Where's my fucking affordable health care, you fucking fuck? [lame]

The BBQ Pit
161

Heh, yeah, well that is your job, and you get paid for it right? Well let me give you a pat on the back!

I AM doing something. I am working in the government relations industry, learning as much as I can, and I hope to someday pretty soon stop working for the “bad guys*” and get active in the public policy arena working for health care reform. BUT my experience here researching their issues will make me that much more prepared to fight them!

*Ok well my company is non-partisan, so we have clients from the whole spectrum, but of course our biggest money makers are the insurance, pharmaceutical and banking industries, because they’re the ones with a ton of money.

162

I admit that pointing out the blatant hypocrisy and selfishness of your world-view does give me cheap laughs. :slight_smile:

Don’t blame me just because you’re the asshole.

163

You keep pretending that the limited options that private insurance can offer amounts to the totality of what can be done.

You consistently ignore the evidence that a socialized system offers a much better solution. Advocating for this solution is not just hand-wringing.

164

Universal health care is a minimum of 6 years away, and I’m still not convinced it’ll be anything but a boondoggle if and when it arrives. Medicare, Medicade and the VA are the three main health programs currently run by the government, and they do not provide standards of care I would wish on rjung. There is no reason to think thet UHC would be any different. Meanwhile, black455 has a problem now, and I’m willing to see if I can point him towards someting that will help him while he’s waiting for the socialist utopia to arrive. And no, in case you were wondering, I won’t make a dime off of him if I do find something.

165

Medicare and Medicaid do not provide health care. They are health insurance program. Beneficiaries have to go out and find health care providers to care for them (with the exception of Medicare Choice or managed care Medicaid plans, which are still privately run plans that are contractors). To the extent that you object to their standards of care you’re simply saying the regular health care system is bad.

The VA actually is a gov’t run health care system. "The socialized medicine to which I refer is the complex of hospitals managed by the Veterans Administration. Longman cites a study published in the New England Journal of Medicine in 2003 comparing veterans’ hospitals with fee-for-service health care funded by Medicare. Both, of course, constitute socialized medicine in the sense that both are paid for by the federal government; but the hospitals treating elderly patients on Medicare are not government-run institutions. By every criterion, the New England Journal found the veterans’ hospitals to be superior. " See Slate , or the original article in Atlantic, The Best Care Anywhere

166

The plain fact that existing socialized systems uniformly operate more efficiently isn’t a reason?

You think Americans have some systemic failing that would prevent you from successfully working to a proven blueprint? What the hell?

167

Yoooo-hooo, Dave? Dave? Hello? Where’d you go? Are you just going to ignore questions you can’t answer? Just going to call me an idiot and run away and hide?

Ohhh-kaaayyy :rolleyes:

168

Have you ever DEALT with the VA? Or had someone you care for dependent on the VA for care??? shudder I sell policies to people with full VA coverage all the time, people who are willing to shell out a couple of hundred extra bucks a month so they can insurance that allows them to get treatment when they need it rather then being dependent on VA “health care”.

Well, that’s exactly what I would expect. Why does everyone keep throwing this out like it’s some big deal or something? Hospitals are saddled with enormous amounts of paperwork to satisfy an ever increasing number of government regulations, they’ve had to add entire staffs to handle the forms required in the last 10 years. The paperwork required to get Medicare to pay a claim is staggering ( To be fair, there is a great deal of paperwork required for private insurance too. What I’m saying is that that’s not going to change if insurance is federalized.). VA hospitals are not subject to the same requirements. It’s an apples and oranges comparison.

169

Have you ever lived with UHC?

It’s fallacious to think that a UHC plan would be like VA care for everyone. A qualitive difference is who the adminstrators are accountable to, and who depends on the program.

The VA is a benefit program for a subset of the population. Do the people who hold its purse strings rely on it? No. How do veterans compare with the population at large for health-care requirements? Of course it’s not going to run the same way as a Universal program.

Apples and oranges? No irony, there, right?

Because successful socialized health programs in other countries are just like Medicare, right?

170

I do a point by point response and this is what I get?

I have thus far tried to keep the major evils of the health insurance field out of this thread, as that’s more of a sidebar issue, but if you are going to continue to tout private insurance as the savior of all of our health care problems without really addressing the numerous issues being raised, that’s a sidebar we’ll have to take.

