70% Of Calfornia's Doctors Expected To Boycott Obamacare

[Mosin]

Boy a blast from the past. I remember and miss Garthe. Truly a really nice guy and he imported my magazine into Germany.

And sadly, those with money from many countries from Europe come to the US to be treated. I remember my chairman who was from Greece had many patients who paid cash on the barrel from his country.

I still miss him, and I think because of him I don't like either system. We need change alright, but I am really wary of the one that we are about to get. I don't see any truly thought out alternatives on the horizon, however. It is like moving a pile of rocks from one place to another because everybody we elected is posturing for some agenda it seems. Meanwhile, we are left holding the tab for it all. Call me disenfranchised.

 

[MylesBAstor]

Yes, we would have paid to bankruptcy. And full agreement with the failure of US system. When I left Microsoft and faced getting our own insurance for the first time, the reality set in of how terrible the situation is. I had some foot pain and my insurance would not cover the medication for it. It is just a tube but it costs a cool $60. My foot doctor says similar medication exists in Canada over the counter for $20 and that it is available in most of the world that way. I currently go to two specialists who only take one insurance plan and mine is not one of them. I have easily spent $5,000 or more with them already. I keep arguing with their accounting department who keeps trying to double charge me. They are shocked every time that someone would even question the bill! They keep asking me, "don't you have insurance?" As if it is not my problem if I do. I remind them that I do not and need to know why they keep charging me extra.

Many people go into bankruptcy to pay for a procedure. To wit, those who had breast or other cancers who wanted stem cell transplants and insurance companies told them that it was an experimental procedure and refused to pay. People paid (or didn't) $250K in those days for a stem cell transplant.

 

[Mosin]

Many people into bankruptcy to pay for a procedure. To wit, those who had breast or other cancers who wanted stem cell transplants and insurance companies told them that it was an experimental procedure and refused to pay. People paid (or didn't) $250K in those days for a stem cell transplant.

At least that was possible before politicians with agendas got involved. Speaking of agendas, a lot of supplements get reclassified as drugs because drug companies want to reissue them under their own brand names. Piracetam is one that the drug companies can't wait to get their greedy hands on, but there are others. It's a catch-22 with the pharmaceuticals because on one hand they develop drugs that would never be developed outside the US, but they also manipulate the market to their own advantage in an unfair way. The Government is complicit, in my opinion.

 

[jazdoc]

Many people into bankruptcy to pay for a procedure. To wit, those who had breast or other cancers who wanted stem cell transplants and insurance companies told them that it was an experimental procedure and refused to pay. People paid (or didn't) $250K in those days for a stem cell transplant.

Myles,

You bring up an interesting point...insurance should be exactly that; insurance against large, unexpected expenses. Our system is more akin to an expensive prepayment plan. No one would expect your auto insurance to pay for routine maintanence or a $5 copay for a tank of gas...and everyone understands that the costs of such car insurance would be prohibitive. The symptoms in the US healtcare system are easy for everyone to see. Obamacare is destined to fail because it misdiagnosis the underlying causes of the symptoms and as a result, prescribes the wrong treatment.

 

[amirm]

Beds are limited, but doctors tend to fill them with the less sick because those patients require less care.
Medical devices are limited, too. Diabetic pumps, CPAP machines, etc. are luxuries, and not commonplace.
Private hospital rooms are virtually unheard of there.
Doctors see a contracted number of patients per day, and then go home, regardless of demand.
If someone needs longterm care, the bed could be anyplace in the UK.
People are given medicine to take at home that only a doctor or nurse can administer here.
The selection of drugs there is severely limited when compared to what is available here.
Certain surgeries are scheduled to certain times because of budget constraints.
Only union members can do certain things, regardless of circumstance.

How much of this is true? I know only what he told me, but things will be different, very different.

