Health Care Costs Today

[rabid1st]

Here is a link to an article about the cost of health care today.

http://www.iom.edu/?id=19175

In case anyone is wondering, the government, meaning you and I, the taxpayers, pick up the cost of the uninsured even now. We just do so inefficiently and inhumanly. For example, my friend is taking her internship in psychology at a local mental hospital. The hospital built a new ward last year, costing millions, which they got in government grants and loans. They even asked their STAFF to pitch in with donations. Now, they cannot afford to repay their loans...so they will be doing a number of corporate things to get by...1) cutting salaries and laying people off [we taxpayers will pick up the unemployment tab] and yes, those are the same people who donated to build the wing 2) writing the loans off as a tax break for corporations, so we taxpayers [even those who've lost their jobs] pay for their error 3) letting the less dangerous [or uninsured] patients go so they are wandering the streets, asking you for loose change. Some of them will insist that you learn about the aliens that have taken over the Qwiki-Mart. Those poor people are not only going to be cold and hungry and frightened, they will also be frightening you...and causing the police, whom we taxpayers pay, to have extra patrols.

Jails, which we pay for, too, will be full of people who should be getting proper mental care, sociopaths who as of their 18th birthday are no longer covered by child care laws. They will cause costly fights and we will need more room, officers and medical personnel. We also pick up more costs than that, though. Because sick people don't just wander out into the streets and get arrested or die, not right away. So property values decline and people are forced to give more to church kitchens and shelters to compensate for their "tax cuts." Would you stand by and watch a sick person die or would you try to help? Shall we begin to take our elderly, childless neighbors in? Well, even if everyone refuses to help and the sick and the homeless do die...we taxpayers would pay for the Hazardous Waste pick up and disposal. Funerals, even pauper funerals, are not free.

So, this isn't REALLY about government spending. It is about priorities in spending. And there is no excuse for all of this clutch-fisted inhumanity. One of my LJ-friends said she met a lady during a health care town hall who was uninsured and told her "We don't want government insurance. We take care of our own." Yes, but really, she will apply for food stamps, medicaid, social security and church charity when she's sick or homeless. Even if she doesn't we will bankrupt our hospitals taking care of her when she comes in to Emergency, and we will pay higher and higher insurance premiums to compensate. Hospitals and doctors and dentists and drug companies will keep raising their rates to cover costs as more and more people have to get stealth care. Or maybe we will carry on being callous and pass laws that let "take care of our own" woman and her 4 children huddle on a trash heap somewhere until she dies. After all, what is she to you and I...but a tax burden, right? The way things have been going in this debate, maybe we should just admit that our fellow Americans are not "our own." Japan takes care of its own...so does Cuba. Little countries, poor countries and somehow they manage to care for their sick. It's not that we can't afford to; it's that we REFUSE to do so. If we don't manage to pound out a bypartisan bill, then maybe America really is motivated by nothing but self-serving, short-sighted greed. Maybe we are a lost cause when it comes to humane behavior toward our fellow Americans.

Rae
being bitter and stuff.

Comments

[nightbeast.livejournal.com]

The beauty of England is that the health and social care sucks... but we all get treated the same way, regardless of whether we're leader of the opposition party or recently unemployed in the recession. It's the same length of queue to get treatment.

[rabid1st.livejournal.com]

Believe me, Lisa...it doesn't suck. I've been in the American system. As both a "well insured" person and a destitute person. We have long waits for doctors. I couldn't see my specialist for 2 months. My sister waited 3 months for a scan to see if she had cancer. Both of us were insured via our employer. And we have no hope if we lose our insurance. That article above is right...people just die and their dying often costs much more than if they had simply been treated.

So...how long do you wait for care? To see a doctor for example?

[nightbeast.livejournal.com]

For me personally to get diagnosed, it started with a visit to my GP. I got an appointment seven days or so but he didn't refer me on to anyone because the symptoms I could remember didn't match any known illness. It was simply written "multi-symptomatic" and not followed up by him. The University, believing I had depression because CFS had been 'ruled out' put me on a waiting list to see a Psychological Therapist. Twelve months later, I saw said therapist and she held my hand while I battled for more physical tests because she was sure I had CFS.

