Author Topic: Healthcare In the US of A  (Read 1569 times)

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Offline JeffPT

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Re: Healthcare In the US of A
« Reply #58 on: September 25, 2012, 09:04:12 PM »
The perceived and perhaps even the real wealth of the US population is a major factor in why we get charged more. The companies know we not only can but will pay.

Actually, the real issue here isn't that we're willing to pay, but that frankly, we just might have no choice in the matter.  When you're in the ER having yourself a heart attack, what are you going to choose?  'You're money or you're life'.  The robbery analogy seems to fit.     
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Offline nogodsforme

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Re: Healthcare In the US of A
« Reply #59 on: September 25, 2012, 09:52:13 PM »
Capitalism is supposed to be about efficiently balancing supply and demand. That means that consumers are supposed to be able to refuse to buy something (or shift to a substitute product) if it is priced too high, so that the producer has to lower the price to attract buyers.

With health care, it does not work that way. Nobody is in a position to refuse a liver transplant or insulin pump because it costs too much, and wait for the price to go down. You can't negotiate price when you are bleeding from a gunshot wound. And there is no substitute for a caesearean section. (That will cost too much. Just leave the baby that can't breathe inside...) 

That is why health care should not be in the capitalist model. There should be some way to pay a reasonable amount to providers, care for everyone at a common sense level and not have taxes over 50%. And still have doctors and nurses who don't have to live on food stamps. But you can't do all that in a for-profit system.

So if we in the US won't control our costs by having the government cap what we have to pay, and spread the costs around so the richest are subsidizing the poorest, we can at least go completely free market and let India and China sell us their medicines for cheaper.... :P
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Offline Death over Life

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Re: Healthcare In the US of A
« Reply #60 on: September 25, 2012, 11:04:54 PM »
I'll need to get back to Truth OT's post, but there was a little thing I just thought about concerning healthcare.

I also tend to notice a lot of times when concerning medicine, these drugs that are perscribed to us are also created in a way that will either make us dependant on them, or gives us side-effects that tend to be worse than what we already have.

As much as I am about saving lives concerning healthcare costs, I think when it comes to perscribed medicines, we should probably stay off the drugs as the go to cure, and instead seek a more natural and organic form of medicine. Much of the pills that we assume benefit us, only end up either masking our problems, or heal us, but at a price in the end.

Either way, the point that I'm proposing is instead of being reliant on drugs as a cure, let us move towards a more natural way of curing instead of pills all while keeping our people healthy, away from side effects, and at a cheaper cost, but not cheap enough so doctors are living on food stamps as pointed above.

Offline LadyLucy

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Re: Healthcare In the US of A
« Reply #61 on: September 26, 2012, 02:18:52 AM »
Regarding healthcare, it sucks if you are not high-income, or in the military services. Luckily, I have military funded healthcare. I want everyone to have the same (or at least almost), like ObamaCare is trying to achieve.


Offline Chronos

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Re: Healthcare In the US of A
« Reply #62 on: September 26, 2012, 05:48:31 AM »
That is why health care should not be in the capitalist model. There should be some way to pay a reasonable amount to providers, care for everyone at a common sense level and not have taxes over 50%. And still have doctors and nurses who don't have to live on food stamps. But you can't do all that in a for-profit system.

Every system of health care involves profit because people do not work for free, as you have alluded to. The problem with health care in the US is that it doesn't include everybody with the same benefits with preset systems for treating people. As long as we have an uncoordinated system of coverage, benefits and treatment plans, we will be very inefficient in how health care is delivered.

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Offline screwtape

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Re: Healthcare In the US of A
« Reply #63 on: September 26, 2012, 07:48:33 AM »
Every system of health care involves profit because people do not work for free, as you have alluded to.

There's profit and there's profit.  Yes, there are people involved who make money.  Docotors, nurses, technicians, janitors, manufacturers, etc.  But there is a big difference between that and corporate profit.  Corporate profit is a voracious pit, an endless appetite for the bottom line.  I believe capitalism and healthcare are somewhat incompatible, like capitalism and water or capitalism and air.  Some things should not be commercialized commodities. 

It is conceiveable to have all healthcare industries not-for-profit, and people still get paid for their services.

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Offline pianodwarf

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Re: Healthcare In the US of A
« Reply #64 on: September 26, 2012, 09:33:09 AM »
We step out on a limb when we make that claim not having the foresight to consider the unintended consequences of acting on such thinking. We must not forget that the only reason modern, quality, advanced HC is available is because we have scientists, doctors, other medical staff working to make our health better and our world a better place to live. They expect to be compensated for their efforts and hard work. Like it or not, the free market economies in this world, namely America, provides these needed workers with the incentive to do what they do. If our government takes steps to reduce the incentives for people to go into these lines of work, then ultimately what good does that do for the citizen's rights to life, liberty, and the pursuit of happiness this government was set up to protect?

