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<p>Are you talking about healthcare in general or specific procedures that are easy to deal with? Universal healthcare systems do ration care based on factors like age so you may have universal coverage but it might not cover you depending on various factors. We ration by ability to pay and employment and likelyhood of success of procedures.</p>
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<p>You’ll also reduce the demands, by a very small amount, on our healthcare resources.</p>
<p>I’ve been in and out of hospitals my whole life (I’m young) and it’s not so much the medical care that’s going down, it’s every thing else. </p>
<p>When I get sick here, I go to the doctor and get a referral to go somewhere else for tests (sometimes that day, sometimes not) and then have to wait for them to get back to my doc. It can be more than a week before starting treatment- much longer than it took when I was young. Whereas when I was in Costa Rica (got a kidney infection in the middle of a VERY rural community), I was able to get in to see a doctor, get my testing done, and get my medicine before ever leaving the facility since it was all housed in one place and I didn’t have to wait for referrals and insurance and such. And this was a clinic in a village that doesn’t even exist on Costa Rican maps. </p>
<p>Here, I’m only 20 and I already have 4 accounts in collections- all medical. I routinely get bills from years ago where it says “this is your final notice” when I never got a bill (I just got one last week from 2009 that said it was my final notice when I’ve never gotten a bill). I even have one account in collections from going to the doctors in June 2010… the only problem is that I wasn’t even in the country June of 2010. When I call the doctors, they never can seem to find my account (or it says I owe nothing) to tell me what the bill is for. When I asked for a bill from the collections company, they literally sent me two bills that had “0s” all the way down and then my total was whited out with a hand-written number over it of what I owed the collection company. It’s f*ing ridiculous (I’ve been fighting it for a while but it hasn’t seemed to affect me so far). </p>
<p>The second to last time I was in the ER here (August of 2010 I believe) was terrible. I was transferred between hospitals and they never communicated with each other. My blood pressured dropped to the point that I passed out in the first hospital and when I went to the 2nd hospital, they had no idea this had happened. The reason that I was transferred from one hospital to the other in an ambulance was because of my blood pressure. The 2nd hospital had no idea what tests and such had been performed on me at the first hospital and really had no other info other than what I told them (after being on a LOT of pain meds and going about 48 hours without sleep). It was a total and complete mess.</p>
<p>With that said, the last time I went to the ER (a few weeks ago because of an accident), I went to one of the best health care systems in Michigan and had an absolutely wonderful experience. Therefore, I don’t know if health care is going up or down but it’s way too hit or miss IMO.</p>
<p>I am talking about people like a friend of mine’s wife thzt had czncer and could not get health insurance…</p>
<p>Or a friend of mine’s son…who has epilepsy…and could never afford health insurance If he did not have help from his dad.</p>
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<p>In an ideal market, people would self-pay, so all rationing decisions would be up to the patient who is paying, not a third party (either the government or a private insurance company whose most direct payer is most likely another third party (employer)).</p>
<p>But the risk of needing expensive medical care (particularly in an emergency or urgent situation where shopping around cannot be done) is enough that most people prefer to have insurance against an unexpected $100,000 or so medical bill. However, the individual insurance model fails because many medical expenses are often more highly predictable and schedulable on an individual basis than in other insurance markets, so many people cannot buy any insurance at all.</p>
<p>So we have the employer (or government Medicare socialized) insurance model, which puts various third parties in the mix, where rationing disagreements occur because the patient has less incentive to self-ration, while the third party payer has more incentive to ration aggressively. Add to that the tendency of employers to shrink everything down to a small co-payment, so patients have no incentive to shop around and keep costs down.</p>
