American healthcare system

[[Fl...]]

No, it's not fair, but the ACA is an insurance mandate only, which is not the same thing as single payer healthcare.

 

If an insurance mandate is not fair, how is a single payer system fair? It all comes down to some people contributing more than they benefit and other people benefiting more than they contribute. That is the opposite of fair.

 

I think you need to do more research into this yourself, FG… single payer is not socialized medicine. It is a healthcare <i>payment</i> system, not a health care <i>delivery</i> system. Single payer healthcare is not socialized medicine any more than the public funding of the defense industry is "socialized defense.” Providers can still be private under a single payer system.

 

It is ALL socialized medicine. The more the government is involved, and that is what a single payer system is advocating, the more socialized it is.

[Guest [mu...]]

 

If an insurance mandate is not fair, how is a single payer system fair? It all comes down to some people contributing more than they benefit and other people benefiting more than they contribute. That is the opposite of fair.

 

That's not how single payer systems work.

 

 

It is ALL socialized medicine. The more the government is involved, and that is what a single payer system is advocating, the more socialized it is.

 

No, it isn't. For it to be actual socialized medicine (and not just political doublespeak), the government would have to own and control the doctors, hospitals, and services you receive. That's not what single payer healthcare does. Your individual doctor would still operate under the same private for-profit service. Again, single payer healthcare is a payment system only - not a delivery system. The difference is that every doctor would deal with a single insurer instead of hundreds, which drastically cuts down on administrative costs and saves U.S. taxpayers billions of dollars a year.

 

We only have one truly socialized medicine service in this country - the Veterans Association. The government owns the V.A. hospitals and pays their doctors. This is very different from single payer systems such as Medicare, where the government pays the bills but the hospitals and other providers remain private. If we were to adopt a single payer system in the U.S., it would look like Medicare - not the V.A.

 

Hope that helps.

 

[[be...]]

Here in British Columbia, Canada we pay monthly premium rates based on income, ranging from $0 per month (based on an income of $22,000.00 or less).  The most you can pay is $150/per month for a family of 3 (based on an income of $30, 000.00 or more), for a family of two with this income or more it's $136.00, for a single person with this income, it's $75.00 per month.  I think we're pretty fortunate from what I'm seeing here, except for the fact that if you make over $30,000.00/ year you still pay the same, i.e.: If you make a million dollars per year, you still pay $75 as a single person up to $150 as a family of 3.   This is one of the many ways the rich keep getting richer.

 

Monthly premium rates for BC, effective January 2016:

 

http://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/premiums

[[Fl...]]

That's not how single payer systems work.

 

Enlighten me.

 

Single payer is basically government acting as the insurance company. It isn't used simply a means to reduce administrative costs, it is used to make some people pay more than they receive and for others to receive more than they pay, whether that is through taxes or premiums or whatever.

 

No, it isn't. For it to be actual socialized medicine (and not just political doublespeak), the government would have to own and control the doctors, hospitals, and services you receive. That's not what single payer healthcare does. Your individual doctor would still operate under the same private for-profit service. Again, single payer healthcare is a payment system only - not a delivery system. The difference is that every doctor would deal with a single insurer instead of hundreds, which drastically cuts down on administrative costs and saves U.S. taxpayers billions of dollars a year.

 

We only have one truly socialized medicine service in this country - the Veterans Association. The government owns the V.A. hospitals and pays their doctors. This is very different from single payer systems such as Medicare, where the government pays the bills but the hospitals and other providers remain private. If we were to adopt a single payer system in the U.S., it would look like Medicare - not the V.A.

 

Hope that helps.

 

You can wrap it up and tie a bow around it but it you are still socializing health care by introducing government.

 

Socialized medicine is a term used to describe and discuss systems of universal health care: medical and hospital care for all at a nominal cost by means of government regulation of health care and subsidies derived from taxation.

 

https://en.wikipedia.org/wiki/Socialized_medicine

[[li...]]

builder,

 

Numbers vary according to source. But I'm suprised that GPs in the USA make that much money. The question would be:  why ? Is that before or after costs ?

 

Anyway, according to this source: http://www.payscale.com/research/US/Job=Family_Physician_%2F_Doctor/Salary salaries vary a lot.