That's all true, but there is one huge benefit to a single-payer system that a lot of people don't think about: it reduces administrative overhead.  The way things are right now, a doctor in private practice often needs to have a fair number of supporting staff of one kind or another to deal with the several different insurance companies who they work with for payment.  If a doctor's pay drops by, say, ten percent, but his administrative overhead drops by twenty-five percent (just made-up example numbers), he still comes out ahead.
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Offline Gohavesomefun

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Re: Healthcare In the US of A
« Reply #65 on: September 26, 2012, 01:58:17 PM »
It's very sad that the external argument is about whether or not a government should look after the health and wellbeing of its people.
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Offline screwtape

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Re: Healthcare In the US of A
« Reply #66 on: September 26, 2012, 02:04:57 PM »
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Offline Truth OT

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Re: Healthcare In the US of A
« Reply #67 on: September 26, 2012, 02:57:44 PM »
That's all true, but there is one huge benefit to a single-payer system that a lot of people don't think about: it reduces administrative overhead.  The way things are right now, a doctor in private practice often needs to have a fair number of supporting staff of one kind or another to deal with the several different insurance companies who they work with for payment.  If a doctor's pay drops by, say, ten percent, but his administrative overhead drops by twenty-five percent (just made-up example numbers), he still comes out ahead.

Prior authorization is in many ways a ridiculous hurdle that increases costs for both the physicians and the consumers. We need to find ways to get the insurance companies and other payers out of the way. I have been an advocate of removing insurance from most non major (surgical) medical care with the exception being lab work and scans as doing so would bring down the costs for both care providers and those of us that need care. It costs us all more to insure non emergency care than it saves us to have those things covered. If you want Cialis, buy it yourself. If you have strep throat, ear infections, urinary tract infections, or skin rashes, go to a RediClinic to get treatment as opposed to going to the ER. It will cost you less than $90 and you won't have to wait all day. If we get insurance out of minor care, then the $90 would likely drop to $75 or less as a cash price. That's affordable! Medicare, Medicaid, and especially insurance company involvement cause prices to rise. For instance, an uninsured patient needing a mammogram would pay a full-price cost ranging from $80 to $120 or more, with an average being about $102, according to Blue Cross Blue Shield of North Carolina. Some providers even offer an uninsured discount for those paying with cash, check, or credit. It's quite common to have the cash price be 20% or more less than the price charged when paid by insurance programs.
However, this is totally the opposite when dealing with lab work and scans. Hospitals drastically overcharge the uninsured for these procedures. MRIs, CT scans, blood tests, EKGs, and the like really attack the pockets of the cash consumer.

What is curious to me is why prescription drugs cost so much in the US when compared to others countries like our northern neighbor. Why does big pharma stick it to us moreso than to other nations? I've heard people say that it's because of the FDA, but other nations have standards as well (though they often are not as bureucratically incumbering).

Offline Truth OT

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Re: Healthcare In the US of A
« Reply #68 on: September 26, 2012, 06:09:06 PM »
We need to focus on the real and exact reasons why our HC costs so much in the States. We see the stats on how our drug costs are significantly more than other nations, but why?

http://www.econlib.org/library/Enc/PharmaceuticalsEconomicsandRegulation.html
http://www.humanevents.com/2009/03/04/reimporting-socialism-not-drugs/

According to some, the price control mechanisms in other countries along with the discounts given to smaller markets by the Pharma Co's in order to be able to at least break even in those nations are factors in why the US market pays so much more. 

Offline Chronos

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Re: Healthcare In the US of A
« Reply #69 on: September 26, 2012, 08:04:44 PM »
It is conceiveable to have all healthcare industries not-for-profit, and people still get paid for their services.

Profit and not-for-profit cannot co-exist unless you are deciding who gets to make a profit and who doesn't. The CEOs of non-profits such as United Way and American Red Cross are paid substantially for their efforts -- a profit -- while each organization has many volunteers (unpaid).

Just deciding who does or does not get to make a profit doesn't reduce the expenses of the system. Even an insurance company, a profit-oriented enterprise, remains so when it converts to a third-party administrator of government benefits. Most people do not realize that Medicare doesn't directly pay money to providers because Medicare hires private insurance companies to make payments to providers. Those Medicare intermediaries do not operate as non-profits.


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Offline JeffPT

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Re: Healthcare In the US of A
« Reply #70 on: September 26, 2012, 09:38:46 PM »
I have been an advocate of removing insurance from most non major (surgical) medical care with the exception being lab work and scans as doing so would bring down the costs for both care providers and those of us that need care.

In many ways, the current status of most insurance plans (high deductible, catastrophic) are exactly like that.  No offense, but I pay about 200 dollars a month for my plan which doesn't even kick in until I've spent 1000 dollars out of my own pocket, which resets every year. I would say this is exactly what you're talking about.  Make us pay for the small stuff first.  I don't consider that a 'functioning' health plan. 

