Who Should Control Your Health Care?
Who should have control over your medical care: your family doctor or a bureaucrat you’ve never met whose sole job is to look out for the government’s financial bottom line?
That question is being debated in court right now, as three states are currently seeking a ruling from a federal judge that the final say in an individual’s medical treatment lies with the government and not with that patient’s doctor.
In March, Georgia, Florida, and Alabama joined in an appeal of a 2008 U.S. District Court ruling that a patient’s physician was better positioned — and better qualified — to make decisions about that patient’s medical treatment than state bureaucrats.
The case centers on Callie Moore, a disabled teenage girl living in Georgia. A stroke Callie suffered in utero left her suffering from multiple conditions, including cerebral palsy and mental retardation. For the last decade, she has received around-the-clock in-home nursing care for her medical conditions.
In 2007 though, the state of Georgia cut coverage of Callie’s in-home care by 15%, from 94 hours a week to 84 over the objections of her attending physician, who was intimately familiar with her case and her needs. State officials (who were not medical professionals) cited disagreement with the attending physician about just how much care Callie needed as the primary reason for this reduction in care.
Callie’s mother filed suit in 2007, arguing that the state had no right to contradict the orders of her personal physician and limit her treatment. However, because Callie receives her medical treatment under Medicaid (the joint federal and state health coverage program for low-income individuals and families), Georgia officials argued that Callie’s care was subject to rationing, as the state bureaucrats’ need to ensure Medicaid resources were allocated “fairly” superseded her doctor’s care prescription or her personal medical needs.
On June 4, 2008, U.S. District Judge Thomas Thrash ruled that Callie’s doctor, not state bureaucrats, had the right to prescribe just what medical treatment and care his patient required. Georgia was ordered to raise Callie’s skilled home nursing care back up to 94 hours a week, as prescribed by her doctor.
Rhonda Meadows, commissioner of Georgia’s Department of Community Health, immediately appealed the ruling to the 11th U.S. Circuit Court of Appeals on behalf of the Peach State. Her argument was that state officials, not doctors, should have final say in what treatments and care patients within their purview require. Florida and Alabama, which fall under the 11th Circuit’s jurisdiction and will have to abide by its ruling, filed an amicus brief with the Atlanta-based court.
This case has thrust into the spotlight the debate about an issue that has long been confined to dark, smoky rooms in state capitals and Washington, D.C., and to the fine print of legislation that members of Congress aren’t bothering — or being allowed — to read before their passage.
Who should have control over your medical care: your family doctor or a bureaucrat you’ve never met whose sole job is to look out for the insurance company’s financial bottom line?
There, I fixed it for you.
Michael, you have in one short sentence, summed up the problem with health care in America. i.e. it is too complex to be summed up in one short sentence.
The reason we have insurance companies is because people decided to pay for their care that way rather than cash. The reason they cover most people is because of govt. intervention (price/wage controls) following WWII.
The reason why medical care is so expensive is because it costs money to do all the things that we want from the system. Drugs, technology, skills, compassion, privacy, oversight, etc. etc. etc.
The real problem is that we have been hearing over and over that, “if we just did…” we could solve this problem. Well, we can’t solve the problem. Never going to happen. That is because of what we call the “iron triangle.” At the three points of the triangle are Quality, Access, and Cost. You cannot affect any of these without affecting the other two. And anyone who says they can is lying to you.
The only involvement the government should have in health care is to put a cap on the outrageous liability settlements that people get. This trickles down to the individual care giver via insurance costs, and to us, so he can stay in business by having insurance.
Spend just a few minutes watching some of Soylent Green- 1973
Det. Thorn: [Det. Thorn takes a cigarette from one of the girls at the party and smokes it] “You know if I had the money I would smoke two… three of these every day.”
Sol: [after reading the Soylent Green State report]
Sol: “I am 65 years old- I’ve lived too long!… I love you, Thorn.”
Det. Thorn: [tearfully] “I love you, Sol.”
Det. Thorn: “Turn the air conditioning way up!”
Shirl: “Way up! We’ll make it as cold as winter used to be!”
Sol: Lying on a roll away metal trolley-
Looking at the panoramic view of all the beautiful flowers and trees-
View stretches and switches to lakes and streams fishes and birds.
He goes into a long deep eternal sleep.
Your state Abortion worker will tell the doctor when you have lived long enough.
If I am paying the bill, I decide what gets paid. If Georgia is paying the bill, Georgia gets to decide what bills to pay. This is why government should not be involved in medicine in any way. The mother can get any care that she wants for her daughter, she just has to pay for it. The reason government does get to decide anything about my car is because they didn’t pay for it, I did. When you want someone else to pay for your services, why can’t they decide not to pay? How about some self reliance? Responsibility? Nope, just more dependence.
