[ul]
[li]The U.S. has the highest rate of deaths amenable to health care among comparable countries[/li][li]Disease burden is higher in the U.S. than in comparable countries[/li][li]The U.S. has higher rates of medical, medication, and lab errors than comparable countries[/li][li]Post-op suture ruptures are worse in the U.S. than in comparable countries[/li][li]The mortality rate for respiratory diseases is higher in the U.S. than in comparably wealthy countries[/li][li]Overall, mortality rates are 826 per 100,000 in the U.S., compared to 723 per 100,000 in comparable countries[/li][li]Potential years of life lost are 4,584 per 100,000 population in the U.S. compared to 2,765 per 100,000 population in comparable countries[/li][/ul]
Maybe you should worry less about wait times, and worry more about surviving your next hospital visit?
I appreciate your honest comments, but do you think that recurring phrases in your arguments like “the specter of what health care would become” and “… what I imagine will be the case should the government ever gain full control of the nation’s healthcare” are obvious enough invocations of what I just said here? …
May I respectfully suggest that instead of “imagining” things, you actually study how health care systems work in other countries, and how and why they were introduced. As I’ve repeatedly said, some of the important consequences of government-run single-payer health insurance are counter-intuitive. One can even agree that governments are inept bureaucracies that lack creativity and specialize in bungling, yet still acknowledge that your get your social security payments on time month after month and always will, just about as reliably as the sun rising every morning. Because there are some bureaucratic rote things that governments do very well, and rote payment systems are one of them.
Many of the fears and concerns you’re expressing – and worse – were also rampant when the province of Saskatchewan proposed the first public health insurance scheme, which at the time was just for hospitalization coverage. Later when it proved very successful, it was extended to full medical coverage. Throughout this process, fear-mongering ran rampant, and the American health insurance lobby along with the AMA went up there to try to convince everyone that it was not only incipient communism but practically Armageddon, and the very least that would happen is that every single doctor would leave the province instead of succumbing to the scourge of socialized medicine. What actually happened was this: the system worked, the people loved it, the medical profession came to accept it, and it eventually was adopted by every single province in Canada, and then its basic principles were enshrined in the Canada Health Act as a foundational pillar of Canadian values. Does that sound like the kind of disaster you’re imagining?
Trump is in good health. I accept it. He also appears to have no signs of dementia. I’m not sure whether that makes me more or less secure.
As a final hijack (then I promise I will let this subject go) I would like to detail how I spend this afternoon (the one afternoon a week that I have to refrain from seeing patients in order to get the insurance crap done).
Patient is a Medicare patient with a Medicare Advantage plan from company X.
I do not participate with insurance X.
Patient has specifically paid more for a PPO that allows her to see out of network physicians so that she can continue to see her usual doctors.
Company X has denied our claims based on the fact that we do not have a Tax ID number on our forms.
I double checked to make sure our Tax ID number is on all of the forms.
I call company X.
The nice computer lady asks for my Tax ID number which I give her. She then directs me to a number of possible choices, none of which are exactly what I want but I choose the closest “check claims status”.
The nice computer lady asks for my provider ID. She does not take “I don’t have one” as an answer.
She asks three times then informs me “You have not entered a correct provider ID. Please have the number with you when you call again. Goodbye.” and hangs up.
I call back and try a different option “questions about provider status” hoping that this will get me a real person.
The computer again asks for my provider ID. I interrupt to say “representative” (worth a shot).
A miracle! Nice computer lady advises me that before they can connect me to a representative I will have to enter my Tax ID number.
I enter it again and she asks for my provider ID but this time she also offers a choice of NPI number.
Score! Now I am not sure whether to enter the business NPI number (which is what we bill under) or my personal provider NPI number (as rendering provider).
I gamble on the personal and actually get a person, and am able to tell her I am asking about a claim.
She asks for the claim number, which I give her but she cannot find it in her system, so I give the patient’s name, date of birth and insurance number.
