profits of doom" (apologies to Big Boab for this shameless pun) out in the cold.

Rat Face

The Purchasing Power Parity indicator for the US and the UK at 1999 figures were $8.51m and $1.25m. The EU, as an economic power, has about parity with the US (it just needs to get it's act together) and China is currently about 50% in comparison to both the latter (but rising fast).

The Parity indicators are better because GDP per head has small but incredibly wealthy places like Luxemburg and Bermuda as 1st and 3rd (which whilst interesting does not actually tell you much).

Edit: Found 2003 Total GDP figures,

US $10,400,000,000,000
UK $1,520,000,000,000

(Source: CIA World Fact Book - any errors take it up with them)

The UK is a bit behind the US but not bad when adjusted for population - so the original disparity in Health Care spend question stands.
04-12-2004, 01:51 AM
hobbes

Quote:

Originally posted by {SHELL%SHOCKED}+11 April 2004 - 21:00--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE ({SHELL%SHOCKED} @ 11 April 2004 - 21:00)</td></tr><tr><td id='QUOTE'>

Quote:

Originally posted by vidcc@11 April 2004 - 19:23
<!--QuoteBegin-{SHELL%SHOCKED}

Quote:

@10 April 2004 - 20:18
Obesity leads to increased medical problems that come on spontaneously like heart attack and stroke. Those unplanned medical procedures for saving life's cost many times more than preplanned medical procedure like for example angioplasty to increase blood flow in clogged arteries instead of on the spot open heart by pass.

i can't deny your statement, however obesity and it's side affects is not unique to the USA so it would be included in both systems.
We are looking at the pros and cons of each system of healthcare

Yah, that was more less a theory why the US spends a larger percentage of the GDP on health care, that's a result of having immediate spontaneous medical care supplied by the free market profiteering medical corporations. In countries were were medical care is more "socialized" or distributed uniformly from class to class or blind to socioeconomic status. A lot of medical care is not spontaneous or hard money "bribes" can't get you to the front of the line, individuals are more inclined to practice preventive medical care opposed to emergency medical care, using the "Heart Attack" example a patient caused that health crises that was years in the making in "Most" cases but not all.[/b][/quote]
I have never heard of "free market, profiteering medical corporations". What are you talking about.

Most people without means us the E.R. as their "family practictioner" for even the most minor of injuries. Sometimes they are covered by Medicare or Medicaid and the hospital gets some compensation for its' efforts, but most is a total loss.

To cover their asses, doctors order a slew of labs and imaging studies because although they may or may not be compensated for the treatment, they most certainly might get sued. This drives cost up considerably.

The irony is that people with nothing get the best care, and those who are able to afford insurance, pay out the ass because the hospitals are trying to get some money for all the people who can't pay.

That is the insanity of the American market, the middle class, through their insurance premiums is having to pay for all those who can't afford insurance, can't pay their bills, and essentially get their healthcare for free.
04-12-2004, 09:54 AM
Biggles

Hobbes

It has to be said that the system you describe sounds awfully like a tax.

On the basis that, if looks like a tax and sounds like a tax, it probably is a duck. ( :blink: - or something like that).