What is wrong with the American health care system?

#1
I am watching this program called "Sick around around the world" on our PBS and I am thinking 'what the feck is our big medical problem' and my immediate thought is: we are being screwed by the big medical companies.

What to do?

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Makes me want to scream. Makes me want to fecking scream.

DD
 
#6
Everything is wrong with the US medical set up. My kids live in the States and when my daughter got really sick (close to death), her doctor said she wouldn't do anything for her because her mother was a little behind on payments for previous treatments.

Any medical system that puts profit ahead of a childs life is SICK SICK SICK

[END OF RANT]
 
#7
mac_uk said:
Everything is wrong with the US medical set up. My kids live in the States and when my daughter got really sick (close to death), her doctor said she wouldn't do anything for her because her mother was a little behind on payments for previous treatments.

Any medical system that puts profit ahead of a childs life is SICK SICK SICK

[END OF RANT]
Sorry to hear about your kids.

Unless we are carefull the same could happen to the NHS.

The national ID card has been spouted as the best method of limiting the NHS facilities being abused by the holiday sick claimers.
 
#8
oldgoat said:
Nothing whatsoever.

Providing you have adequate insurance and a good job and a few dollers in the bank.
I'd agree with that if you tag on the end, "and don't ever get sick".

Just because you have insurance, it doesn't mean the insurance company will pay the claim, if they don't feel like it.

I'm firmly of the opinion that universal health care should be a right and not a privilege. The US system falls squarely in the latter category.
 
#9
Its a template for the UK Private health care Insurance system.

Who have the right to dump you at the nearest NHS hospital if they are no longer able to treat your ailment.
 
#10
mac_uk said:
Everything is wrong with the US medical set up. My kids live in the States and when my daughter got really sick (close to death), her doctor said she wouldn't do anything for her because her mother was a little behind on payments for previous treatments.

Any medical system that puts profit ahead of a childs life is SICK SICK SICK

[END OF RANT]
Then maybe she should have paid the bills. Furthermore as a last resort she could have taken the kid to the local ER and sought treatment. Any public hospital MUST treat regardless of insurance or ability to pay.

What's wrong with health care and it's costs is Government involvment, laywers that are sue happy and insurance companies just paying out friviolus claims to avoid having to fight the non-sense in court.

Next time she takes the kid to the Dr for a visit have her ask what it costs him to carry mal-practice insurance and how much he is required to carry. How much it costs him to have staff to process the claims through Medicare/aid, the various insurance companies, and then chase down the same for payment.

The solution is quite simple HSA's and a tax write off of upto 15K a year. Let me deal with the Dr and let the Dr deal with me.
 
#11
PsyWar.Org said:
oldgoat said:
Nothing whatsoever.

Providing you have adequate insurance and a good job and a few dollers in the bank.
I'd agree with that if you tag on the end, "and don't ever get sick".

Just because you have insurance, it doesn't mean the insurance company will pay the claim, if they don't feel like it.

I'm firmly of the opinion that universal health care should be a right and not a privilege. The US system falls squarely in the latter category.
My bold.

Unofrtunately thats completely impossible and some would argue that unachievable rights are therefore not actual rights.

As it happens, the US healthcare system is poor, but not nearly as black as you guys paint. The main problem lies not in treatment at hospital (of which there are a few annecdotes of appalling care, but I can provide many from the NHS to match) but in vaccinationg those without insurance. This is not covered by anyone, whereas hospitals will still treat the uninsured in emergency cases.

Its an expensive system but the US govt actually pays comparatively little in comparison to this country. On an individual level the quality of care is much higher in general and those with the ability to pay the (actually quite small) insurance costs have access to world beating treatment. IT is indeed a shame about those who miss out and this needs urgent attention from the next president, but at least lets be clear on this before we rip the entire system apart.


Edited to add: As ctauch said, we could cure most of the problems by getting rid of their litigation system. No fault litigation with structured pay outs would be a much cheaper way of running the system. It would also improve the quality of care as doctors wouldn't be scared of treating people.
 
#12
jew_unit said:
PsyWar.Org said:
I'm firmly of the opinion that universal health care should be a right and not a privilege. The US system falls squarely in the latter category.
My bold.

Unofrtunately thats completely impossible and some would argue that unachievable rights are therefore not actual rights.
Every other country in the Western World manages it.

As it happens, the US healthcare system is poor, but not nearly as black as you guys paint. The main problem lies not in treatment at hospital (of which there are a few annecdotes of appalling care, but I can provide many from the NHS to match) but in vaccinationg those without insurance. This is not covered by anyone, whereas hospitals will still treat the uninsured in emergency cases.

