Do you have a reliable cite for this? Keep in mind that the plural of anecdote is not data.
Thanks in advance.
Regards,
Shodan
You need a cite to demonstrate that it costs more to keep someone breathing on a respirator in an ICU rather than switching off their life support?
Of course it does, but I’m not sure this is common enough to add significantly to the kind of health care costs we’re talking about here, especially if you limit it to those who maintain futile life support for religious reasons.
In my experience, most of the cases where someone ends up on futile life support are due to indecisiveness on the part of the family, disputes within the family, failure to accept the diagnosis, or just an inability to let go. Religious fanaticism rarely comes into it. True nutjobbery like you saw from Terri Schiavo’s parents and their enablers is thankfully rare.
I would be much more amenable to UHC if we took special care to make sure the care provided to politicians, their families, and their friends were open to public scrutiny. A possibility that worries me greatly is that it will become a system where “knowing someone” will get strings pulled such that you receive care far better than the norm. I’d be much more comfortable with the idea if I were certain that the interests of the people in charge synced up with my own.
You mean to say you think this doesn’t happen under your present system? :dubious:
My sister worked in the ICU of a VA hospital, where it was common - but not for religious reasons. The widow often couldn’t afford to live off the reduced pension and social security once her husband died, so she would keep him alive as long as possible to stretch out the checks. As long as he wasn’t in pain and the VA was picking up the bills…Sad that we’d spend tens of thousands of dollars a month keeping a man alive so his wife could get an extra $200 a month.
No, I need a cite to demonstrate that a significant factor driving up end of life costs is religious fanatics trying to keep already dead people on life support so God can work a MIRACLE! That’s what you claimed, so I would like to know what the basis is for the claim.
Thanks in advance.
Regards,
Shodan
I apologize for not speaking more clearly. What I meant was that when religious nuts intervene to prevent death* by insisting on ventilators, etc., and refusing to allow the body to die*, the end of life costs for that person go through the roof. I don’t know how many cases there are like the Schiavo one – probably none so contentious because of the debate within the family. I do know, that even in my own family, my mother’s body was kept alive* for some time because my father couldn’t accept her death. (I include my father as a religious nut, btw.)
However, I can’t quantify how often this happens or the total costs to the medical system as a whole.
- – I can’t define what exactly constitutes death, but it’s arguable that many bundles of living cells that look like human beings are effectively dead.
Ahh I see. Rather then say why you disliked my approach you choose to write an obtuse post and waste my time trying to figure out what the hell you’re on about. Instead of just coming out and saying what you thought.
Kinda weak dude.
Now on the subject of my approach, it’s strategy. If you’re gonna argue an idea you’ll have much better luck presenting it in a way that’s appealing to those in your audience. The Jingoistic crowd really believes in America. The line “It won’t work here” is actually calling the whole nation incompetent compared to the rest of the world, a slur against America. So lets get fired up and show those asshats why they’re wrong. Which was the tone of my post.
The jingoistic crowd also tends to have a lot of overlap with the antiUHC crowd. By making one of their arguments unpatriotic you take the teeth out of it, and have a good counter argument. “it won’t work here? are you saying America can’t do what the rest of the world does easy?”
Then you go into stats, costs, etc. without having to deal with “we’re different just because we are” crap.
IOW you personally don’t find what you write compelling but think the “jingoistic crowd” will? I certainly agree with the first half …
The first step is understanding them.
If you think your target audience is “asshats” there’s reason to suspect that your wooing might not be success, and in fact, you might not be the right suitor altogether …
I’d say it’s more a slur against the ability of the U.S. government to function effectively, myself. The U.S. government is notoriously wasteful and bureaucratic, penurious with benefits, and answerable to no one.
I also think it may well be largely a fiction that UHC works all that well in European countries. (I recall even here on the boards a poster from Canada’s vaunted system whose mother had to wait eight months for cancer surgery.) And to the degree it does, that is no guarantee that it will not collapse as time goes by.
To my mind there are a couple of things that enter into the claim that UHC works so well in Europe. For one, people get used to things…especially if that’s all they have. When you have no other choice, you accept you what you get and it becomes the norm. Then once it’s become the norm, problems and drawbacks get written off as being just the way things are.
A secondary reason is that it’s very likely that, just like here, the people who are most happy with it are people who take the view that they would have nothing otherwise. The fact that it’s better than nothing is hardly a ringing endorsement of how well it works.
I’d opt any day for a system that provides excellent to adequate care, virtually immediately, for approximately seventy to eighty percent of the population to one that provides so-so care, long waits and their resultant worsening of illness and/or death, and endless red tape, for one hundred percent of the population.
But lefties for some reason seem perfectly happy to accept substandard-to-terrible results as long as nobody is getting more or better than somebody else.
You see this same effect in communist countries where everybody lives in crackerbox apartments or tiny houses, long lines are required for the most basic of amenities, and nobody has anything to speak of, and yet one hears time after time from members of the left about how communism is the most perfect form of government.
In short, I perfer a system that works very well for most rather than one that’s tortured and substandard for everyone.
I do think that some sort of system should be established to assist people who are truly poor or who can’t get health insurance otherwise, but I strongly object to bringing the entire population under the auspices of the United States government for its health care.
What you’re overlooking is that the corporate bureaucrat has to compete with other corporate bureaucrats at the same company, because showing that you can cut company expenditures to the company leads to advancement.
Corporate health care simply has too much of an incentive to deny claims and not enough disincentive to pay them. This booga-booga spectre of “government bureaucrat” is a way to protect profit, not health or choice.