By this point, the government had introduced a reduced waiting time scheme for GPs, so my surgery would only let you book two days in advance. If there weren't any appointments, you had to phone the following day. Baring in mind all appointments would be taken in the first ten minutes of the line opening. So it probably took longer than seven days from wanting an appointment to actually getting one. It's one of those 'government targets met but patients worse off' things.

Armed with my outpatient piece of paper, I waited in a four hour queue for blood work, which three weeks later came back negative for the things they tested for. I was then put on a waiting list to see a Rheumatologist, but I gave up waiting after 4.5 months and paid to see one privately. So, it took... over eighteen months to get diagnosed once I'd made first contact, but I'd been ill nearly three years.

Since being diagnosed, I get an annual visit to my GP (when I remember to book) to confirm I'm still ill and the medication still doesn't do much. In five years, I've had one visit to pain management for an hour consultation... one visit to physiotherapy for the maximum thirteen hour-long sessions... and I think two visits to rheumatology to confirm I still have FMS.

My personal favourite visit to rheumatology was the doctor saying "I won't put you on the waiting list to be referred to pain management because it's too long." Another example of meeting government targets but failing to care for patients.

My Dad is slightly better since he's been diagnosed with cancer. It took them three years of check ups before they found it, but the doctor nags the admin that if he says he wants to see my dad in three months, he really means it! There was a twelve month gap of 'rescheduled' appointments (i.e. given to newly diagnosed) after removing the initial tumour, but now he's seen monthly because he's trialing a new cancer drug.

So, the NHS has its weaknesses. I'm very grateful for it, because if I lived anywhere else I'd be dead by now. But the limited funding (and by limited I mean it goes to middle management and not the ground staff and patients) means regions and illnesses are prioritsed. My local hospital is poor... my dad travels to one a two hour drive away because the resources and appointment times are much better. Plus, he is prioritised because he has one of 'the big five.'

I've got a rubbish illness. Pain is recognised but not prioritised, but fatigue is ignored. I am not good for 'tick box statistics.' Take hydrotherapy for example. Someone with a broken leg makes quantifiable improvements each session, and there is an end point when they will no longer need the treatment. My improvement in the water is not cumulative, and I'd need it for life... my long life because my illnesses don't reduce longevity.

So, over there your treatment is determined by your wallet, and over here it depends on where you are, what you've got and whether you're useful.

Lisa

[wickedgillie.livejournal.com]

Not sure if it makes you feel better, but I went through a near-identical rigamarole to get diagnosed with FMS 17 years ago. I reported symptoms to my GP as early as 1991 and didn't get a diagnosis until 1994 after a barage of tests and being shuffled from one doctor to another.

I, too, have been going through a similar diagnosis purgatory

[rabid1st.livejournal.com]

I became sick for the first time in 2004 but my primary illness wasn't identified until May of this year. I was sent from doctor to doctor. Worse, I was given many different types of treatment. First I was written off as stressed, then depressed, then sensitive and then I was diagnosed with Sleep Apnea and they blamed it for everything. I kept being given medication that didn't work, taking tests that showed I was in pain or that my muscles were injured...or that I was seriously suffering from exhaustion...but no conclusions were forthcoming beyond the Sleep Apnea, Chronic Fatigue and Fibro...so I, like you, was left to stuggle without proper care.

The difference here is that I kept forking over money for these tests and procedures. I imagine...well...let's see...if I was to go with the once a month visit to some doctor and the six times a year lab work...and the sleep studies...which are refused, my insurance would pay to discover I HAD sleep apnea...but not to treat it with a secondary study. I suppose they expected my doctor to GUESS how to set my machines. But...let's do the math on my health care out of pocket...with insurance...about 8000 dollars out of pocket over the last 6 years.

And now, I have no insurance, no way to pay for my required medications...which means...I am not going to be able to even think about working or exercising or feeding myself or anything like that. And, if I can't keep up my blood pressure meds...well...it won't matter because I'll just keel over...unless I have a stroke or something and have to go into some sort of state home.

