IT'S TIME FOR UNIVERSAL HEALTH CARE

it's not a new version. it's just updates to the current version. new procedures and diagnoses added. these updates happen a few times a year.

oh, and cerner isn't in the "medical-insurance" industry. we are a medical technology provider. the only thing we have to do with insurance is the automation and streamlining of the billing process. we are actually leading a movement to change the way insurance is handled. our ceo says that he hopes that in the future we can do away with insurance companies (as they exist today). specifically, we use a clinic model based on an integrated EMR system. the patient carries a debit-type card that he uses to check into the clinic. this card also acts as an HSA debit card to pay for medical needs as well as store the insurance information for the patient. this would eliminate the need for the long waits for payments and the disputes about whether or not a claim is covered. all of this would be handled in real-time before the patient ever leaves the office.

Why then have ICD-10s and 11s?

Couldn't tell you. I don't know why a new library is needed either unless it has something to do with the organization of the diagnoses and procedures - which is very possible. ICD-9 is worlds better than LYNX and SNOMED for that reason. The latter two do not inherently display any sort of organizational structure. ICD does. A general diagnosis will have a code lik e 799.00. More precise or descriptive diagnoses of the same thing will have the decimals filled out - such as 799.02.

The ICD "provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease".

And since that changes constantly, it's constantly re-written (e.g. new chapters, de-organised etc) - since the first ICD came out in ....

ICD-1 - 1900
ICD-2 - 1910
ICD-3 - 1921
ICD-4 - 1930
ICD-5 - 1939
ICD-6 - 1949
ICD-7 - 1958
ICD-8 - 1968
ICD-9 - 1979
ICD-10 - 1992 (officially 1994)

my point was that it can (and is) simply be updated and have new code added. there is no need for an entirely new "version"

Until now, the new versions differed totally - as does the ICD-11 as far I a followed the discussions and what has been published so far.

(The difference between ICD-9 and ICD-10 is really great - just comapre some chapters especially in psychiatric.)

All too often, you prove yourself wrong...You don't need anyone to do that.

I'm not even sure what to say to this. Walter has looked it up and said he found that we still use ICD-9. I've posted proof that hospitals in the US are currently using ICD-9 databases in their computer systems. So, how exactly am I wrong ?

ICD-9 or whatever, our society (the most powerful in history) can make decisions on it's priorities and some of us think total medical care is a priority and some do not. The difference is in one's values of what we should be doing.

"Forms" do not replace the attending physician.

Very true. Some think a person should provide for him or herself, while others think each person is entitled to be "taken care of by the Governement".

In other word, there are those for WELFARE and those who aren't for WELFARE...

So you think, universal health care is "welfare"? I pay my insurance fees any month as does everyone else, even those "on welfare".

That's the primary misconception of universal health care; people think it's a total welfare system, and it's not.

Total welfare system? Who thinks that?

In Massachusetts, we have Universal Health Coverage. Some individuals are covered by the welfare portion ( medicaid), while others are covered by Medicare and still others by private insurance.

Thus, only those on WELFARE ( medicaid ) are in the WELFARE system.

So, there isn't total welfare in the Massachusetts system, is there?

how is it that the universal health care systems are not largely welfare based? if we mandate that every person must have health insurance, then what of the people who insist they are too poor to pay for it, but whom do not qualify for medicare/medicaid? they will have to be paid for by the gov't. or, i suppose we could force them to buy their own insurance - but we know that won't really work.

under the ontario health insurance system , the premium is based upon annual income . my premium is deducted every month by my former employer from my pension payment .
at year-end my i calculate the total premium payable from a simple table and any adjustments are made at that time .
anyone not having a regular pay/pension income , such as self-employed , make the payments when they make quarterly interim tax payments .
those not having any taxable income , do not have to pay the premium - no income tax = no health premium . it's pretty simple imo .
hbg

that would be simple. but that would leave far too many people not paying into the system. i like the idea presented in the last plan where the funding is generated from an increased sin tax. given that smokers and drinkers have higher rates of illnesses related to this, it seems only fair that they help shoulder the burden of the cost of treatment.

we certainly have plenty of SIN TAXES that flow into the health-insurance fund .
since people with low incomes - many of them seniors - do not pay income taxes , i can't see how they can pay a health-insurance premium unless they are given some additional money . it would just be extra administration costs to first give them the money and then collect the premium imo .
by including them in the health-insurance plan , they can get the same health care as any other citizen - the physician doesn't know and doesn't care if you have paid a premium in any particular month .
the patient may have paid into the fund for a long time while working but may later not have had to pay into it because of lower income or loss of job .
the physician receives the same amount of money whether he/she treats a prince or pauper - doesn't have to worry about getting paid .
if low-income citizens had no insurance , they would not be able to afford primary health-care and would cost additional monies once they appear in the ER when they are really sick - better to treat as many people as possible up-front imo - it saves money .
hbg

Again to explain how it works here (simplified):
- if employed with earnings below a set incomelimit, you pay half the insurance contributions as an employee, and your employer pays the other half.
- the poor, the unemployed, and the elderly get their fees completely or partly paid by those organisation they get their money from.

