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[PatzCU]

I just don't get why America cant go for socialised medicine, you have socialised education ffs and its a lot easier to teach kids yourself than it is to perform open heart surgery on them

Socialized education is a stretch. We have under-funded education for pre-college education; however, once you are finished with high school, you are on your own. State universities can be very expensive.

The US is working it's way towards socialized medicine but we have decades of growing pains to work through first. "Obamacare" is a start with an unbalanced straddle between private and public healthcare. We just need to take baby steps.

 

[frankie_baby]

Yep. When my friend had her baby two years ago, she not only had to pay for herself, the hospital visit, and all of the other costs associated with having a child, but she her child also got charged. She is -still- paying it off two years later and she even had insurance. Shitty insurance, but insurance.

sounds like the childs charges would be very easy to wrangle out of if she tries, delay payment til its 18 then the child can claim it never signed a contract, (I know nothing about us law but got to be worth a try)

 

[remnant]

hospitals have more bargaining power than insurance companies usually because of greater marketshare/monopolies, etc. As for price, the customer doesnt know the price, and most of the time, neither does the doctor. How the hell can we shop for a better price if we don't find out until we get the bill?/

That's my point. We don't know the price because our insurance pays for it.

If more people paid out of pocket, doctors would feel pressure to actually advertise prices imo. With the way things are now, why would they?

A no insurance, out of pocket system would definitely make health care cheaper, but what would you do for people who can't afford healthcare or get a serious health complication that they go bankrupt from it? Its not going to get cheap to the point where its an MRI, CAT scan, and some surgery is going to cost 100 bucks

Make a public system. Have people only get insurance for major shit. I wouldn't mind paying 50 bucks a month for "serious shit coverage" and pay for physicals or normal stuff out of pocket.

If the government has to be involved, do it in a way that makes it easier for people to operate more and more off insurance. We already have medicare. Give americans a HSA and replenish it every year. Have the government negotiate cheaper prices for non-brand prescriptions

Personally, I think it makes a lot more sense to go single payer so we don't have to worry about people becoming bankrupt due to health care costs or have an extreme finanacial burden placed on them just because they were unlucky enough to get sick or injured.

As for the truly poor, well, those people are just going to go to the ER, which will still be more expensive than regular care, won't be able to pay for it, and then the bill will have to be picked up by the tax payer. No insurance doesnt solve that

Single-payer healthcare is expensive. Cheaper than what we currently have, but still expensive.

I believe if we moved to a system where costs are lowered is the forefront of policy, healthcare costs would be cheaper here, and we can set up smaller programs, public options, whatever you want to call it that directly helps the poor without having to increase taxes.

Anyway that is just my opinion. I just hate this logic that is common now that anything in healthcare that isn't the NHS is "free market medicine" when it's anything but, and a lot of the problems can be solved if we moved away from an insurance focused instead of doubling, tripling down on it.

 

[ronito]

But isn't that the fault of the insurance companies. This attitude to abandon even the idea of searching for a better price? This is why i don't understand the love affair with obamacare. We currently have a system where an insurance company or hospital can run up a bill as high as they want, and the consumer is boned. We need to move away from insurance as much as possible, and get more people to pay out of pocket. Not move more and more people into this bureaucracy.

Oh I'm largely no fan of Obamacare. For me the problem is the system, not who pays. In many respects Obamacare will make things worse before it makes things better. But there are some good things that have come of it. Mainly the strive to kill readmissions. Kaiser did this themselves before Obamacare but they largely went about it the wrong way by only focusing on the things that cost a lot and specifically targeting them to cut out while not paying attention to/encouraging things that made them money. That didn't work so well. What Obamacare does differently is that it makes it across the board for everything and essentially states "If you have x% of readmissions you'll get y% lower in medicare payments". By Obamacare coming out and saying this Insurance companies have largely come out and said "Me too." I don't think that's a bad thing. It's changing the way hospital managers think instead of "I need to clear my beds for new patients!" they're starting to think "I need to make sure this person is getting the care they need before they leave."