Seriously...lines and paperwork are frustrating. I know...because I had to deal with them during my youth. We were very poor and we went to free clinics for health care...and waited for hours with very sick people all around us. Every system is going to have it's share of tragic failures. But the system we have...is frighteningly inhumane. We need to do much better for the poor and disabled in our society.

Rae
one of the disabled...and so...now...one of the poor, too.

I think the British

[nightbeast.livejournal.com]

... have what is called 'war time spirit.' We were on rationing during WWII and the decade afterwards. Everybody was treated the same - given the same booklet of tokens - but it was so little everyone clubbed together and helped each other out. I think the NHS was born out of that spirit, that regardless of who you are, everyone should be entitled to free hospital treatment. I suppose it helped having all these wounded soldiers in need of care, and the motto "the army should carry its wounded."

On a slight tangent...

The poor and disabled are easy targets in a recession. Because tax revenue is down with businesses closing, the government are looking for easy targets to put money back in the public sector. They plan to take away Disability Benefit from individuals, pay it to Social Services (three years and counting for a downstairs toilet) who will then administer you a 'personal budget' to cope with your disability. That's over half my income, that will pay someone else's wages... meaning there's no money left to spend on me.

Lisa
Like I need any more stress

Well, yes, there is that

[rabid1st.livejournal.com]

I know you are fighting for income...and yes, I agree that creating more departments won't solve anything. But the alternative is to regulate our insurance industry...along the lines of Japan or Germany...and that will really put a lot of people out of work. Because American businesses are like French aristocrats...they believe in throwing wild parties and ignoring the bread lines outside the ivory towers.

Rae

Insurance

[nightbeast.livejournal.com]

Forgot to mention,

There's no money for research at the moment in the NHS. I'd sign up for sleep studies and drug trials in a heartbeat, to know I wasn't being ignored as a bad statistic. I only found out about the Modafinil because my Dad was listening to the Radio at 4am during sleep week (target audience for insomniacs). The only study I've been a part of for FMS is to help someone (by coincidence, from my old University) graduate.

The insurance people are the same over here in terms of treatment. The people that came to fit our windows last winter, he barely had movement in his right arm. The doctors wanted to enter his wrist to ease the muscle tension so he could move his fingers more, but the insurance would only pay if they entered the skin through the existing surgery wound... by his elbow! Those would be an impressively long pair of snips.

Lisa

Re: Insurance

[rabid1st.livejournal.com]

There are experimental drugs over here, yes! For example, the drugs I was offered that were just found to cause Lymphoma in 1/3 of the patients taking them. They were dropped on the unsuspecting market thanks to deregulation and television advertising and door-to-door pharma reps spread their use to a lot of desparate people. Or the drug my sister used to help her breathe...it has eaten a hole through her septum...now she can't breathe again.

My doctor did know about Modafinil and did not hesitate to prescribe it...but many other doctors are not so savvy.

Still, your point is well taken. I believe anyone in our condition, anywhere, would be frustrated with their medical system. And it is probably true that Americans do not want NHS. What we appear to want is regulated health care...insurance that is affordable...and doctors and hospitals to make a lot less money. I do think a lot of people would be happy to have fewer, less harmful drugs at a more reasonable cost. I think that the "magic research" phase of drug discovery has given way to exploitation and poisoning over here.

[asahifirsa.livejournal.com]

Somehow health care seems to precariously work here in Austria. Everyone has to be in health insurance, you're free to pay for a private one for special privileges, like your own room, but that's basically it. It's usually not even a problem to go to a specialist. Roentgen, MRTs etc are all covered and done whenever necessary. The only thing you really pay for are medicine (where you only pay a recipe fee, not what it actually costs) and special stuff like ceramic or gold fillings and alternative treatments. Usually the money for health insurance is directly deducted from your salary, if you are your own business you have to enter yourself. If you are jobless, you get entered automatically without having to pay. Students are entered until they are 26 or 27 and then they can enter a cheaper student health insurance which costs something like 30 Euros a month.

