Impeding changes to our Health Care system

[classicman]

Perhaps we could have a more productive discussion. With all the BS coming from ALL sides, its difficult to address the issue at hand and what changes need/should be implemented.
What costs are we trying to reduce?
Where is the waste - specifically?
Is it the Ins Co.'s, or the Hospitals or Pharma?
Who is going to pay for what & how?

These are just a couple of the basics that seem to get lost in the partisan BS.

[Kitsune]

Originally Posted by classicman

What costs are we trying to reduce?
Where is the waste - specifically?
Is it the Ins Co.'s, or the Hospitals or Pharma?
Who is going to pay for what & how?

Are you asking about the current system or the proposed reform? If you're willing to spend some time reading, here is a fair summary of the current issue list.

I'm just now 30 and I've already experienced one of the delightful ways insurance companies screw people. During my stint in a highly stressful contract position, I developed anxiety-induced skipped heartbeats at the age of 23. Harmless, but I felt I should get it checked out just to be sure. A quick doctor's visit was all it required.

What a mistake. I got a clean bill of health from the doctor, but the insurance company had a field day with it. Despite resolution of the issue a year prior with a simple change in jobs, my policy renewal had a giant rider stapled to the top of the contract indicating that they would have no problems covering any cardiovascular issues because the doctor gave a thumbs-up but would not drop a dime for treatment of "any neurological disease or disorder". That vague statement included every single mood disorder, depression, anxiety, nervous system degenerative disease, palsy, stroke, seizure, syncope, brain tumor, and spinal disease. Had they really wanted to, they likely wouldn't have had to cover a head injury if I had skipped and fallen on the sidewalk. They would, of course, review the rider in 2 years and had the option to remove it if they deemed it viable. Of course, they didn't. It was likely stuck with me for life. Why would they ever feel the need to remove it? Not only did it decrease their potential exposure as an insurance company, but they raised my rates slightly because of it.

Fuck you, Blue Cross.

Thankfully, I got a job some years later that had underwritten insurance, but a large number of jobs in my field leave it up to the policy holder to deal with insurance directly. Next year, my company will reduce the choice of insurance policies from 3 down to 1, and there are discussions that the burden of health coverage will soon be left to the employee in order to remain competitive. It makes one very hesitant to even get an issue checked out for fear that it will bite you in some unexpected way down the line.

This needs to be fixed. It's fucking criminal.

[glatt]

Originally Posted by classicman

Where is the waste - specifically?

This was addressed by a very good study by a nonpartisan group that Undertoad mentioned in post 152 of this thread and that I linked to directly again about a month ago. It really is worth visiting and spending a lot of time digesting. There is a tremendous amount of information there.

There is an interactive graphic overview here. And the front page that takes you to the detailed study is here.

It shows that by far the greatest rates of waste in the US health care system are in insurance and administration of health care. But we over pay in virtually every other area of health care. The only place where we are cheaper than other countries is in home care and long term care. The report suggests that is because the nurses who do that work are underpaid compared to other countries. The doctors (mainly the specialists, not the general practitioners and OB/GYNs) are payed more than in the other developed counties.

To read the chart, the light blue area is what the average costs are in other developed counties. The dark blue areas are how much more we pay for those areas of health care. The orange is where we pay less. And then at the far left is all of the bar graphs added up into the total.

As of 2003, we pay $477 billion a year more than we should, compared to other developed countries, which works out to around $1,500 per person per year. Makes the cost of reform pale in comparison, assuming we can eliminate the waste.

[classicman]

eh - I really don't trust Wiki - especially when it starts with:
"The debate over health care reform in the United States centers on questions about whether there is a fundamental right to health care, on who should have access to health care and under what circumstances..."

[Shawnee123]

Well, that IS the debate, is it not?

[Clodfobble]

I think that's a pretty fair assessment of it, classic. Perhaps it makes you uncomfortable to put it in those terms, but you either believe that healthcare is a fundamental human right, or it's not. The trick is to not be ashamed of what you believe (or if you are, reassess what you believe.) Lookout, for example, will openly tell you he doesn't think healthcare is a fundamental human right, just like being rich and being happy are not fundamental human rights.

[dar512]

This is one of the reasons I love the Cellar. It just helped me clarify where I stand. I do not believe that health care is a fundamental right - if by that you mean "free to everyone".

I believe that health care should be available for a reasonable cost -- whether or not you work for a major corporation. That's a horse of a different color.

[lookout123]

Wow. Am I the go to posterchild for heartless bastards in the cellar, or what?

[Clodfobble]

Originally Posted by Kitsune

I'm just now 30 and I've already experienced one of the delightful ways insurance companies screw people.

Us, too. I have two children with lifelong pre-existing conditions. (Because even if I manage to recover them, the insurance companies go by the current medical assumption that recovery is impossible, so they will be forever autistic even if they no longer meet diagnostic criteria, and thus uninsurable for the rest of their lives.) If my husband is ever laid off, they will have to go on a state plan for uninsurable children, like my friend's daughter who is diabetic. That government-run health insurance program has been quite literally a lifesaver for her.

[lookout123]

Then you and I agree on that issue dar. I think the major problem is we having a wide range of definitions for "reasonable cost". I believe the system needs improvement, I do not believe our government is approaching the problem from the right angle though.

[lookout123]

like my friend's daughter who is diabetic. That government-run health insurance program has been quite literally a lifesaver for her.

ABSOLUTELY! I whole heartedly support safety net programs like this. My concern is where we draw the lines for the programs to prevent corporations from dropping benefits and pushing more people to the government sponsored plans simply for the sake of ease and profit.

[classicman]

I think the debate is more how to fix what is perceived to be broken, if possible. Can we spend less money and insure an additional 15-25 million people?
Can we provide care to everyone without expanding facilities and caregivers?
I still have not heard one valid argument that answers those questions with a yes.
Therefore, I come back to... How are we going to do this?

[classicman]

Which of those countries is comparable to the United States in size, population....?
Canada, Czech Republic, Denmark, Finland, France, Germany, Ireland, Italy, Mexico, Netherlands, Norway, Spain, or Switzerland.

Are any of them? They are referred to as "Peer Countries." I never thought of the US as peers to many of them - no offense intended.

Does that matter? This is the problem that I'm having with all the BS which is out there - The fact get lost in all the noise. Also this study used data which is 6 years old. Are things better or worse now?

[glatt]

Originally Posted by classicman

Which of those countries is comparable to the United States in size, population....?

They are all comparable. The costs are normalized to take into account the different economies of each country.

I can't copy and paste text from the PDF of the full report, and am too lazy to retype it, but they said in the report that they adjust for the differences in the economies of each country.

[classicman]

Can you really do that? I've been reading it and it seemed like once you accept that , its pretty straight-forward.