Dispelling US Health Care Myths: Part 1

[emacknight]

@Magiver

And if you have cancer then your chances of survival just went out the window.

Beautiful, another gem!

The wait times in Canada are, ready for this, need based. If you need a CT scan, you get it, instantly. If you only kind of need it, the guy that actually needs it goes first and you wait an hour. If you don’t need it at all, and just thought it would be fun, you wait 26 weeks.

I’m going to tell this story again later, but for now know that my mother in law has a bad back, and wants an MRI, she had to wait couple of weeks to get it. My mother had cancer and received multiple MRIs without wait over the course of her treatment, as deemed necessary by her team of physicians.

@Magiver

I don’t know if you’re actually challenged in some way and can’t understand that I’m not suggesting we make no changes. I’ve been clear on that.

You just don’t get it. Hospitals are required to provide life saving medical care. Private insurance is a lot easier to fix than a government bureaucracy. You’re lack of medical services is not acceptable.

If fixing private insurance is so easy, why are 19 year olds being denied coverage? Everything I’ve seen in the past 20 years tells me that it is impossible for government to make changes to private health insurance. What I have been able to see is massive improvement in the Canadian system.

@Magiver

Emergency responders don’t ask you if you can afford to live when helicopters are brought in. I’ve personally watched them bring in a helicopter on a highway that was 6 miles (by road) to the nearest hospital. Actually there was a closer hospital but it is dedicated to children (by charter).

That’s right, they don’t, and if you ask they can’t/won’t tell you. But 6 months later you’ll receive a bill starting at $1200 for an ambulance and going as high as $10,000 for a helicopter. A bill that your insurance may or may not decide to cover. There was also an article I’m going to try to dig up about over use of helicopters to justify their existence. That 6mile ride cost that person $10,000 when he didn’t need it, but they’re profitable so the system loves to over use them. You’ve got CT scanners on every corner being unused/overused that racks up the cost of your care unnecessarily.

What you don’t realize is that I know the Canadian system, and I know the American system. You on the other hand know neither.

[Perciful]

I am against Obama care. I work with the poor and unemployed and they have better health care coverage then I do. It’s called Medicaid. Anyone under the poverty line can apply. It is free and pays 100 percent except for one dollar co-pays for scripts. The taxpayers already pay for part of it to make sure that the marginally poor have no copays. That is why the emergency rooms are so full. There is a 50 dollar penalty for most insurance companies if you use the emergency room, not so with Medicaid. I know a woman that calls an ambulance to bring her to the ER evrytime she has gas.

It is a myth that the poor have no coverage. In NH we have Healthy Kids Gold and they get free dental and braces. Things I had to pay for out of pocket for my own children.

I have a hard time believing that we are all going to be under one plan that covers everything. How is it going to be funded? By us I’m sure. Are we going to all have to go to a dirty clinic or can we pick our doctors? Have you ever been to the clinics? Screaming dirty children, hour long waits, I hope it doesn’t come down to that.

[gonzomax]

Please define Obama Care. I see a bill by the house and another by the senate. I did not know Obama had one too. Tell us about Obama care.

[Duke_of_Rat]

@DanBlather

Any cite that our govt is either inefficient on an absolute basis or relative to other countries? Or did you just pull this assertion out of your ass?

Medicare fraud is estimated at $60 billion/year.

That may seem like the model of efficiency to some, sounds rather inefficient to me.

Even the government itself realizes that Medicare is inefficient.

Since 1990, GAO has periodically reported on government programs and operations that it identifies as “high risk.” This effort, which is supported by the Senate Committee on Homeland Security and Governmental Affairs and the House Committee on Oversight and Government Reform, has brought a much needed focus to a targeted list of major challenges that are impeding effective government and costing the government billions of dollars each year.

Impeding effective government. Their words. “High risk” program.

Maybe the problem is just inherent to Medicare and UHC will be a totally different type of program that’s run in a much more efficient manner, I don’t know.

And I apologize for my remarks about the USPS being inefficient. They only lost $7 billion/year, that makes them a model of efficiency compared to Medicare. An anecdote: My dad retired from the USPS. He recently passed a milestone where he’s been retired longer than he worked there (he did have military service that combined with his civil service if I’m not mistaken).