It costs us all more to insure non emergency care than it saves us to have those things covered. If you want Cialis, buy it yourself.

And what if you have to take a pill 2 times per day, every day, for the rest of your life, and it costs 20 dollars a pill? 

If you have strep throat, ear infections, urinary tract infections, or skin rashes, go to a RediClinic to get treatment as opposed to going to the ER.

I don't know anyone who would go to the ER for any of the things you mentioned.  There are many other options for that type of health care now. 

Medicare, Medicaid, and especially insurance company involvement cause prices to rise. For instance, an uninsured patient needing a mammogram would pay a full-price cost ranging from $80 to $120 or more, with an average being about $102, according to Blue Cross Blue Shield of North Carolina. Some providers even offer an uninsured discount for those paying with cash, check, or credit. It's quite common to have the cash price be 20% or more less than the price charged when paid by insurance programs.

Part of the reason for this is because when a provider sends a bill to an insurance company, they jack up the price of the service they provide.  Know why?  Because the insurance company looks at the price their charging and decides what percentage they will pay.  I've worked in therapy clinics for years and this is how I've always seen it done.  They never pay the whole thing. We would charge something like 45 dollars for say... a manual therapy (we bill by CPT codes) and get like 22 dollars in reimbursement.  So while you may think you're getting a break when you only have to pay 80% of the price, the insurance company is probably only going to pay the provider 60% of the price they were billed, so the provider is making out better even if you pay 20% less, because your 20% less is 20% more than they would get from the insurance company. 

I still say the benefits of single payer far out-weigh the negatives. 
Whenever events that are purported to occur in our best interest are as numerous as the events that will just as soon kill us, then intent is hard, if not impossible to assert. NDT

Offline JeffPT

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Re: Healthcare In the US of A
« Reply #71 on: September 26, 2012, 10:00:05 PM »
I also tend to notice a lot of times when concerning medicine, these drugs that are perscribed to us are also created in a way that will either make us dependant on them, or gives us side-effects that tend to be worse than what we already have.

It's not that they are created purposefully with the side effects.  It's just that when you put chemicals into a system, it may help some parts, but hurt others.  Take Chemotherapy for example.  A lot of it is designed to kill the fast growing cells in the body, which is what cancer is.  But it also kills hair follicles, stomach lining, etc.  Sure, you can stop taking it, but you risk dying. 

Also, nobody will put a gun to your head and tell you to take a medicine.  It's always the patient's choice.  If the side effects of a medicine are worse than living with the condition you're taking the medicine for... stop taking the medicine. 

As much as I am about saving lives concerning healthcare costs, I think when it comes to perscribed medicines, we should probably stay off the drugs as the go to cure, and instead seek a more natural and organic form of medicine.

This is not narrow enough.  You make a sweeping generalization here that I just can't agree with.  Lots and lots of medicines work really well at fixing what they're supposed to fix.  You'd have to do a case by case look at each medicine to determine whether or not you're right here.  I'm sorry, but if I've got an infection, I'm going to take penicillin if that's what I'm given.  I'm not going to eat tree bark or some crap that isn't proven to work.   

Much of the pills that we assume benefit us, only end up either masking our problems, or heal us, but at a price in the end.

First of all, a symptom reducer is different from a cure, and if you're unsure whether or not you're taking a cure or a symptom reducer, then you should ask the doctor or your pharmacist.  It's not like a doctor gives you Tylenol and says, 'Here, this will fix your broken ankle'.   

Second, a health care professional will ever put a gun to your head and tell you that you have to take something or they'll kill you.  Taking medicine is a personal choice. Like I said, if you don't like the side effects, don't take the meds.  It's not the doctor's job to make your choice for you; it's their job to offer you the best choice they think you have. 

Either way, the point that I'm proposing is instead of being reliant on drugs as a cure, let us move towards a more natural way of curing instead of pills all while keeping our people healthy, away from side effects, and at a cheaper cost, but not cheap enough so doctors are living on food stamps as pointed above.

There are lots and lots of drugs out there that work really well.  You seem to discount those in favor of... natural cures.  What are you talking about when you say 'natural way of curing'?  Please provide an example of an effective 'natural' cure to a condition where currently modern medicine is using some sort of synthetic cure?  I'm very much for natural cures, but not if they don't work anywhere near as good as the synthetic cures that have been discovered and tested by the scientific method. 
Whenever events that are purported to occur in our best interest are as numerous as the events that will just as soon kill us, then intent is hard, if not impossible to assert. NDT