<p>And even if one does shop around, there is no price transparency, since providers have different negotiated prices with each insurance company, and the list price for self-pay patients is often made extremely high since its main purpose is to be a starting point for negotiations with insurance companies. Of course providers have to deal with different reimbursements and rules for each insurance company and insurance plan.</p>
<p>How about driving down costs aggressively (by providing supply or the tools for supply)?</p>
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<p>The problem with collection companies is that they assume that all of their targets are deadbeats, and all claims of “this is not my debt” are lies, because most of their targets actually are lying deadbeats, so they won’t believe anything you say (of course, they are not necessarily the most upstanding citizens either). That is obviously a (well known) problem if you are not a lying deadbeat and the error is on their (or someone else’s) part.</p>
<p>[Debt</a> Collection FAQs: A Guide for Consumers](<a href=“http://www.ftc.gov/bcp/edu/pubs/consumer/credit/cre18.shtm]Debt”>Debt Collection FAQs | Consumer Advice)
[The</a> Fair Debt Collection Practices Act](<a href=“http://www.ftc.gov/os/statutes/fdcpa/fdcpact.htm]The”>Fair Debt Collection Practices Act | Federal Trade Commission)
[FTC</a> Office of the Secretary - Fair Credit Reporting Act Links](<a href=“http://www.ftc.gov/os/statutes/fdcpajump.shtm]FTC”>Fair Debt Collection Practices Act | Federal Trade Commission)</p>
<p>^ The collection company are well-known for having no customer services and just flat out lying. They have NUMEROUS complaints against them. I’m fairly certain this was the company: </p>
<p>[United</a> Collection Bureau, Inc. Business Review in Toledo, OH - Northwestern Ohio and Southeastern Michigan BBB](<a href=“http://www.bbb.org/toledo/business-reviews/collection-agencies/united-collection-bureau-in-toledo-oh-7271]United”>United Collection Bureau, Inc. | Better Business Bureau® Profile)</p>
<p>ucb, I know how it goes with deadbeats and such. But I’m not paying a bill that they can’t show I owe. I’ve never not paid a legitimate bill but when the hospitals can’t find my bills and the only thing that the collection company sends me is a bill that shows I should owe nothing, but that a person hand-wrote some amount in (over a whited-out “$0.00”)- I’m not paying.</p>
<p>^You should respond to them in writing as soon as you are first contacted to prevent the debt from showing on your credit report.</p>
<p>^ I didn’t even know about them until they came up on my credit report. (It was about 5 months after seeing them on my credit report that the constant calls started and I asked for the bill.)</p>
<p>I have disputed them, in writing, and they’re still on my credit report. ETA: The collection calls did stop after I disputed it in writing (which I did around September- I think).</p>
<p>Let’s say that of the men who have cancer, prostate cancer is quite common, especially so among older men. And further, men who have it typically live for many good years, perhaps decades, and typically die with it and not because of it. Assume there are studies in Europe that make a case for very selective intervention even compared to what we’re doing here today.
Now let’s say there’s a drug company that says its research shows some prostate cancer patients can get an additional 4 months of life, and the drug costs over $90 grand.<br>
Question: should the insurers/government make this available and have the policy holders/taxpayers pick up the tab?</p>
<p>In industries such as defense, healthcare, education, etc. we can increase spending five-fold or in some cases even the country’s GDP, and people can still find justifiable cause for more spending. The question is when do you say enough is enough, and ration this resource and have the will to let some needs goes unfulfilled? </p>
<p>As individual families, mainly through external constraints, and sometimes due to our values, the majority of us limit our expenses to levels below what we would spend if unchecked. Those in government, don’t yet have absolute external constraints, and have every incentive to spend more to bribe people and receive bribes to keep their jobs, hence the steadily creeping rise of govt spending directed generally to the ones that bribe the best or scream the loudest.</p>
<p>All I’m saying is that until we establish firm boundaries of fiscal responsibility, recognize that there will always be unmet needs, and make hard choices on what we won’t do based on what’s reasonable than who you’re p**ing off, it’s best not to use the strategy of just throwing more money because there’s the risk of things going downhill.</p>
<p>PS - the answer to my prostate question, is yes, Medicare and a few payers will pick up the almost $100K tab for up to 4 more months of life.</p>
