Universal Healthcare...

[Johnny Vinyl]

Pretty much every nation has this in place, and I truly fail to understand why the U.S. seems so against it!

 

[amirm]

I have seen the good and the bad. Having lived in UK for a bit and had family live there for years, I see some of both sides. My bother had cancer and without question, they saw her at the hospital and ran all kinds of tests. But then my brother would complain about months it would take to get in front of doctor.

The solution that seemed to work was a combo: private insurance to cover faster visits if needed and universal health care for everything else.

 

[Johnny Vinyl]

Isn't a wait better than nothing at all though? And what about those people that don't have private insurance...do we discard them? Do we show them the door and say..."sorry buddy, you're out of luck!"?

 

[Gregadd]

I favor Universal health care. It has to be a tiered system. You can't expect AMIR to sit in the same Doctors office as me.

 

[FrantzM]

Hi

Not much I can add to this discussion. I must however point out the high cost of Medical Care in the USA. It is compared to most developed counties inordinately dear. There also seem to be a disconnect between the cost and quality of the care, I could be wrong on that last part but the USA do not figure among the first 20 nations in most WHO ranking of Heath Care Systems.. They certainly are the most expensive system by a very wide margin.
The cost of health care needs to be addressed seriously for Universal Health care to take hold, IMO.

HEALTHCARE RANKS

 

[Johnny Vinyl]

A tiered system is not a bad idea, and we're seeing that in Canada to some degree. However, it's still flawed as only those with coverage , or in a financial position to do so, can take adavantage of that. What about the other 75% -80% - 90% of the population?

 

[Phelonious Ponk]

Sadly, something even less intrusive and much more market-friendly than the tiered system imagined here was debated in America and shouted down by politicians under the influence of the insurance and pharm lobbies. We couldn't even get a weak "public option," much less a single-payer, universal system with supplemental insurance on the side. The combination of extreme divisiveness, and a political system fueled by private money seems to have paralized the US. We can't get anything substantive done until we are in crisis. And we don't seem to be able to recognize crisis.

Tim

 

[Gregadd]

At least i heard we had 40 million uninsured. Everybody can contribute something. If you pay more, you get more.Tthe way everything works in America. There are so many cost accelerators that have nothing to do with treatment.

 

[Steve Williams]

Isn't a wait better than nothing at all though? And what about those people that don't have private insurance...do we discard them? Do we show them the door and say..."sorry buddy, you're out of luck!"?

John

First off, no one is ever turned away for the treatment of an "acute" problem for lack of medical insurance either by a physician or a hospital as it is against the law. Also hospitals can be severely sanctioned if they were to ever attempt to transfer an acutely ill patient to a different facility for lack of medical insurance

Here in California if an uninsured patient is admitted to the hospital for treatment of an acute emergency most always they are able to receive "Medical" insurance (California's version of medicaid)

When I was in practice in Southern California in South Orange County our hospital was constantly bombarded by illegal immigrants crossing the border illegally. Here they were admitted in active labor and had their babies who were now American citizens. What I could never understand is how and why these people could obtain Medical to pay the hospital as well as the on call OB doc who got to deliver the baby whereas some other American family who owned their own house but perhaps was down on their luck due to loss of job etc could not obtain Medical when they were admitted to the hospital because the state felt they did not qualify due to their economic situation. For me as a physician I found this mind boggling that we could not care for our own citizens but rather bestow full medical insurance on someone who not only entered the country illegally but has never worked a day in this country.
God Bless America

 

[Johnny Vinyl]

As an outsider, to me it's plain as day...it's all about greed. The doctors, hospitals, corporations, pharmaceuticals, etc, are more concerned about their own bottom line than they are about the welfare of the nation. No one is willing to give an inch, and their lobbyists have done a great job convincing the "what's in it for me" politicians. It's a joke.

 

[Steve Williams]

John

I disagree totally with your notion about "doctors" and their concern for the bottom line. As I said patients are never turned away in acute situations nor can the hospitals deny care.

I cannot tell you the number of deliveries I did over the years and never got paid or better yet I can recount stories about illegal immigrants with no insurance who presented to our ER in southern California having been in obstructed labor for days only to get out a badly affected baby whereupon these people found lawyers who turned around and sued the doctor because of the patient's negligence

 

[Johnny Vinyl]

Steve...I'm not talking about illegal immigrants....that's a whole other issue.