In short, I'm a big supporter of State Health Insurance. If you feel sick, you go to the doctor or to a hospital without having to worry about bills, it's that simple. And a few days in the hospital after an accident won't ruin you, just the opposite, you won't have to pay anything and if you need a walking stick or wheel chair, it gets supplied and you return it after you're better. I really think it's worth it.

[thisficklemob.livejournal.com]

For quite some time I have felt that, as a Republican said, bipartisanship is political date rape. Democrats will compromise away half a bill, which was a compromise to begin with (hello, single payer?), and NO Republicans will vote for it. Period. So fuck bipartisanship, pass a good fucking bill.

Other than that: agree 100%.

The latest rumor is that Obama is about to cave...

[rabid1st.livejournal.com]

...on the public option. Which means all this will be is a taxpayer bailout for insurance companies and hospitals. I am spitting mad. As you say..."Fuck bipartisanship!" I have had it with these people. They are screwing us over for their corporate masters. I've also had it with the ignorant and selfish stooges who are playing puppet to the health care industry over this issue. I have one thing to say to the republicans. Ever wonder why you think the government is corrupt and can't be trusted to do anything...when you've been in power for most of the last twenty years?

Rae
sorry for the Republicans on the flist...but still...come on...Reagan, Bush, Clinton, Bush, Obama...20 years vs. 9...and you still don't trust the government not to screw you over?

Re: The latest rumor is that Obama is about to cave...

[thisficklemob.livejournal.com]

I heard that... and then there was backpedalling. "Sebelius misspoke" or whatever. All I know is, a mandate to buy insurance from these thieves isn't reform, it's a robbery.

Yes it is...absolute robbery

[rabid1st.livejournal.com]

And these morons who are all about "No Socialism" seem to think it is perfectly fine to offer the insurance companies an under the table bailout like this. Crackers!

Rae

[(Anonymous)]

No one said the US health care system is perfect -- but it's a hell of a lot better than becoming a Socialist economy, which is what the current administration seems to be aiming for. It's a livable situation for people who don't go to the ER everytime they have a sniffle.

[princessblue791.livejournal.com]

I'm about on my last hair on this issue. People are calling into our newsroom about the damn Death Panels. There are no death panels but people want to believe there are. Its like they're mad at us for not reporting that the sky is falling.
Then we find out that insurence companies are suspected of planting people at these town hall, to spread misinformation and to start chaos so nothing gets done. My guess is that if this is so, you'd better believe that Palin is in on it or she's that fucking stupid.
There has to be common ground somewhere. When one of our older employees catches an upper respirtory infection and it turns into pneaumonia, because he can't afford to go to the doctor and get treated, there is a problem. When I cracked my lower leg, I had to suffer with it for months because I couldn't afford treatment. I work hard. I have a full-time job with a company that can't afford to give me or other employees proper insurance. Something needs to change.
Worried about crowding in hospitals? In Paris, they had medical teams that make house calls for everything from a cold to a heartattack. Doctor visits are $65 and are paid for if your income is too small to cover it.
There has to be something better than what we have.

[pncwho.livejournal.com]

People are calling into our newsroom about the damn Death Panels. There are no death panels but people want to believe there are. Its like they're mad at us for not reporting that the sky is falling.
Then we find out that insurence companies are suspected of planting people at these town hall, to spread misinformation and to start chaos so nothing gets done. My guess is that if this is so, you'd better believe that Palin is in on it or she's that fucking stupid.

I'd say she's both. Death Panels. The whole idea is ludicrous. My ultraconservative Obama-hating aunt sent out her usual Chicken Little e-mail detailing the latest anti-Obama rumor, talking about these Death Panels. Considering how many Congresspeople are in their senior years or getting close, I would be extremely surprised if they voted to turn the US into Logan's Run.