I am already under government control, I have medicare. I have a company as a rider who offers some care that medicare does not. Well it is run by Gov personnel. And they keep dropping coverage. i.e. I had eye exams covered last year. Eye exams is one reason I pay for a rider. Well they dropped it this year. And guess what I needed an exam. Most elderly do.
If the government takes it over totally it will be a disaster in my mind. They will made decisions for you. Even if you Dr says you need a procedure they will say it costs to much and the person will not be here to much longer so it is not cost effective.
You all are missing the point. When the state rations healthcare, the incentive to become a Doctor, who have to defray enormous costs, their education, office equipment and personnel, will be reduced. This will impact specialists, e.g. surgeons, the most. Fewer Doctors means longer waits and Canadian or British get-in-line healthcare. I suppose those who can afford it can always go to Mexico for treatment
…if you want high quality that is. Remember, your government won’t be able to fully pay for everyone’s healthcare and have enough conviscated earnings left over to fund other progressive, socially engineered programs designed to secure votes. More taxes anyone?
People arguing against socialized medicine need to come up with some numbers. Americans life expectancy at birth is 50th in the world at 78.11 years. Our rate of infant mortality is 45th at 6.26 per 1000 live births. These numbers come from the notoriously left-wing CIA world factbook. For me, the life expectancy number is unconvincing since lifestyle factors have a huge impact on lifespan. Infant mortality on the other hand, is influenced almost entirely by the quality of medical care received before and after birth. Most of the countries ahead of us have some form of socialized medicine.
I’m willing to listen to logical arguments but private health care folks need to stop making these anecdotal arguments. Even if your great aunt in Canada got crappy healthcare, the evidence seems to suggest that Canadians on average get better treatment than Americans on average.
You get sick….Doc writes you a prescription……..your kindly Government employee changes the prescription for you to something less effective but cost savings….you die.
end of story.
It is wrong for a government to stand between a patient and the care that they need, and it certainly is not the role of government to determine whether an individual needs that care or not.
Geez, the ignorance, lack of compassion and care displayed by some at the Las Vegas V.A. medical community (nurses, receptionists, etc.) towards my father who is a 100% combat-related disabled veteran (“Priority Group 1″) and other Pri Group 1 veterans like him, would be magnified 1000% if the rest of the nation was to receive care from the Government. I’m all for people receiving healthcare, but the Govt telling you who you should see, when and why is not the answer.
Don’t get me wrong — there are many in the V.A. who truly care and understand their role in the system and in the process (i.e., they understand they exist to aid and care for the ill or injured veteran), but there are also those few who truly are worthless permanent civil servants who give the rest of us career Federal Govt employees and officials a bad name and reputation. They exist in the system simply to pass the time and ensure they get a promotion or a paycheck.
Trust me on this — you do not want to be treated or dealt with by those rotten, selfish few in the Government.
“to the recommendations the mechanic makes for fixing your worn-out brakes or broken transmission — was subject to final review by a state bureaucrat with no experience in the automotive industry.”
Several years ago I owned 50% of an auto repair business in California. California has specific procedures as to what a brake or transmission job consists of.
As an owner/operator, you had to be very aware of the consequences when the California Bureau of Automotive Repair entered the picture. There was a high probability that it would not be a good outcome for you, regardless of the evidence presented.
The BAR put out a monthly blurb highlighting violators and penalties with articles of how and why they were caught…
If not sure that there is a general realization as to how far the State has already penetrated into individual’s business/personal lives. The present actions of the federal and state governments etc. are simply the continuation of a long term trend. Health care is not already government run? I say that it’s a matter of degree that is being discussed now.
Micheal says; Who should have control over your medical care: your family doctor or a bureaucrat you’ve never met whose sole job is to look out for the insurance company’s financial bottom line?
Dear Micheal, I think you’ve missed a key distinction. Once you have the government medical plan, you have no redress – you are stuck with their desicions. Under a private plan, you can appeal or sue (and many have). However, you cannot sue the government unless they agree to be sued. You can appeal to your employer under your private plan, and I have seen this happen many times. HR departments can and have interceeded on behalf of their employees. And too many complaints and the business can switch providers.
The problem is that the government has too much power – and make decisions that may be best for the ‘group’ but not for your – and you are stuck in a way you’d not be stuck under a private plan.
The degree of damage that will be caused by nationalizing healthcare is far larger than you can imagine.
A. Many if not most doctors will likely opt out of the nationalized system in favor of private payors. The result being
1. too few doctors for patients in the nationalized system.