This is true in a limited sense, but insurance companies are still bound by the terms of their contracts, they still depend on their reputations to acquire new customers, and they are subject to lawsuits and regulatory oversight in the event they go too far…none of which applies to government health care.
The “booga-booga” spectre of the government bureaucrat is due to the very real fact that they exist. Or have you never had to deal with a government bureaucracy?
And besides, the government will be just as limited in resources (if not moreso) and as cost-conscious as any corporation when it comes to doling out care, and unlike corporations who are bound by contractual obligations and the force of law, the government can decide on a daily basis what it has the money to cover and what it doesn’t and can do whatever it wants accordingly.
I don’t want my health care decisions being made on the basis of whether or not the government can pay for it.
I actually think the government will stick it to the doctors before they do it to the public. IOW, lessen the level of reimbursement paid to providers, and incur the wrath of their lobbyists rather than the wrath of the public. (This effect already exists in the case of Medicare reimbursement rates.)
Step 2 is when the top providers opt out of the system.
Truth is that even now a lot of the top providers don’t accept insurance. But their charges can be offset by out-of-network insurance coverage, which many or most people have. I don’t know how widespread supplementary insurance would be under a UHC plan - I don’t see employers jumping at the chance to offer this.
So you could end up having the same two-tiered health care system, but you’d need to be even richer to get into the club.
Well, it can apply if the laws are set up that way. It’s certainly possible for a citizen to sue a government agency. Corporations can indeed get sued, which is why they have lawyers on retainer and can operate on the principle that all they need do is delay long enough and the policy-holder filing a claim will either die or run out of funds.
I could buy the “reputation” argument if the marketplace was such that every individual could pick and choose their personal medical insurance. As I understand the American system, though, most get insurance through their employers, who (naturally enough) have their own interests in mind.
This isn’t a slam against capitalism, which I love. In this particular case and for this particular industry, I just don’t see the point of general-purpose private medical insurance when its existence makes the overall system more expensive and less useful, the same way I’d feel about private fire departments.
Yes, every time I use my provincial health card. It’s actually quite painless. The mistake is in assuming that a government bureaucrat must automatically be worse than a corporate bureaucrat.
Actually, I did have one bad experience - a private insurance company initially declining dental coverage (covered by my employer, since the provincial system doesn’t automatically cover dental) because they thought the procedure was cosmetic in nature. I wrote one letter explaining that it wasn’t and got satisfaction.
And that would be worse than what you now have… how? The contractual obligations you describe are not absolute - they’re only enforceable if the courts say they are, and even getting to court can take months or years.
Unless you’re independently wealthy, somebody somewhere is going to make that decision. At the very least, the corporate bureaucrat has a personal incentive to say no, while the government bureaucrat does not.
The government bureaucrat won’t have *any *incentives to say yes. In fact, they may not even have the option to say yes.
So the only medical care some older folks haveli, which is run by the government, decided that if you have a certain disease you get to go blind. Even though there is treatment. [/li]
Heck, it took President Bush to finally make a change in 2002 to cover Alzheimer’s. Link.
Slee
Yes, there are problems and horror stores, but I don’t see how having the issue in private hands is better.
I have read this 27% statistic before and suspect that most of those expenses relate to advanced cancer treatments. I’ve seen the bills, an IV chemo combined with a drug like Tarceva and all the white cell supplements and drugs for the chemo symptoms cost our insurance company over 50K a month.
The issue with prognosis rationing, as I see it, is that these expensive treatments sometimes work. If we take stage 4 pancreatic cancer, which has the worst prognosis… 30,000 new case a year prognosis average 6 months at diagnosis and a .05 percent 5 year survival rate.
Denying these treatments may seem like a no brainer, but these grim .05 5 year survival rate equals 1500 people per year who are put into a deeply extended remission by these treatments and a handful of actual cures. I have met a few 15 year+ survivors. Furthermore, these survivors are telling their stories to other patients and the drug companies use these stories to promote the chemo drugs.
Working with statistics may be fine in practice, but everything changes when the patient is you…or your husband, or your Mom.
No, not really. Fine Appeal to Emotion, though.
On the subject of health care costs, insane or otherwise:
We’ve heard a lot (including from the Obama Administration) about how creating nationwide eletronic medical records (EMR) by hospitals and medical practices will save lots of money and help finance government-guaranteed health care.
I was at a seminar this week that discussed EMR phase-in, and it was stated that for a medium to large-sized multi-physician clinic, the start-up EMR cost was $44,000. Per physician. If there are a dozen docs in the clinic, that’s about $500,000. Add in the annual cost of maintaining system functionality and security, and that’s another $240,000 for those 12 doctors.
Of course, those are only the current cost estimates. The Administration has allocated some funds to help finance EMR start-up, but that won’t remotely cover what needs to be done across the U.S. There are also something like 200-300 different EMRs being marketed, not all of which are suitable for a given practice/hospital setting. If, despite all precautions you wind up with an EMR that doesn’t work for you, there’s the cost of getting rid of it and salvaging all the patient data, then buying yet another system.
Now, I think EMRs are a good idea, and I love the setup at my hospital that allows me to rapidly access lab, radiology and clinical reports so I can better diagnose a patient’s disease. Ultimately, if good systems are used and concerns about security of patient info are resolved, I think patient care will benefit from EMRs.
But this is not going to be cheap. It’ll cost more than what we’re spending now on paper records. And anyone who claims big cost savings is misinformed or lying.
This is a theme we’ll be revisiting over and over as we move towards universal coverage, a good and necessary thing in my view. However we should all be prepared to pay more and experience some health care rationing as the price of universal care. Those with pretty good plans now are not going to be happy.