I have personal experience with most of these as both my brother and dad were hospitalized there (both UK residents). My brother was put in a double room which would pass for the same in use for a semi-private room. Half the time no one was next to him so he had the whole room to himself -- again like US. He did have private insurance so perhaps that was the reason. His issue was that he would cough heavily and pass out! This went on for days and weeks. So I went to visit him and pushed the doctor on some kind of remedy. While I was there in front of my brother and his family he calls the nurse over and asks if she has XYZ medicine. She says no. He asks for another and the same answer. So he asks what they do have and she answers. The nurse leaves and I ask him what that was about. He said they don't have any of the strong medications he wanted to use. The only thing they had was weak stuff and he did not want to use. So for sure there is an issue there with drug availability.

My dad had heart problems and a triple bypass. I saw him after the operation. He was in a large hall with maybe 10 other people. I have not seen this in US. The operation of course was completely free to him and was successful. So on that front, it was good. The nurses there were nice but not nearly as attentive as US ones where we live.

My sister in law always complained about how long it took to get simple medical things taken care. I would hear her constantly calling people and complaining about the wait. She was shocked when I told her we could just go to a doctor or hospital and get it taken care of.

Ultimately I think the right system is a basic insurance system for all with the option of paying for better service on top of that. So no one dies because they don't have insurance. But if you dont want to wait and such, you could pay for that.

 

[Mosin]

...

Ultimately I think the right system is a basic insurance system for all with the option of paying for better service on top of that. So no one dies because they don't have insurance. But if you dont want to wait and such, you could pay for that.

That seems reasonable to me, too. I don't expect anything reasonable too much anymore, however. Now, we get theater more than anything else.

 

[Asamel]

I deal with significant drug shortages every day. That's a problem right here in the US.

I also have huge problems getting patients appointments with consultants in a timely fashion.

Bruce in PA

 

[rbbert]

But that sounds pretty much like what most of the rest of First World countries have now, and if something like that were seriously proposed the current vested interests would cry "socialized medicine" often enough and loudly enough that it would probably not happen.

Unfortunately, too much of our health care system and health care philosophy are controlled by big business, whether it be the pharmaceutical industry, the medical device industry or the insurance industry. In part because of that, our society has the idea that there is a treatment for every ailment, even death. The world doesn't work that way, though.

 

[Mosin]

I deal with significant drug shortages every day. That's a problem right here in the US.

I also have huge problems getting patients appointments with consultants in a timely fashion.

Bruce in PA

If the original poster's link has any merit, you haven't seen anything, yet.

But that sounds pretty much like what most of the rest of First World countries have now, and if something like that were seriously proposed the current vested interests would cry "socialized medicine" often enough and loudly enough that it would probably not happen.

Unfortunately, too much of our health care system and health care philosophy are controlled by big business, whether it be the pharmaceutical industry, the medical device industry or the insurance industry. In part because of that, our society has the idea that there is a treatment for every ailment, even death. The world doesn't work that way, though.

It is socialized already. The Hill-Burton Act guarantees some measure of care, and then there is Medicare and Medicaid. Those things are already in place. A sensible change could actually simplify it all without adding to the bureaucratic nature of it. You are dead on about the big business aspect, and don't forget that lawyers are the ones who are making any upcoming changes as things stand. That should speak volumes in itself, but don't expect the other big business players to police themselves, either.

 

[DaveyF]

I have personal experience with most of these as both my brother and dad were hospitalized there (both UK residents). My brother was put in a double room which would pass for the same in use for a semi-private room. Half the time no one was next to him so he had the whole room to himself -- again like US. He did have private insurance so perhaps that was the reason. His issue was that he would cough heavily and pass out! This went on for days and weeks. So I went to visit him and pushed the doctor on some kind of remedy. While I was there in front of my brother and his family he calls the nurse over and asks if she has XYZ medicine. She says no. He asks for another and the same answer. So he asks what they do have and she answers. The nurse leaves and I ask him what that was about. He said they don't have any of the strong medications he wanted to use. The only thing they had was weak stuff and he did not want to use. So for sure there is an issue there with drug availability.

