Universal Healthcare...

[Ron Party]

Follow the money and one will find the problem(s), be it healthcare or virtually any other matter. Capitalism, at least the version of it we have now, is the root of many evils. I'd say all, but that would give religion, amongst a few others, a free pass.

 

[docvale]

Despite I don't practice clinical medicine, I've been trained as an MD and I'm licensed in Italy.
I will describe here how the system works there and I'll try to explain why I like it.

The system can be considered "socialist" or "welfare-oriented" or whatever you prefer It's public and supported consequently through taxation on the citizens. The individual expense for health care in Italy in among the lowest in Western World The system allows the existence of a privately handled medical practice, to which every citizen is allowed to access, supported by his own pocket or through an insurance (if purchased). Doctors that work in a public hospitals make good, but not as good as doctors here: anyway, they're allowed (unless they are unit directors) to add private practice to their public service. Moreover, they can do the so-called intra moenia: they can do private practice inside a public hospital (obviously on top of their public duties) using the hospital machines, just giving the hospital treasury a percentage of the income produced there. I think it's a good deal. And, importantly, there's no limit in the annual money a doctor can make.

As a citizen, I think that a system which is fed by taxation costs enormously less than a system based on private insurances. Here in NYU, my boss, on top of my salary, pays 30% more for my benefits, that are just my health insurance costs (as a postdoc research fellow I don't qualify for retirement plans... ). I'd prefer to have a +30% in my gross salary and pay more taxes for public health.
But I also know that I'm probably biased in favor to the Italian system... *


* you maybe noticed that Italy ranks #2 in the WHO rankings. If you stop the average Italian man on the street and you ask him what he thinks about the health system, he'll tell you it sucks. Actually, he'll tell you that whatever is Italian sucks. It's a handicap of our culture, always complaining for everything and focusing only, in this case, on cases of malpractice... I wish Italians advertised better our system in the World

 

[Johnny Vinyl]

I see that the thread has been "cleansed".

 

[NorthStar]

Health is a human right for EVERYONE.

But reality doesn't work like that. You have public, and you have less public (or private) practices.
People (humans) are not considered equal. Different classes based on income, and all that Jazz.

Who are we to complain when we can't even take care of all the kids dying of malnutrition across our planet?!!

Here in Canada we have this and that, but we also have some very bad situations in providing care for the poor in emergency cases!
And I know that for a fact myself!

In the USA, many people complain about Healthcare; it's only one issue among Education, Economy, Politics, and Sociology.

When God created the Universe, he didn't expect people from other way far galaxies, living on other planets, to impregnate our planet Earth with the seed of 'penitential predestination'.

...And the rest is history.

 

[Phelonious Ponk]

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.

I can only guess what you mean sane triage, but the issue of malpractice and tort reform was a big talking point back in 2009 when healthcare reform was being debated, and it was a red herring. The most recent medical malpractice/tort cost numbers at the time were from 2007 and they were $30.4 billion for the year. In 2009 we had a more than a $2 trillion health care system. That put litigation costs and malpractice insurance at about 1.5 percent of total medical costs. In our current budget debate, that would be a rounding error. And while I don't have any recent numbers I do know that the size of our healthcare system has been trending up faster than the cost of malpractice insurance and litigation. So it's probably a smaller rounding error today.

Of course none of that means we don't need tort reform, I'm just a big fan of tempering debate with the intellectual discipline of a few facts.

Tim

 

[Steve Williams]

I see that the thread has been "cleansed".

I hope I'm not naive but if you meant posts deleted ..Uh, Uh.

 

[Johnny Vinyl]

I hope I'm not naive but if you meant posts deleted ..Uh, Uh.

thread "cleansed"...posts deleted....semantics, really! But ok.