2. Too few specialists for referrals.
3. Many doctors may just retire and look for other occupations (lets hope that includes politicians so that we can try and reverse the damage in the future)
4. Delayed healthcare due a lack of availability of doctors (in addition to the rationing of healthcare).
5. Higher number of malpractice cases due to doctor fatigue.
6. Higher unemployment form cuts in the insurance industry as well as closed or closing doctors offices and hospitals.
B. Delay in care while awaiting approval for care by the government (and that is after the government gets up to speed).
C. Cost savings by the government by insisting on time limits of hospitalization of patients by diagnosis. This results in incomplete care or huge losses for hospitals when they keep the patients beyond the unreasonable limited number of days.
D. Hospital and physician refusal to accept patients when the government puts in place monitoring systems for evaluation of outcomes. Patients who are so very sick that it will require heroic efforts by physicians and hospitals will become a thing of the past. Why would anyone want to take on those type of cases if they know that they have a limited likelihood of success and a higher likelihood that they will get paid less in the future for the cases that are more typical.
E. Denial of care by the government in favor of less expensive forms of care. God forbid someone get’s pancreatic cancer (likely remaining life expectancy of less than 6 months) where care may just plain be denied. The result is the small percentage of successfully treated cases would go to zero.
Currently everyone has access to emergency healthcare. I am a hospital based physician and 30% of my patients are uninsured or medicaid(may as well be uninsured). It is not unusual for patients arriving in the Emergency Room to lack insurance or coverage. THEY GET TREATED ANYWAYS.
The only good news(?) from the population as a whole (and its a matter of perspective) is that the mortality rate will go through the roof and the life expectancy will decrease such that Social security will have less recipients. Obviously, I am very strongly opposed to nationalization of healthcare and control of patient care by non-medical, non doctor-patient relationship care decisions.
Part of the problem is that doctors are prevented via anti-trust laws from forming a group of doctors across different specialties, and taking money from patients as an annual premium, sort of like insurance but cutting out the middle man, the insurance company.
Instead, we are forced to use insurance companies as a middle man, and it takes away a large percentage of money toward that bureaucracy, money that could otherwise actually be used for health care.
In the near future, a nameless bureaucrat may determine what kind of medical treatment you receive.
I hate to be the one to tell you this: they already do. They work at the HMO.
Why should I prefer a bureaucrat with a profit motive, rather than one with a public health motive?
That’s the question I want a clear answer to.
Peace.
DS
Paul #8:
We have more mothers who are smoking crack, drinking alcohol, etc. while pregnant than does Japan, Switzerland, or most other countries, it’s just our crummy poverty culture, so your comparison is unfair.
Recent studies show that US patients have higher 5 year cancer survival rates than most western countries, and those in the US with private insurance have better survival rates than those under a government health plan.
“Averaging the rates for men and women, the top five performers are as follows: United States (64.6%), Sweden (61.0%), Iceland (59.8%), Finland (58.5), and Switzerland (57.9%). The worst performer was Scotland. England was fifth from the bottom.”
This information was reported through the Lancet Oncology Report. Lancet is a respected medical journal – UK based.
The life expectancy (overall) may be lower in the US due to our sedentary lifestyle and obesity issues, and also due to the violence in the inter cities. But this does not mean that our healthcare is failing.
Miriam #17
If we were number 5 or 6 in the world I’d accept that it was lifestyle factors contributing to the fact that we spend way more money per capita and get poorer results. At 45th we need to take a real honest look at why our cutting edge hospitals, exceptionally well trained doctors and high per-capita income doesn’t translate into a much higher infant survival rate.
Plus many European countries don’t have the hang-ups we do about drinking while pregnant. I don’t have any data but I’m pretty sure mothers-to-be in Iceland (#6) and Finland (#8) drink far more than their American counterparts.
And how many crack addicted mothers are there? Not 3.95 per 1000 surely, that’s the difference between us and Singapore at #1.
Under the current system doctors and patients do not decide care; insurance companies do. There are hundreds of different companies that have differnent policies about what they will or will not cover. They will frequently deny claims that they know they should pay because they know that most patients do not have the ability to fight with them. This notion that universal health care will somehow wrest control of decision making from the patient and give it to a government bureaucrat is nonsense. It will simply create uniformity in what is and is not covered and not leave the patient at the mercy of the insurance company bean counter who will put profit over the needs of the patient.
I a military retires with 70% disibility, and 78 years old.
I am not willing to share my benifits with any one!
The only answer to socialized medicine is to not treat every problem of every patient. At my age, and income bracket of top 2% in the nation, I would probabley not recieve full medical attention so some one else tould be treated.
This is to Paul (#8) and his question on infant mortality. Miriam (#17)answered part of it. There is no one major causal factor, but here are a couple of other key factors.