That sort of retiree benefit load will crush the bottom line of many programs, no doubt, but does Medicare have as many employees/retirees as the USPS? Even close? Something tells me that it didn’t make the GAO’s “High Risk” list because of retiree benefit loads.

I have no idea how inefficient our government is compared to other countries, or how health care is funded and administered in other countries.

Again, I’m not against UHC in this country, it’s just that I don’t get a real feeling of confidence in our government’s ability to administer such a huge program efficiently.

Maybe if government made an effort to cut Medicare fraud and inefficiency, prove that it’s up to that task before embarking upon an even larger undertaking, that’d give me confidence.

[emacknight]

@Duke_of_Rat

Medicare fraud is estimated at $60 billion/year.

That may seem like the model of efficiency to some, sounds rather inefficient to me.

Even the government itself realizes that Medicare is inefficient.

Impeding effective government. Their words. “High risk” program.

Maybe the problem is just inherent to Medicare and UHC will be a totally different type of program that’s run in a much more efficient manner, I don’t know.

And I apologize for my remarks about the USPS being inefficient. They only lost $7 billion/year, that makes them a model of efficiency compared to Medicare. An anecdote: My dad retired from the USPS. He recently passed a milestone where he’s been retired longer than he worked there (he did have military service that combined with his civil service if I’m not mistaken).

That sort of retiree benefit load will crush the bottom line of many programs, no doubt, but does Medicare have as many employees/retirees as the USPS? Even close? Something tells me that it didn’t make the GAO’s “High Risk” list because of retiree benefit loads.

I have no idea how inefficient our government is compared to other countries, or how health care is funded and administered in other countries.

Again, I’m not against UHC in this country, it’s just that I don’t get a real feeling of confidence in our government’s ability to administer such a huge program efficiently.

Maybe if government made an effort to cut Medicare fraud and inefficiency, prove that it’s up to that task before embarking upon an even larger undertaking, that’d give me confidence.

This is another of the many myths I’ll need to fight. But to clear up some things about USPS: Yes, it has inefficiencies, and ran at a deficit of $7billion last year. In contrast, Fedex made $9billion in gross profits, seems like it is extremely efficient (it is actually a very well run company).

If you were to apply that concept directly to health care, what it would say is that when a system is run as a not-for-profit it tends to run at a deficit, in other words it is hard for Medicare to pass their costs on to consumers, so it has to make up for budget shortfalls the next year. The package should cost $15 to send, right now you’re being billed $12. On the other hand, in a profit driven system, there is an extra $9billion in profit “lost” to the consumer. That $9billion goes into someone’s pocket, and not into your service. That $15 package is costing you $20, but you’re not getting $5 more in service, same package same delivery times, the $5 is gone to profit.

In a normal capitalist system you want profit, it’s what drives the economy, it’s what forces Fedex to work harder and be more efficient.

But when it comes to health care, it means that a person dies because they can’t “send that package.”

So yes, the lines are longer at the Post Office, and the decorations aren’t as nice, and there may be fewer offices. But it means everyone has access. Fedex can be profitable by making the choice to NOT ship somewhere that they don’t’ want to ship, or by charging 10x as much. That’s the difference between government run and private run. Yes, government is inefficient, but the trade off is that they deliver everywhere to everyone. Fedex is efficient, because they can pick and choose the most profitable routes, and pass the cost directly to the consumer, or refuse to deliver.

You are also making the mistaken assumption that UHC would look like Medicare For All. Medicare exists because it has to act like an insurance company in a system of insurance companies. Do away with the insurance system and you do away with the need for the Medicare infrastructure and all of it’s inefficiencies.

You also make the mistake of assuming that under UHC everyone in the health care industry would be an employee. That’s not how it works.

[emacknight]

@Duke_of_Rat

And I apologize for my remarks about the USPS being inefficient. They only lost $7 billion/year, that makes them a model of efficiency compared to Medicare. An anecdote: My dad retired from the USPS. He recently passed a milestone where he’s been retired longer than he worked there (he did have military service that combined with his civil service if I’m not mistaken).

My previous post is a bit garbled, allow me to say it in a more concise manner:

You see USPS as inefficient because they lost $7billion last year.

I see Fedex as inefficient because they overbilled their customers by $9billion last year.

Neither company was able to provide service at the correct price.

[Ruminator]

@emacknight

You see USPS as inefficient because they lost $7billion last year.