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<p>Of course, special tax breaks, deductions, and credits should also be included in this category, since they are effectively like government spending for specific lobbies.</p>
<p>But also, the biggest categories of government spending, Medicare and Social Security, are non-discretionary automatically spent entitlements that will continue to grow and devour more of the government budget, while the rest ends up fighting for the scraps left over.</p>
<p>Every other country in the modern world has universal health insurance. Every other country in the modern world pays less than half of what we do on health care. Most of the developed countries have better health outcomes than we do. Health insurance for employees is a drag on American competitiveness. Medical bills are the leading cause of personal bankruptcies. Why do we cling so tenaciously to this dysfunctional system?</p>
<p>The highly profitable private insurance industry has an obvious interest in convincing us that universal coverage is akin to the gulag, and they’ve done a good job of that. In fact, the insurance industry is the only party who’s benefiting from the current system, and they are benefiting in a big way; Anthem made a $1.1 billion profit in 2010. That would have bought a lot of health care for people who can’t afford Anthem’s premiums.</p>
<p>“A nation’s greatness is measured by how it treats its weakest members.” (Mahatma Ghandi). How are we doing, America?</p>
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<p>And which of these reasons is the one that leads to people from EVERY country in the world coming to the USA for healthcare?</p>
<p>And why people are headed from the U.S. to India, Costa Rica, Thailand, Brazil, Argentina, England, Sri Lanka, and Canada for health care, paid for by insurance companies and often subsidized by U.S. taxpayer money.</p>
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<p>Our health care system is great and very attractive to foreigners- if you’re in the wealthy elite that can afford it. </p>
<p>A great health care system means absolutely nothing if many (most perhaps) of your citizens cannot afford it.</p>
<p>Without the subsidy of the government of India that produces Indian doctors for the U.S., and the subsidy of the Filipino government to produce Filipino nurses for the U.S., much of this absolutely wonderful medical system would grind to a halt.</p>
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<p>And your stats to support this claim? Those same ones who “can’t afford healthcare” walking around with an iPhone wearing $100 shoes and carrying $100+ purses.</p>
<p>Look, I realize healthcare is screwed up and I won’t disagree with that. But we have Da%$ good healthcare here in the USA. Yes sometimes it’s expensive.</p>
<p>US healthcare is fantastic if you have decent insurance or you’re in the medical field. </p>
<p>About 1/4 working-age adults are without insurance, and about 10% of children. That seems fundamentally wrong to me. </p>
<p>And your stats to back your claim? Your claim that it is THIS 25% without insurance who are walking around with iphones and expensive bags? </p>
<p>How much would it cost to cover a family of four for out of pocket insurance? Currently it costs on average about $14,000 a year. That is close to $1200/mth (post tax dollars?) and probably not realistic for a lot of people working full time. </p>
<p>I worry about those folks who lose their jobs during the recession, and along with it lose their healthcare. With pre-existing medical conditions, can they even afford their own healthcare? What happens if someone in their family gets hit with a serious diagnosis? Ah, this seems like such a nightmare.</p>
<p><a href=“http://money.cnn.com/2011/09/13/news/economy/census_bureau_health_insurance/index.htm[/url]”>http://money.cnn.com/2011/09/13/news/economy/census_bureau_health_insurance/index.htm</a></p>
<p>Look up how many people go bankrupt each year from medical bills- it’s over a million last time I checked. That will be your answer. Can’t post links from my phone, sorry. </p>
<p>FWIW- As I’ve said before…Personally I received better treatment in a Central American country than I’ve often received here for a fraction of the cost. I shudder to think of how much I would have spent on my kidney infection here. My story is not unique and that’s quite depressing.</p>
<p>How about this romanigypseyes? </p>
<p>[Medical</a> bills prompt more than 60 percent of U.S. bankruptcies - CNN](<a href=“http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH]Medical”>http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH)</p>
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