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Hot Topic! Health care...public or private?, Is there really a crisis?
Pyxis
post Sep 17 2008, 02:17 PM
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The most frustrating thing in this (and past) elections is the lip service given to the health care crisis in the U.S. I work in health care, and I do think there is a crisis...and nobody is dealing with it. When a working class individual cannot afford to get basic preventative care, then that person is forced to wait until health issues become complicated, and expensive, to treat...that's a problem. When underinsured people use emergency rooms as a clinic, because they can't afford to establish with a regular physician...that's a problem. When the elderly and the chronically ill skip doses of medication in order to stretch them out longer...that's a problem. When the cost of unexpected medical expenses puts excessive strain on a family who was unable to obtain health insurance...that is a huge problem.

So, what do you think? Do you feel the Republicans have a solid plan for addressing this, or is it just business as usual? Is the Democratic plan to work on national health coverage for individuals to buy into a wise move? I would love to know how government run health plans work in other countries, for instance, I have heard horror stories about waiting times for basic services in Canada...is it really that bad?

Barack Obama's plan
John McCain's plan


This post has been edited by lirene: Jul 27 2009, 11:33 AM
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JohannMdlAmerica
post Sep 17 2008, 02:52 PM
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What happened to you watching the best Quidditch game ever???? tongue.gif


Neither party has a decent plan for health care IMNSHO.

It starts with a basis in law: Docs will work to provide the best health care possible. If a malpractice happens, the inherent obligation of the doc and the hospital is to make it right. The law presumes a malpractice is the responsibility of the doc and the hospital.

That puts a monkey on the hospital to make sure the doc does things right.

OK. Ban consumer advertising for prescription meds. That's two.

Third, docs and nurses, upon completion of residency/training, must spend 10 years practicing in rural America. That's any city under 100K population. There's too many areas these days underserved by the healing arts.

Fourth, implement a tax credit to the individual/family: X dollars per year for a physical examination. Credit can only be taken if the physical is taken.

Fifth, implement a tax credit for medication: Generics only. X dollars per year per generic prescription. X is defined as cost of manufacture + 15%. How pharmaceutical manufacturers and pharmacies split the 15% is their business.

Those are my thoughts. There's no hard policy analysis behind them, but what we need is something like the Dole Board for veterans medical care: Elder statesmen from both parties laying out a common sense solution. There has to be one out there. Socialized medicine isn't it. Let the free market play isn't it either.


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Lady Lovegood
post Sep 18 2008, 08:21 AM
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I think there's no reason we should be in healthcare crisis. And I'm certain we are. Basically, you're only guaranteed insurance if you work full time. With so many jobs leaving the country, that's constantly adding more names to the long list of uninsured.

If you work part time, like me, you're screwed. I do have an insurance plan. But it's practically worthless. It only covers one thing, hospitalization, and that's after I pay the $2,000 out of pocket. Which I'm not even financially well enough off to have in my pocket.

I know many seniors have a hard time affording medication and what not. Their simply not adequately covered. Medicare is supposed to help them, but many seniors say it's not enough. Or they can't afford all the multiple plans.


I also think a major problem in this country is abuse of the medical system. I've heard countless stories of people claiming to have a disease they don't so they can scam their way into free money. I have distant relatives who are always trying to use the latest disease as a free ticket to a portion of social security or something. Or I know women who get pregnant, repeatedly, refuse to work, but still draw welfare.

All this costs us money. A few scammers are forcing the rest of to pay out money we shouldn't have to, and can't afford to. And unfortunately, these numbers keep growing. Whatever happened to honesty?


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jberry116
post Sep 18 2008, 01:05 PM
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I personally believe there is a huge problem with health care, but i'm not really sure either party has a great plan or will do enough. It seems to me that it should be a basic human right to have access to health care. You shouldn't have to worry about money in order to be allowed to live. Basic services like annual checkups, life saving medications and treatments, should be something we all have access to.

Though it does seem that if as an individual you are engaging in dangerous activities (i.e. drugs, smoking, and other unhealthy lifestyle choices) then perhaps you should be expected to cover costs related to those issues, but the basic right to live shouldn't be a consideration. I hate drug comercials because they're selling a product to make money, and that seems wrong to me. Medical bills shouldn't be something that destroys lives, or prevents treatments. Perhaps I'm way off the mark, but that's my opinion.
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George Weasley...
post Sep 18 2008, 01:13 PM
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QUOTE(jberry116 @ Sep 18 2008, 01:05 PM) *
I personally believe there is a huge problem with health care, but i'm not really sure either party has a great plan or will do enough. It seems to me that it should be a basic human right to have access to health care. You shouldn't have to worry about money in order to be allowed to live. Basic services like annual checkups, life saving medications and treatments, should be something we all have access to.