Its an expensive system but the US govt actually pays comparatively little in comparison to this country. On an individual level the quality of care is much higher in general and those with the ability to pay the (actually quite small) insurance costs have access to world beating treatment. IT is indeed a shame about those who miss out and this needs urgent attention from the next president, but at least lets be clear on this before we rip the entire system apart.
The US spend far more on healthcare than anyone else, yet they don't have anywhere close to "the best" healthcare. Most of Ford's (and many other companies') problems are directly attributable to healthcare costs. Insurance is hugely expensive and the insurers will try everything they can to get out of paying up. Medical costs are the single biggest cause of debt and bankruptcy in the US.

Some numbers from here:

In 2007, health care spending in the United States reached $2.3 trillion, and was projected to reach $3 trillion in 2011. Health care spending is projected to reach $4.2 trillion by 2016.

Although nearly 47 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens.

In 2005, the United States spent 16 percent of its gross domestic product (GDP) on health care. It is projected that the percentage will reach 20 percent by 2016.

The annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $12,100 in 2007. Workers contributed nearly $3,300, or 10 percent more than they did in 2006. The annual premiums for family coverage significantly eclipsed the gross earnings for a full-time, minimum-wage worker ($10,712).

Health insurance expenses are the fastest growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits by 2008.

A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. The study noted that 68 percent of those who filed for bankruptcy had health insurance. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses. Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.

Retiring elderly couples will need $200,000 in savings just to pay for the most basic medical coverage.

The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.
 
#13
"Its an expensive system but the US govt actually pays comparatively little in comparison to this country. On an individual level the quality of care is much higher in general and those with the ability to pay the (actually quite small) insurance costs have access to world beating treatment. IT is indeed a shame about those who miss out and this needs urgent attention from the next president, but at least lets be clear on this before we rip the entire system apart."

Couldn't have said it better. As it stands, 15% of Americans do not have health insurance. That is sad and unfortunate, and I would welcome some kind of limited free healthcare benefit extended to those who cannot afford it. At the very least for children (under 18). But socialized healthcare in this country is not possible. Right now, the 85% of Americans who can pay insurance have access to world class health care. Now before everyone cites examples from Michael Moore's latest flick, remember that there are health care horror stories everywhere, even outside the US. I have experienced the healthcare system in Canada and it would take me an entire day to point out all the wholes in the system. Just a few examples are the ridiculous waiting lists, the almost nonexistant specialists (there are only 2 ENT doctors in the greater Montreal area, for example), the 24 hour wait for lab results (when they should only take 30 minutes) and the lack of equipment and people that can treat an advanced illness (I know of a Canadian who spent his life savings in the States to remove a tumor that couldn't be done in Canada) . And Canadians pay almost twice as much in taxes we do, for a mediocre system. Yet the response by many is "well, at least it's free". I can't tell you how many times I had to let mother nature do all the treatment before I could see a doctor. The beaurocracy in the system is ridiculous. And for all the complaints, it isn't that hard to get insurance, even if your financial situation is less than ideal. 10 years ago my sister waited tables at TGIF's and got health insurance for both her and her kid for the cost of her 2.85 an hour minimum wage, which was an infinitestimal amount compared to what she took home in tips.
 
#14
jew_unit said:
PsyWar.Org said:
oldgoat said:
Nothing whatsoever.

Providing you have adequate insurance and a good job and a few dollers in the bank.
I'd agree with that if you tag on the end, "and don't ever get sick".

Just because you have insurance, it doesn't mean the insurance company will pay the claim, if they don't feel like it.

I'm firmly of the opinion that universal health care should be a right and not a privilege. The US system falls squarely in the latter category.
My bold.

Unofrtunately thats completely impossible and some would argue that unachievable rights are therefore not actual rights.
Why is it completely impossible? Both the US and UK has universal education, so why not health care? The UK has universal health care and, despite the bad press it often receives, it is still a world class system.

As it happens my wife is an RN and she has worked for the NHS in the UK, in the US health system and in other countries. The quality of care isn't an issue, on the whole the US and UK are fairly equal in terms of medical treatment and professionalism of the medical staff. There are some things, in her opinion, that the US system is better at and others the NHS are better.

For me it's a no brainer, the more people that pay into an insurance system, the lower the premiums, combine that with an insurance system that is run at cost, rather than one that is commercial, which is the better? Surely it's the one with the most members and doesn't make a profit?
 
