<p>Echoing what others have said, I paid 4000 dollars for my insurance last year, and my employer chipped in another 8 or 9. I’ll take some of that in salary and be happy for the rest to go to taxes to pay for national healthcare. The overhead would go down tremendously if the hundreds of redundant, superfluously varying healthplans was consolidated and the profit-making were removed from the equation.</p>
<p>“It seems as if everyone on this forum has had disasterous results with medical care. Are you all still alive by being healthy and exercising, with BMIs less than 25?”</p>
<p>I think maybe you might otherwise come to the conclusion that if you HAVEN’T had a disastrous result, you are the exception rather than he rule.</p>
<p>"By the way, mini, are all people in the US, regardless of legal status, included in your (free) universal health plan?'</p>
<p>Caught in the picky details again. That can be worked out, as it has in all of the other 24 countries with some form of national health care. But it betrays a mindset - that it is “them folks” that have trouble with the health system, not “us”. It’s what got us into trouble to begin with. (It used to be, for example, that close half those without coverage were African American or other minorities - why would we want to provide health care “to them”? Now, it is no longer the case.)</p>
<p>When you don’t provide health care to ALL residents, you end up with them in emergency rooms (at HUGE expense to YOU) or dying in the streets. You can take your pick.</p>
<p>From Ezra Klein:</p>
<p>Here’s a fun puzzle. Fill in the blanks in the statement below:</p>
<pre><code>In his talk, __________ conceded that “the ___ healthcare system is not timely.” He cited “recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month.”
</code></pre>
<p>If you said “Troy Brennan, CEO of Aetna,” and “United States,” you’d be right! If you said Canada, or Britain, you’d be wrong. The article goes on:</p>
<pre><code>A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times were worse in the U.S. than in all the other countries except Canada. And, most of the Canadian data so widely reported by the U.S. media is out of date, and misleading, according to PNHP and CNA/NNOC.
In Canada, there are no waits for emergency surgeries, and the median time for non-emergency elective surgery has been dropping as a result of public pressure and increased funding so that it is now equal to or better than the U.S. in most areas, the organizations say. Statistics Canada’s latest figures show that median wait times for elective surgery in Canada is now three weeks.
“There are significant differences between the U.S. and Canada, too,” said Burger. “In Canada, no one is denied care because of cost, because their treatment or test was not ‘pre-approved’ or because they have a pre-existing condition.”
</code></pre>
<p>I would take the three-week wait anytime over the almost 9 month wait we had here. So would 85% of British Columbia residents, and more than 70% of Washington residents, including a majority of Republicans.</p>
<p>Having insurance companies decide what treatment a patient is entilted to is such an obvious conflict of interest, but unless you have actually experienced a poor outcome as a result of this conflict of interest, it may not hit home.</p>
<p>Pearl,
I’m not in a major city (though my area has close to 700,000 people currently, so it’s not exactly unpopulated), but my experiences do not reflect this in the least. Due to a series of health issues that concern my doctor (none of them bother me at all :)) I have seen or will see my primary care doctor, a gastroenterologist (scheduled a colonoscopy and upper-endoscopy to search for ulcers last Friday and had the procedures, complete with an anesthesiologist who stayed with me the entire time, on Monday), a hematologist, a neurologist, and an oral surgeon. I’m actually finding myself pushing appointments back because right after my doctor gets the referral, I start getting calls. My sister was referred to a dermatologist this summer who she saw a week or so later. When my mother was diagnosed with breast cancer a couple of years ago within a week and a half–we were on vacation at the time, so we waited until we were home–she had an oncologist and a surgeon at two of the major hospitals in Boston. I was treated regularly at Boston Children’s Hospital while growing up even though it’s not my local hospital. I have actually been treated at Children’s for three different issues with three different specialist-types despite the fact that all of these doctors exist locally. All of the appointments I can remember were made in a timely manner (I don’t know about in childhood, of course, but I never had that impression). Is my family just lucky?</p>
<p>As I’ve said, the current US medical set-up is inefficient and poorly-planned; however, I do not think that UHC is the only alternative. In the end, I tend to take the view that overall most things run better in the private sector than in the government-sector. It’s not true with everything, certainly, but I’ve never been convinced that there are good reasons why UHC is the best (only?) alternative to the current system–which is undoubtedly flawed.</p>
<p>The previous posters covered pretty much covered everything, but here’s my own overview of things that came up while reading your post:
- insurance companies don’t run medical schools