I see Fedex as inefficient because they overbilled their customers by $9billion last year.

Neither company was able to provide service at the correct price.

Sorry, this is ridiculous.

By your logic…

Every employee that charges their time (wages) to their employer is “inefficient” because he asks for a salary above & beyond the basic cost of food for sustenance and the gas it requires to commute to work.

And… if a farmer expends 500 calories to pick some coffee beans, it’s “inefficient” when he gets a payment of eggs that cost 600 calories to collect from the chickens. There’s 100 calories of thermodynamics that was “lost” to not providing more coffee beans to more people.

The thing you’re missing is that these services wouldn’t even exist if you could only collect a payment that was exactly equal to the effort you put in to create them.

[Euphonious_Polemic]

@Duke_of_Rat

Again, I’m not against UHC in this country, it’s just that I don’t get a real feeling of confidence in our government’s ability to administer such a huge program efficiently.

One of the differences here is that you think of the government as “them”, whereas I think of the government as “us”.

People who work for the government are not “them”. I do not think that they are faceless bureaucrats who exist merely to make things more inefficient and troublesome. They are my neighbors. They are fellow citizens. They are working in a very large system, but often are working hard to make it better.

I"m amazed at the lack of faith people have in their fellow citizen’s ability. The low opinion people have of YOURSELVES and your own country is incredible.

It seems that I have a better opinion of Americans and their abilities and work habits than some Americans do themselves.

[Euphonious_Polemic]

Magiver, having CT scanners, X-Ray machines etc. etc. scattered all around a metropolitan area, just sitting there, waiting for someone with insurance to utilize them… This is perhaps not a good model for a system that is hemmoraging money.

It does not make financial sense to have a CT Scanner down at the Quickie-Mart so that any idiot with insurance and a desire to see their kidneys can get a scan along with their squishy.

Furthermore, you realize that much of this great equipment you speak of is not available to those without insurance, right? They need to wait until their condition is serious, then trundle down to the (frequently lesser equipped) E.R.

You know, we get it, we get it. YOU are currently getting great medical care. YOU have access to good equipment and medical personnel on demand, when you want it. And YOU don’t want to share this with anyone, and are afraid that if more people were in the system, it would dilute it down so that YOU might not have FAST, FAST access whenever YOU want. We get it. It’s all about how any change would affect YOU.

[gonzomax]

@Magiver

Canada spends less per person and it shows. They don’t have the equipment or the doctors to meet demand. CT scanners and emergency helicopters are not the norm. Not only does every hospital in my area have CT scanners we have outpatient facilities that serve private practice medicine. These are common diagnostic machines. My family doctor has had an X-ray machine in his office since the 60’s.

Japan probably pays too little for their health care. as a result there is competition for patients and for equipment manufacturers. They have come up with smaller cheaper MRI s . They are starting to export them here.
For Medicare costs, much of the theft is by doctors and companies working in concert to bill for procedures that are not being done. They pay homeless people to fill out paper work which they submit to the government. Doctors are fleecing the tax payers.
The equipment manufacturers overcharge medicare badly. But the pols have allowed them to do so. When the bills come up to end the gouging, the equipment lobbyists always get their way. Like Pharm ,they can pay for political power. Of course ,with our recent stupid Supreme Court ruling, it will get worse.

[DanBlather]

@Duke_of_Rat

Medicare fraud is estimated at $60 billion/year.

And you have not answered my question: how does that compare with either the private sector or other countries? Just citing a large number by itself shows nothing. The best cite I can find, and the one that seems to be cited by all stories on the issue is this. Here are some highlights:

What is absolutely clear from virtually every reliable source on the subject is that health care fraud is a systemic problem affecting public and private insurers alike, in the individual market, the employer-sponsored group market, and public programs. Because Medicare and Medicaid are government-sponsored and thus are required to report on fraud, the problem is perhaps better known, but combating fraud is a challenge that faces both public and private insurers…
Perhaps the most striking examples of fraud are those that involve the private health insurance industry itself. In these cases, the deception can involve either overstating the insurer’s costs in paying claims, or systematically and deceptively under-valuing the amount owed by the insurer to a health care provider – all with the intention of shifting increased responsibility for the cost of care to the plan member and group sponsor, in ways that violate the terms of the contract:

In one recent New York case reported prominently in the press, leading private insurers were found to have manipulated the prices they paid for physician services in order to systematically drive down the amount they owed for out-of-network physician care and thereby drive up members’ financial exposure for the balance. This intentional manipulation of provider payments resulted in an estimated 10% to 28% increase in members’ direct financial exposure for the cost of out-of-network care.

