Hah! No, but he the doctor was rather conveniently in Alaska. Which smacks of ‘My girlfriend who lives in Canada’.
Let me add something to that. Much – far too much, IMO – is made of wait times, compared to the total dysfunctional disaster of the commercialization of human life that is the hallmark of US private health insurance. The cited wait times are for non-critical outpatient elective procedures. If you’re in an emergency, or in hospital – regardless of emergency or not – there are effectively no wait times.
I was in hospital recently for the first time in my life, and – long story short – a vast suite of diagnostic procedures was performed over the course of a weekend, on Monday a team was put together to look at different possible surgical options, a decision was reached Tuesday morning, I was in surgery that same afternoon, and I was home the next day. So tell me all about the wait time horror stories, Republican assholes. And none of it cost me one thin dime. Nor was there a single shred of bureaucratic paperwork. I left with a big pile of paper, alright, but it was all medical records for my doctor and myself.
It’s called health care in the interest of health, not the profit of insurance thieves. I get sick and tired of hearing about the evils of single-payer, and the alleged wonders of private enterprise in financing health care. Health insurance is not like a new car or TV set. It’s morally critical and must be universal and uncompromising. “Free enterprise” concepts are just bullshit here – they just don’t work.
I completely agree, wait-times are the stick for policy makers a lot of the time as they are relatively easy to measure.
A few years back I ended up in ER one afternoon with a fever and lower right-side abdominal pains. Some blood tests and 2 hours later I was admitted and spent the night in hospital, scheduled for surgery first thing the next morning to have my appendix removed. I spent about 5 days in hospital due to some complications. Went home at the end with a script for some painkillers. Our private insurance covered the $800 ambulance bill, the rest was done on the public system.
FTR, in Ontario the ambulance charge is fixed at $45 and many people are exempt – for example, elderly who are on home care.
I’d like to give a viewpoint from a primary doctor. The American system is broken and has been for years. Spending hours on the phone getting confirmations is nothing new. Insurance companies have been denying care or making doctors jump through hoops for decades. There are some aspects of the ACA that nobody seems to mention that have been a real boon for providers.
For example:
-The decision that a certain percentage of the money the company takes in has to be actually used for healthcare. There was a time before the ACA when one local insurer was known for knocking a day or two off every hospital stay. The reason didn’t matter, they just tried to minimize payments at all costs. As a doctor I wasted countless hours jumping through hoops to justify these stays.
-People coming in for physicals. Leaving aside the question of whether or not a routine physical is necessary, some insurance companies covered them and some did not. The ones that did sometimes waived copays for routine physicals and some did not. Some covered them once each calendar year and some once every 365 days. If a patient came in for a physical and I billed them for it when their insurance didn’t cover it I had to deal with the fallout. If I billed as an “extended visit” and it turned out the patient considered it a “physical” and was charged a copay, that meant many more hours on the phone sorting it out. Now, everybody is entitled to one physical, free of copay, every year. I don’t have to spend half an hour waiting for the patient to call their insurance company to find out how to categorize the same visit.
-There is a clear and concise summary of benefits required to be available for each plan. By looking at this 1-2 page sheet a patient can easily see what the copay is for labs, or X-rays or an MRI and if there is coverage if they go outside the plan. We no longer have to spend hours on hold to figure out where to send a patient’s blood for labs.
