Should the US have a national health service?

Discussion in 'Archive: The Senate Floor' started by Darkside_Spirit, Nov 14, 2001.

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  1. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    No problem, Treecave. Don't forget to pack your toothbrush. :)
  2. Genghis12 Manager Emeritus

    Member Since:
    Nov 18, 1999
    star 6
    anakin_girl...
    "Genghis: Let's say you are in the situation you just described, and you have no money. After a lay person who knows first aid is able to stop you from bleeding and treat you for shock, who is going to follow up with you to make sure your leg doesn't get infected, or to make sure you don't get rabies?"

    There's a number of different places I can go to. Just a few examples:
    1. Family
    1. Friends
    2. Charity
    3. Religious hospital, subsidized by the "sponsoring" church to treat poor.

    Something to consider. Having stopped the threat to life, there's another thing to explore. It would be nice if I could have my leg back. Is it society's responsibility to provide for that, regardless of the cost. No, I don't think so. So, in this case, if I have no money, I may lose the leg. Whereas someone who has money to burn may find a way to save it and reattach it regardless of whether it costs $100,000.00, $1,000,000.00 or $10,000,000.00. Life is not fair in that respect.

    The difference is that 1-3 are done on a voluntary basis. I could also have included another one...
    4. Robbery.
    And I find that a distasteful alternative regardless if it's a legless vagrant holding the gun or the federal government.

    Treecave,
    Glad we see eye to eye on the necessities of life. Sorry about the confusion. When I see the title of this thread, "national health service" to me implies not only the doctors, but also the federal bureaucracy which invariably will go along with it.
  3. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    OK, enough about Canada, here?s Fierce?s idea :eek:.

    Since the main issue in providing good health care to the entire population is the high cost of funding it, then rather than infinitely trying to finance a system of inherently growing costs, I?d rather find a solution that attacks the source.

    Why are health care costs so high? IMHO:

    1. In a country with a population pushing 300 million people, we have only 500,000 doctors. Do the math, that?s one doctor for every 600 patients. That?s absurd, and no doctor can handle that kind of patient load. What do you think happens to costs when demand is high, and supply is low? You don?t have to be an economics major to answer that. Now, why don?t we have more doctors? Part of the answer is in item 2.

    2. To become a licensed doctor, you have to go to medical school. Is anyone not aware of the years and money required to do so? And it?s extremely rare to get financial aid for medical school. Only the very privileged even have a shot at it, and the very privileged also have many other options that don?t have the same burdens as medical school. Not to mention the government regulations on the number of students admitted to medical school annually. High education costs result in doctors charging high prices for their services.

    3. Malpractice insurance. It costs a fortune, and the cost is passed on to, you guessed it, the patients. Now, I?m all for patients being compensated for poor treatment, but in today?s litigious society, people are suing for obscene amounts of money over trivial things. And more often than not, they?re winning. Guess who pays?

    Okay, so here?s my theory. Say someone, let?s call him Mr. Boneguy, wants to practice medicine, and can specialize in repairing broken bones. Why does he have to spend years and years, and thousands and thousands of dollars learning the intricacies of open-heart surgery, the history of disease, and every eight-syllable word ending in -ism ever invented to describe psychological disorders? And then, why must he spend thousands and thousands of dollars in insurance every year to protect him from a mother who sues for millions because her son is traumatized over wearing a cast?

    If we eliminate these burdens, then Dr. Boneguy can be educated, and also function, at a reasonable cost. Then he can charge a reasonable cost for his services. In fact, Dr. Boneguy can?t overcharge for his services, because if he does, Dr. Bonegirl, who has access to the same education, can open an office across the street from him and charge less for her services. Imagine, patients would get to choose their doctor, and choose how much they want to pay!

