IT'S TIME FOR UNIVERSAL HEALTH CARE

So if we regulate the prices down and regulate the reimbursement the hospitals get down... How do we subsidize for all those people who abuse the system? Hospitals need money to operate. And like it or not, it is a business and doctors and nurses need to be paid well if you want them to continue to do the work.

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Some people's brain are monopolized by money; while some others are monopolized by humanity and what's best for society.

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USAFHokie80 wrote:

So if we regulate the prices down and regulate the reimbursement the hospitals get down... How do we subsidize for all those people who abuse the system? Hospitals need money to operate. And like it or not, it is a business and doctors and nurses need to be paid well if you want them to continue to do the work.

I think it'd work the other way round. You could institute a mandatory system. Everybody would have to pay into a health insurance. Having a bigger pool of payers, it would not be unreasonable to expect that that might bring premiums down. As everybody would be paying premiums, hospitals would get reimbursed, too. Same for doctors and nurses.

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under the ontario health system there are NO co-payments for any listed treatments .
there are certain treatments - don`t know which - that are not covered . generally speaking these are experimental treatments that have not gone through all the testing stages . in some circumstances , drug companies will provide these drugs free of charge since they are interested in obtaining experience - so you are essentially a guinea pig .

my brother was hit by cancer some 20 yers ago at age 65 - caused by long exposure to asbestos when he was a young man . he received all the most modern treatments both at our local university hospital-cancer centre and at sunnybrook in toronto - he did not have to make any co-payments .
unfortunately , cancer treatments for his type of cancer were not advanced enough to be of help to him .

as far as patient abuse is concerned , i`m sure it does happen . however i don`t think there are enough people that enjoy swallowing a lot of unnecessary pills or that find it enjoyable to go under the knife just for the fum of it .
the physicians we have had over the years would not have given us medications or agreed to medical procedures we didn`t need .
hbg

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I've some difficulties with "abuse of the system" as well.

Certainly, there may be some who e.g. just go to the hospital to get a free bed, a shower and some good hot meals (I was the probation officer for one who did so in Hamburg: stayed there "1st class" for 10 days in four hospitals ...).
That's fraud - and gets punished under German law with imprisonment for not more than five years or a fine.

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perhaps there is actually an advantage to a slight hospital bed-shortage in ontario .

those admission nurses can be pretty `hard-boiled`and would likely toss any faker quickly .
hbg

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hbg, My wife worked as a nurse for some 45 years, and they know more about the patients than most doctors. They see the patient eight hours a day, and the doc sees them for about 15-minutes, so the nurses have a better sense of how the patients are doing. A good nurse knows how to recognize when the patient is in stress.

Many of our friends call my wife before they even speak to a doctor, because they trust her knowledge and judgement.

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cicerone imposter wrote:

Some people's brain are monopolized by money; while some others are monopolized by humanity and what's best for society.

you keep saying crap like this, but the reality is that "humanity" doesn't pay the rent. where are these "solutions" you talked about? this is another example of you just saying "i want this" with absolutely NO idea what it takes to get there.

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old europe wrote:

USAFHokie80 wrote:
So if we regulate the prices down and regulate the reimbursement the hospitals get down... How do we subsidize for all those people who abuse the system? Hospitals need money to operate. And like it or not, it is a business and doctors and nurses need to be paid well if you want them to continue to do the work.

I think it'd work the other way round. You could institute a mandatory system. Everybody would have to pay into a health insurance. Having a bigger pool of payers, it would not be unreasonable to expect that that might bring premiums down. As everybody would be paying premiums, hospitals would get reimbursed, too. Same for doctors and nurses.

What about illegal immigrants and people with no jobs? They wouldn't be paying into the system. Every working person now pays into the system and hospitals are still closing because there isn't enough reimbursement. If this is going to happen, it will require a not-small hike in taxes.

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Walter Hinteler wrote:

I've some difficulties with "abuse of the system" as well.

Certainly, there may be some who e.g. just go to the hospital to get a free bed, a shower and some good hot meals (I was the probation officer for one who did so in Hamburg: stayed there "1st class" for 10 days in four hospitals ...).
That's fraud - and gets punished under German law with imprisonment for not more than five years or a fine.