She asks for the date of service and I give the most recent one.
She tells me that there is no claim for that date.
I give another date and she again finds no claim.
I explain what her company said was the reason for the rejection and that our Tax ID number is on all claims.
She asks again for the Tax ID number and the NPI numbers, which I give her.
“Here’s the problem,” she tells me, “you are not in our system.”
“No kidding,” I respond, “maybe that is because I don’t participate with your insurance.”
“Well we cannot process a claim if we do not have your information.”
I ask what she needs, given that our claims contain all the information she could possibly need.
“I need your address”
“You mean the one on the claim form?”
“You need to submit a W-9” via email.
Now I can easily generate a W-9 but it has to be manually signed (Medicare does not allow e-signatures) so I ask if it can be faxed, since we rarely use our scanner and I think it is broken (our electronic record sends e-faxes but cannot sent to email because of HIPAA).
“Can I fax it/”
“No, it must be emailed only.”
So I fill out my W-9 online, print it out and manually sign it.
I don’t have time to deal with IT so I end up just taking a picture with my phone and emailing it to myself at the work address so that I can forward it to the insurance company who I hope will accept it.
Then I will wait (and hope) for them to acknowledge that everything is OK so that I can rebill.
The good news is that although they say that I only have 90 days from the date of service to bill, she informs me that since I am out of network, I have an entire year.
Now only another 40-50 of these denied claims to go to clean up accounts receivable.
(Also, for those asking why the physician is doing this-these claims are the ones that my staff and the billing people have tried and failed to get a resolution on).
Finally, I have omitted the actual on-hold waiting time which can be up to 45 minutes for Medicare plans.
Which is, of course, precisely SA’s cartoon image of socialism. No matter how much evidence you present he will refuse to believe it because it contradicts his beliefs. He knows what he knows and that’s that.
Those calls do sound rather horrid! So … do you support a single-payer system?
I’ve had tedious run-around conversations with both private and government organizations. Government may tend to be worse; OTOH my almost-unbelievable success story (which I’ve probably related at SDMB before) involved sparkling cooperation from three unrelated government organizations to get a multi-day task done in a single day.
Though, if The Atlantic’s summary of the cognition test which Trump took is accurate, what it seems to me to prove is that, if he is impaired in any way, the impairment doesn’t reduce his cognitive skills to something below those of a second grader.
My father is 84 years old; he’s been suffering from memory loss and early signs of dementia for several years. It’s obvious to all of us in the family, his doctor has indicated it’s going on, and my father understands that it’s happening. That said…as I look at the questions in this exam, I expect that my father would get most, if not all, of these correct.
The funny thing is (Hi, ETF, long time, no see!) that you people are doing the very same thing you’re accusing me of. Those of you in this thread have made up your mind as to what I think, based on your own biased views, and I’ve seen little evidence that anything I say will ever change anybody’s mind, because it never has before. You prefer to interpret things I say in a way that makes it easy for you to mock and dismiss, and almost certainly in the hope that others will be similarly swayed.
Trust me, the idea of Scandinavian life that I have in mind is nothing compared to life behind the Iron Curtain. And no, I don’t confuse socialism with communism or regard them as being one and the same. But socialism is a big step in that direction, and knowing as I do the fact that liberals are never, never, ever satisfied with anything, I know fully well based upon the things they rant about, that if given free reign communism will be the end result. And that, along with the problems with it that I’ve mentioned upthread, is why I and many other conservatives find it objectionable and fight against it.
Well, call me crazy but I think that everything you just listed is yet another example of problems created by liberalism that liberalism then wants conservatism to bear the cost of. In the last fifty years family unity and commonality of responsible two-parent homes has gone by the wayside, schooling as gone way to hell, in the name of fighting racism every sort of self-destructive and burdensome upon society has been defended and in effect promoted, and drugs, seized upon by liberals like manna from heaven in the sixties and an ever-present problem since, are the reason we have so many homeless people as well as others who are a burden on society because due to the way they were raised and schooled can’t hack it in life.