1) Singapore, Iceland, and Finland are all very small countries with a pretty high percentage of the population that is homogeneous. So a more apt comparison might be between a middle class homogeneous County (not a State unless it is Vermont, Maine, the Dakotas, etc.) and these countries.
2) Some of the countries don’t count premature babies as part of their infant mortality figures the same way the US does. For example, a baby born before 35 weeks in Finland and ultimately dies might not be a part of their statistics, but in the US the baby would.
Naturally premature babies have the highest infant mortality rates. So unless we can be sure that the same number of weeks is being used by the countries we are being compared against, how can we trust the information?
Oy. So much smoke and heat, so little light. OK, here goes:
Problem: Health care is, or is perceived to be, expensive, such that large numbers of people either have their bills paid for by the gov’t, or pool their payments with thousands of others (i.e., insurance), such that, if they require treatment, they won’t have to pay out of pocket for all of it, or some mixture of the two (e.g. Medicare plus insurance).
Only solution proposed on the horizon: Get gov’t more involved, essentially putting everyone on Medicare/Medicaid, a la Canada, UK, etc. Likely result: Long waiting lines; marginally better outcomes in terms of large numbers of people (at best), possibly worse outcomes, depends on which experts you believe (most ‘experts’ quoted are socialists, so guess what they say…); hard to say as the populations are not equivalent; also markedly less freedom, as, in the final analysis, the one paying the bill gets to say what goes and what doesn’t.
The only REAL solution: Look at why medical care is expensive. Turns out it’s b/o restrictions on competition brought about by (you guessed it) gov’t regulation. Which regulations? Primarily the state medical practice acts and the FDA. Right now the gov’t pretends to be competent to tell you whom you can pay for medical care, and which medicines are safe/effective enough to be worth taking. They aren’t competent to do so, but they pretend to be. The result: fewer docs and medicines on the market, and higher costs to get on the market at all. Doesn’t take an econ major to tell you what a lower supply and higher production costs do to consumer price…
This is the US. If I want to go to the village idiot to have my appendix out, I should have the right to do so. If one adult wants to make/import/sell any pharmacologic substance and another adult wants to buy it, they should be free to do so. Period.
However, as long as we want Big Daddy gov’t to protect us from our own incompetence at choosing a physician or medication, we will have higher costs, and these higher costs will inevitably allow the socialists to take control. I would cheerfully surrender the protection from competition that my state license grants me if the medical practice acts were overturned. Among other things, the supply of specialists would skyrocket, and my limited-income patients would no longer be prevented by cost considerations from seeing the few that are in practice in my area. And if the FDA was abolished, I suspect they’d be better able to afford their BP meds as well.
Abolish the medical practice acts and the FDA. Watch health care costs drop like a rock as availability skyrockets. Watch Medicare/Medicaid/private insurance disappear for lack of need. Applaud and get on with your real life.
Don’t bother complaining about ‘those poor people who won’t know which doc to see’ or ‘which medicine to take’ or ‘quacks’ and ‘snake oil’. Guess what: THERE’S QUACKS AND SNAKE OIL NOW!
(Hit ‘submit’ too soon, sorry) The point is not whether people might be harmed by bad meds or incompetent docs: the points are:
1. Who ever said it’s gov’t's job to protect people from their own incompetence at choosing a doc or med? I resent having money taken from me and my family to pay some gov’t flunky to supposedly decide who is competent to be a physician and which meds may be allowed on the market by the great beneficence of our all-wise masters.
2. Are you sure the side effects of the ‘medicine’ (gov’t regulation of medicine by medical practice acts and FDA) don’t outweigh the benefits? Beware of the unintended effects of legislation. Vote principle, not pragmatism.
#13: LIL,
Well said. My husband and I pay over $1000.00 per month (we are middle aged) for our health insurance. He was diagnosed with cancer a few years back. Insurance company decided they would not pay for everything at the 80/20 – X amount out of pocket expense agreed to. They called it “A special circumstance.”
I fought! With every ounce of my being I fought!
Result: They are paying!
I can’t even imagine if that fight was with the Government! I would still be on hold!
My two cents…What a lot of people need to do is quit buying homes, boats, cars, etc. you can’t afford and pay for health insurance! There are too many out there who don’t give it another thought to have a $1000.00 house payment or a six or seven hundred dollar car or boat payment, but squeal like a bunch of pigs if they have to pay for health insurance!
US 50th in life expectancy? Not according to the World Heath Organization (granted not to estemed medial group CIA) reports that we are 29th, not 50th.