My dad had heart problems and a triple bypass. I saw him after the operation. He was in a large hall with maybe 10 other people. I have not seen this in US. The operation of course was completely free to him and was successful. So on that front, it was good. The nurses there were nice but not nearly as attentive as US ones where we live.

My sister in law always complained about how long it took to get simple medical things taken care. I would hear her constantly calling people and complaining about the wait. She was shocked when I told her we could just go to a doctor or hospital and get it taken care of.

Ultimately I think the right system is a basic insurance system for all with the option of paying for better service on top of that. So no one dies because they don't have insurance. But if you dont want to wait and such, you could pay for that.

Amir, in the UK, one always has the option of using private care and paying for it oneself. So, while the NHS is available to all, so is private care and the cost associated with it, along with insurance to cover that portion if desired.

 

[rbbert]

Amir, in the UK, one always has the option of using private care and paying for it oneself. So, while the NHS is available to all, so is private care and the cost associated with it, along with insurance to cover that portion if desired.

As mentioned above, this essentially describes medical care in most of the rest of the developed world (outside the USA). In some ways it works, in some it doesn't. We have the potential to do better, but as I mentioned the journey there is obstructed by some powerful vested interests. The only ones who benefit are those seeking/needing health care, not the industries with money, power and influence.

 

[DaveyF]

As mentioned above, this essentially describes medical care in most of the rest of the developed world (outside the USA). In some ways it works, in some it doesn't. We have the potential to do better, but as I mentioned the journey there is obstructed by some powerful vested interests. The only ones who benefit are those seeking/needing health care, not the industries with money, power and influence.

+1

 

[Phelonious Ponk]

+many more.

There are, no doubt, problems with the systems in other developed nations. Imperfection is really easy to achieve in large systems, but none of the players opposing ACA are trying to make it better or proposing an alternative that would even meet the most basic needs of the American uninsured. They are, and have been, since long before it became law, trying to kill ACA or make it worse, so It cannot succeed and survive. It is either simple political opposition or the more complex support of more powerful political lobbies than the people they were elected to represent. and it is directly at odds with the health of the American people and the American economy. It is anything but conservative. It is, at best, blind worship of free markets, at worst, the cynical manipulation of the system to the benefit of powerful constituencies.

All of this discussion of the issues, here and in other countries, will only be relevant when we have decided to address the issues, to reform our healcare system instead of obstructing any attempts to do so.

As with all complex endeavors, it starts with objectives, and healthcare ROI should be a tertiary goal, behind cost control and, #1 -- universal world class care. A lofty goal? Sure. An unachievable one? Perhaps. When, exactly, did we stop trying?

It should be painfully clear, to anyone who is paying attention, that anyone in Washington failing to work diligently and obviously toward those goals, does not represent the American people, they represent the end of representation, and they should be removed from the American political system. Before someone asks how we pay for it -- skip the next few elective wars/nation-buildings, stop trying to be the world's police department.

Tim

 

[rrr]

+many more.

Imperfection is really easy to achieve in large systems, but none of the players opposing ACA are trying to make it better or proposing an alternative that would even meet the most basic needs of the American uninsured. They are, and have been, since long before it became law, trying to kill ACA or make it worse, so It cannot succeed and survive.

Tim

That is because the basic structure is fatally flawed which has resulted in the major meltdown of the entire nation's functioning healthcare system. You can't "fix" a huge system with so many fatal flaws that attempted to suspend the rules of economics. Attempted repairs just prolong the agony and waste resources.

If the principal designers had possessed business experience and common sense they would have designed a system with at least some buy in from the other party (as opposed to the description delivered by Pelosi, "We have to pass the law to find out what is in it!"). Any major program like this in the business world would have had an iterative roll out which would have provided time and bandwidth to resolve deployment issues. Failure to follow common sense, generally accepted methodology by ignorant, incompetent people, has destroyed a nationwide healthcare system that worked and has further proven that existing government is bad.