Though it does seem that if as an individual you are engaging in dangerous activities (i.e. drugs, smoking, and other unhealthy lifestyle choices) then perhaps you should be expected to cover costs related to those issues, but the basic right to live shouldn't be a consideration. I hate drug comercials because they're selling a product to make money, and that seems wrong to me. Medical bills shouldn't be something that destroys lives, or prevents treatments. Perhaps I'm way off the mark, but that's my opinion.


Doctors cannot by law refuse you care if you need it. That is the reason that the emergencies rooms in the US are going out of business too many people who can not pay their bills using them as doctors offices. So my question, what do you think is a fair amount to pay a doctor for their services and that of medical staff, what is the fair price for medication and what is the fair price for medical procedures? Things cost money. While insurance is an option, expensive but an option, how do you propose the medical field charge patients so they can 1 make a profit, but not bankrupt someone who needs to go to the doctors?


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Pyxis
post Sep 18 2008, 01:25 PM
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QUOTE(JohannMdlAmerica @ Sep 17 2008, 12:52 PM) *
It starts with a basis in law: Docs will work to provide the best health care possible. If a malpractice happens, the inherent obligation of the doc and the hospital is to make it right. The law presumes a malpractice is the responsibility of the doc and the hospital.

That puts a monkey on the hospital to make sure the doc does things right.


I think torte reform is a must when considering how to lower health care costs. Malpractice insurance premiums are so out of control that there are many specialties docs will not even consider going into because the risk of lawsuit is so high (Obstetrics is one of those specialties, there is already a shortage of OB's in my neck of the woods). Arbitration in front of a panel of peer physician's might be a better way to handle disputes in healthcare. The patient still has the option of legal representation by a lawyer, but the facts of the case are presented to doctors instead of a jury, and damages are awarded by an arbitrator. The benefit of this is that a doctor is more likely to understand the subtle clinical decisions, the downside is the possible bias physician's might show for each other. Going along with torte reform would have to be increased public knowledge about those doctors who have been investigated for malpractice within the medical community. Currently, I believe, the hearings are confidential, so a doctor who is known to have a consistent history of poor performance is shuttled within the system leaving a trail of mistakes behind. McCain supports torte reform. Obama doesn't address it at all.

QUOTE
OK. Ban consumer advertising for prescription meds. That's two.


I have worked in a private physician's office and a private clinic...the public would be stunned to realize how much money is spent by the drug companies to woo the doctors into prescribing their meds. In both places of employment we had drug reps who would buy lunch for the entire office staff in order to get a few minutes of time with the doctor. Not once a week, not twice, but every day. I don't think it is unreasonable to limit the profit that a company can make from a drug.

In the U.S. drug companies are granted a patent for their new drugs for a period of, I believe, seven years. During this time nobody can make a generic, and the drug company is allowed to charge a ton of money for a drug that is not available as a generic. I have been told that this is to allow the drug company to recover the cost of research. If we remove the patent privilege, then there is no incentive to research new drug therapies, but again, I don't see anything wrong with limiting the profits and drug companies should be required to justify the charge for new medications.

QUOTE
Third, docs and nurses, upon completion of residency/training, must spend 10 years practicing in rural America. That's any city under 100K population. There's too many areas these days underserved by the healing arts.


This seems a bit harsh. With technology the way it is now, it is feasible for rural communities to have access to specialists. My hospital runs a telemedicine clinic, where doctors meet with patients via satellite and internet cameras, X-rays are sent digitally.



QUOTE(Aphrodites Lady @ Sep 18 2008, 06:21 AM) *
If you work part time, like me, you're screwed. I do have an insurance plan. But it's practically worthless. It only covers one thing, hospitalization, and that's after I pay the $2,000 out of pocket. Which I'm not even financially well enough off to have in my pocket.


I think the days of employers offering comprehensive health insurance, cheap, are over. Health care costs are just too high for employers to continue to pay the outrageous premiums, so they are passing the increasing costs to the employee. It would be much better for a person/family to be able to buy their own policy that stays with them no matter where they work. The problems that I faced when trying to do this very thing, is the ever present 'pre-existing condition'. Overall my family is fairly healthy, but I have one child with a chronic (easily treatable) condition and the companies I applied to turned the entire family down because of this one condition. It was very frustrating. I like Obama's plan to offer a national health care policy for people to buy into, but it has to be attractive to the healthy people as well as the unhealthy, or it will not be able to succeed for very long. I also think that McCain's plan to offer tax incentives for people to apply towards a personal Health Savings Account is good, but the money would have to be directed to an account that is only accessible for health costs, otherwise we are right back where we began.
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jberry116
post Sep 18 2008, 01:39 PM
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Oh yes,they can give you care if you need it, and then a bill comes later. And define need. If I have cancer can I just walk into the cutting edge cancer treatment center int he country and expect to get care? I work in Benefits for a large company, and I see things like the company paying for a drug that costs $20,000 per pill. Is that a fair price? For the employee they luckly only pay the company set copay, but the company has to pick up the other 19,000 dollars for each pill.