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Re: Healthcare In the US of A
« Reply #72 on: September 26, 2012, 11:11:04 PM »
Re: natural cures. I do think we can do a much better job of eating healthy, exercising, and otherwise using "natural" methods to be healthier. BUT, there are a whole lot of "natural cures" that are killers. As a cancer patient I heard so many people tell me to eat right or take this herb and the cancer would shrink or go away. You know what? There's no evidence for that. In fact, the evidence is the exact opposite. People who put off medical treatment in favor of "natural cures" tended to give up and finally go to a doctor after it was too late. They'd progressed to stage 4, and could not be helped. One has to be very careful about promoting "natural cures." I'm sure there are plenty of natural items that can help, and we certainly tend to eat in unhealthy ways. But we need independent testing and verification before we start replacing medicine with herbs. And anyone who says, "its natural, so it can't hurt," has apparently not heard of arsenic or any of a number of other natural toxins.
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Offline Chronos

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Re: Healthcare In the US of A
« Reply #73 on: September 27, 2012, 07:10:59 AM »
I have been an advocate of removing insurance from most non major (surgical) medical care with the exception being lab work and scans as doing so would bring down the costs for both care providers and those of us that need care.

In many ways, the current status of most insurance plans (high deductible, catastrophic) are exactly like that.  No offense, but I pay about 200 dollars a month for my plan which doesn't even kick in until I've spent 1000 dollars out of my own pocket, which resets every year. I would say this is exactly what you're talking about.  Make us pay for the small stuff first.  I don't consider that a 'functioning' health plan. 

It isn't. It's the opposite of a functioning health care system.

Common sense has shown that fixing problems early is less costly than fixing them later when they become worse. The problem is that insurance is the wrong tool to use for that kind of need. Originally, Health Maintenance Organizations (HMOs) were created to provide whatever health care was needed with the expectation that each member of the plan would get a yearly physical to help spot early problems. The HMO plans were designed to have each member pay little or no co-pays for each visit to a doctor or emergency room, so those plans became attractive because members knew they didn't have to pay much up front. However, the plans have become de-facto insurance plans because the members do not use them properly and are, largely, not encouraged to use them properly. Few members actually go for their annual physicals, lab tests or age-specific exams because, well, Americans have been trained to just tough it out and not go to the doctor. Going to the doctor, especially for minor symptoms, is viewed as a weakness.

The British National Health Service is the best example of a well-functioning HMO because not only is every citizen covered, but everyone is encouraged to use the system -- they are sometimes even paid for the costs they incurred to make the trip to the doctor or hospital. Go figure.


It costs us all more to insure non emergency care than it saves us to have those things covered.

That's a statement that needs some disassembling.

If you mean that the monetary cost to society of actually having an insurance plan pay for non-emergency expenses costs us more in premiums than the costs it saves by prevent a furthering of disease, then I must disagree. We must eventually pay more when untreated people become sicker.

If you mean that the internal workings of an insurance plan require those covered to pay for the smaller expenses to reduce overhead for administering smaller claims, then I agree with you.


The problem here is that a plan of insurance is the wrong tool for the job of managing the costs of health care. The smaller expenses are the ones that should be covered first. Insurance is almost always structured to have the smaller costs paid by the members of the plan because if the members of the plan had sufficient funds to pay the premiums, it's likely they can also bear the cost of smaller claims. This is not the situation with health care.

The principles of insurance do not allow everyone to be covered -- risks must be identified, eligibility determined, grouped and separately surcharged or discounted. If everyone is to be covered, the principles of insurance must be thrown out the window because they no longer apply as there is no question of eligibility, grouping or separately charging people who have more risk or discounting ones with less risk. To continue to speak of a universal health care plan as "health insurance" is to only apply the label we have been using because people lack the appropriate vocabulary for a universal health care plan. I often hear people refer to Medicare as "insurance" but Medicare is not insurance -- it has no resemblance to the principles of insurance. It's universal care for a certain segment of society. It's the opposite of insurance. In fact, the reason Medicare exists is because it covers a segment of society that any traditional insurance plan cannot afford to cover.


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Offline screwtape

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Re: Healthcare In the US of A
« Reply #74 on: September 27, 2012, 07:15:29 AM »
http://www.econlib.org/library/Enc/PharmaceuticalsEconomicsandRegulation.html
http://www.humanevents.com/2009/03/04/reimporting-socialism-not-drugs/


"Reimporting socialism"?  dude, seriously?  The first sentence in that stupid link:

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One of the media’s favorite whines is that Americans pay a lot more for prescription drugs than do people in other countries.

Whine?  We are whining because drugs cost us a ton more than in other countries? 

Your respect has been revoked until you can post something sensible instead of partisan bullshit.
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Offline Chronos

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Re: Healthcare In the US of A
« Reply #75 on: September 27, 2012, 07:20:36 AM »
Re: natural cures. I do think we can do a much better job of eating healthy, exercising, and otherwise using "natural" methods to be healthier.

As a society, we don't treat ourselves well. We don't eat right, we don't exercise enough and we don't take enough time to relax. We are overweight and stressed-out. It's doing more to us over the next 50 years than anything a terrorist has done to us in one day.