All these issues are the direct result of liberal ideology and practices, and now, all of a sudden, after decades of us telling you exactly that all this would happen, you’re concerned about government expense. It’s funny how the amount various societal problems cost the country is suddenly so important, given that the left seems to view its taxpayers as a golden goose that could easily cough up all the dough needed for every program and problem you can think of if only those evil damn Republicans would loosen up the purse strings and pay their ‘fair share’ :rolleyes:.
So in short we didn’t cause all this shit, so don’t come looking to us for money to bail out all those people whose lives you’ve ruined. Pare down things like welfare, food stamps and schooling for illegal aliens and you could probably house those 600,000 people yourselves…for all the good it would do. History has shown that when you give people housing, even those without emotional and drug problems, it soon gets run down and becomes a hotbed of drug use and crime anyway.
And as I said before and as backed up by a Scandinavian Doper herself, plenty of people die under UHC too. You’re problem isn’t that people are dying, it’s that they aren’t dying under a system you favor
As someone who has worked in benefits and eligibility for private health insurance (Cigna, Anthem) and government health insurance (Medicaid, Medicare) for 10 years - let me just say that you have this completely backwards.
If I may:
Do you have any idea the number of times I’ve had to tell people that their claims aren’t covered because:
a) they had a pre-existing condition
b) the doctor they saw (often while unconscious) was out of network
c) they went to someone other than their Primary Care Provider
d) that procedure isn’t covered on your plan
e) that medication or procedure is considered experimental at this time (even though it’s been around for years and is the primary way of doing things. But it still costs more, so we’ll go with experimental)
f) You failed to get pre-authorization for that procedure.
g) The review board for medically necessary procedures (staffed by medical experts chosen by my health insurance company to make decisions that keep costs down) denied your request for pre-authorization.
Most of all, please stop advocating for a system where I have to take phone calls where people are in a panic because their spouse who needs a transplant might die, because my company hasn’t approved paying for the transplant yet, and the surgeon absolutely will not schedule the surgery until that’s happened.
These are issues that simply *do not arise in single-payer government health insurance - Medicaid and Medicare - because there is no profit motive driving them to raise impediments to care, or to intentionally drive the prices up.
And universal healthcare is not a “specter of what health care would become once the government would gain complete control over it” - single-payer means exactly that - a single entity that pays for health insurance coverage. That’s all. The hospitals remain private, the doctors remain private, the healthcare remains private. The only thing that changes is that instead of trying to convince a couple dozen health insurers to provide care even though it costs them money, the providers simply provide healthcare, then send the bill to Medicare.
Yes, and as I’ve said, if I could be sure that a UHC system like Medicare would remain that way, I’d be very much inclined to support it. People here like to say I never change my mind or view about things, but I’ve come around quite a bit on the issue of universal health care. To my mind if the money we spend on the military (which I’m 100% in favor of) is justified in order to protect us and our interests from outside threats, then spending the money it would take to protect us from the internal threat of health problems is justified too.
My big issue when it comes to UHC in the U.S. is what will it eventually become once the government has full control of it. Anyone who has to deal regularly with government agencies knows how difficult and problematic they and their red tape are. Further, those who pay the bills call the shots, and there’s simply no way the U.S. is going to simply hand out money every time a claim gets submitted in perpetuity. There will be some form of rationing, and people will wind up on the short end of it where they don’t with insurance they are paying for directly.
A big source of the disconnect between us is that I think a program or system that works great for 85 to 90% of the populace is a great system. It’s hard to achieve that. I feel that our economy and our health care system accomplish that. And generally speaking, one way or another those in the 10 to 15% that it doesn’t serve well still manage to get what they need one way or another, either through family or friends or church or charity. From my point of view though it seems like liberals invariably home in on the small percentage of what’s wrong with something, behave as though it’s the worst thing imaginable, and what to tear down the whole system. Thus we hear from the left so often about the evils of capitalism and how unfair it is, and what a problem income inequality is even though it harms no one.