Still not great. But consider this:
Life expectancy is not dependent on just medical care. For example, Texas A&M health economist Robert Ohsfeldt and health economics consultant John Schneider point out that deaths from accidents and homicides in America are much higher than in any other of the developed countries. Taking accidental deaths and homicides between 1980 and 1999 into account, they calculate that instead of being at near the bottom of the list of developed countries, U.S. life expectancy would actually rank at the top.
America’s relatively high infant mortality rate also lowers our life expectancy ranking. A 2007 study done by Baruch College economists June and David O”Neill sheds some light on why U.S. infant mortality rates are higher—more low weight births. In their study, U.S. infant mortality was 6.8 per 1,000 live births, and Canada’s was 5.3. Low birth weight significantly increases an infant’s chance of dying. Teen mothers are much more likely to bear low birth weight babies and teen motherhood is almost three times higher in the U.S. than it is in Canada. The authors calculate that if Canada had the same the distribution of low-weight births as the U.S., its infant mortality rate would rise above the U.S. rate of 6.8 per 1,000 live births to 7.06. On the other hand, if the U.S. had Canada’s distribution of low-weight births, its infant mortality rate would fall to 5.4. In other words, the American health care system is much better than Canada’s at saving low birth weight babies —we just have more babies who are likely to die before their first birthdays.
The fact that Americans tend to be a lot fatter than the citizens of other rich developed countries increases their risks of heart disease and diabetes. A recent international survey reported that 31 percent of Americans are obese (body mass index over 30), whereas only 23 percent of Britons, 21 percent of Australians and New Zealanders, 14 percent of Canadians, 13 percent of Germans, 9 percent of the French, and 3 percent of Japanese have body mass index measurements over 30.
Taking all these unhealthy proclivities into consideration, the American health care system is most likely not to blame for our lower life expectancies. Instead, American health care is rescuing enough of us from the consequences of our bad health habits to keep our ranking from being even lower.
To WJ #22
1) Iceland and Finland do have homogenous populations but Singapore is a melting pot of English, Chinese, Indian and Malaysian populations. Incidentally, the food there is excellent as you might imagine. But we can just as easily compare ourselves (#45 6.26/1000) to Canada (#35 5.04/1000), the UK (#31 4.85/1000) or France (#7 3.33/1000) which are all large countries with reasonably diverse ethnic populations.
2) I would assume the CIA tries pretty hard to make sure their information is equalized for purposes of comparison. If this is not the case though, how would we find out? Is it reasonable to assume that among western nations there are similar standards for reporting this sort of thing? I’m not pretending to be an expert here, I’m just a guy with a pile of open source data.
To Jane #25
I picked the CIA factbook because I thought it was a non-partisan source for facts. They’re not experts on health care but hopefully(!) they are experts on compiling data from foreign countries
Teen pregnancy correlating to higher infant mortality sounds pretty reasonable, where did you find this study? I’m interested in whether the authors compared US health statistics to Europe or Asia. The UK, I know does have a very high rate of teenage pregnancy.
I would also argue that universal access to preventative medicine might save a lot of lives from even lifestyle factors like tobacco, over eating and lack of exercise. When I go to the VA they know they’re stuck with me as a patient for life so it’s in their best interest to give me preventative care now rather than emergency care later. My insurance company doesn’t always feel the same way.
Socialist countries have FULL CONTROL of the reports produced to “prove” that their system works. Too bad their citizens don’t agree.
TO: All
RE: Heh
If you want to properly visualize the future that Jeff is envisioning, I recommend you do one or both of two things:
[1] Watch the movie, THX-1138, a scifi classic starring a very young Robert Duvall
[2] Read Joe Halderman’s The Forever War.
Pay particular attention to the forms of medical ‘care’ offered in both.
Regards,
Chuck(le)
P.S. Both of these classics came out in the 1960s-70s.
Talk about prescient…..
“..universal access to preventative medicine might save a lot of lives from even lifestyle factors like tobacco, over eating and lack of exercise.”
You would think – and yet – when government is determined to ‘hold costs down’, early treatment can get shorted.
One story that has stuck with me is the 20-something woman in England with a breast lump. She was denied diagnostics on the lump because she was not in a high risk group. True, most lumps in 20-somethings are nothing, but breast cancer in young women is often the most aggressive kind (MY OB-GYN sister-in-law informs me). It took her 9 months to convince them to run diagnostics on her – by the time they did – too late to treat. She died leaving a husband and young daughter.
Antidotal? True. But I think this is our future. Long waits (even if we can’t afford to wait), rationing of care, etc.
This is important: Tom Daschle (a key player in the early design of our universal health care program) has already said that we all need to get used to the infirmities of old age. In other words, after a lifetime of paying taxes, our government may decide that we’ve outlived our usefulness and not provide the kind of treatments that will either save our lives or ease our pain.