- medical training takes years, and setting up a med school takes years; there can’t be instant response to a growing or increasingly unhealthy population
- I’ve never heard of a profession that grows in size/popularity when income falls, but that seems to be what you’re aiming for
- I want the smartest people to become doctors, so I want doctors paid enough money to attract those types of students
- I don’t understand your implication that insurance companies cause long waits for certain specialists (though I haven’t experienced this myself); How does that work? How would single-payer solve this problem?</p>
<p>Do you know what the average salary of a primary care physician is in England? (do your homework)</p>
<p>No, Mini, but I was responding to Pearl who seemed to think that lowering physicians’ salaries was good and necessary.</p>
<p>“Having insurance companies decide what treatment a patient is entilted to is such an obvious conflict of interest, but unless you have actually experienced a poor outcome as a result of this conflict of interest, it may not hit home.”</p>
<p>Yes, but I’m no more confident, if not LESS confident, in our govt. Have you tried getting through on the phone to talk to someone at tax time in the IRS lately? Or in the passport office? Or social security? How about something as simple as getting a drivers license replaced (finally they started doing it online, but before that it was a nightmare)? I cannot think of one govt interaction that has been easy for me in time of need.</p>
<p>How about the Post Office? :eek:</p>
<p>(My office is currently having to spend our valuable time making follow-up calls to everyone who has been invited to an upcoming event because many of the invitations haven’t arrived at their destinations. Very frustrating.)</p>
<p>“In the end, your answer shows what I’ve been saying–you think a doctor “deserves” a nicer house and better schools than my doctor-H’s family has, and I don’t. We’ll just have to disagree…”</p>
<p>You happened to have found a very cheap area of NJ. I don’t have any idea where this is, or what your quality of life is. I do think that docotors deserve a life-style that includes a safe place to live, with good schools, and the opportunity for a spouse to stay home, as you did, while the children are growing up.</p>
<p>My experience in the NY/NJ/Boston/DC areas is that on $3000/month, it would be very hard to have all of that.</p>
<p>The model of doctors as public servants in the US for low salaries would greatly decrease productivity. Do you think that the GPs in the UK have incentives to work harder? It is a 30-36 hour week at most, with private offices added on during the week. Doctors here generally have much longer hours.</p>
<p>As to the question about US medical schools, yes many of them are state supported, and this takes a big commitment from the states to fund them. The accreditaion process is also very tough. But there are several new medical schools in the US cropping up.</p>
<p>The bigger question in all this is how to get the population of the US to be healthier. It doesn’t take a doctor to tell people to cut back on junk food and exercise, instead of sitting in front of a TV, video games, or a computer. Or to stop drinking 12 beers a day, which are high-caloric and ruin the liver. Or to stop smoking cigarettes. The favorite medical pasttime for a lot of these folks is to then doctor-bash when they can’t make a 300 pound patient feel better immediately.</p>
<p>I would rather see the government and insurance companies provide incentives for these people, then fund another giant entitlement program.</p>
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<p>And so we swing back around to post #11.</p>
<p><a href=“http://talk.collegeconfidential.com/showthread.php?t=363896[/url]”>http://talk.collegeconfidential.com/showthread.php?t=363896</a></p>
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<p>I see your point, Doubleplay, and I agree it is worrisome. But, like they do with Social Security and personal retirement accounts, might not people who are concerned purchase private supplemental insurance? At least with universal healthcare, the poor and a good portion of the middle classes would not go uninsured the way they do now.</p>
<p>Let’s not discount the myriad of ailments that affect otherwise healthy and active people, though. My son, as a young healthy athlete, had far more medical bills than I ever did before the age of 20! I’d be willing to bet that his <em>bills</em> rivaled my parents (up until they were in their 70’s, at which point no one could be blamed for parts failures). </p>
<p>I read some statistic somewhere that some ungodly percentage of our total lifetime health bills (like 90% or more) occur during the last phases of our lives. Nothing you can do about <em>built-in obsolescence</em>.</p>
<p>“I read some statistic somewhere that some ungodly percentage of our total lifetime health bills (like 90% or more) occur during the last phases of our lives. Nothing you can do about <em>built-in obsolescence</em>.”</p>
<p>It is actually “end-of-life care,” which is different, and includes all ages. It is not just being old. </p>
<p>If you take the statistics of how much in the way of lung cancer treatment and COPD treatment (mostly from smoking), heart attack treatment (smoking, obesity, high cholesterol), liver treatment (alcoholism), etc etc is spent versus what is spent on generally healthy people of all ages with a desirable BMI, no smoking, no alcoholism, no obesity, than the statistics are very astounding.</p>