171

The VA hospitals aren’t better on doing paperwork, they provide better quality of care to their patients. "the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be “significantly better.” "

“The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care. It gets stranger. Pushed by large employers who are eager to know what they are buying when they purchase health care for their employees, an outfit called the National Committee for Quality Assurance today ranks health-care plans on 17 different performance measures. These include how well the plans manage high blood pressure or how precisely they adhere to standard protocols of evidence-based medicine such as prescribing beta blockers for patients recovering from a heart attack. Winning NCQA’s seal of approval is the gold standard in the health-care industry. And who do you suppose this year’s winner is: Johns Hopkins? Mayo Clinic? Massachusetts General? Nope. In every single category, the VHA system outperforms the highest rated non-VHA hospitals.”

The Best Care Anywhere (Sorry confused the Atlantic with Washington Monthly in the original post.)Washington Monthly

Using the horrific paperwork requirements imposed on health care providers by the US health insurance system, private and public, isn’t a good defense. It just demonstrates how inefficient and wasteful the system is and why UHC would be a better alternative.

172

Does anyone have a good explanation for this disconnect? Why it the best care in the U.S. perceived as the worst? Is it only insurance co. propaganda? Because if everyone was clamoring for VA style health care, it would go a long way towards pushing the U.S. towards UHC. But nobody seems to want this, despite the proof published in peer-reviewed medical journals that it provides superior outcomes.

Here’s 2 reasons I came up with

  • One of the things I learned in veterinary school is “People don’t care what you know until they know what you care.” Since the vast majority of people can’t assess the quality of their care, they put all their stock in the convenience of getting in and out of the doctor’s office. Friendly nurses, new magazines in the waiting room, and easy to file forms are something a person can relate to. Overall improvement in mortality rates is too abstract to feel on a personnel level. Most could give a rat’s ass if their doctor is providing the best medicine possible as long as it’s delivered with a smile, and you get in and out quickly. Could it be that the V.A. system is less “caring”
    This is the one I think it really is: Most Americans don’t want the best medical care. They want to call the shots for themselves, they don’t want to be forced to go by a doctors’ decisions based on epidemiology or evidence-based medicine. And they want this even if their health is negatively affected. Those who are sick enough to want it some other way are too small a part of the population to change anything.

If every pediatrician refused to script out antibiotics for minor ear infections most parents would go nuts. They wouldn’t want to hear about resistant strains of bacteria and no change in outcome. They want their kid to stop crying now, they think antibiotics will do that form them, so they want their antibiotics NOW.

My sister-in-law had her first baby in a Japanese hospital. She was not given an epidural or other pain killers because she was told that there was a higher chance of harm to the baby when they were used. Can you just imagine the uproar if U.S. hospitals stopped giving laboring mothers epidurals. It would probably improve our overall infant mortality rate and decrease NICU admissions, but women in pain don’t want to hear that. They want Dr. Feelgood to make the pain go away NOW.

And they’d hate a system that would prevent that from happening.

173

I remember lots of terror reporting in years past about VA hospitals.

This is extremely condescending. Are you aware of that?

174

[hijack] Just out of curiosity, did they have verifiable medical evidence and studies to back up their claim that epidurals cause harm to infants and increase infant mortality? [/hijack]

175

I don’t know about infant mortality (and my intuition is that epidurals have an insignificant effect on that the number of infant mortalities,) but there are acknowledged risks associated with their use.

Personally, if it were me that were going into labour, having done an informal risks/benefits analysis, I’d choose the epidural in a heartbeat. Hell, yeah.

(They’re totally covered here, by the way.)

176

Cite?

177

The USA spends about twice the proportion of its GNP on healthcare as the UK- approximately 12% vs 6%. The USA spends a higher proportion of its GDP on health than any other country in the world.

Most of this extra cost is from administrative costs (20% in the USA vs 5% in the UK) rather than an actual difference in care.

Still, the WHO rates the USA 37th in the world, based on the following criteria:

Overall level of population health

Health inequalities or disparities within the population

Overall health system responsiveness (patients satisfaction +how well the system works).

Distribution of responsiveness (how well the system serves the poor vs the rich).

Distribution of the financial burden within the system (who pays).