And availability? I have several doctor friends who are re-thinking their future in medicine if their autonomy is threatened and their ability to earn a living commensurate with their level of schooling and experience is deminished. Our access to good heath care would diminish if good people leave the profession or just choose not to go into medicine.
Oh, the data I posted earlier came from a WSJ article, which did a good job citing its stats.
I am very against nationalized healthcare, but am not sure they picked the best example here. The state should have a right to say “we can pay X amount and the rest is up to you, the family” even in medicaid. I can’t imagine the millions spent on this girl who will never recover, that could have gone elsewhere while still keeping her comfortable. After all, I pay my electric bill. so I get to say how much electricity we use. Why should a healthcare bill be different? You pay, you make the decisions, as someone else pointed out.
That said, I do NOT want those states winning. Too slippery a slope, I just think there are better examples of why not to ration healthcare.
Paul @8: Infant mortality on the other hand, is influenced almost entirely by the quality of medical care received before and after birth.” No, not really. It’s influenced by how the country designates live births. Many, many countries make you live 24 hours or more, even up to a week, to be a “live birth”. We count every infant who takes a breath as alive here, and rightly so. Many countries also do not count as living infants with known health problems incompatible with survival. Preemies here get the best care available in the world. Other countries won’t even try with micropreemies.
Health insurance needs to go back to being insurance-not a prepay system. It should not cover vacs, sniffles, and other small and expectable problems. Much like car insurance, it should cover things that “total” your health and pocketbook-cancer and trauma and the like. The rest you should pay for. That would drop health insurance costs considerably. It should also be competitive and not hooked to employment, again like car insurance. The state could mandate minimums and you can pick what else you want.
I’m just not buying the argument that people will stop going to medical school if doctors weren’t so highly compensated. Americans do difficult training for little financial reward all the time. Americans graduate Yale law school and go to work for the Justice Dept. for $65k a year. They get PhDs in psychology and take jobs with the public school system. Americans earning less than $40k a year go to BUD/s and SERE school and compete for the privilege of being a Navy SEAL.
It just seems to me that we spend an awful lot of money, much more than any other country and we’re not getting the best results. Which can only be described as a failure of the market.
I think disconnecting health insurance from employer funding would be a good start. If people could switch health insurance providers at their own discretion without having to quit their jobs the insurers would have to answer to their customers directly instead of negotiating with the human resource dept. Even then though, the financial incentive will always be for the insurers to charge high premiums and provide the minimal care required to keep you as a customer.
To momof3 #32
“Many, many countries”, “other countries”? Which countries? The only information I was able to find was that Switzerland requires a baby to be 30 cm. (11.8 inches) in length in order to be recorded as a live birth. That’s the average length for a delivery at 24 weeks here in the US, which is premature but not extremely so. There are some other discrepancies in how other western nations count births by foreigners or military families stationed overseas when compared to ours but I’d be surprised if that could impact the numbers decisively.
Government health care expands the influence of the government, not at all reflective of expanding the quality of medical services. If the feds were wildly interested in health care, they would launch the food police, mandate exercise in the work place, issue fat calibers, and rip through the food industry looking for the mysterious non-nutritional food additives. Try to find some food stuff in the store without high fructose corn syrup, and then think lobbyist from the corn kings. A compassionate bureaucrat is almost an oxy-moron.
I don’t know what planet you live on but nameless buraucrats already control your health care. Try getting your insurance company to cover procedures they don’t want to – hell their job is to deny as much coverage as they can because they are under pressure to increase profits
Paul:
A few thoughts:
We have practically porous borders generating a lot of people that have no job, no insurance, no innoculations and medical care issues that ahve to be treated. . Not saying we couldn’t do better but that is not a market problem, its one caused by the feds failure at border control.
Our justice system plays a role in this too: cut out the Fourth amendment and loosen some search and seizure laws and pfft! Fewer crack dealers in the bad areas to sell to young moms.
And needless to say, you’d get even better care in states like California if prudence were rewarded and sloth or illegal status penalized: hospitals MUST treat and stabalize patients even if no insurance: so when an uninsured person pops in, we all eat that cost: is it right? Perhaps so. Does it drain the system for masses of illegals that other countries don’t deal with? You bet.
We make the most fierce effort on the plant that I know of to save premies even at 2 months whereas lots of places let ‘em go. I think its good that we do that but big hearts mean big budgets.
Medical malpractice is still a big issue: there are certainly incompetent doctors, but in few countries does a medical error cost what it does here. That drives up the cost of malpractice insurance and doctors have to pay it. Some in calif pay $100,000 a year! Cut out med mal suits and you can cut compensation needed to ppay for the insurance.