 

[Steve Williams]

I can only guess what you mean sane triage, but the issue of malpractice and tort reform was a big talking point back in 2009 when healthcare reform was being debated, and it was a red herring. The most recent medical malpractice/tort cost numbers at the time were from 2007 and they were $30.4 billion for the year. In 2009 we had a more than a $2 trillion health care system. That put litigation costs and malpractice insurance at about 1.5 percent of total medical costs. In our current budget debate, that would be a rounding error. And while I don't have any recent numbers I do know that the size of our healthcare system has been trending up faster than the cost of malpractice insurance and litigation. So it's probably a smaller rounding error today.

Of course none of that means we don't need tort reform, I'm just a big fan of tempering debate with the intellectual discipline of a few facts.

Tim

Tim...

wow $30.4 B that ain't hay. How much went to attornies

all due respect, IMO if there were ever a way to curb lawyers's greed for petty lawsuits and allow truly realistic claims as well as keep the awards to a realistic value this would be a step in lowering healthcare expense inasmuch as doctor's malpractice premiums would fall, insurance remunerations to the provider would go down and as a result premiums to the patient would go down. This would pump a whole lot of money everywhere but into a lawyer's pocket. Perhaps it could give a boost to the economy. Sadly this will never be the case.

BTW John, I am also reminded by my colleagues in Canada that the cost of their annual malpractice premiums approaches that of here in the USA

 

[Steve Williams]

thread "cleansed"...posts deleted....semantics, really! But ok.

John, unless I have missed something myself as I have been following this thread with great interest I can say again that I have not deleted any posts nor do I think Lee, Ron or Tim have as they are posting here as well

 

[Phelonious Ponk]

all due respect, IMO if there were ever a way to curb lawyers's greed for petty lawsuits and allow truly realistic claims as well as keep the awards to a realistic value this would be a step in lowering healthcare expense inasmuch as doctor's malpractice premiums would fall, insurance remunerations to the provider would go down and as a result premiums to the patient would go down. This would pump a whole lot of money everywhere but into a lawyer's pocket. Perhaps it could give a boost to the economy. Sadly this will never be the case.

Like I said, Steve, it doesn't mean that we don't need tort reform, but in the account of the overall cost of healthcare in America, it's pocket change. It's not the problem, and denying everyone the right to sue the medical establishment wouldn't contribute significantly to the solution. I suppose, as my blessed mother used to say, "every little bit helps said the old man as he peed in the sea," but it doesn't help much.

Tim

 

[Phelonious Ponk]

John, unless I have missed something myself as I have been following this thread with great interest I can say again that I have not deleted any posts nor do I think Lee, Ron or Tim have as they are posting here as well

John72953 deleted his own post on page 2. That's the only deletion I'm aware of.

Tim

 

[NorthStar]

John had probably a steak that was too stiff last night!

 

[RBFC]

I haven't deleted anything here either. As mods, we can see if a member has deleted or edited his post. Nothing unusual that I see.

Lee

 

[Gregadd]

Steve- I don't know if Doctors are greedy. How about unnecessary office visits, unnecessary prescriptions, and unnecessary operations? We all have to pay the rent. Then you can be in business when a real sick person comes along.

When I did civil I could tell you the games insurance companies play. They claim they need all these huge reserves to pay the huge malpractice claims that never materialized.

Besides if we were that greedy we would not have let a certain OBGYN escape unscathed.

 

[Ron Party]

There are remedies in place for nuisance and fraudulent claims. There also are remedies for meritless claims. It is a wonderful talking point, usually espoused by the Republican Party here in the U.S., but like most talking points once you peel back the layers you see there is little to no validity to it.

Insurance companies take as profit between 5 and 20 percent of all the money spent on healthcare, far more than what is paid out on all malpractice claims. Those of us in the business of making claims against insurance companies know that they train their staff to pay out as little as possible and preferably nothing. Insurance companies are not in the business of treating people fairly. If they did, I'd be practicing environmental law.