As to the USPS, if it runs at a deficit that does not show it is inefficient or that a private carrier would do better. What it shows is that the rates that Congress have approved are lower than what is needed to cover costs. Congress controls rates as a matter of public policy. Part of this policy is that delivery is provided for the same price regardless of where is sent. Again, you have not shown that the USPS is less efficient than other countries’ service or that a private company could provide equivalent service for the same price.

[elucidator]

@Magiver

I’m just voicing the sentiment of 100’s of millions of Americans who don’t want their medical care FUBAR’d like Canada.

I don’t get you. You offer anecdotal evidence, stories from your own life and experience, as if they were Gospel, and should be accepted as evidence. But when somebody who actually lives there tells you you are full of it, you blithely bat it aside, it has no more effect on you than a Nerf ball on a brick wall.

The most generous assessment possible here is that you are unaware that you do it, and now, being advised, you will cease. Boundless optimism, perhaps, but I also buy the occasional lottery ticket…

[Lobohan]

@Shodan

So if Obama-care costs way more than he claims it will, this is good? Interesting way to look at it.

That’s not what I said, and I would have hoped that you’d have sense enough to know that.

“More efficient” in the sense of currently running at a deficit, costing almost ten times more than expected, and scheduled to go bankrupt altogether in a few years. But apparently these are not flaws.

It costs less to provide service than private insurance. Private insurance’s costs are increasing much faster than Medicare’s. It is costing more than expected primarily because people are living on average 5 years longer and we actually have treatments now for things that used to just kill people in the 60s.

Medicare costs much less than private insurance. It is much more efficient than private insurance. Private insurance will bankrupt the nation before Medicare does.

Can you at least pretend you understand the issues?

[Sateryn76]

@Lobohan

That’s not what I said, and I would have hoped that you’d have sense enough to know that.

It costs less to provide service than private insurance. Private insurance’s costs are increasing much faster than Medicare’s. It is costing more than expected primarily because people are living on average 5 years longer and we actually have treatments now for things that used to just kill people in the 60s.

Medicare costs much less than private insurance. It is much more efficient than private insurance. Private insurance will bankrupt the nation before Medicare does.

Can you at least pretend you understand the issues?

Can I get a cite for Medicare costing less than “private insurance”? And a comparison to what services are provided by each, so I can compare the numbers?

[Voyager]

@Shodan

So if Obama-care costs way more than he claims it will, this is good? Interesting way to look at it.
“More efficient” in the sense of currently running at a deficit, costing almost ten times more than expected, and scheduled to go bankrupt altogether in a few years. But apparently these are not flaws.

Regards,
Shodan

Your post makes no sense. The question about efficiency is not about the current deficit, but would private health care do the job more cheaply? Because of the massive overhead, the deficit would almost certainly be worse of the insurance was private, unless of course they “fixed” the problem by denying coverage to the elderly who were going to be more expensive.
No one is disputing that healthcare in the US is too expensive. The question is why UHC countries do it more cheaply. You’re complaining about the expense of our system, while your friend magiver clearly thinks our system is just fine and is complaining about measures in Canada which reduce the cost. You righties really need to get on the same page.

[Lobohan]

@Sateryn76

Can I get a cite for Medicare costing less than “private insurance”? And a comparison to what services are provided by each, so I can compare the numbers?

http://krugman.blogs.nytimes.com/2009/07/29/medicare-versus-insurers/

Which links to some good data here:
http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf

There is some good information here about how the Medicare administration costs compare to Private Insurance:
http://krugman.blogs.nytimes.com/2009/07/06/administrative-costs/

One thing to remember, is that in America, Medicare gets pretty much everyone over 64. It gets to deal with people when they have the most need for medical care and during the period when their lives will end from whatever reason.

It’s like being a mechanic that specializes in cars with over 200k miles, you’re going to spend more as an absolute amount. But that’s because the old beater needs more service than a 4 year old Corolla.

[Shodan]

@Lobohan

That’s not what I said, and I would have hoped that you’d have sense enough to know that.