Trav, we live in an area that is chock-full of that lifestyle. Keep trading up to a bigger home with a bigger mortgage, travel farther between work and home, work 12-16 hours/day to get that promotion or sale or vote ... it's slowly killing all of us.


From what I have read, not only is obesity the biggest problem we face (most of us already know that), but the current medical studies are showing that the consumption of sugar, which we already knows can cause obesity, may also be a primary cause of dementia/Alzheimer's. It's called Type 3 diabetes. Can you imagine what our society will endure when all the sugar-addled, overweight baby-boomers[1] acquire Type 3 diabetes? It will be like having zombies roam the earth.


 1. Technically, society considers me to be post-baby-boomer but not part of Generation X. I don't fit anywhere.
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Offline nogodsforme

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Re: Healthcare In the US of A
« Reply #76 on: September 27, 2012, 05:06:57 PM »
Some good points here. Bottom line is that getting health care resembles getting heat safely, or clean water from a public utilty more than it does buying a pair of tennis shoes or a new car.

We can't just tell people that small problems are on their own dime. Who knows what a small problem is? Is a lump that doesn't hurt a small problem or not? What about having to pee a lot and sugar cravings? By the time you have really bad, painful symptoms, you may have later stage cancer or diabetes.

How many people will be exposed to your infectious whooping cough while you decide whether it is bad enough to pay money for? And as stated above, how long should a person tough it out with increasing pain or whatever, before biting the bullet and pulling out the credit card?

It is not rational to have everyone use their personal pain threshold or budget to judge a scientific issue like severity of illness. High deductible/low payment plans that only kick in with coverage when someone is seriously ill are the worst way to manage health care. Waiting for something to worsen enough to pull out the wallet costs more overall, in health care expenditures, in lost productivity, in spread of disease to others and in pain and suffering.
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Offline Death over Life

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Re: Healthcare In the US of A
« Reply #77 on: September 27, 2012, 09:07:45 PM »
Also, nobody will put a gun to your head and tell you to take a medicine.  It's always the patient's choice.  If the side effects of a medicine are worse than living with the condition you're taking the medicine for... stop taking the medicine. 

This is the problem. It’s not a choice, it’s an ultimatum. It’s either the drugs, or nothing. Sometimes nothing does work and the disease runs it’s course! Sometimes, the lack of the drugs means the death of an individual. The point is, we need more options rather than ultimatums. One shoe size does NOT fit all.

First of all, a symptom reducer is different from a cure, and if you're unsure whether or not you're taking a cure or a symptom reducer, then you should ask the doctor or your pharmacist.  It's not like a doctor gives you Tylenol and says, 'Here, this will fix your broken ankle'.   

To begin with, I take nothing at all, and I’m as healthy as an ox as the saying goes. You are right concerning doctors, but in the area I live in, what you said is the mentality of the patients, but not the straw man you have presented. It’s not with broken ankles, but the second any ailment comes, take this drug, take that drug, be on these pills etc. It’s disturbing really.

Second, a health care professional will ever put a gun to your head and tell you that you have to take something or they'll kill you.  Taking medicine is a personal choice. Like I said, if you don't like the side effects, don't take the meds.  It's not the doctor's job to make your choice for you; it's their job to offer you the best choice they think you have. 

Answered above.

There are lots and lots of drugs out there that work really well.  You seem to discount those in favor of... natural cures.  What are you talking about when you say 'natural way of curing'?  Please provide an example of an effective 'natural' cure to a condition where currently modern medicine is using some sort of synthetic cure?  I'm very much for natural cures, but not if they don't work anywhere near as good as the synthetic cures that have been discovered and tested by the scientific method.

I’ll list the main medications I’m talking about: depending on the case, antibiotics unless I got the word wrong, and painkillers.

I have seen far more harm from those than anything else, so please don’t assume I’m talking about extreme cases like cancer or chemotherapy or surgery.

Now that I mentioned that, for example, if you have a temporary bug, it is better to let the system run it’s course than attempt to speed up the process with various drugs. If you have any sort of pain, it’s better to be aware of the pain to limit your activity for the healing process than take painkillers, which does nothing more than masks the pain, and causes you to start using your injured body part when you should be letting it rest.

If you are groggy, get rest instead of taking pills to stay awake, or using those 5 hour energy pieces of crap.

Antibiotics, lest I have the wrong word, they are great way to help problems, but from what the research has shown, they only kill off most strains, while some strains are immune to the said antibiotic. So, you think you have cured yourself, but only have created a much stronger strain of the disease you are fighting. Now with this knowledge, we are constantly switching back and forth between all these medicines just to hinder the disease we can’t get rid of.

The point that was missed is not the medicine itself is bad, but the over-reliance and over-dependence on these drugs while being completely oblivious to the fact that one shoe size does not fit all and sometimes NOT taking the medication is the answer, but taking herbs and spices instead. The point is our medical system is an ultimatum, not a selection as it’s portrayed, and that’s one of the things we need to fix up in our healthcare overhaul.