#15
ottar said:
jew_unit said:
PsyWar.Org said:
I'm firmly of the opinion that universal health care should be a right and not a privilege. The US system falls squarely in the latter category.
My bold.

Unofrtunately thats completely impossible and some would argue that unachievable rights are therefore not actual rights.
Every other country in the Western World manages it.
I won't bother dealing with the statistics as they prove nothing, particularly as they change their point of reference casually throughout.

No country in the world delivers universal healthcare free at the point of delivery. Almost all in the west achieve universal healthcare, including the US. There is a major difference between the two. The NHS does not and cannot provide universal care. Those in the medical profession already know that the NHS is in hot water, and the public will very soon realise that a comprehensive NHS is impossible without a massive hike in taxes and drop in burocracy. Even then, we don;t have the doctors to do the task. The problem is the same in the US but they have a diferent way of dealing with it. The difference is that it will not cost them much to deal with their problem (largely to do with vaccinations and community care) whereas there seems to be no way out of ours.

The best healthcare in the world is considered to be in France (god knows how they managed it) which uses a combination of private and public health. The US is moving towards this, but an insurance led system actually would prevent many of the problems of the French system which requires you to pay up front for care and the recoup about 80% of the spending. The real point here, however, is that a pure public healthcare system is impossible to run.

Edited to respond to psy: Our system has a lack of competition which drives up costs massively. We also do not have universal education, nor does the US. All that happens is that the governments tell us we do. To prove this, do any of you send your kids to private or grammar schools? If not, do you ever complain about the private or grammar schools? If the answer to either of these is yes then you don't believe in the universality of the system either.
 
#17
I'm sure we've been and done this before but -

1. The trial lawyers and the millions they donate to ensure there will never be a 'loser pays' legal system

2. The fact that insurance is now expected to be provided by the employer. Millions have never had to pay there own insurance and are unaware of the the cost. They gripe when their copay goes up a few bucks or their monthly contribution hits sixty dollars. It's like taxes. If it is deducted monthly and at the end of the year they get a refund they don't realize how much they are taken for.

If the full amount of the employer's health contribution was payed to the employee who then had to write the check to the insurance Co. It would never have got this bad.

3 and 4. 'Medical Billing' has got so complicated it is now a career. You have to go to class to understand it. The problem is with most of the payments now being made by 'insurance' not individuals. This means nobody really cares or checks the invoice.

When my kid was born, we went through the eight pages of billing and found a $400 charge for circumcision - I don't know if that was a fair charge or not but as we had a baby girl it would probably be illegal! When we reported it to the insurance company did they care - no. Did they pay it -probably they don't care they just up the rates if they start loosing margins.

5. Lawyers again - have a fender bender and they will have a list of doctors for you to go to and get the claim run up.

6. Lawyers again - In the rest of the world if you go to the quack with a headache they give you an asprin first and if that doesn't work they will look for other things. Here they will start with all the expensive tests first even if the chances are they are not needed because there might be that 1 in a thousand chance it might be a brain tumor and if the don't rule it out first they will get sued.

OK rant over for now - don't tell Blue Cross but I'm going for a drink!
 
#18
gimme-shelter said:
"Every other country in the Western World manages it."...Except, no other country in the Western world has a population of 300 million people.
Surely that's an advantage, not a drawback? As I suggested above, the more people that pay into a system, the cheaper it can deliver its results - that's the whole principle of insurance.
 
#19
ottar said:
jew_unit said:
PsyWar.Org said:
I'm firmly of the opinion that universal health care should be a right and not a privilege. The US system falls squarely in the latter category.
My bold.

Unofrtunately thats completely impossible and some would argue that unachievable rights are therefore not actual rights.
Every other country in the Western World manages it.
At what cost?

The rest of your post just furthers my point that what is needed is an option other then insurance companies or universal health care.

My employer is paying a premium for my health care (not sure what it is this year but last year the premium according to the documents we got was $7K for just me, wife has her own plan), offset a bit by my contribution of $70 a month (falls in line with your whole 10% bit).

I have an OOP of 5K per year, since I chose the cheapest of health plan offerings. I have been to the ER once in 7 years to have a finger sewn up, and in the same time period seen my primary care doctor twice, once for the flu (or severe cold) and once to have the sutures removed from the ER visit. I had to pay my $30 co-pay to see the Dr each time and a $50 co-pay for the ER visit.