What about a guy who works and makes $15 an hour and his company offers no insurance whatesoever? What happens to him and his family when an emergency, or even just regular checkups arise? Maybe he'll get seen to, but can he expect a bill he now has to take out a loan for?

 

[Steve Williams]

U.S. Appeals Court Rules Against Health Care Law's Individual Mandate


01:37 pm

August 12, 2011

by BILL CHAPPELL

A U.S. appeals court Friday has found the mandate in President Obama's health care law that requires individuals to purchase health insurance to be unconstitutional. The 2-1 ruling on a suit brought by 26 states agreed with a lower court in ruling against the "individual mandate," but it disagreed with the lower court's finding that the rest of the law must be struck down.

In late June, the health law was upheld by an appeals court in another case. The Cincinnati-based 6th Circuit Court of Appeals found that "the health care mandate requiring everyone to have health insurance or pay a penalty does not violate the Constitution," as Nina Totenberg reported for All Things Considered.

The new ruling comes from the U.S. Appeals Court for the 11th Circuit, based in Atlanta. As the AP reports, "the decision didn't go as far as a lower court that had invalidated the entire overhaul as unconstitutional."

However, some experts argue that without the mandate that everyone purchase health insurance, the rest of the law won't work. The Patient Protection and Affordable Care Act requires that insurance companies cover everyone, regardless of preexisting health conditions. But as an economic proposition, the argument goes, universal health coverage is sustainable only if there are plenty of healthy people paying into the insurance pool — not just sick folks.

With two appeals courts now having come to two different conclusions about the constitutionality of President Obama's health law, it is likely that the Supreme Court will eventually rule on the matter. None of the legal challenges facing the law have yet made their way to the nation's highest court. (Kaiser Health News offers this handy scoreboard tracking the status of the lawsuits.)

In another development concerning the health care overhaul Friday, the Ohio Supreme Court ruled that signatures on a petition circulated by opponents of the health care plan were valid, clearing the way for a November vote on portions of the legislation dealing with changes to individual insurance.

 

[Steve Williams]

John, you make a valid point however the law says that if the employer provides insurance for himself he must do the same for his employees. The underlying problem John is that the cost of medical insurance for a small business employer is almost always prohibitive, so much so that the employer cannot afford to even cover himself and his family

 

[Johnny Vinyl]

John, you make a valid point however the law says that if the employer provides insurance for himself he must do the same for his employees. The underlying problem John is that the cost of medical insurance for a small business employer is almost always prohibitive, so much so that the employer cannot afford to even cover himself and his family

Does that not signify that something is wrong with the current system? Why is there such hesitency to improve it?

 

[Steve Williams]

I'm gonna play Devils Advocate here Steve! Why did you move to the U.S.?

I've said many times why I moved John. Simply put as a practicing OB in Toronto where I resided I felt that in winter time I was taking my life in my hands when I got the usual 0200 call to come stat to the labor room for a delivery only to look out and see 10" of freshly fallen snow and to also see that the road cleaners had plowed the streets only to block my driveway preventing me from getting out. Then the mad dash to the hospita along the 401 and then up the 400 on ice covered highways became a heart stopper. I hate snow and winter

Finally, as a physician I never agreed with OHIP. In the early 1970's I remember when the doctors threatened to go on strike if socialized medicine were implemented. I remember the meetings at Convocation Hall at the University of Toronto. In the end however the doctors never went on strike and continued to care for patients. Now let me tell you that in the early 70's doctors could either opt in or opt out of the plan and they could charge above OHIP reimbursement rates. Now I can tell you that in 1978 when I left and moved to California, the great OHIP system payed obstetricians for "total Ob care" (ie entire prenatal care and delivery) a whopping 90% of $200 or a grand total of $180. Now let me see, that amounts to under $1 per day not withstanding all of the medical-legal issues that go with a high risk specialty such as mine. I still have Ob friends in Toronto who hate the system. I know that there used to be a "soft cap"put on doctors earnings through the OHIP system. If the cap was reached in November before the end of the year, they were either working for free or at a much reduced rate until the new year began. Many took forced leaves rather than working at even more reduced rates. I ask you John, if the person who wrote your paycheck said to you in Novemeber, "John you're making too much money and for the rest of the year you either take an unpaid leave or work at a much reduced rate", I ask you how you would react. And by the way John let's not forget the $50K-over $100K annual malpractice premiums just to practice what you've been trained to do.