Sure the customer is boned. And yes, this is tiny, tiny step. But its at least a step in the right direction. My biggest concern about Obamacare is that it's largely preventative. And like anything you do that's preventative that's costly, it is easy to criticize. For example say that a doctor tells you "Take this $100 a bottle medicine and your chances of getting an ulcer within the next 3 years goes down substantially." If you pay the $100 and get an ulcer, even if it's smaller than it would've been otherwise you'll be like "I wasted all that money!" on the other hand let's say you didn't get an ulcer it'd be easy to say "Man, I didn't even get an ulcer and I wasted all that money."

Fact is Obamacare doesn't address the root cause of the problem. As such the problem will still exist even if it's lessened just a bit. For example I remember someone in my company complaining that our insurance premiums went up like 5% last year and they were blaiming it on Obama. Nevermind that nearly every year in the past five years the premiums were going up 10%. I understand that some view it as a foot in the door. I'm not so sure I'm convinced.

 

[frankie_baby]

Socialized education is a stretch. We have under-funded education for pre-college education; however, once you are finished with high school, you are on your own. State universities can be very expensive.

The US is working it's way towards socialized medicine but we have decades of growing pains to work through first. "Obamacare" is a start with an unbalanced straddle between private and public healthcare. We just need to take baby steps.

baby steps are the opposite of what you should be doing, just go for a proper nhs style system in one quick move, rip that plaster off

 

[Alcoholikaust]

Its the price of freedom.

3 back surgerys and a ton of therapy would have cost me $489,000

US AIR Force ate that bill and pays me $2,230.00 a month for the rest of my life!

 

[AstroNut325]

3 back surgerys and a ton of therapy would have cost me $489,000

US AIR Force ate that bill and pays me $2,230.00 a month for the rest of my life!

So the solution to the US healthcare problems is.... YVAN EHT NIOJ!

 

[LegendofJoe]

3 back surgerys and a ton of therapy would have cost me $489,000

US AIR Force ate that bill and pays me $2,230.00 a month for the rest of my life!

The government is evil though, being a military man you have to see this right?



lol

 

[Polari]

? What is the downside you are trying to highlight?

Isn't it obvious? When you make something free you encourage overconsumption.

 

[Gintamen]

Its the price of freedom.

The freedom to be fucked over.

Germany is nowhere near those numbers, even if I work with our population number, something is going horribly wrong in the US.

 

[Measley]

About a year ago, my mother had to stay in the hospital for a couple of days because she had severe stomach cramping and diarrhea. Turns out she had an ulcer as well as the stomach flu. When she got home, she got a nice big fat doctor bill. I think it was around $ 3,000 after insurance. She paid half of it, and she's trying to pay the other half. Thing is, she gets calls from the medical bill collectors daily because part of the bill went into collections.

Now shes starting to get the stomach pains again, but she's afraid to go to the hospital because she doesn't want to have to pay another huge doctor bill. However, her primary care physician ( and her family) is recommending that she goes. I even told her that I'll help her pay for the bill, but she still is reluctant to do it.

Then there's my constant battle with my insurance company who likes to say they cover something, but then turn around and don't cover the procedure at all. Nothing's better than getting dental work done, and paying $30 co-pay, then a few weeks later getting a $400 bill because your insurance company messed up the paperwork.

I pay about $200 a month in health insurance for me and my wife. When we Have a kid, its probably going to get even higher.

I'm willing to bet the average Canadian doesn't pay that much per month for their insurance.

 

[Angelus Errare]

All I know is root canals are expensive as shit in this country. Honestly if I was in a bad accident and needed major surgery...just let me die.

 

[Mr Swine]

If its this bad, doesn't that mean that half of the Americans or more in e US have big depts to pay for hospital bills?

 

[Angelus Errare]

If its this bad, doesn't that mean that half of the Americans or more in e US have big depts to pay for hospital bills?