The ER visit $750, the office visits were $120 each. So my total cost for health care in 7 years was about $1,000. Now take into consideration that my employer in that same timeframe paid a $7K premium * 7 years = $49K. I lost $7K a year in wages, because they weren't paying the premium I was, it's just money I never saw which they call a "benefit", plus the additional charge of $5880 deducted from my pay check for the privilege of having that benefit.

So all told in 7 years about $56K was paid into a insurance plan that paid out a whole $1K in claims.

I contend that had I been given the ability to just take that money and stuff it under a matress I would be up about $55K, and I bet you that I could have seen the Dr for much less then what he billed the insurance company for my visits by paying him directly, since he wouldn't have to deal with any insurance company to get his money. I bet that instead of $120 I could have given him $50 - $70 in cash and been out of there.

Seeing that I wouldn't put the money under a mattress I would have been pulling interest on it and have more then $55K today, and would let it ride and only draw on it if I needed to pay for health care, and if I kick it I can leave it to my family.

See the problem is I can opt out of the health care plan but my employer won't give me the difference. You know why? Because the less people the company has insured the higher the premiums (is a group discount thing) so they will use my $7K if I were to opt out to offset the higher premiums. Then I'm fecked no health insurance and no way to pay for my future healthcare needs. Now that is criminal!!!!

Universal healthcare doesn't work, and is unsustainable. It also invites fraud and waste.

Let me deal with my Dr and him deal with me!
 
#20
jew_unit said:
I won't bother dealing with the statistics as they prove nothing, particularly as they change their point of reference casually throughout.
Damn those pesky facts getting in the way of your rant.
Change their point of reference, indeed :roll:

No country in the world delivers universal healthcare free at the point of delivery. Almost all in the west achieve universal healthcare, including the US. There is a major difference between the two. The NHS does not and cannot provide universal care. Those in the medical profession already know that the NHS is in hot water, and the public will very soon realise that a comprehensive NHS is impossible without a massive hike in taxes and drop in burocracy. Even then, we don;t have the doctors to do the task. The problem is the same in the US but they have a diferent way of dealing with it.
Some more pesky fact from this 2004 report for you to pretend not to exist:

Six Nation Summary Scores on Health System Performance

...........................................................AUS..........CAN..........GER..........NZ............UK............US
Overall Ranking....................................3.5...........5...............2............3.5............1...............6
Quality Care..........................................4.............6.............2.5...........2.5............1...............5
Right Care.............................................5.............6..............3..............4..............2...............1
Safe Care..............................................4.............5...............1..............3.............2...............6
Coordinated Care..................................3............6...............4..............2.............1...............5
Patient-Centered Care..........................3.............6..............2..............1..............4..............5
Access...................................................3.............5..............1..............2..............4..............6
Efficiency...............................................4.............5..............3..............2...............1..............6
Equity....................................................2.............5..............4..............3..............1..............6
Healthy Lives.........................................1.............3..............2............4.5...........4.5.............6
Health Expenditures per Capita*.....$2,876.....$3,165.....$3,005.....$2,083.....$2,546.....$6,102

So we get the best healthcare of the six and the US the worst, despite them spending twice as much as anyone else.

Our system has a lack of competition which drives up costs massively.
That would be true if the NHS was trying to make a profit, but as it isn't, it's not.

gimme-shelter said:
"Every other country in the Western World manages it."...Except, no other country in the Western world has a population of 300 million people.
What has that got to do with the price of fish? Similar percentages of the population would work in it and similar percentages would be paying a similar percentage into it. You pay more now than anyone else in the world.

edited to add

ctauch said:
At what cost?
See above. It is substantially less than you pay now. Bear in mind those figures are from 2004 and US healthcare costs are rising faster than anywhere else. You've got profit making hospitals and profit making insurance companies creaming money off before it goes anywhere near providing healthcare.

So all told in 7 years about $56K was paid into a insurance plan that paid out a whole $1K in claims.
But that is the gamble with insurance. You could be lucky and go your whole life not needing it or it could be that next week your cokc drops off. At least if your insurance isn't going to a profit making company you're either going to get better care or cheaper premiums.

Because the less people the company has insured the higher the premiums (is a group discount thing) so they will use my $7K if I were to opt out to offset the higher premiums.
That's why it is better to have the whole country paying in. An American friend of mine that works for a small company is paying more for his familiy's medical insurance than the average Brit pays in income tax.

Universal healthcare doesn't work, and is unsustainable. It also invites fraud and waste.
The evidence suggests otherwise.
I do get the feeling that a lot of Americans just attach the word 'socialized' to universal healthcare, so reject it out of hand without looking to see if it would cost them less - and 95% of the time, it would.
 

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