What I need from President Obama

...I think he might just need to wait for his second term....

...
My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well....

My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well.

The main reason a major part of the right opposes any potent change from Obama is to hurt Obama's presidency. I wonder if any of the rightwingers on A2K have the integrity to even acknowledge that?

georgeob1 wrote:

My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well.

who can fix the health care insurance morass the U.S. finds itself in? do you think the insurers/big pharmas/other vendors/suppliers will make efforts to make the system work more effectively for the consumers? who should/can take the lead in this?

Using the U.S. banking system as an example isn't exactly brilliant, since it's a bit of a laughing-stock internationally these days.

Seems to me most of the discussion has been around changing access (aka funding/insurance) to healthcare, not U.S. healthcare itself. Suggesting the discussion is primarily around the healthcare system is a trifle misleading. Where the idea of the government being involved in healthcare decisions comes from is beyond me.

i can't remember if it was here or someplace else; but it was pointed out that it's not the healthcare system, but the health insurance system that needs reform. we have a lot of really good doctors (we could always use more good ones), the facilities are generally pretty good and most of the drugs seem to actually do something.

"As a primary care doctor, you are a gatekeeper of the medical system," said Manriquez, 26, who with Glass is a first-year student at the University of Washington School of Medicine. "Primary care is where you can have the most immediate impact in affecting patients' lives by managing their health."

Still, Manriquez realizes that he's setting himself for considerable challenges.

For one thing, as a family doctor, Manriquez will probably make one-fourth the salary of a specialist while trying to pay down $140,000 on average in medical school debt.

Of course, there has always been a profit motive in medicine. Doctors who own their own imaging machines order more imaging tests; to take an example from my moonlighting work, a doctor who owns a scanner is seven times as likely as other doctors to refer a patient for a scan. In regions where there are more doctors, there is more per capita use of doctors’ services and testing. Supply often dictates demand.

...I disagree and think that the problem in the US is in the health care, not the insurance, and that the insurance problems are a symptom of that fundamental problem...

i see what you mean, but what i was talking about is the quality of our doctors, facilities, machines and drugs. not so much about behavior.

...There is a trend toward specialization that is leaving basic medical care as the job no doctors want.....

i agree with you here.

..." Doctors who own their own imaging machines order more imaging tests; ".....

ohh, indeed they do. it makes very good business sense. and in terms of ease, i.e., walking from one room to another for a ct scan, it is good for the patient to have a ones stop shop.
but again i agree that there is the tendency to order more tests than are really needed to pay the thing off and get it into the profit column. which could also be accomplished by getting a very good lease on the machine and a favorable rate on the capital loan. one of those "for payments received and one dollar" deals. sounds bizarre, but we did it that way on big ticket equipment and managed to make money without ripping people off.

in real world action though, how would you go about telling the doctors that they can't buy the machines? how do you tell them that they can only order a test for this, or for that? because, at that point, you do then have a bureaucrat making decisions and a doctor saying, "hey! who's the doctor? me or you?"

that will go over like a leak in a space suit.


I, for one, do not want universal insurance paying for this ridiculous medical service that inflates costs so dramatically. I want public health care, not public insurance. That way doctors don't have personal motivation to inflate the costs to make more money in the public system.

i don't want to pay for extraneous stuff either.

The way I'd structure it is similar to how it is in many countries I've lived. The public health care is simple and not "nice". If you have any money at all you want to avoid it. It just does it's job and is for people who can't afford anything else. It keeps people alive, and the keeps the costs of the private sector in check. I think we can do this for far less than we can insure everyone while letting the medical industry keep trying to squeeze blood out of a rock.

The Republicans had 8 years with control of all three branches of government for much of the time, and did nothing.

BOTH parties have refused to try and fix healthcare.
Why is that?

We in this country have been wringing our hands about how to fix healthcare for 60 years.