<p>United Health Care announced a program recently where health insurance deductibles will be incrementably lower for people who don’t smoke, aren’t obese, and have other lower risk factors. They do not include risk factors that are not controllable. </p>
<p>The other way to control these behaviors that lead to poor health, is to do what Mayor Bloomberg did, to discourage smoking. The tax on cigarettes is now $1.50 a pack in NYC, and because of this and other changes, the smoking rate in NYC has decreased by 18% in the past 5 years. This should greatly improve health for both smokers and those around them.</p>
<p>How does one establish incentives for R&D under a government universal health care system?</p>
<p>So much of what we take for granted, all the ads we see on TV about stuff like urinary incontinence, male impotence, sleep and depression problems…all that stuff is profit ruled. None of those “new” drugs would be developed without a profit motive. Fast forward/backward to stuff like breakthroughs in joint replacements, microsurgeries, etc. How much of that stuff wouldn’t be around if it weren’t for a profit motive.</p>
<p>Look at NASA. 30 years ago the govt decides that we don’t need to advance space exploration for now. So we stop. How much further along would we be right now if we would have continued development at the pace of the 60’s? Can you imagine? </p>
<p>In the event of a universal medical system, how many OPPORTUNITIES will be lost because of political decisions? Our children and grandchildren will never know what they missed, just like we don’t know what we missed by the space program slowdown.</p>
<p>Look at stem cell research…how much politics can affect medical decisions. Think about FULL government control.</p>
<p>“so much of what we take for granted, all the ads we see on TV about stuff like urinary incontinence, male impotence, sleep and depression problems…all that stuff is profit ruled. None of those “new” drugs would be developed without a profit motive. Fast forward/backward to stuff like breakthroughs in joint replacements, microsurgeries, etc. How much of that stuff wouldn’t be around if it weren’t for a profit motive.”</p>
<p>You make a good point. But many of the so-called “improved” treatments are not any better or safer than the older medications. If there was federal grant money to develop new drugs and procedures by doctors and scientists, then I think that the research would still happen, as long as the funding was sufficient. The billions of dollars of profit for drug companies would be eliminated, but drug prices should also go down enormously. So much of those new medications are reformulations or hype. The really necessary ones would still be developed.</p>
<p>The TV advertising has caused so many unnecessary and more expensive prescriptions to be written by doctors. Patients demand new drugs that often are not as good and have more side-effects than the older drugs. Then a lot of the drugs get recalled. That TV advertising should be the first to go.</p>
<p>Just jumping in to say that I will read this thread tomorrow, but I just returned from seeing the movie. I am a healthcare provider and found the movie to be painfully accurate, IMO.</p>
<p>After seeing the movie, my wife and I briefly (but seriously) talked about moving. She’s a hospice nurse, and in demand virtually everywhere. But because of her “prior condition”, if I retire, there isn’t a health insurance company in the country that will write us coverage. </p>
<p>Now that would be an interesting one: a healthcare provider LEAVING the U.S. because she couldn’t get medical coverage. </p>
<p>“None of those “new” drugs would be developed without a profit motive.”</p>
<p>No, none of those drugs would have been developed without HUGE GOVERNMENT SUBSIDIES that we pay now, through NIH, and through subsidizing the trials and evaluations. We then get the honor of paying twice (for the drug we already paid for.) Go check the actual RD budget of the major pharmaceutical companies in the U.S. - they are TINY compared to the profit margins. </p>
<p>And when there are no subsidies (as in the case of providing low-cost vaccination that can save tens of thousands of lives), the drugs don’t get produced.</p>
<p>Mini, if you currently have health insurance in WA, you CAN move to private insurance and have the pre-existing condition be covered. You have to make sure the coverage is continuous, however. It may not be cheap! My husband and I pay about $1K/month, but we do have coverage.</p>
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<p>I agree, and that is why I think that many are trying to “shoot the messenger”. By attacking Moore’s personal health and weight, we are avoiding the larger issues. Even Moore explained how in France the doctor gets bonuses for getting people, like Moore, to improve their health. France seems to practice a lot of preventative medicine.</p>
<p>I don’t know if there will be any solutions that come out of this movie, but I am glad that Moore made it.</p>
<p>“Go check the actual RD budget of the major pharmaceutical companies in the U.S. - they are TINY compared to the profit margins.”</p>
<p>The pharmaceutical companies claim that they put at least 1/2 billion dollars into research for each drug that is produced. </p>
<p>mini, do you have a reference for the claim that they don’t?</p>