(The yalies that go to DOJ for 65k often have family money: rarely is the yalie at DOJ some poor kid that ignored the temptations of private practice. Yale waives a lot of tuition repayments for public service grads unless I’m mistaken.)
Paul:
One thing everyone who advocates public control of health care ignores is a simple fact: the countries that have successfully implemented it severely limit legal and illegal immigration to their country, and restrict health care to those who are in their country legally. Neither of these circumstances is even possible in the United States, no matter what you think. That means that here, unlike much of the rest of the world, Nationalized Health care costs will skyrocket out of control pretty much automatically. It’s why emergency room costs have skyrocketed and why the rest of our government services that are given out for free are strained to the limit. This isn’t Norway.
“I’m just not buying the argument that people will stop going to medical school if doctors weren’t so highly compensated.”
Fine – don’t buy it. But we all have a lot at stake in this. I know a lot of MDs personally and right now they talk about this a lot.
Their training is rigorous and expense, their hours are typically tiring and hard on their families, and they have the stress of life and death decisions daily. At some point, as compensation declines, they will ask themselves if it is all worth it. It’s human nature. Truly talented, resourceful and hardworking individuals will look at alternatives. Some will stick with it, but certainly not all of them. This is one of the reasons healthcare will be less available to the patients.
To add to the above – its not just about compensation – its about being able to make what you believe is the best decisions for your patient. This is HUGE for the MDs I know. Yes, insurance companies already impose upon doctors, but the government is promising more interference.
25. Sue:
#13: LIL,
Well said. My husband and I pay over $1000.00 per month (we are middle aged) for our health insurance. He was diagnosed with cancer a few years back. Insurance company decided they would not pay for everything at the 80/20 – X amount out of pocket expense agreed to. They called it “A special circumstance.”
I fought! With every ounce of my being I fought!
Result: They are paying!
I can’t even imagine if that fight was with the Government! I would still be on hold!
Glad there was a happy ending. You’re last line made me chuckle because it’s so true.
As a MD. I can repeat what I overheard the other day from another doctor-
” The day we get Socialized Medicine, doctors will be saying one of three things-
One third will say “I quit”, One third will say ” If you’re gonna treat me like a government employee, I’m gonna WORK like a government employee” and the last third will say
“The heck with this- I am going back to my own country!”.
And Paul, you are a total fool if you think people are still going to go to Med School, rack up over $100,000 in tuition costs and spend 12 years becoming a doctor just to have some Government imbecile tell you how to practice medicine. Law school doesn’t have a residency or internship and you make a LOT more money (but you produce nothing). Guess where the smart ones will go… I know several doctors who already quit and went to Law School.
If you want to see what your health care under the government will be like- just go to the nearest VA. And then ask yourself why so many VA patients got to private hospitals when they get sick. It’s even worse than you can imagine.
And if Canada’s system is so great- why are there so many Canadian nurses and doctors here ? They ran away from their own system !
#42
And Paul, you are a total fool if you think people are still going to go to Med School, rack up over $100,000 in tuition costs and spend 12 years becoming a doctor just to have some Government imbecile tell you how to practice medicine.
Maybe the medical schools will just lower tuition.
Yeah, I could barely type that with a straight face.
I just can’t wait for the ‘Gubment’ takin’ over our health care. Hell, they’ve done such a great job with everything else thus far, so why not trust them with our livers, lungs, kidneys, stem cells, ear infections, yeast infections, erection dysfunctions, infected hang nails, SARS, e-coli, MSRA infections, cancers, tumors, gun-shot wounds, sanitized needles, band-aids and Tylenol at 100 0bama bux a pop, colon polyps, salmonella riddled veges and peanut butter victims et al?
They do SUCH a great job of EVERYTHING after all the red tape, mismanagement, lack of empathy and gutless B.S. wrapped in a supposed ‘CARING’ package. *cough-COUGH* Whoops! Hope that ain’t contagious!
Good F*ckin’ grief! -Ever stand in a line at the DMV? Quadruple that nightmare and voila! Healthcare from the government 101. -Don’t worry be happy, they may start paying for your burial too. Just dump ya in a big bin of carcasses and call it a day. Yippppppeee!
Oh! -And lest I forget… The gov will start injecting micro-monitoring/tracking/spying devices in your children via required/legit vaccinations. Yeah, that’s a bit over-the-top ‘tin-foil hat’ speak but…it’s not empirically implausible.
Hmm. I just re-read myself and got a slight ‘nutter’ vibe. There’s a fine line isn’t there?
The real purpose behind universal health care: slowly kill off the older folks to save money on social security obligations!
45. californiataxslave,
You got that right, my friend! “Solent Green” ain’t just a movie…it’s an “ensure shake”… Dun dun DUNNNNNN!