BTW I understand that malpractice awards have risen considerably since I left and doctors in Canada are now paying annual premiums similar to here in the USA

 

[Johnny Vinyl]

In the end though...will you not agree that the potential of much greater financial reward for you and your family was the driving force behind you leaving?

 

[Phelonious Ponk]

I don't really think doctors are the problem. There are doctors in America who, in addition to being really good physicians, are also really good businessmen, er, persons, and make a LOT of money. If they can be good doctors, good businessmen, and deal with the mutli-layered hunt that is required to get paid by insurance companies, they probably deserve a lot of money. Hell, we bonus CEOs more in a year in which they fail by any objective measure. Others just make a very good salary. It's not the doctors, but something is desperately wrong.

We move people out of intensive care, and out of hospitals faster than we ever have. We have drugs, the R&D of which has long-since been paid for and have been brought down to inexpensive generics that...jeeze, let's see...avoid thousands of bipass surgeries a year, eliminate the substantial negative effects of chronic hypertension and have turned formerly dangerous infections into minor problems, just to name a few miracles. We have reduced many formerly invasive, complication-prone surgeries to minor outpatient procedures with minimal chance of error or infection. We have some very expensive diagnostic equipment, but surely the long illnesses, major surgeries, hospital stays, rehabilitations, etc, that those machines regularly make unnecessary are more expensive than the scan?

We have made incredible medical progress in my lifetime and almost all of it has reduced the time, effort, pain and care necessary to bring patients back to wellness and increased the odds of doing so. So much of it has made diagnosis and treatment so much more efficient, yet a serious brush with illness in this country -- some diagnostics and a few days of hospitalization -- could drive an affluent but uninsured family into bankruptcy. Medicine is faster, more effective, more efficient...and yet it could ruin you financially in less than a week of serious care.

Yeah, something is desperately wrong.

Tim

 

[Gregadd]

U.S. Appeals Court Rules Against Health Care Law's Individual Mandate


01:37 pm

August 12, 2011

by BILL CHAPPELL

A U.S. appeals court Friday has found the mandate in President Obama's health care law that requires individuals to purchase health insurance to be unconstitutional. The 2-1 ruling on a suit brought by 26 states agreed with a lower court in ruling against the "individual mandate," but it disagreed with the lower court's finding that the rest of the law must be struck down.

In late June, the health law was upheld by an appeals court in another case. The Cincinnati-based 6th Circuit Court of Appeals found that "the health care mandate requiring everyone to have health insurance or pay a penalty does not violate the Constitution," as Nina Totenberg reported for All Things Considered.

The new ruling comes from the U.S. Appeals Court for the 11th Circuit, based in Atlanta. As the AP reports, "the decision didn't go as far as a lower court that had invalidated the entire overhaul as unconstitutional."

However, some experts argue that without the mandate that everyone purchase health insurance, the rest of the law won't work. The Patient Protection and Affordable Care Act requires that insurance companies cover everyone, regardless of preexisting health conditions. But as an economic proposition, the argument goes, universal health coverage is sustainable only if there are plenty of healthy people paying into the insurance pool — not just sick folks.

With two appeals courts now having come to two different conclusions about the constitutionality of President Obama's health law, it is likely that the Supreme Court will eventually rule on the matter. None of the legal challenges facing the law have yet made their way to the nation's highest court. (Kaiser Health News offers this handy scoreboard tracking the status of the lawsuits.)

In another development concerning the health care overhaul Friday, the Ohio Supreme Court ruled that signatures on a petition circulated by opponents of the health care plan were valid, clearing the way for a November vote on portions of the legislation dealing with changes to individual insurance.

That decision will be stayed pending a ruling by the Supremes.

 

[Johnny Vinyl]

The only thing that will make health care work is sane triage without retribution and a sane legal system, neither of which we have, and pointing the fingers at greedy insurance companies, doctors and hospitals is barking up the wrong tree.

What is sane triage without retribuition? Sorry...layman explanation please.