It is extraordinarily difficult to prosecute that case in that you cannot say a patient is not in pain. A physician cannot deny a patient's pain. And there are more ways to abuse the system. For instance, the lady who goes to 5 different doctors in a month, telling them all the same story so she should get a script for percoset from each.

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Yes. That's life.

How does the actual insurance system in the USA prevend such?

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The insurance company won't pay for the patient to visit 5 different doctors for the very same problem. Cool

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And why should such be impossible for insurance companies under universal healthcare?

It's done so, to some poent, at east.
(Personally, I really like to get a different doctor look at some medical problems, especially if they are of the more serious kind.

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Some American doctors believe that many Medicare patients spend a good part of their free time visiting doctors are part their senior social time.

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There is a detectable difference here between the advocates of "universal" health care (mostly European and Canadian, based on a sample post count over the last few pages) and those (mostly Americans) who oppose it or who have reservations about it.

The latter group appears to view health care primarily as a personal service and therefore value attentiveness to their own needs or wants as a primary objective. The former appears to value the supposed "universality" of the system as matter of primary importance and therefore more willingly accept the (often unseen or undetected) rationing of services attendant to such government-mandated systems. Some go so far as to imply moral values to the question, suggesting that governments that fail to directly provide or require such "systems" somehow fail certain norms for "morality" or "decency".

The "morality" argument opens up very large avenues for other, logically related actions that I doubt that the advocates here for "universal" health care would accept. My point here is that this argument is itself suspect and likely involves contradictions on the part of those who use it.

Personally, I, in general, value individual freedom and responsibility more than I do the tidiness of government-sponsored programs for the redress of various human sufferings. I'm not doctinaire about this - in either direction - but it does often decisively influence my views on matters that are not otherwise clearly determined one way or another.

I wouldn't oppose some government program for the direct subsidization of a basic menu of services for preventive health and maternity care as well as public health related issues involving infectious diseases. Beyond that, I believe the less government involvement we have in the matter, the better.

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georgeob1 wrote:

... therefore more willingly accept the (often unseen or undetected) rationing of services attendant to such government-mandated systems.

I admit, it's not so easy as it has been before to get six weeks in convalescant care clinics after operations as it has been ten years and more before.
But three weeks (plus possibly 14 more) after major operations still is the rule.

Yes, you don't get more than six physiotherapy treatments on one prescription now; but it's no problem to et another prescription if you need that physiotherapy.

Not every of our 300 insurance companies pays more than a few alternative medical treatments. But you get e.g. accupunture - and can choose that company which fits you best.

To what rationing were you referring which everyone gets in the USA but not under universal healthcare, George?

georgeob1 wrote:

Personally, I, in general, value individual freedom and responsibility more than I do the tidiness of government-sponsored programs for the redress of various human sufferings. I'm not doctinaire about this - in either direction - but it does often decisively influence my views on matters that are not otherwise clearly determined one way or another.

I wouldn't oppose some government program for the direct subsidization of a basic menu of services for preventive health and maternity care as well as public health related issues involving infectious diseases. Beyond that, I believe the less government involvement we have in the matter, the better.

We got such offered by the goevrnment via the city's/district's/county's health departments - that is a voluntary thing, no one has to go there and it's not related to health insurance at all.

Mainly, however, the check-ups - which finally lead to monetary reductions - are offered by the insurance companies.
Certainly you are free to change to a different which doesn't offer such but has less service and higher monthly fees.
(Like in any other free market, however, you won't find many who do such .... and survive.)

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Rationing of care under insurance schemes or government financed programs takes many forms.

Standard reimbursement rates for various services set by insurers and government are, for example, price ceilings that some physicians will accept and others will not. This is a big country and the cost of living varies a good deal from region to region. As a result, insurers maintain their own networks of participating doctors who will accept their rates: those not in the approved network may not be available to an individual consumer. The net result is restrictions, sometimes hardly noticeable but often very limiting on just whose medical services one can seek. This problem is particularly severe in government financed systems such as our Medicare system for people over 65 years - most doctors in San Francisco will not accept more Medicare patients. In Canada and the UK the problem is managed by government by directly limiting the supply of doctors and hospital beds, thereby rationing all services by queuing - a situation that in both countries has led on occasion to major political issues. The point here is that a little bit of government control of an economic market usually leads to more and more government control, and more and more inefficiency.