Now that said, it would be 1000 times better if everybody had the same insurance. Imagine knowing what is covered or only having to check one plan instead of hundreds. I wouldn’t have to deal with the January medication dance when people change insurances or their plans change and all of a sudden I have to completely change all of their medications that I have spent months adjusting. There would be one DP4 inhibitor, instead of 4 (or 5) and I wouldn’t have to waste my time and the patient’s time trying to figure out which one his particular insurance approves at which tier. I have a great electronic record, and when I prescribe medications it is supposed to tell me whether it is covered on the patient’s plan. It conveniently tells me: covered, Tier 1 or Tier 2 or Tier 3. The problem is that for some insurances Tier 0 is generic and Tier 3 is the most expensive (where the patient might pay 50% of the cost), and for other insurances Tier 5 is generic and Tier 1 is the most expensive. If a patient asks me what the cost will be for a non-generic medication I have no way of knowing. The pharmaceutical companies also have coupons available for high copay products so to give an example, one patient used to pay $10 a month for his medication and the company picked up the rest. This year, they bumped it to $50. However, the company has a coupon that pays everything over $25 of the copay up to $100 a month. I got him the coupon and now he pays $25 for 3 months BUT these coupons do not apply for federal programs including Medicare and Federal Employee insurance (common here in the DC area). Also if he had one of those plans where he paid 50% and the actual cost was $400 then his monthly cost would be $200 and even with the coupon he would still pay $100 monthly. It would be so nice just to say “this is the medication you should take and this is what it will cost you”. Don’t even get me started on the Medicare “doughnut hole” where somewhere in about September, all of the Medicare patients are responsible for 100% of their medication until the new year and we scramble to get them samples or get them compassionate use from the insurance companies (forms,forms,forms) or change them to inferior medications until the new year when we can change them back again. This is not easy for an 80 year old on multiple medications, particularly one who, for example, cannot read and just knows that he takes 2 blue pills and the long red one.
tl:dr
The ACA has made medical practice more streamlined in some ways but we really would benefit from a single-payer plan.
(I would also like to say that sometimes wait times are a good thing. 95% of back pain will resolve spontaneously in 6 weeks. If wait times for non-urgent MRIs were longer, there would be a lot fewer unnecessary tests ordered.Not to mention that wait times here are insane sometimes and do not depend on severity of disease but rather on insurance. Depending on a patient’s plan, they can wait 6 months to see an endocrinologist here; not because none are available but because their plan limits their choices to those that are the most cost efficient, or uses that plan’s preferred hospital)
In Australia ambulance charges vary stare to state. We pay about $1.00 a week for ambulance insurance through a private insurer. I could need the ambulance once or ten times in a year and it would be covered.
So many misconceptions in this one short sentence!
First: Nobody is advocating “substandard” health care for all. Other developed nations have UHC systems that provide health care for all that isn’t substandard. We don’t have to settle for less than they do.
Second: Even the “excellent” end of the traditional US system is in many ways inferior to its counterpart in most UHC systems. Americans have to put up with far more time-wasting and money-wasting paperwork, as well as attempts to deny coverage and the uncertainty of retaining coverage, than people in other developed nations with UHC.
The overhead costs of the American health insurance system are huge, wasteful and inefficient, and make our healthcare simultaneously the most expensive in the world and often not very good at actually providing care, much less care that the recipients can manage to pay for. Before the ACA, over half of all US personal bankruptcy filings were due to medical bills
Third: Achieving health insurance for only about 80-85% of all Americans just isn’t good enough. Before the ACA, around 16-18% of Americans didn’t have any health insurance coverage at all. Add to that the high numbers of Americans who have insufficient or crappy coverage, plus all the bureaucratic inefficiencies that our patchwork of for-profit insurers creates by shuffling treatment charges back and forth like a perpetual game of paperwork hot-potato, and it’s evident that Americans have not been getting our money’s worth out of our healthcare system.
What you are willfully ignoring is that your unsubstantiated “opinion” is contradicted by factual analyses such as the one I linked to above.
It’s not about being liberal or conservative. It’s about being able to recognize the well-documented fact that the traditional US healthcare system is more expensive, and performs worse for many more people, than universal healthcare systems in other developed countries.
Even conservative political parties in other developed nations don’t advocate getting rid of universal health care systems in favor of one on the traditional US model. Their constituents would think they were insane to propose exchanging a universal-coverage system with good health outcomes for the sort of expensive byzantine mess that leaves Americans on average not only less healthy but at far greater risk of financial catastrophe.
Yes
Yes
Not presently, we don’t live in the UK anymore. But previously yes.
Your comment that the NHS is not free as you pay for it is inane. Of course someone pays for it. It’s a matter of having the most efficient and effective system. That the NHS can be as good as it is without having to shit around with the US’s bureaucratic nightmares is one of its positive features.