Offline screwtape

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Re: Healthcare In the US of A
« Reply #78 on: September 27, 2012, 09:15:34 PM »
It is conceiveable to have all healthcare industries not-for-profit, and people still get paid for their services.

Profit and not-for-profit cannot co-exist unless you are deciding who gets to make a profit and who doesn't.

really?  I thought it was pretty simple.  You can have a non-profit organization - like NPR - where the organization's main objective is not profit, but where the people who work for that organization do get paid.

http://en.wikipedia.org/wiki/Nonprofit_organization
Quote
A nonprofit organization (US) or not-for-profit organisation (UK and elsewhere) (NPO) is an organization that uses surplus revenues to achieve its goals rather than distributing them as profit or dividends.

You seem to be suggesting that the people who work for the organization necessarily should not be paid, which is not at all what I am talking about.  Some non-profits do that, but not all.

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Offline nogodsforme

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Re: Healthcare In the US of A
« Reply #79 on: September 27, 2012, 10:55:55 PM »
People are confused about what profit means. Profit is income that a business generates that exceeds the costs of running the business. The costs of running a business will necessarily include employee salaries. After all costs including salaries are paid, what is left over is the profit. If a business makes a lot of profit, it can hire more workers, make shareholders rich, give bonuses to top executives, etc.

A non-profit business doesn't have anything left over after all costs (including salaries) are paid. People can be paid well, but there are generally no big bonuses or huge CEO salaries or fancy perks. In many European countries all health care services and even private health insurance companies are non-profit by law because it is considered ill form to make money off of the sick and desperate.
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Offline Chronos

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Re: Healthcare In the US of A
« Reply #80 on: September 28, 2012, 09:06:15 PM »
really?  I thought it was pretty simple.  You can have a non-profit organization - like NPR - where the organization's main objective is not profit, but where the people who work for that organization do get paid.

NPR is not owned by stockholders, and neither are some corporations that operate as mutual organizations, which can be both profit and non-profit organizations (such as credit unions). However, re-characterizing organizations from profits to non-profits doesn't mean that the products or services delivered will cost less, or not much less. It will require that the organizations be planned and funded differently, and perhaps even change the products and services they offer.

http://en.wikipedia.org/wiki/Nonprofit_organization
Quote
A nonprofit organization (US) or not-for-profit organisation (UK and elsewhere) (NPO) is an organization that uses surplus revenues to achieve its goals rather than distributing them as profit or dividends.

As you have pointed out, a non-profit organization can still make a profit, but it is typically characterized as a "surplus" that doesn't get distributed. It is typically reserved to use for something else later, such as a year in which no profit occurs. However, is a profit less of a profit merely because it is not distributed to anyone?


You seem to be suggesting that the people who work for the organization necessarily should not be paid, which is not at all what I am talking about.  Some non-profits do that, but not all.

I am suggesting that singling out a particular portion of the health care system, such as insurance companies, to eliminate the profits of that particular portion of health care delivery is not going to accomplish much. Even the administration of a non-profit entity still has costs.

Suppose that an insurance company makes a 3% profit off the premiums it collects in a particular year. A profit of 3% is not a lot of profit by any standard. Removing that entity doesn't save 3% on the cost of health care. You are saving, maybe 1.5% because somebody still has to administer the health care system and private companies are often used for that. If you employed the same people within a government entity and you optimistically saved the entire 3% of profit for that same year, that will have little impact on health care costs. The $100 fee your specialist charges to see you turns into a daily special of $97.

Now, suppose that same 3% is eliminated entirely every year. The regular inflation of health care is still going to go up no matter what because the organizations that provide that care, even if operating as non-profits, will still have to increase their charges and obtain a "surplus" for other uses.


Two excellent ways to reduce the expenses of health care delivery: (1) have a universal federal health plan that is not subject to the laws, administrative procedures and whims of 50 different state insurance departments, which currently causes duplication of costs for administering health care for every company in every state, and (2) give the responsibility for development of new drugs, equipment and procedures to the federal government, which will incur the research costs and license the production of drugs and equipment to private companies. Nevertheless, even that second one will re-characterize the type and rate of new products and services, in both good ways and bad.


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Offline Chronos

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Re: Healthcare In the US of A
« Reply #81 on: September 28, 2012, 09:21:07 PM »
A non-profit business doesn't have anything left over after all costs (including salaries) are paid.

That is not correct. As pointed out by screwtape, many non-profit entities do have profits, but they are called surpluses. Non-profits are allowed to have such surpluses for a variety of uses, but those uses are restricted such that they cannot be used to enrich a few people who are responsible for operating the entity -- the corporation officers, or say, the top 20% highest-earning employees.