I heartily agree that our current health care system is broken and needs to be fixed. Despite my good work record and my skills, I can't get a job to save my life, and all we can afford is catastrophic health insurance (if I get hit by a Mack Truck, I'm covered, anything less and I'm SOL). I don't particularly care for the proposed bill, but I've yet to see anyone offer any better ideas.

I'm wondering if a system like Canada has would be an option. Any Canadians care to talk about their health care system?

[(Anonymous)]

I'll agree about workplaces offering suck insuurance, but that would change if the upper echelon quit getting salaries that would feed a third-world country for a year. Instead of reducing their income from $100 million to $25 million, they take it away from their employees.

As for health insurance -- yes, it's overpriced and rather selective. However, a large part of said overpricing can be at the feet of those who commit insurance fraud (and ye gads, there are a lot of 'em) and those who go to the ER every third time they sneeze. Much of the rest is greed on the part of doctors/hospitals/medical communities, but as a wise woman once pointed out, doctors etc. are in it to make a living. You probably hate working paycheck to paycheck; why wouldn't they? Plus, I think it takes something like 7 or 8 years to pay off med school and the student loans most med students have.

Are there flaws? Yes.

Do changes need to be made? Definitely.

Will becoming a Socialist economy to make those changes and correct the flaws actually solve anything? Not in a million years.

The reason: once health care is socialized, everything else is fair game for the same reasons -- and I for one don't want the government telling me what I can do, when I can do it, and who I can do it with.

And that is my $0.07 (rate of inflation) on the subject.

Again, you speak...

[rabid1st.livejournal.com]

Oh, anonymous one. The thing is that Medicare and the VA are both socialism as you define it. Yet, they haven't destroyed America...far from it in fact. Most people with VA benefits and in Medicare agree that they love their plans.

Also, how in the world do you think other countries survive? And why is it that health care should be for profit anyway? I don't get that. Yes, doctors want to make money...and I believe they should...but seriously...how WELL do they need to be paid? There are doctors working in VA hospitals right now...what is WRONG with them? Are they people who just believe in medicine and care? Or are they make a good living?

But...okay...let's say we agree that changes need to be made. What sort of changes are you purposing that will allow me to afford health care now that I'm unemployed?

Rae

[joools.livejournal.com]

I'm baffled here. On the one hand, you don't want government to tell you what to do for your health care but on the other hand we're supposed to limit executive’s salaries? If they earn it and someone is willing to pay it, why not allow them? Or are they supposed to just give it back?

To cap executive pay sounds like what you call socialism. Who would be responsible for limiting this pay? The government is the only entity I can think of that has the wherewithall to accomplish this.

[xfphile.livejournal.com]

I would think, based on what anonymous said and my somewhat limited knowledge of medical billing, that it isn't so much 'capping' top executive salaries as being reasonable about them to start with. It's kind of like the money athletes get. It doesn't matter how good you are at throwing/running with/catching a football, can anyone honestly say it's worth $10 million a year? And, actually, I've always wondered: what DOES one do to 'earn' $15 million a year, plus bonuses?

The upper echelon in the majority of large. private corporations overpay themselves. This isn't something the government controls when said corporations are private entities.

As for 'willing to pay' that much money -- have you ever worked in, say, fast food? If so, I posit: who works harder? You, dealing with customers who are frequently too stupid to live, employees who think coming to work is optional, and the other myriad joys in between, like food prep, money handling, and 'my kid just spilled the third large drink at our table; can you clean it up?'?

Or is it the guy up top who's likely never worked in fast food and thus thinks that 60 seconds is enough time for a customer to find their wallet/purse/checkbook, argue about the total and/or add something to their order, pay, wait for you to make their order, get their drinks/food/condiments/extra napkins/the nickel you dropped, and get everyone (if there are multiple people) in the car situated.

You, the guy in the actual restaurant, are likely making at or less than a dollar above minimun wage if you aren't an assistant mgr or store manager (who averages between $25,000 - $35,000 a year, I think). The guy who likely seldom goes into the fast food joint is bringing home $5 million a year or more.