    Now, bring in socialized health care. The government tells Dr. Boneguy and Dr. Bonegirl they no longer should charge their customers, because the government will reimburse them for all their costs. The price war is over. Do you think Dr. Boneguy won?t double his price? Triple it? Why stop there, why not increase it tenfold? Who?s going to complain? The patients? Hell no, they?re now getting FREE medical care! Plus, now everyone with a broken fingernail is visiting Dr. Boneguy. ?Hey, I figured all I needed was to clip the nail, but why not have a professional do it? So what if he charges $5,000 to clip my fingernail, it?s free to me!? That?s taxpayer money we?re talking about. Yours and mine.

    The only people who can stop Dr. Boneguy?s price hikes is the government, and if that didn?t just make you laugh, you haven?t been paying attention to our government. I imagine a phone inquiry regarding rising costs going something like this:

    GOVT: ?Dr. Boneguy, I have some questions for you. Regarding the costs of your procedures??
    DR. BONEGUY: ?Oh, my procedures? I thought you were calling about next week?s fundraiser. I want to make a contribution.? [Fierce?s translation] ?Hey, if you keep putting loads of taxpayer dollars in my pocket, I?ll make sure a cut of it gets into your pocket? [/Fierce?s translation]
    GOVT: ?Hey, you know what, I gotta
  4. tenorjedi Jedi Grand Master

    Member Since:
    Aug 17, 2000
    star 5
    National health service. No

    Government intervention. Yes

    Governments do a poor job in efficency and would kill an industry, and could keep talented, intelligent people from going into the industry. However HMO's are increasing the cost of health care to the point that if you don't carry insurance a trip to the emergency room could send you to bankruptcy. Doctors make a fraction of their fees if they work with the HMO. Private doctors who charge reasonable prices loose business because the HMO won't pay for doctors that won't buy into their network of care providers who give them (the HMO) a huge discount. Privately own hospitals are a thing of the past. HMO's primary concern are paperwork, the bottom line and lawsuits. I swear that it'll come to the point where you could walk into the ER with a gunshot wound and they'll tell you to take a seat and fill out your paperwork. It's like that now with anything non life threatening. The government needs to step in and control the HMO's to keep health care affordable. No one says it's can't be profitable, but when a hospital bed can cost close to 100/hour, they need to either bring in some high dollar hookers or get things reasonable.
  5. Genghis12 Manager Emeritus

    Member Since:
    Nov 18, 1999
    star 6
    Hey, Darth Fierce - quit stealing my ideas! :D

    Dr. Boneguy and Boudreax the Brain Butcher can set up shop together. :)
  6. TreeCave Jedi Master

    Member Since:
    Jul 28, 2001
    star 4
    "national health service" to me implies not only the doctors, but also the federal bureaucracy which invariably will go along with it.

    I think there's middle ground. Socialized insurance could work, if done properly. But that's the problem, isn't it? Any system would work if done properly - nothing ever is, because corrupt/inept humans always figure into the equation.

    Fierce, I agree with your "1, 2, 3" onservations, especially 3. As important as it is for maltreated patients to be able to recover both real - and in very bad cases - punitive damages, when a profession starts making policies based on the assumption of lawsuits, that hurts everyone. Unfortunately, this is happening in every business in America. And let's not just blame the people who sue - let's remember the judges who find for them. If those judges ruled against them, trivial cases would not be such a threat.

    Do you think Dr. Boneguy won?t double his price? Triple it? Why stop there, why not increase it tenfold?

    This has already happened, in a way - I know of several people in my family whose hospitals billed their private insurance, the patient and Medicare (if applicable) for the same expense. When the patient catches it, the hospital says, "Oops, billing error." Yeah, right - it's double and triple billing, and if my family's example's anything to go by (and yes, this happened for a surgery I underwent), this may be disturbingly common.

    If you're correct about doctors having to go through a lot of medical classes not related to their specialty, I think that could be changed. Make it more like a vocational school, focusing on a narrow specialty, with only some high-end biology classes to round out the education. And for god's sake, let's throw in some people skills classes, too. :D

    However, while I'm not in favor of just turning healthcare over to a democratic govt already in the habit of accepting bribes in broad daylight, I do think socialized insurance plans could work.