Well educated cad:
” I know several doctors who already quit and went to Law School.” That is a real laugh! I wonder how they feel now that there are so few jobs for lawyers and their compensation is coming down so fast. I talk to doctors all the time in my job and although they are generally conservative, they complain mostly about the restrictions that the bureaucrats in the insurance industry impose on them. The government is already heavily involved in medicine via medicare and only a tiny fraction opt out of the medicare system.
“Who should control your health care?” The answer to whom you are most responsible is you! You should control your health care, and be responsible for yourself. That is not the doctor, not the insurance company, and not the big government.
The entire health care question is far from over, expecially under the light of massive spending, risk, and continous programs. Freedom is also at issue and risk.
Granted that life is not fair and bad things happen to good people, imagine what would happen to the entire health care cost if self-inflicted injuries were reduced. Let us include the addictions under that seemingly unnecessary plan. There would go the bankrupcies every 30 seconds as so advertised. The supply/demand of medical costs would be greatly shifted. Alas no such magic wand exists, but the personal risks do go down with personal responsibility and not government or corporation responsibility.
I’m black; So to answer the question, Obama should control my health care.
47. The Shadow:
Well educated cad:
” I know several doctors who already quit and went to Law School.” That is a real laugh! I wonder how they feel now that there are so few jobs for lawyers and their compensation is coming down so fast. I talk to doctors all the time in my job and although they are generally conservative, they complain mostly about the restrictions that the bureaucrats in the insurance industry impose on them. The government is already heavily involved in medicine via medicare and only a tiny fraction opt out of the medicare system.
Compensation in every field is either flat or declining, due to the oversupply of labor relative to demand. In addition, as mentioned above, the time required to become a lawyer is far less than the time required to become a doctor, so people at the outset of their careers will decide accordingly, when the time-cost ratio is something they consider. Of course, much of a person’s career decision is self-selection into a field where one has talents, but when social and economic pressures push one in a direction where, although one may not favor that career, it is the easier to enter and “make a living” from, I have no doubt it will push some on the margin into law over medicine. The irony of the left, and it is the irony of all parasitic life forms, is that by making parasitism pay so well, it’ll destroy its capitalist host. It won’t even be a matter of people “going Galt”. It’ll be that everyone of a certain level of intelligence will want to work for the government because that will be the only place where you’ll be safe from the government, just like every kid in a gang-infested neighborhood, no matter how good a kid he is, wants to be in the gang. Hopefully, this will never happen, but if it does hopefully I’ll be out of the country or dead before then, because it will be too stupid for words. You’ll fit right in, though, Shadow.
As far as your point about a “tiny fraction” opting out of Medicare, statistics tell a different story:
http://online.wsj.com/article/SB123993462778328019.html?mod=googlenews_wsj
Here’s something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn’t automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especially government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have.
Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients. The statistics are similar in New York state, where I practice medicine.
More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. One of the top mammographers in New York City works in my office building, but she no longer accepts Medicare and charges patients more than $300 cash for each procedure.
The problem is even worse with Medicaid. A 2005 Community Tracking Physician survey showed that only 50% of physicians accept this insurance.
You cannot force intelligent, well-educated people to play by bureaucratic rules in America. We will always vote with our feet against you.
Should there be a law that requires insurance and gov’t bureaucrats (Medicare, etc.) to have a MEDICAL degree?
Should there be a law that requires insurance companies dealing with medical care to be non-profit organizations?
It’s all up to you, legislators!
With coverage in the New York Times and Wall Street Journal recently, the Texas Medical Association’s survey of primary care physicians’ reluctance to take new Medicare patients is getting lots of play. Certainly the economic and administrative hassle factors are there and make a big impact on physicians trying to keep open their practice.
What has been omitted, though, is the other major finding from our survey: Texas physicians will not refuse their current Medicare patients. Nearly 70 percent say that is something they will not do. Fewer than five percent say that is something they have done or will do.
As a family medicine specialist from Dallas said in response to our survey: “I will continue to provide care to my existing Medicare patients as a courtesy to them, but I will soon be closing my panel to new Medicare patients, because not doing so will jeopardize my ability to provide care to everyone else.”
Steve Levine
VP, Communication
Texas Medical Association
Unfortunately, you CAN force intelligent, well educated people to play by bureaucratic rules an America. Our officials have already grumbled about us Texas doctors not accepting Medicaid for the farce it is- and have mentioned making us accept medicaid or they will not issue us a license !
The system was broken mostly by the government- and now people want the government to take it over and “fix it”. Sound familiar ?
I’ve learn several excellent stuff here. Definitely price bookmarking for revisiting. I wonder how much effort you place to make such a magnificent informative site.