Someoby posting under your name said it was a good thing that Medicare cots were almost ten times higher than projected. Also that a system rapidly going bankrupt was efficient.

Fortunately, I have too much sense to believe anything as dumb as that.

@Voyager

Your post makes no sense. The question about efficiency is not about the current deficit, but would private health care do the job more cheaply?

The question about efficiency has everything to do with the deficit created by Medicare. Selling at a loss is not “efficient”. You can always undercut your rival if you do that. The problem is that it isn’t sustainable.

Medicare is running a large deficit, and will continue to do so until it goes bankrupt altogether. This is the model whose efficiency you would like to emulate?

You righties really need to get on the same page.

No, that’s bullshit. You lefties just aren’t used to dealing with people who ask what’s in the Flavor-Aid before they gulp it down.

Regards,
Shodan

[Euphonious_Polemic]

@Shodan

Medicare is running a large deficit, and will continue to do so until it goes bankrupt altogether. This is the model whose efficiency you would like to emulate?

You seem to be confusing the absolute cost of Medicare with the EFFICIENCY of Medicare.

I’m sure Medicare costs a lot, and if it is running at a deficit, this simply means that the government is not currently collecting enough in payments/taxes in order to fund it properly. The deficit says nothing about how efficient Medicare is.

What you need to do, is show that Medicare costs more PER PERSON over 65 years old to run, compared with a program of private insurance for the elderly.

[Lobohan]

@Shodan

Someoby posting under your name said it was a good thing that Medicare cots were almost ten times higher than projected. Also that a system rapidly going bankrupt was efficient.

No, you simply are having trouble understanding what I said. I’ll go slow so that you can really dig your teeth into this one:

Medicare costs more than projected because people live longer now, and we have treatments for things that used to just kill people in the 60s. Can you understand that? Read it again if you have to.

It’s a good thing that we have longer life spans and more medical options than we used to. This is because long healthy lives is a good thing. Can you understand that? Read it again if you have to.

Okay, that’s part one. Take a break, and come back when you think you’re ready for part two.

[Muzak version of Girl From Ipanema plays]

Ready for part 2? I don’t want to stress you out.

Medicare takes in money from Americans who pay into it. Got it?

America has an aging population. Which means that we have more old people than we used to in the 60s. Got it?

The old people we have live another five years on average than in the 60s. Got it?

It costs more money to treat people over 65 years of age because that is the period in their lives when the majority of their health problems come up. Got it?

Medicare isn’t going to be able to take in enough money to pay for the longer living, especially sick, larger portion of the population in a few years. Got it?

This has nothing to do with it’s efficiency. This has to do with the costs associated with treatment. I know you can understand this if you just read it a few times and try real hard. Got it?

Medicare is more efficient than Private insurance, that’s a fact, so you can ignore that fact or pretend it’s not true if you want. But your adherence to ignorance doesn’t make facts not true. It just makes you look like a blindly partisan person.

Fortunately, I have too much sense to believe anything as dumb as that.
The question about efficiency has everything to do with the deficit created by Medicare. Selling at a loss is not “efficient”. You can always undercut your rival if you do that. The problem is that it isn’t sustainable.

Private insurance isn’t sustainable. Got it?

Medicare is running a large deficit, and will continue to do so until it goes bankrupt altogether. This is the model whose efficiency you would like to emulate?

Yes, because medicare getting X dollars and paying out X+2 dollars will mean that we have to either bring in more dollars or pay out less. Medicare won’t disappear, the costs will have to increase.

But the same thing is happening to private insurance, and it’s happening much, much faster. Can’t you understand that? Why do you say things that are incorrect when you’ve been shown time and time again that you are wrong?

No, that’s bullshit. You lefties just aren’t used to dealing with people who ask what’s in the Flavor-Aid before they gulp it down.

You are arguing a fantasy and you are unwilling to address facts.

[gonzomax]

Atul Gawande: The Cost Conundrum Redux | The New Yorker Here is an article from the New Yorker discussing 2 similar Texan communities are the disparity in health costs. One routinely ran test that were unneeded because the doctors were financially involved in the testing companies. The difference between the costs were dramatic.
We need a rule banning doctors from having interests in testing companies of all sorts. They can not be allowed to have a profit motive in testing. They have been shown to abuse the relationship to make more money.