I certainly agree that everyone should be compensated for the work that they do, however I would argue against the idea of profit for the health care industry. They aren't selling a product, they're keeping people alive, and I don't feel thats something that people should profit from. I don't want to wonder if I'm getting the best treatment because I don't make enough money, or if the drug I'm getting is the best/necessary because the doctor gets a bonus or perks from the drug reps. Perhaps medicine should be something that we do because it's the right thing to do, and because eventually we're all going to be sick or need help, rather than some business to make loads of money in. Perhaps health shoudl be an effort to better humanity, not something to make piles of cash. That's all I'm saying.
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JohannMdlAmerica
post Sep 18 2008, 01:56 PM
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First we get the lawyers out of medicine.

Then, we make the cost of medical education beyond reasonable. I'd put some powerful tuition incentive in play in the land grant universities for med students/nursing students to educate and then stay in-state for a major chunk of their workforce time. (OBTW, create a disincentive to bail out... like the cost reverts instantly).

That's part of it too. When your 30-something doc, entering practice, has $500K in loans behind him for med school, he's got to charge to get out from under.


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lirene
post Sep 18 2008, 01:57 PM
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QUOTE(jberry116 @ Sep 18 2008, 02:39 PM) *
I certainly agree that everyone should be compensated for the work that they do, however I would argue against the idea of profit for the health care industry. They aren't selling a product, they're keeping people alive, and I don't feel thats something that people should profit from. I don't want to wonder if I'm getting the best treatment because I don't make enough money, or if the drug I'm getting is the best/necessary because the doctor gets a bonus or perks from the drug reps. Perhaps medicine should be something that we do because it's the right thing to do, and because eventually we're all going to be sick or need help, rather than some business to make loads of money in. Perhaps health shoudl be an effort to better humanity, not something to make piles of cash. That's all I'm saying.
As a medical professional, I hear this argument all the time. In order to get care, doctors need to get paid. I've spent my entire life in school to give cancer patients the treatment they deserve and in order to do that, I too need to be able to pay my bills smile.gif So what you are proposing is a bit unrealistic. I personally don't get perks just because I use certain chemotherapeutic drugs. And I don't allow drug reps to buy either myself or staff lunch. I abolished that one because it wasn't necessary. If a drug rep has a drug to offer; I, as well as my colleagues meet with them in conference. And whoever is hungry can eat, but during their own time smile.gif

I can't treat patients with my bare hands, without the necessary equipment, without the different departments in the hospital, etc. Treating patients is the number one goal; and not making money.

Having said this, health care definitely needs to be improved in this country.


This post has been edited by lirene: Sep 18 2008, 01:58 PM


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jberry116
post Sep 18 2008, 03:17 PM
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QUOTE(lirene @ Sep 18 2008, 02:57 PM) *
QUOTE(jberry116 @ Sep 18 2008, 02:39 PM) *
I certainly agree that everyone should be compensated for the work that they do, however I would argue against the idea of profit for the health care industry. They aren't selling a product, they're keeping people alive, and I don't feel thats something that people should profit from. I don't want to wonder if I'm getting the best treatment because I don't make enough money, or if the drug I'm getting is the best/necessary because the doctor gets a bonus or perks from the drug reps. Perhaps medicine should be something that we do because it's the right thing to do, and because eventually we're all going to be sick or need help, rather than some business to make loads of money in. Perhaps health shoudl be an effort to better humanity, not something to make piles of cash. That's all I'm saying.
As a medical professional, I hear this argument all the time. In order to get care, doctors need to get paid. I've spent my entire life in school to give cancer patients the treatment they deserve and in order to do that, I too need to be able to pay my bills smile.gif So what you are proposing is a bit unrealistic. I personally don't get perks just because I use certain chemotherapeutic drugs. And I don't allow drug reps to buy either myself or staff lunch. I abolished that one because it wasn't necessary. If a drug rep has a drug to offer; I, as well as my colleagues meet with them in conference. And whoever is hungry can eat, but during their own time smile.gif

I can't treat patients with my bare hands, without the necessary equipment, without the different departments in the hospital, etc. Treating patients is the number one goal; and not making money.

Having said this, health care definitely needs to be improved in this country.


I never said I didn't believe doctors should get paid. Of course they should get paid, and they should get paid a good salary for all the hard work they do to get a degree and the work they do once they have that degree. I think the salary of doctors and the profits of insurance and drug companies are two completly different beasts, and my irritation goes more toward that side of the argument.
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