    Tenor, you make a good point. Some govt regulating or oversight could definitely help.
  7. anakin_girl Jedi Grand Master

    Member Since:
    Oct 8, 2000
    star 6
    Genghis: Somehow I don't think you'd be so nonchalant over the rich receiving better medical care if it were you losing a leg or needing brain surgery. [face_plain]

    Fierce: I like your idea as long as a) it would work, and b) everyone would be treated for life-threatening conditions whether they could pay right away or not.

    I don't really think it's the doctors who are money-grubbing (maybe a few, but not most); but if I were to ever organize a protest in front of a large corporation, it would be in front of an insurance company.
  8. tenorjedi Jedi Grand Master

    Member Since:
    Aug 17, 2000
    star 5
    everyone would be treated for life-threatening conditions whether they could pay right away or not.

    I'm not sure if it's a state law or a national one but an ER here cannot turn away someone in critical condition wether they can pay them back ever or not.

    I know what you mean about non pressing life threatening conditions though (cancer aids etc). One thought; doctors who are not apart of an HMO are much more likely to do a surgery for free for someone without insurance than a doctor who works for an HMO. Logical reason? The non HMO doctor, who costs less to an uninsured isn't struggling to pay his mortgage.

    hmmmm.
  9. TreeCave Jedi Master

    Member Since:
    Jul 28, 2001
    star 4
    What about preventative medicine that insurance refuses to cover?

    When I was a teenager, I was diagnosed ovarian cysts, which often leads to ovarian or cervical cancer if untreated - and my doctor said once you're diagnosed with those forms of cancer, you're generally beyond help. "The Pill" was the safest and most effective treatment, so they put me on it. My dad's insurance plan immediately excluded not only the pill, but my whole reproductive system: if I got ovarian cancer, we had to pay for it. If I got pregnant (I wasn't even having sex), if I had some totally new disorder turn up anywhere near my cervix... the insurance company had let itself neatly off the hook. But if we hadn't gotten the cysts diagnosed, and I'd developed ovarian cancer, they'd have paid for treatments which mostly likely wouldn't have saved me anyway. Sad to say, but that's as monumentally stupid as anything the govt has ever done.

    One thing that very few insurance plans cover is birth control - whether you're using the pill for contraceptive purposes or something like what I had. There have recently been some grass roots movements to change this, because any form of birth control you'd get by prescription is going to be something a woman takes, and generally therefore will be paid for by a woman. If men can get Viagra on insurance just in order to have sex, doesn't it seem fair that women should get their contraceptives covered by insurance?

    Now while there's room to make an argument about gender bias in insurance coverage, that is not my point. My point is that birth control prevents unexpected leaves of absence from work - which are VERY expensive for businesses. It prevents complicated pregnancies that cost a lot more than normal ones, in the case of women who are taking contraceptives for health reasons. It prevents unwanted babies from being born and sometimes being supported by taxpayers instead of parents. Aren't these things that the whole nation might actually benefit from?

    As opposed to Viagra, which really does no one but the patient and his partner any good.
  10. TreeCave Jedi Master

    Member Since:
    Jul 28, 2001
    star 4
    I'm performing CPR on this thread I apprently killed. I think it just had a near-death experience.

    Or maybe it was on an HMO. (yeah, okay, that's a joke worthy of getting shot at in 47 states)

    :D
  11. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    TreeCave, are you licensed to do CPR? If not, I might have to sue you. ;) Actually I'm sure I owe some responses here, I just haven't had time to devote to this in the past few days. But believe me, I will... [face_mischief] :eek:
  12. TreeCave Jedi Master

    Member Since:
    Jul 28, 2001
    star 4
    Darn! Let my CPR license expire about... 11 years ago. Ahem. Fortunately, you'll never find me! And any judge will laugh you out of court if you try to sue a "Mr./Ms. Tree Cave".
  13. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
  14. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    ...continuing from another thread.