Churches can run profits to invest in physical assets, such as building a new church or school, buying buses to transport members, etc. If the entity uses the surpluses for just increasing the salaries or bonuses (if applicable) of the officers or, say, the highest 10-20% of paid employees, then the entity can lose its non-profit status. Also, accumulating a surplus in excess of a certain amount (which can vary) is frowned upon by the IRS and can cause loss of non-profit status.


People can be paid well, but there are generally no big bonuses or huge CEO salaries or fancy perks. In many European countries all health care services and even private health insurance companies are non-profit by law because it is considered ill form to make money off of the sick and desperate.

That depends on what you consider to be huge. To have the CEO of a non-profit earn $600,000/year is a huge salary in my view, considering that the entity may be a charity.



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Offline JeffPT

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Re: Healthcare In the US of A
« Reply #82 on: September 28, 2012, 11:16:12 PM »
This is the problem. It’s not a choice, it’s an ultimatum. It’s either the drugs, or nothing. Sometimes nothing does work and the disease runs it’s course! Sometimes, the lack of the drugs means the death of an individual. The point is, we need more options rather than ultimatums. One shoe size does NOT fit all.

I have no problem with other options.  What do you have in mind that modern medicine is not already doing and that gives the same or better benefit than that?  Health care isn't magic and its far from perfect.  If you've got something else in mind, let's hear it.   

To begin with, I take nothing at all, and I’m as healthy as an ox as the saying goes.

Me too.  Maybe I'm wrong here, but this statement almost hints at the idea that NOT taking medicine is what makes you healthy as an ox.  I disagree and the reason I disagree is because you don't start taking pills and then get sick; you get sick and then start taking pills.  You and I just happen to be healthy and not require any right now.  There are many people out there who experience pain every day that you and I don't deal with.  I see them where I work.  They hurt.  Badly.  And sometimes its not as easy as you think it is to just suck it up and deal with it instead of taking a pain pill that might make it easier to get through a really long 12 hour night shift. 

You are right concerning doctors, but in the area I live in, what you said is the mentality of the patients, but not the straw man you have presented. It’s not with broken ankles, but the second any ailment comes, take this drug, take that drug, be on these pills etc. It’s disturbing really.

That's cultural more than anything else.  I'm over generalizing here, but as Americans, we just don't want to deal with our problems.  We're too busy.  We'd rather pop a pill to get thin and rub creams on our faces at night instead of wearing protection from the sun during the day.  We think there should be a magic pill for everything from weight loss to foot fungus.  And when those people go into the doctor's office, guess what they do?  They want a pill.  As a doctor, if you want to make the customer happy (remember now, doctor's get paid for patient visits in our system, and good customer service keeps them coming back, while bad customer service will make patients go elsewhere) you give them what they want. 

BTW, you have to keep in mind... Most people HATE going to the doctors office.  If they are there, then by-in-large, they're there because they've reached a point where their distaste for doctors offices has been overridden by the discomfort of their situation.  That's pretty bad.  And it's the doctor's job to help them out.  They help out the only way they know how.  If something better came along, I'm sure they'd do that too. 

I’ll list the main medications I’m talking about: depending on the case, antibiotics unless I got the word wrong, and painkillers.

That's fine.  If you want to make a case that too many antibiotics and painkillers are dispensed, that's fine.  You may be right.  I don't have any statistics to pull from, but I would think this should be taken on a case by case basis.  To say ALL doctors are guilty of that is a bit far fetched.  Just like with any job, you have good doctors and shit doctors. 

I have seen far more harm from those than anything else, so please don’t assume I’m talking about extreme cases like cancer or chemotherapy or surgery.

If you've seen more harm than good out of antibiotics and painkillers, then you're obviously not in the medical field.  You probably can't imagine how many deaths are prevented every year with antibiotics, and how many man hours of work are saved with pain killers.  I treat patients for a company that everyone on this website would recognize, and they manufacture things that everyone on this website uses every day.  They work 12 hour shits on concrete floors with lots of bending and stooping.  They get pain all over their body, and without some basic pain killing methods, they would be out of work pretty fast. 

I will not say that antibiotics and painkillers can not have detrimental effects, but to say they do more harm than good is just not true. Or maybe what I should say is that I'd really need to see some data comparing the beneficial effects versus the problems they create, and that I'd be willing to wager everything I had that the pro's would outweigh the con's.   

Now that I mentioned that, for example, if you have a temporary bug, it is better to let the system run it’s course than attempt to speed up the process with various drugs.

Why would you say that it's better to let it run it's course if you can take something that stops it sooner?  What if you can't take many days off from work?  What if you've got 3 kids at home and getting better faster is imperative?  This isn't a perfect world we live in.  Nobody has time to be sick for days on end if they are a few pills from getting rid of the problem.     

Plus, it totally depends on the bug.  Many bugs can become non-contagious after taking antibiotics for 24 hours, whereas not taking them can keep you contagious longer, allowing the bug to spread. 