Greg is right in every one of his posts in this thread. Doctors, lawyers, insurance companies, and victims of professional negligence all are greedy. This is to state nothing of the politicians who are indirectly paid to advocate for one or more of these groups. For anyone to come on to this thread and say "fix this one thing, e.g., tort reform, and everything will smell like roses is just plain ignorance.

Follow the money, you will almost always find the heart of the problem. The so called economic model of *Capitalism* we have in this country simply fails when it comes to health care (amongst many other things).

 

[Ron Party]

Assuming for the purpose of discussion that the tort system does not in any way perform the ostensible job that it claims to be doing, an assumption with which I wholeheartedly disagree and if need be can point to numerous examples of it doing exactly what I claim here and know to be true after more than 25 years in the business, how do you propose we deal with the physicians and other health care practitioners that perform below the standard of care and cause injuries and damages not just to their patients but their patients' families?

Let's take a man in his late twenties, high school drop out, husband and father of two, working two part time jobs adding to 12 hours a day but earning less than 100K per year. His wife is unemployed, well, not really, since she is raising the two kids. Now let's say he is driving home after a long day's work and a drunk driver runs a red and takes him out. Being uninsured, he is of course taken by AMR to Highland Hospital, Alameda County's *finest*. It is determined he has at least one if not more conditions which require immediate surgical intervention. The surgeon, radiologist, anesthesiologist, take your pick, screws up royally, rendering this man totally and permanently disabled or, even worse, due to the health care provider's failure to perform within the standard of care, this man dies.

This husband and father may never work again (or, in the worse scenario, he dies). His wife and his children have lost the sole source of income they rely upon for their entire existence. This is to state nothing of the noneconomic damage all of them have suffered. Are you really expecting me to believe the legal system does not even ostensibly do what it purports to do? Really?

 

[jazdoc]

Very interesting thread which I would summarize as follows:

Physicians and insurance companies are greedy.
Lawyers are humble servants who are not greedy.
Threat of litigation does not contribute significantly to healthcare costs.
Consumers who want a valuable service for less than cost are not greedy.

Profit driven healthcare is bad.
Taking profit out of healthcare will ensure cheaper and better health care.
No opinion has been profferred as to whether taking profit out of the legal system or any other business will make said business cheaper or better.

Because healthcare is a right, people seem to advocate government run universal healthcare that allows each citizen and non-citizen unlimited access to healthcare services and not pay anything out of pocket.
No one has stated how much they are willing to pay in taxes for such a system.

More to follow...

 

[Gregadd]

Insurance companies and doctors have lawyers. There is no free lunch. Insurances companies are supposed to pool risk. They are supposed to invest the money and hope you stay well and don't have any accidents. Instead they "cherry-pick "patients, squeeze doctors and gouge premiums. Ironically lawyers seem to be the only group able to get money from them.

 

[amirm]

Insurance companies and doctors have lawyers. There is no free lunch. Insurances companies are supposed to pool risk. They are supposed to invest the money and hope you stay well and don't have any accidents. Instead they "cherry-pick "patients, squeeze doctors and gouge premiums. Ironically lawyers seem to be the only group able to get money from them.

And insurance companies then take money out of doctors with a mark up for their troubles. The doctors then have to raise their rates to accommodate. Plus of course a margin to cover their cost of business. That means the customer who had no role in the whole transaction then pays the price. In turn the frustrated consumer says he hates lawyers, insurance companies and doctors all colluding to cost him more money.

Did I get this right?

 

[Steve Williams]

And insurance companies then take money out of doctors with a mark up for their troubles. The doctors then have to raise their rates to accommodate. Plus of course a margin to cover their cost of business. That means the customer who had no role in the whole transaction then pays the price. In turn the frustrated consumer says he hates lawyers, insurance companies and doctors all colluding to cost him more money.

Did I get this right?

Amir between your post and jazdoc it really sums up the whole aspect of socialized medicine. It is like a dog chasing its tail

BTW Greg, you state that lawyers never never have problems extracting money from insurance companies. To me it only goes to show that lawyers don't work for free.....only the doctors