Are you suggesting that Nicole Kidman is not Australian?
This habit of yours to put words in your opponents’ mouths and then mock what they never said is one of the reasons I don’t bother much with you. I didn’t say a ‘vast’ number were quitting. I said they were being driven to quit by the ACA, and in a later post I said my cardiologist said ‘many’ were quitting due to the ACA. Nowhere can be found the words ‘vast’ or ‘en masse’. And I said nothing about what they’d do afterward but it was explained to me that they were simply retiring. Thus it’s reasonable to expect that those who are too young to retire will stick it out as long as possible, and it’s this fact which will make it possible for patients to continue to see specialists…eventually.
Since the problem is primarily the creation of the ACA, I’ll say it’s the government. Perhaps if Obama had done what presidents are supposed to do and have his aides and advisors do due diligence and formulate a health care plan free of these kinds of complications to submit to congress, rather than just telling congress to cobble something, anything, together and he would sign whatever they came up with. Typically, when you have a major piece of legislation crafted by 535 different people, you’re going to wind up with a huge clusterfuck for your trouble. And that’s exactly what we have. Increased difficulty with insurance companies is but one of the many problems this ridiculous and nonsensical plan has created.
Are you suggesting the fact that she’s a citizen of both countries precludes her from having an opinion on American politics?
This is silly as the study linked by Kimstu shows that you are wrong.
I can agree with this, but it ignores that the ACA was based on what the Republicans came up when opposing the Clinton health care plan. Like Romney care it is really a system put together to work under the byzantine system we got as a result of leaving the efforts of giving health care to workers through the employers.
The irrational system that we still have if ACA is removed was bound to fail as soon as job security became a a thing of the past and costs were not controlled. But the ACA is not really a reason for the failure that has been ongoing because the ACA and other efforts in reality have tried to help most people under the current bizarre framework. Thing is that I’m convinced that when the economy was a bad one most got cold feet and we end up with the ACA, but I do thing that if it had been more effective or to properly cover all Americans the result would had been a lot more unemployed people at the time that was not a good idea.
With a better economy it may be politically feasible to at least use Trump’s Chaotic Neutral words and ideas that he has reported in the past and recently that in other times are anathema to many conservatives. We may get something similar to what was needed eons ago, but most likely it will be grossly unfunded (Trump’s tax cuts have to come from somewhere) and it will have to be fixed later after the bubble bursts. As it is usually the case.
This is hilarious - you cite your “opinion” as an example of reality. You are manufacturing assertions out of whole cloth and pretending that they are established fact. In my actual experience - and in actual reality - the NHS produces better outcomes for far less money per capita than the US system. It’s not perfect - and it always suffers when Conservatives are in power and drastically cut funding - but the model works.
The “free market system” pre-ACA was killing 45,000 people a year who couldn’t afford health insurance. Having experienced both systems, I’ll take the NHS any day.
for historical reference -
I don’t see how you could have made such a mistake.
-Kidman is Australian.
-Kidman normally stays out of politics.
-If badgered into commenting on politics, Kidman seems to under the impression that the election is over.
Is Kidman also an American-yes, or no?
It’s the Republican way.
Oh, so I’m being called dishonest by one to the two or three most dishonest posters in the history of this board? I can live with that.
Dude, you are presenting as sole evidence of this exodus of specialists (OK, not en masse but enough to create unacceptable delays in treatment) something that you claim your cardiologist has said, i.e. completely unverifiable. If you don’t see why that might be mockworthy, there is no hope for you.
Likewise, I trust readers can see for themselves that I am not putting words in your mouth; I am merely pointing out what you seemingly wish to imply with them. Your previous posts have not magically disappeared and I trust the readers to determine whether I am being unfair to you or not.
Evidence for these claims is presumably forthcoming at around the same time Trump shows a shred of basic human decency.
Prior to ACA, doctors didn’t retire? Thanks, Obama!
Oh sure, they were retiring prior to the ACA. What they weren’t doing was retiring prematurely because of the onerous burdens created by the ACA.
(Like shooting fish in a barrel. :D)