Yes.

A 2007 survey had found about 70 million Americans either have difficulty paying for medical treatment or have medical debt. Studies have found people are most likely to accumulate large medical debts when they do not have health insurance to cover the costs of necessary medications, treatments, or procedures – in 2009 about 50 million Americans had no health coverage. However, about 60% of those found to have medical debt were insured. Health insurance plans rarely cover any and all health-related expenses; for insured people, the gap between insurance coverage and the affordability of health care manifests as medical debt. As with any type of debt, medical debt can lead to an array of personal and financial problems - including having to go without food and heat plus a reluctance to seek further medical treatment. Aggressive debt collecting has been highlighted as an aggravating factor. A study has found about 63% of adults with medical debt avoided further medical treatment, compared with only 19% of adults who had no such debt.

It only ever increases, in 2007 more than as 60% of US bankruptcy declarations are due to medical bills

But you have to remember, in the US healthcare isn't considered a constitutional right but rather a privilege.

https://en.wikipedia.org/wiki/Health_care_in_the_United_States

 

[fastford58]

If you want health care like Canada, you would have to be taxed accordingly.

There are downsides to our system that you would have to live with. Need an MRI? 6 month wait. Cancer screenings and interventions can take a long time (sometimes fatally so).

Many people in Canada don't trust our system when it comes to dealing with potentially life ending disorders and will pony up the cash to go to the US for immediate intervention. Diagnosed on Monday, cancer free by Friday. If they wait for our system, it's diagnosed Monday, maybe cancer free in a few months.

Canadians are also at the whims of determinants of health just like anyone else. Impoverished families still do not get equal access to health care here for a variety of reasons. Lack education, no money for meds, bad health seeking habits, lack of community supports etc.

Our system is mired with inefficiency and health care workers are often times over worked and underpaid.

We tend to have cycles of brain drain where health care professionals leave the country in order to get better paying work. In the late 80s to early 90s, it was nurses who were going to the US for better paying jobs and working conditions. Because of that, plus the bulk of Canadian baby-boomer nurses retiring, we have a near critical shortage of nurses. For the last decade, the brain drain has been physician based. If you don't have a family physician, it can take some voodoo to find one.

Our system has also enabled people to be lazy with their health seeking. Instead of being proactive in their health, the bulk of us just exist until something gives, and then seek help because we know it is there. This may sound comforting, but it has lead to a situation where people with totally manageable conditions are going to hospitals for even the smallest issues that are easily dealt with. It also means that diseases of excess (hypertension, T2 Diabetes, etc.) are on the rise because people don't realize how dangerous these conditions are, and if they do get them, we will fix them.

Meds are still not paid for unless you are on some form of medical insurance. Many of the jobs in Canada are shit jobs that don't offer benefits. Like anywhere else, unskilled labour is becoming the norm for people with little education. If they work, they still cannot afford the insurance plans that are around.

Canada has "premium" rooms, and other bonuses that people with money can get, so the equal access to care thing is a bit of a misnomer. MRI and other diagnostic tests can be had quickly if you have the cash. Don't have the cash? Tough tits, you have to wait.

Where do we go from here?

Canada's system worked well for a long time, but we are nearing a point where it is going to be completely ineffective. Acute care centers are now on a push to come up with patient teaching programs in order to empower them to deal with conditions at home. Chronic Obstructive Pulmonary Disease is getting a big push because COPD exacerbation is the number one cause of hospital admit (in Ontario at least). COPD is a VERY manageable condition if the patient possesses a modicum of knowledge about it.

I believe health care is going to go through a paradigm shift where more home based care for chronic illness is indicated, and hospitals are only used for acute or emergency conditions. The indicators are there. What effect this will have on health care wages and brain drain, I don't know.

Implications for the US health care system.