    I'm more than willing to change my opinion on this, so tell me where I'm going wrong.

    First, what I need to have explained is: Prescription medicine costs a full day's salary, a simple doctor visit costs hundreds of dollars, and an overnight hospital stay can cost in the thousands. How is it doctors and hospitals can charge these ridiculously inflated and unaffordable prices... and get them paid for?

    Second: Regardless of right and wrong, when people complain they want this paid for and that paid for, are they saying in so many words that they want me (a taxpayer) to pay for their health care? I'm not saying I don't want to help, but in order to not skirt around the issue, we need to be direct and to the point: Do you want me to pay for your health care?
  15. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    Is this thread broken? It didn't bump up. Oh well.
  16. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    Testing...




    Finally. It took four posts to get this thread to bump up. :eek:

    Please see two posts up.
  17. Vaderize03 Manager Emeritus

    Member Since:
    Oct 25, 1999
    star 5
    First, what I need to have explained is: Prescription medicine costs a full day's salary, a simple doctor visit costs hundreds of dollars, and an overnight hospital stay can cost in the thousands. How is it doctors and hospitals can charge these ridiculously inflated and unaffordable prices... and get them paid for?

    Darth Fierce, you must always remember that there is more than one side to every story. Some of your statements are just plain ludicrous.

    A simple doctor's visit costs hundreds of dollars?? My father, who is a cardiologist, charges $35 per visit. Most physician specialists do charge somewhere over $100 for office time, but you must remember what they charge is not what they are paid.

    Doctors are not the problem here. Insurance companies and lawyers are. During the 80s, the moral demand that all receive health care resulted in many unemployed, uninsured drug addicts and the like using hospitals as hotels, in addition to whatever injuries and illnesses they were contracting from unhealthy and dangerous lifestyles. If a drug user was shot and ended up in an ER, every bit of his care was paid for by other patients.

    Ten dollars for the aspirin, five a day for the phone, one-hundred for an x-ray, all this was done to cover the costs of those who could not pay. This is known as cost-shifting, and it worked for decades.

    As the 80s wore on, this system became overtaxed. Population growth, immigration, the advent of new and experimental technologies, drugs and protocols, the cost of medical and pharmaceutical research, and inflation all contributed to a tremendous surge in the cost of health care. Doctors at the time had been using an 'ivory tower' philosophy-ie "the money is there" to justify ordering any test, doing any procedure, on any patient regardless of whether or not they could pay. The result was an unprecedented financial crisis.

    Enter the HMO. HMO's approached hospitals with the promise of salaried physicians, rationed resources, and controlled costs. Because doctors are for the most part very egotistical and loathe to work together in enormous numbers to effect political change (unlike lawyers), physicians were forced to swallow the changes without any input. Doctors decision making powers then were whittled away, piece by piece, until the current situation in which insurance bureacrats without MDs or DOs haggle every physician over every decision. In my medical school training I learn about "what the insurance company is going to fight us on" along with pathophysiology, physician-patient interactions, and physical diagnosis.

    Furthering the problem, trials lawyers saw in physician error the potential for almost unlimited liability. While the overwhelming majority of malpractice cases are decided in favor of the doctor, some cases nationwide, and especially in philadelphia, resulted in enormous payoffs. In a panic, this has caused insurance companies, over the past several years, to raise malpractice rates for most specialists, surgeons, and ob/gyn's to exorbitant numbers, usually over $250,000 a year. In philadelphia, one of the three remaining insurers of neurosurgeons offered coverage for $320,000 per year, whereas in North Carolina, a policy with the same coverage cost around $25,000.