 

[Phelonious Ponk]

That is because the basic structure is fatally flawed which has resulted in the major meltdown of the entire nation's functioning healthcare system. You can't "fix" a huge system with so many fatal flaws that attempted to suspend the rules of economics. Attempted repairs just prolong the agony and waste resources.

If the principal designers had possessed business experience and common sense they would have designed a system with at least some buy in from the other party (as opposed to the description delivered by Pelosi, "We have to pass the law to find out what is in it!"). Any major program like this in the business world would have had an iterative roll out which would have provided time and bandwidth to resolve deployment issues. Failure to follow common sense, generally accepted methodology by ignorant, incompetent people, has destroyed a nationwide healthcare system that worked and has further proven that existing government is bad.

The large system I was talking about was healthcare, not ACA. ACA Was created with plenty of input from the opposition party, and plenty of input from the insurance, pharma and medical industries. That's why it's an ineffective dog's breakfast of a law, not a single payer system or an extension of Medicare. You seem to think it is broken because it is poorly designed, and I think you're half right. I think it was broken by compromise, broken by concession, broken by the will and the power of those who never wanted it to work for the American people, who only wanted to preserve the profits of their sponsors. Both democrats and republicans broke it; only the Republicans now have the freedom and audacity to point at it and say "look! It's broken! Burn it down." But when it was being written, there was plenty of corporate protectionism at the expense of care to go around,

Tim

 

[rbbert]

JMO, of course, but like so much else that is "wrong" today, we are seeing the effects of greed, a far more deadly sin in the long run than pride, envy or any of the others...

 

[Orb]

Amir, in the UK, one always has the option of using private care and paying for it oneself. So, while the NHS is available to all, so is private care and the cost associated with it, along with insurance to cover that portion if desired.

However Davey that can be a really bad decision because if you take private care for an illness the Health Care trust may refuse to treat you at all.
There have been many cases where patients want to use some of the newer drugs that have been certified but Care Trusts/Medical Association rule that the medication is not cost effective, however if the patient then wants to look at paying for this privately they are in effect cut off from NHS in all ways.
The irony is these people paid National Insurance and tax (so contributed to the NHS all their life), looking to take some of the burden off the NHS by using some of the newer drugs privately and yet they are then refused access to NHS services such as specialists,monitoring via scans,etc - the key point being general aspects that were not linked to the private solution.

So then their only option is to ignore the new drugs (not talking about all just some that have good results but are expensive) and stick with ones that are less effective with the NHS.
Same story with Alzheimer tablets; deemed to be not cost effective and so not available.

I was a fan of the NHS, but Gordon Brown started to be too clever and created several different kind of trusts that are involved from the business-procurement-regulation-regional-local-etc and it is a mess, combined with lumping care trusts with PPI-funding that is up to 10x more expensive and put onto local budgets, locking in the health trusts for a ridiculous amount of time for expensive external contract services.
There was an interesting research program done showing how the various types of care trusts, budgets, and PPI all interlink; it is freaking incredibly complex and does not work.
The hospitals that are well known for their services here in the UK, well they do a lot of charity raising or supported by charities to help.

Cheers
Orb

 

[jazdoc]

JMO, of course, but like so much else that is "wrong" today, we are seeing the effects of greed, a far more deadly sin in the long run than pride, envy or any of the others...

'Greed' is like gravity; ubiquitous and ignored at your own risk. I am always amazed that any one would believe that political self interest (aka 'greed') is somehow more noble than enlightened self interest. I see no evidence of such.

Obama has made a career of pride and envy. From NY Times' Jodi Kantor in her book "The Obamas"

Obama had always had a high estimation of his ability to cast and run his operation. When David Plouffe, his campaign manager, first interviewed for a job with him in 2006, the senator gave him a warning: “I think I could probably do every job on the campaign better than the people I’ll hire to do it,” he said. “It’s hard to give up control when that’s all I’ve known.” Obama said nearly the same thing to Patrick Gaspard, whom he hired to be the campaign’s political director. “I think I’m a better speechwriter than my speechwriters,” Obama told him. “I know more about policies on any particular issue than my policy directors. And I’ll tell you right now that I’m gonna think I’m a better political director than my political director.”