As for me, I’m simply not willing to throw the baby out with the bathwater because our economy or our health care system isn’t perfect and replace it with something that more or less sucks for everyone but is at least equal.
Right now the government is essentially in competition with health insurance companies, and actually works alongside some of them in providing care ala Medicare Advantage plans and so forth. But take all that away and put it solely in the hands of the government and my belief is that things will change drastically. Maybe not all at once, but eventually.
Convince me that UHC will work as well as or better than Medicare in perpetuity and I’ll get on board.
I think you would be surprised. I use these tests regularly (although I usually use the mini-mental status which is a little simpler) and almost nobody gets a perfect score. The serial 7s (subtract 7 from 100 in your head and then keep subtracting by 7s up to 4 more times) trips up anybody with minimal concentration problems and the memory test where people do other tasks then are asked to remember prior random words are very difficult for people with short-term memory loss. These are test that are hard to fake. I can’t tell you how many times somebody appears to be alert and mentally stable yet has mild to moderate impairment on testing.
And for the person that asked, I am in favor of single payor healthcare. However, I don’t think Medicare for all is necessarily the answer because there is no upper limit on out of pocket expenses with Medicare so that those who get very sick can still go bankrupt unless they have supplemental coverage.
You cannot imagine how much easier life would be if there were consistent rules on what was covered and what wasn’t. Its hard to even prescribe medication when there are 6-7 virtually identical medications in each class and each individual insurance has different rules on which they cover and at which copays. Even though my EMR can sometimes tell me the tier it is on for a particular insurance, it doesn’t tell me what the tiers mean (for some insurances, tier 1 is generic, tier 2 is a fixed copay, and tier 3 is a percentage; for some tier 0 is generic; for some tier 1 is the most expensive and tier 5 is generic, etc).
Don’t even get me started on the different sub-insurances. I participate with about 12 different plans, but each of these has at least seven or eight varieties. The company may contract with you for six of them but decide not to for the seventh. You have to know every plan, what medications are covered, which labs you can send blood to, which radiology centers to send patients to and which specialists participate, all for at least a hundred different plans. Sometimes you have to ask the patient to go home, print out a list of the available specialists and send it back so I can circle the ones I trust (at least if there are even any on the list that I know and trust).
I’d argue government health insurance isn’t in competition with anyone. They can’t “lose” you as a customer. In fact, they’d be more than happy to “lose” you to private health insurance, since they still have the tax money we paid in for Medicaid or Medicare, but they’re no longer required to use that tax money for healthcare. Yet despite not “needing your business,” they still end up with more satisfied patients than those under only private health insurance, for what that’s worth.
I could try to convince you that Medicare is the better option; but what more can I say other than I want it to put me out of work (at a private health insurance company,) it saves money ($5 trillion less over ten years), has better healthcare outcomes, higher satisfaction, and covers everyone versus 27 million uninsured now?
If you really want to learn more about it, I’d highly suggest watching the upcoming Medicare for All Town Hall on Jan 23rd at 7PM EST where they will no doubt give a much more thorough analysis than I ever could:
I saw my GP today at no cost, she arranged for me to have a brain MRI tomorrow at no cost. I will see her for results on Friday at no cost.
I am on a government disability pension. The only phone call my doctor had to make to arrange this was to the radiology centre to get the appointment. No red tape for me, no insurer questioning the need.
On the way home I filled a prescription for the usual $6.30.
But do go on, tell me more horror stories about universal health care.
Even though the well is poisoned by the likes of Bernie Sanders and the Young Turks I’d like to see it. I’ll be out that evening though. Do you know if it’ll be available after that one showing?
But don’t be so shocked, I also acknowledged that my original understanding of Trump was incorrect.