Quite franky, I'm not willing to pay that, but I'm not a shareholder, so I don't get a vote. And no, government control isn't the answer I'm thinking. Something along the line of 10% of net profit is more what I'm thinking -- because, in all blunt honesty, it's the peons who do the hardest, grungiest work -- and who get paid the least. Those in the upper echelon certainly deserve good money because they are the ones doing the marketing and whatnot, but what they make as upper management and what I make as the defined 'front line' shouldn't have a descrepency the size of Canada. Government control has no bearing on that.

Health care is much the same way. Anonymous didn't say 'give it all back'. Nor did (s)he say they shouldn't make high salaries. It was simply pointed out that part of the problem with health insurance costs is that we, the consumers, are paying those ridiculously high salaries -- and a little common sense and a lot less greed when setting the companies up would go a long way toward equalizing things.

Final thought: suppose government-controlled health care does happen. Where do you think that money's going to come from, because it sure as hell isn't going to fall off a tree. I mean, let's face it: premiums, actual costs for testing, hospital stays, medication, staffing, research, funding . . . one single entity CANNOT provide everything, which is why things like HMOs first got started. So, which do you choose? Do you pay monthly premiums or full price for prescriptions? Do you truly think government controlled health care will lessen wait times for specialists? Yes, if you're unemployed you will, in theory, have health care -- but you'll also have higher sales tax and probably higher income tax, property tax, etc.

Honest to God last thought: there is no such thing as something for nothing. Government-controlled health care won't lessen any of the costs; they'll just be called something else. You won't be saving money, it just won't come out of the bank quite as fast. Just . . . something to think about.

[joools.livejournal.com]

excellent points.

ok, here we go... I hope this is coherent- i haven't had enough coffee yet so i make no promises. :)

my thought was that the poster was trying to argue for free market health care and then complained about salaries paid in a free market society to excutives etc. To my mind, this is inconsistent logic. It doesn't matter whether or not I think it justifiable to pay sports people 10 million a year- the market thinks they are worth it and pays accordingly. However, if you're going to argue for controls, why pick excutive salary or sports figures? Who does that benefit, really? Lower prices? better goods? faster service? doubtful. Why not pick health care which is something we all need, anyway? healthy people want to work, they'll produce more, live longer and thereby contribute more. To argue against it in part b/c there are 'bad apples' denies the fact of all systems and societies- there will ALWAYS be 'bad apples'. Seriously, who DOESN"T know somebody who doesn't want to work, etc etc etc. We have no obligation to legislate to these people. Instead, legislate for the majority of people who are, i still think, good people who sometimes need help.

As for paying for health care- we already do. It just isn't an itemized list on the 1040 every year. We pay directly through our taxes for medicaid and medicare, our property taxes which go for local and state hospitals, clinics and doctors who treat uninsured people and etc etc etc. We pay indirectly through lost productivity, higher premiums, etc.

We already have a couple of government run health care systems: medicare and medicaid. While both have fraud issues, so do the privates. Access for Medicare is quite good, to the best of my knowledge. Access to Medicaid would be better if the reimbursement rates were more competitive. I simply don't see a problem with expanding these programs. And no, I have no problem paying more to get everyone covered.

Lastly, I'm not sure i understand what you mean by 'governemnt controlled'. Do you mean like Canada or like Britian? Near as I can tell, neither option is really on the table here.

anywho... must toddle! thanks for you reply!

[xfphile.livejournal.com]

I'll keep this short because I just had the day from hell.

My main concern with government controlled health care is this: once the government is providing health care for everyone, how long will it take before limits are imposed about how much health care an individual gets based on his 'worth' to the ecomony?

And yes, it is entirely possible for that to happen. Dicatorships don't happen because power is an easy lure to ignore.

And, truthfully, that is all I want to say. Thanks for the debate, though. My brain is now wide awake from the stimulation. Have a great night!

[joools.livejournal.com]

Rae, this post wasn't bitter, it was cogent and entirely accurate. We WILL pay for health care- coming and going. The problem is people refuse to assess the actual cost INCLUDING the indirect costs you so very clearly elucidate in your post. I like to think it fear that drives them rather than raw selfishness.