The UK rates 18 and Ireland 19, while the top three health care systems in the world are in France, Italy and San Marino-followed closely by Andorra, Malta and Singapore.

Something in the USA is deeply wrong with the health system, and thowing more money at it wouldn’t appear to be the solution.

178

In response to the requests for citations. Here goes:

First of all, there is no cite for a random Japanese doctor’s belief that the way they handle laboring women is the reason there is less infant mortality in Japan.

It is an easy to find the data that infant mortality in Japan is approximately half that in the U.S.
http://www.prb.org/Content/NavigationMenu/PRB/Educators/Human_Population/Health2/World_Health1.htm

BUT - before the frantic typing-in-response begins - it is important to aknowledge that there are lots of reasons for this. How about crack epidemic babies? Etc. etc. The U.S. is a much more diverse country both genetically and socio-economically than Japan. It is widely agreed that the key to healthy babies is good prenatal care. The only prenatal coverage any American women receives is either paid for out of pocket or provided by insurance or via a government or state program the mother-to-be qualifies for. Lots of women (can you say working poor?) fall through the cracks -so the lack of UHC comes back to bite us in the ass yet again. Couldn’t that be the main (i.e. iceberg sized) reason for the difference? Not laboring practices (i.e. ice cube). Absolutely.

The best way I could come up with to look at the effect of laboring practices on baby health in this country was to compare non-medicated births in the US to “standard” births.
Doing this takes you down a long, political bunny trail. It ends up at home birth, as I couldn’t find any info on non-medicated hospital births in the US.

The sites that are propenents of home births cite lots of articles that would support its practice:

http://www.changesurfer.com/Hlth/homebirth.html

http://www.ub2b.com/AtHome/HomeBirth.html sums up a large study comparing the two this way:

“The hospital group showed six times more infant distress in labor, five times more cases of maternal high blood pressure, and three times greater incidence of postpartum hemorrhage. There was four times more infection among the newborn; three times more babies that needed help to begin breathing. While the hospital group had thirty cases of birth injuries, including skull fractures, facial nerve palsies, brachial nerve injuries and severe cephalohematomas, there were no such injuries at home.” There was no difference in infant mortality in either group, BTW. The morbidity mentioned in the hospital birth group would earn the victim a ticket to the NICU in most instances.

If there are other articles out there that show the opposite, they obviously aren’t being linked on these sites, and I couldn’t find them using a Pub MEd search. These site also maintain that home birth cuts across socio-economic and racial boundries, taking away the arguement that it’s only healthy, rich vegans who home birth. Again, I could not find sites out there to dispute that assertion.

I have not cite to back my impression that most women would be very unhappy if they were denied epidurals (Although 95% of the pregnant women I work with wouldn’t be too pleased), but IMHO one can tell what the current pregnant population thinks is important in a hospital by seeing the advertisements on TV and on billboards. In my area the things that are highlighted are well appointed, “home-like” single rooms, having anesthesiologists on site, and the hospital’s committment to making the mother comfortable. Whether the hospital has a NICU is never brought up, or, God forbid, morbidity and mortality comparisons.

179

Oh, please. While I was working at a glorious financial institution, I could not afford their healthcare because it was easily anywhere from 20-30 percent of my paycheck, which never topped 1000/month.

However, my boss estimated that I’d brought, with my sales, about 100,000 extra dollars in revenue just in a couple of months. And guess whose fucking pockets that was lining? Not mine–they wouldn’t give me a raise, or give me more hours even though they knew I needed them.

So you know what? I’VE subsidized someone else’s healthcare or new car or whatever it was when the CEO awarded himself and all the top management a 5 percent raise and gave the bottom half of the company nothing.

I think it’s only fair now that someone pass the same on to me, or others like me. The insurance my parents (saints that they are) will lapse soon, and I don’t know that my round of surgeries will be over before that happens. What’s wrong with me actually getting some fucking healthcare for my labor?

180

Maybe because it doesn’t happen? Very few people are rich enough to pay for healthcare when they most need it, but that doesn’t stop people from getting sick, injured, and needing expensive surgeries. Taxpayers routinely cover the costs of indigents. People also subsidize the care of others through their premiums. Because preventative care is cheaper in the long-run than treating disease and terminal illness, its in the public’s best interest to have attainable healthcare before it is a life and death issue.