Or as key advisor Valerie Jarrett observed

“I think Barack knew that he had God-given talents that were extraordinary. He knows exactly how smart he is. … He knows how perceptive he is. He knows what a good reader of people he is. And he knows that he has the ability — the extraordinary, uncanny ability — to take a thousand different perspectives, digest them and make sense out of them, and I think that he has never really been challenged intellectually. … So, what I sensed in him was not just a restless spirit but somebody with such extraordinary talents that had to be really taxed in order for him to be happy. … He’s been bored to death his whole life. He’s just too talented to do what ordinary people do.”

Obama is the law professor who never published, the community advisor who never organized anything, the state senator who voted 'present', a man who never worked a day in the private sector. He never built or ran anything in his life other than a campaign. Why would anyone be surprised that when he redesigned 1/6 of the economy, he discovers 3 years after the fact that "insurance is difficult"? He and his parties' leadership rammed this through without understanding it or reading it, because they could. Indeed, Obama can truly say "he built this". They own it and their cries for help now ring hollow. Oh for the halcyon days when "dissent was the highest form of patriotism"....

 

[zztop7]

OH BAD CARE - Ohbadcare should be the name.
My wife & I run a huge deductible, and still our health premiums will be DOUBLE in 2014. Another redistribution of the $$$ of hard working citizens.
zz.
Many KUDOS to jazdoc for the following:

'Greed' is like gravity; ubiquitous and ignored at your own risk. I am always amazed that any one would believe that political self interest (aka 'greed') is somehow more noble than enlightened self interest. I see no evidence of such.

Obama has made a career of pride and envy. From NY Times' Jodi Kantor in her book "The Obamas"



Or as key advisor Valerie Jarrett observed



Obama is the law professor who never published, the community advisor who never organized anything, the state senator who voted 'present', a man who never worked a day in the private sector. He never built or ran anything in his life other than a campaign. Why would anyone be surprised that when he redesigned 1/6 of the economy, he discovers 3 years after the fact that "insurance is difficult"? He and his parties' leadership rammed this through without understanding it or reading it, because they could. Indeed, Obama can truly say "he built this". They own it and their cries for help now ring hollow. Oh for the halcyon days when "dissent was the highest form of patriotism"....

 

[DaveyF]

However Davey that can be a really bad decision because if you take private care for an illness the Health Care trust may refuse to treat you at all.
There have been many cases where patients want to use some of the newer drugs that have been certified but Care Trusts/Medical Association rule that the medication is not cost effective, however if the patient then wants to look at paying for this privately they are in effect cut off from NHS in all ways.
The irony is these people paid National Insurance and tax (so contributed to the NHS all their life), looking to take some of the burden off the NHS by using some of the newer drugs privately and yet they are then refused access to NHS services such as specialists,monitoring via scans,etc - the key point being general aspects that were not linked to the private solution.

So then their only option is to ignore the new drugs (not talking about all just some that have good results but are expensive) and stick with ones that are less effective with the NHS.
Same story with Alzheimer tablets; deemed to be not cost effective and so not available.

I was a fan of the NHS, but Gordon Brown started to be too clever and created several different kind of trusts that are involved from the business-procurement-regulation-regional-local-etc and it is a mess, combined with lumping care trusts with PPI-funding that is up to 10x more expensive and put onto local budgets, locking in the health trusts for a ridiculous amount of time for expensive external contract services.
There was an interesting research program done showing how the various types of care trusts, budgets, and PPI all interlink; it is freaking incredibly complex and does not work.
The hospitals that are well known for their services here in the UK, well they do a lot of charity raising or supported by charities to help.

Cheers
Orb

Orb, no one is stating that the UK NHS is a perfect system, far from it. OTOH, it sure the heck beats having nothing, like previously in the US.