I think that if the US tries to set up a system that mirrors Canada now, it is doomed to fail. They will be implementing a system that is not forward thinking, and arguably very outdated. Obama care is not really an effective step in the right direction. Health care systems as a whole would have to come together and draft a plan. Doctors have to take some hits, nurses have to take some hits. Health care is big business, but it needs to be a big business with a strong ethical backbone, which is often not the case.

Having a centralized Government come up with a bill and ram it down everyone's throats is going to achieve very little, and may end up harming the process in the end. Healthcare is a much more complex equation that that.

 

[Angelus Errare]

Honestly Canada's implementation is overrated and I'm tired of US citizens asking for it.

 

[fastford58]

Honestly Canada's implementation is overrated and I'm tired of US citizens asking for it.

It is an intrinsically flawed system. It wasn't as evident as it is now, but we are starting to see some major problems developing. That is why a change is needed.

 

[poppabk]

Isn't it obvious? When you make something free you encourage overconsumption.

Except the US rate of C-sections is about 33% which is higher than New Zealand.

 

[Septimius]

US hates everyone paying taxes, as a little bit for welfare so no one has to pay a lot when they have to use it. Everyone has insurance.

syduck:

 

[Nothing1016]

If you want health care like Canada, you would have to be taxed accordingly.

There are downsides to our system that you would have to live with. Need an MRI? 6 month wait. Cancer screenings and interventions can take a long time (sometimes fatally so).

Many people in Canada don't trust our system when it comes to dealing with potentially life ending disorders and will pony up the cash to go to the US for immediate intervention. Diagnosed on Monday, cancer free by Friday. If they wait for our system, it's diagnosed Monday, maybe cancer free in a few months.

Canadians are also at the whims of determinants of health just like anyone else. Impoverished families still do not get equal access to health care here for a variety of reasons. Lack education, no money for meds, bad health seeking habits, lack of community supports etc.

Our system is mired with inefficiency and health care workers are often times over worked and underpaid.

We tend to have cycles of brain drain where health care professionals leave the country in order to get better paying work. In the late 80s to early 90s, it was nurses who were going to the US for better paying jobs and working conditions. Because of that, plus the bulk of Canadian baby-boomer nurses retiring, we have a near critical shortage of nurses. For the last decade, the brain drain has been physician based. If you don't have a family physician, it can take some voodoo to find one.

Our system has also enabled people to be lazy with their health seeking. Instead of being proactive in their health, the bulk of us just exist until something gives, and then seek help because we know it is there. This may sound comforting, but it has lead to a situation where people with totally manageable conditions are going to hospitals for even the smallest issues that are easily dealt with. It also means that diseases of excess (hypertension, T2 Diabetes, etc.) are on the rise because people don't realize how dangerous these conditions are, and if they do get them, we will fix them.

Meds are still not paid for unless you are on some form of medical insurance. Many of the jobs in Canada are shit jobs that don't offer benefits. Like anywhere else, unskilled labour is becoming the norm for people with little education. If they work, they still cannot afford the insurance plans that are around.

Canada has "premium" rooms, and other bonuses that people with money can get, so the equal access to care thing is a bit of a misnomer. MRI and other diagnostic tests can be had quickly if you have the cash. Don't have the cash? Tough tits, you have to wait.

Where do we go from here?

Canada's system worked well for a long time, but we are nearing a point where it is going to be completely ineffective. Acute care centers are now on a push to come up with patient teaching programs in order to empower them to deal with conditions at home. Chronic Obstructive Pulmonary Disease is getting a big push because COPD exacerbation is the number one cause of hospital admit (in Ontario at least). COPD is a VERY manageable condition if the patient possesses a modicum of knowledge about it.

I believe health care is going to go through a paradigm shift where more home based care for chronic illness is indicated, and hospitals are only used for acute or emergency conditions. The indicators are there. What effect this will have on health care wages and brain drain, I don't know.

Implications for the US health care system.