A second form of rationing is in the lists of approved medicines, the formulary available to dispensers of medicines and services. Insurers and governments tend to limit the issue of medicines and services to those they deem the most cost effective. In terms of the individual relationship of a patient to his/her doctor on matters of health this introduces a third - very remote and disinterested - party to the relationship. In general the track record of such bureaucratic control mechanisms isn't very good: free markets work much better.

In response to a post by hamburger above, who was bragging about the speed and responsiveness of the Canadian system to provide catharact surgery for his wife, I made an inquiry with an acquaintance - a well-known and qualified local eye surgeon about comparable waiting times here for the procedure (he does 8 - 10 of these every week). he informed me that, from the first visit confirming the need for the procedure, the wait for surgery is about one week, mostly to provide time for the ordering & delivery of the replacement lens after measuring the patient's eye dimensions. He added that, although in Canada many surgeons will perform simultaneous surgery on both eyes, his practice (and, he said, that of most doctors here) was to do them individually about two months apart to limit the risk to the patient.

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My sister is in the process of setting up our "quarterly" sibling luncheon between October 18 and November 7 (when I'll be home from vacation). I'll ask my brother, an ophthalmologist, with about two dozen doctors who work for him in Lodi and Stockton about waiting times for surgery. I'll report back after I've had a chance to talk with him.

The reason I'm doing this is very simple; I don't think speed of service is the same no matter whether it's under a system like ours in the US or any of the universal health care systems elsewhere. I'm sure there's are a wide range of timings involved. I'm also not sure there is an "immediacy" to eye surgery - most of the time.

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georgeob1 wrote:

In response to a post by hamburger above, who was bragging about the speed and responsiveness of the Canadian system to provide catharact surgery for his wife

<snip>

He added that, although in Canada many surgeons will perform simultaneous surgery on both eyes, his practice (and, he said, that of most doctors here) was to do them individually about two months apart to limit the risk to the patient.

you might want to re-read hamburger's post. nothing about speed of the canadian system (unless you think that he thinks 6 months is fast), and there were two separate surgeries (roughly two months apart)

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george wrote :

Quote:

In response to a post by hamburger above, who was bragging about the speed and responsiveness of the Canadian system to provide catharact surgery for his wife,I made an inquiry with an acquaintance - a well-known and qualified local eye surgeon about comparable waiting times here for the procedure (he does 8 - 10 of these every week). he informed me that, from the first visit confirming the need for the procedure, the wait for surgery is about one week, mostly to provide time for the ordering & delivery of the replacement lens after measuring the patient's eye dimensions. He added that, although in Canada many surgeons will perform simultaneous surgery on both eyes, his practice (and, he said, that of most doctors here) was to do them individually about two months apart to limit the risk to the patient.

in response to george :
- i certainly made no attempt to brag . i was just stating how it is handled in ontario .
my wife certainly would have been happy to have the operation done more quickly - AND SHE HAD THE OPTION , but choose to wait .

- as already stated , the two eyes were NOT done at the same time but about six weeks apart .

-would you care to inform us how much your eye surgeon would charge a person WITHOUT insurance coverage ?
would patients be required to make a co-payment ?

-if you HAVE read my posts , you may have read that i have MORE THAN ONCE stated that i believe the ontario system needs to be improved upon .

-you may have also read that we have to thank a CONSERVATIVE government for almost running our public system into the ground by severely restricting the access to medical schools - resulting in fewer graduates . as you no doubt know , doctors DO NOT grow on trees ; they have long training periods and the mistakes that were made several years ago are what the health system is burdened with now .

(as an aside : a provincial election will be called soon and the new leader of the conservative party swears that he is ALL FOR IMPROVING the public health system !
do i believe him :NO !!!) .

george : please reread my post and tell me where i was BRAGGING ; i'll gladly retract any such statements . all i want to do is explain how the system works - no more , no less .
hope that sounds fair to you .
hbg

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IT'S TIME FOR UNIVERSAL HEALTH CARE

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