    Now, this thread asks what would happen if the government became the single payer insurer of all physicians and their services nationwide. To control costs, an extreme rationing, such as is done in england and canada, would be needed, especially so given our enormous population. Additionally, the government would gain direct control over 1/7th of the national economy, an enormous bureacracy would be created, and quality of care would drop further than it already has due to capitation.

    While money should never be the sole motivating factor for a medical career, the brutality of residency training, the extreme level of commitment, responsibility, and liability physicians face, as well as the mental fortitude needed to make life-or-death decisions on a daily b
  18. Darth Fierce Jedi Master

    Member Since:
    Feb 6, 2000
    star 4
    "Some of your statements are just plain ludicrous. "

    Eh? You made quite an informative post there, but I don't see where it disagrees with anything I said. ?[face_plain]
  19. Vaderize03 Manager Emeritus

    Member Since:
    Oct 25, 1999
    star 5
    Sorry Darth Fierce...I just got a little testy over the 'doctors charge hundreds per visit' thing...I thought you were blaming the docs.

    My bad :)

    Peace,

    V-03
  20. malkieD2 Ex-Manager and RSA

    Member Since:
    Jun 7, 2002
    star 7
    hey folks - I perhaps can offer an unbiased opinion in this debate as I'm from Britain (free health care), but now live in the US (health insurance).

    There are pros and cons to both sides here. Obviously free health care helps those who are unable to pay for their treatment, while paying for healthcare perhaps leads to a better overall service.

    Vaderize03 I loved your post - you highlight the real problem; its the nasty insurance companies. We pay them hundreds of dollars a month (my policy is $220) and rarely use our insurance. Doctors etc etc also have to pay liability insurance incase they make a botch and we sue them.

    Then when it comes to claiming something, your insurance says you are not covered for that particular whatever. (prime example was my friend who had to have his spleen removed after an accident, and he's still paying it off years later).

    If the insurance companies were not grabbing as much money as they are, we'd all be better off.

    I think it would be impossible to try and start a national health system now - it would cost too much money. (and then what would all the insurance companies do ? ;) )

    M
  21. Maveric Force Ghost

    Member Since:
    Oct 17, 1999
    star 4
    malkieD2

    I think that you will provide a unique perspective to this thread. If you would be so kind to answer a question for me I would appreciate it.

    If you needed to see a doctor in Britain, how long would you have to be on a waiting list before you saw him? Say it was something non-emergency matter like a sinus infection.


    How does this wait compare to what you have experienced in the US?
  22. tenorjedi Jedi Grand Master

    Member Since:
    Aug 17, 2000
    star 5
    Yeah it would be too devestating to the economy to social health care, but it could be regulated if someone wasn't afraid of the insurance companies lobbists.

    Step 1. Realistic caps on malpractice
    Step 2. Make it illegal for HMO's to recieve discounted serivce from doctors or hospitals.
    Step 3. Regulate the costs of treatments to a more realistic affordable price.
    Step 4. Make it illegal for insurance companies to own or be affiliated with any company that owns a hospital.
    Step 5. Increase the protection for those without insurance, so that hospitals can't just patch them up and ship them on to another hospital.
    Step6. Make it illegal for insurance companies to give bonuses to doctors.

    Just a few thoughts about how to reorganize health care.
  23. Vaderize03 Manager Emeritus

    Member Since:
    Oct 25, 1999
    star 5
    Thanks, Malkie

    Hey Tenorjedi, good points, but on that last one, I do need to say that doctors have never gotten 'bonuses' from HMOs or insurance companies in that way.

    What happens is that an HMO withholds 10% of a physicians salary as incentive not to order too many tests or refer to too many specialists. At the end of the company's fiscal year, physicians who have not gone over their 'quota' get that 10% as a 'bonus'.

    So it's not really a true bonus. It was also against the law for physicians to tell their patients about that until a federal court threw out gag clauses.

    Don't you just love insurance companies ;)?

    Peace,

    V-03
  24. ShaneP Ex-Mod Officio

    Member Since:
    Mar 26, 2001
    star 6
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