(Btw: only about a quarter of persons with incomes above the income limit choose to purchase private health insurance.)

Prostates and Prejudices


By PAUL KRUGMAN
Published: November 2, 2007
"My chance of surviving prostate cancer ?- and thank God I was cured of it ?- in the United States? Eighty-two percent," says Rudy Giuliani in a new radio ad attacking Democratic plans for universal health care. "My chances of surviving prostate cancer in England? Only 44 percent, under socialized medicine."


The Conscience of a Liberal It would be a stunning comparison if it were true. But it isn't. And thereby hangs a tale ?- one of scare tactics, of the character of a man who would be president and, I'm sorry to say, about what's wrong with political news coverage.

Let's start with the facts: Mr. Giuliani's claim is wrong on multiple levels ?- bogus numbers wrapped in an invalid comparison embedded in a smear.

Mr. Giuliani got his numbers from a recent article in City Journal, a publication of the conservative Manhattan Institute. The author gave no source for his numbers on five-year survival rates ?- the probability that someone diagnosed with prostate cancer would still be alive five years after the diagnosis. And they're just wrong.

You see, the actual survival rate in Britain is 74.4 percent. That still looks a bit lower than the U.S. rate, but the difference turns out to be mainly a statistical illusion. The details are technical, but the bottom line is that a man's chance of dying from prostate cancer is about the same in Britain as it is in America.

So Mr. Giuliani's supposed killer statistic about the defects of "socialized medicine" is entirely false. In fact, there's very little evidence that Americans get better health care than the British, which is amazing given the fact that Britain spends only 41 percent as much on health care per person as we do.

Anyway, comparisons with Britain have absolutely nothing to do with what the Democrats are proposing. In Britain, doctors are government employees; despite what Mr. Giuliani is suggesting, none of the Democratic candidates have proposed to make American doctors work for the government.

As a fact-check in The Washington Post put it: "The Clinton health care plan" ?- which is very similar to the Edwards and Obama plans ?- "has more in common with the Massachusetts plan signed into law by Gov. Mitt Romney than the British National Health system." Of course, this hasn't stopped Mr. Romney from making similar smears.

At one level, what Mr. Giuliani and Mr. Romney are doing here is engaging in time-honored scare tactics. For generations, conservatives have denounced every attempt to ensure that Americans receive needed health care, from Medicare to S-chip, as "socialized medicine."

Part of the strategy has always involved claiming that health reform is suspect because it's un-American, and exaggerating health care problems in other countries ?- usually on the basis of unsubstantiated anecdotes or fraudulent statistics. Opponents of reform also make a practice of lumping all forms of government intervention together, pretending that having the government pay some health care bills is just the same as having the government take over the whole health care system.

But here's what I don't understand: Why isn't Mr. Giuliani's behavior here considered not just a case of bad policy analysis but a character issue?

For better or (mostly) for worse, political reporting is dominated by the search for the supposedly revealing incident, in which the candidate says or does something that reveals his true character. And this incident surely seems to fit the bill.

Leave aside the fact that Mr. Giuliani is simply lying about what the Democrats are proposing; after all, Mitt Romney is doing the same thing.

But health care is the pre-eminent domestic issue for the 2008 election. Surely the American people deserve candidates who do their homework on the subject.

Yet what we actually have is the front-runner for the Republican nomination apparently basing his health-care views on something he read somewhere, which he believed without double-checking because it confirmed his prejudices.

By rights, then, Mr. Giuliani's false claims about prostate cancer ?- which he has, by the way, continued to repeat, along with some fresh false claims about breast cancer ?- should be a major political scandal. As far as I can tell, however, they aren't being treated that way.

To be fair, there has been some news coverage of the prostate affair. But it's only a tiny fraction of the coverage received by Hillary's laugh and John Edwards's haircut.

And much of the coverage seems weirdly diffident. Memo to editors: If a candidate says something completely false, it's not "in dispute." It's not the case that "Democrats say" they're not advocating British-style socialized medicine; they aren't.

The fact is that the prostate affair is part of a pattern: Mr. Giuliani has a habit of saying things, on issues that range from health care to national security, that are demonstrably untrue. And the American people have a right to know that.