I think that if the US tries to set up a system that mirrors Canada now, it is doomed to fail. They will be implementing a system that is not forward thinking, and arguably very outdated. Obama care is not really an effective step in the right direction. Health care systems as a whole would have to come together and draft a plan. Doctors have to take some hits, nurses have to take some hits. Health care is big business, but it needs to be a big business with a strong ethical backbone, which is often not the case.

Having a centralized Government come up with a bill and ram it down everyone's throats is going to achieve very little, and may end up harming the process in the end. Healthcare is a much more complex equation that that.

You articulated everything I was thinking about the US and Canada perfectly.

 

[remnant]

Honestly Canada's implementation is overrated and I'm tired of US citizens asking for it.

I think a big problem with the healthcare discussion in america is that it rarely is based in healthcare. it's more based around the ideologies of both parties. People look at canada healthcare for example, and evangelize it because it's leftist/socialist/ whatever. Vice versa on the right.

But in reality both systems have flaws. We can cut through a lot of bullshit on a policy level at least if we stopped trying to essentially emulate other countries models or stick to some "free market" rule and just look at what works. What keeps costs down. Consumers paying out of pocket? Let's do that. Can government negotiate cheaper prices? Let them do that. If charities and small public options can provide better care for the poor, than let them do it. If the state or federal government can do it better, let them do it.

No other area in american politics make we want a third major political party than healthcare.

 

[this_guy]

It's why I don't trust doctors/hospitals. They're a capitalistic entity just like any other and will lie, manipulate, and steal just the same. Why would they cure me and turn off the money faucet?

I think the worst part is, they blame every thing else for why things are the way they are. Blame it on the insurance companies, the student loans that their employees (the doctors) have, the people who don't pay their bill means we'll just jack up everyone else's bill multiple times to recoup costs, etc.

 

[poppabk]

Yep. When my friend had her baby two years ago, she not only had to pay for herself, the hospital visit, and all of the other costs associated with having a child, but she her child also got charged. She is -still- paying it off two years later and she even had insurance. Shitty insurance, but insurance.

Yeah they get your kids insurance details as soon as possible. It's kinda crazy that a 2 day old baby can rack up thousands of dollars in debt. Oh yeah and they charge you thousands of dollars in room fees for the baby that sleeps in the same room as the mother who is also paying room and board.

 

[Zornica]

Threads like these always make me sad...
btw, I always wondered how much would you have to pay for medical insurance? (monthly/quarterly)

 

[GaimeGuy]

Isn't it obvious? When you make something free you encourage overconsumption.

Yes.

You encourage more people to seek out their doctors when they notice health problems.

You encourage people to have frequent check ups.

You encourage the use of health care

That's a good thing.

What is DONE, however, is up to the discretion of the professional community.

You can't get an MRI just because you ask for one. (as is the case now) You can't choose what your doctor prescribes you (as is the case now).

You don't make the medical decisions that require professional expertise, or diagnose what your condition (And thus, what the appropriate treatment) is. The only decisions you make involve following (or not following) the professionals' advice and opting in or out of different treatments offered.

And you DON'T have to focus on the costs or the bureaucratic/legal matters because they're handled for you.. which isn't currently the case.


Ex:

In March, when I met with my doctor about an issue, he sent the prescription over to my pharmacy. When I got there, the pharmacist told me the medicine wasn't covered by my insurance, and asked me if I wanted to fill it as a prescription or as an over the counter medication.

Now, as far as I'm concerned: It's on doctor's orders, who cares what the insurance company said? And why are you asking me such a question? I'm not a pharmacist. I don't understand insurance law or medical malpractice or anything like that. I don't understand the differences and I don't need to understand the differences and i'm just following the doctor's recommendations, so consult with HIM, damn it. :|

It should be, in order of importance: Patient, then doctor, then pharmacist, then insurance company, with all parties directing their questions towards the doctor

NOT: Patient defers to doctor. Pharmacist defers to Insurance. Patient has to weigh the advice of his doctor against the advice the pharmacist received from the insurance to make a decision.