If you have any sort of pain, it’s better to be aware of the pain to limit your activity for the healing process than take painkillers, which does nothing more than masks the pain, and causes you to start using your injured body part when you should be letting it rest.

That's not always true.  Any condition (and there are LOTS of them) where you have pain regardless of the activity you participate in (kidney stones, migraine headaches, superficial bruises, etc) then painkillers are just fine and very appropriate.  Letting things rest is not always the answer to physical problems, and it can sometimes even be detrimental.  Again, I think you are way over-generalizing here.  What about the 55 year old factory worker with bad knee arthritis who can't afford knee replacements?  What about the 'weekend warrior' who overdid it on Sunday and is sore all over his body for his Monday shift?  There are many, many good uses for pain killers.   

If you are groggy, get rest instead of taking pills to stay awake, or using those 5 hour energy pieces of crap.

What world do you live in where you always have the time to get rest when you need it?  I've got 3 kids and a full time job and so does my wife.  I don't know what 'rest' is anymore.  I've been tired for 10 years straight.  In a perfect world, where days are 35 hours long, what you're saying is fine.  This isn't that world, though.

Antibiotics, lest I have the wrong word, they are great way to help problems, but from what the research has shown, they only kill off most strains, while some strains are immune to the said antibiotic.

Evolution breeds immune resistant bugs sometimes when people don't go through their full compliment of antibiotics.  Yes, that does happen.  The vast, VAST majority of the time, however, that doesn't happen.  MRSA is one you might hear about in the news.  Honestly, antibiotics save more lives per year than we could ever know. 

So, you think you have cured yourself, but only have created a much stronger strain of the disease you are fighting.

Most often you're cured with an antibiotic.

The point that was missed is not the medicine itself is bad, but the over-reliance and over-dependence on these drugs while being completely oblivious to the fact that one shoe size does not fit all and sometimes NOT taking the medication is the answer, but taking herbs and spices instead. The point is our medical system is an ultimatum, not a selection as it’s portrayed, and that’s one of the things we need to fix up in our healthcare overhaul.

In order to have a selection, you have to have a set of options that are equally as effective in treating whatever it is you want to treat. Sometimes you have that, and other times you don't.  Until that day, if you were a doctor, wouldn't you want to give your patient the thing you think they would benefit from the most? 

And when you say 'sometimes NOT taking the medication is the answer', I have to remind you that NOT taking the medication is usually what most people are doing prior to going to the doctor in the first place.  In other words, that doesn't seem to be an effective tactic for most conditions. 

But don't get me wrong, DoL.  I understand what you're saying.  Really I do.  Medicine isn't perfect and sometimes things ARE over prescribed, but the factors behind that are not as simple as you might think.  There's a lot of poor diagnosing going on out there.  And there are many patients who tell the doctors what they're going to get instead of letting the doctor decide on the best course of action.  And there's a lot of pressure from pharmaceutical companies who want doctors to push their drugs.  Here are a few things that I think would make the system a lot better.  They are admittedly a bit pie-in-the-sky however.   

1. Give doctors at least 1/2 an hour with every patient they see.  Let them hear the symptoms clearly so they can accurately diagnose people.  Let them examine patients thoroughly.  Let them decide what to do together with the patients.  Take the time to educate them about their general health.

2. Put a cap on the dollar amount that you can sue a doctor for.  Doctors are human beings and they are GOING to make mistakes.  It just happens to be that when a doctor screws up, someone can die.  But they're human just like everyone else. 

3. Innovate. 
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Offline Graybeard

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Re: Healthcare In the US of A
« Reply #83 on: October 02, 2012, 12:40:40 PM »
That is why some US people are going for surgery in Argentina, South Africa or India-- medical tourism.

That's assuming you can afford all the travel and medical expenses out of pocket right? How much does it have to cost in the us for a procedure in order for this to be cost effective for this?
Just an example:

"In an article entitled How Much Does Baby Delivery Cost? the author says (of course depending on a million factors) that in the United States those without insurance you can expect to pay $9,000 – $17,000 for a natural birth."

Read more: http://www.moneyhelpforchristians.co...#ixzz289Vez6RQ

In Greece, rates are far better but there are drawbacks...

"A hospital in austerity-stricken Greece told a new mother she could not take her baby home until she had paid the cost of delivering the child, it has been claimed.
Helena Venizelou Maternity Hospital in Athens threatened to keep hold of the child, the mother said, until she paid up 1,200 euros (£970/$1,500) they were demanding to cover the costs of the Caesarian section."


Read more: http://www.dailymail.co.uk/news/arti...#ixzz289YS8H7k

(The price is correct but the story was untrue - the hospital did not threaten this.)

So, a minimum saving of $7500 for childbirth and a potential saving of over $20,000 - you can stay a long time in Greece for that sort of money.
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