[[bu...]]

builder,

 

Numbers vary according to source. But I'm suprised that GPs in the USA make that much money. The question would be:  why ? Is that before or after costs ?

 

Anyway, according to this source: http://www.payscale.com/research/US/Job=Family_Physician_%2F_Doctor/Salary salaries vary a lot.

 

Well, yes there is a lot of variability.  But you would find  a similar, or even greater, variability, for most prof essions in the US.  That's the way a market economy works.

 

But the $167,000 median for a family physician (GP) reported at the link is very close to the $161,000 reported in my link.

[Guest [mu...]]

Enlighten me.

 

Single payer is basically government acting as the insurance company. It isn't used simply a means to reduce administrative costs, it is used to make some people pay more than they receive and for others to receive more than they pay, whether that is through taxes or premiums or whatever.

 

Hmmm... maybe I was misreading your question. I was responding to your assertion that the ACA is just as unfair as a single payer program would be. Right now under the ACA, some people are getting high quality insurance for very little, while others pay much more for often lower quality care. Under a single payer system, you would pay healthcare taxes based upon your income level (just as you do now), but everyone would receive the same services and quality of care.

 

Now I'm thinking that your original question had more to do with whether or not it's "fair" for those with higher incomes to pay higher taxes. If so, that's a whole other discussion for another day....

 

 

You can wrap it up and tie a bow around it but it you are still socializing health care by introducing government.

 

Socialized medicine is a term used to describe and discuss systems of universal health care: medical and hospital care for all at a nominal cost by means of government regulation of health care and subsidies derived from taxation.

 

https://en.wikipedia.org/wiki/Socialized_medicine

 

This wikipedia article does not stop after the first sentence, FG:

 

"The original meaning [of socialized medicine] was confined to systems in which the government operates health care facilities and employs health care professionals.[10][11][12][13] This narrower usage would apply to the British National Health Service hospital trusts and health systems that operate in other countries as diverse as Finland, Spain, Israel, and Cuba. The United States Veterans Health Administration and the medical departments of the U.S. Army, Navy, and Air Force, would also fall under this narrow definition. When used in that way, the narrow definition permits a clear distinction from single payer health insurance systems, in which the government finances health care but is not involved in care delivery.[14][15]

 

More recently, American conservative critics of health care reform have attempted to broaden the term by applying it to any publicly funded system.... The term is often used by conservatives in the U.S. to imply that the privately run health care system would become controlled by the government, thereby associating it with socialism, which has negative connotations to some people in American political culture.[18] As such, its usage is controversial,[4][5][6][10] and at odds with the views of conservatives in other countries prepared to defend socialized medicine such as Margaret Thatcher.[19]"

 

https://en.wikipedia.org/wiki/Socialized_medicine

 

We can turn this into a semantics debate if you want, but single payer insurance and socialized medicine are indeed different.

[[Fl...]]

Hmmm... maybe I was misreading your question. I was responding to your assertion that the ACA is just as unfair as a single payer program would be. Right now under the ACA, some people are getting high quality insurance for very little, while others pay much more for often lower quality care. Under a single payer system, you would pay healthcare taxes based upon your income level (just as you do now), but everyone would receive the same services and quality of care.

 

Now I'm thinking that your original question had more to do with whether or not it's "fair" for those with higher incomes to pay higher taxes. If so, that's a whole other discussion for another day....

 

Either way some people get the long straw and some people get the short straw. In both cases the government is heavily involved with it and that rarely makes anything better.

 

 

[[pr...]]

That's good coverage.  Are you planning on getting any tests done to check out what the benzo beast has done to us?

 

I don't know what good it would do. I suppose I could get vitamin levels checked, and maybe testosterone just to see where I am at. I just know there is a drug for just about everything and the last thing I want to do is have to get into a discussion with the doctor about why I will only take certain things.

 

One thing I might get checked for is sleep apnea. The past few nights I have slept very well but I have had some really rough sleep off and on recently that I think could be related to sleep apnea. Who knows. Honestly though, if that is a problem I could very likely solve it by losing a few pounds so it might pay me to buckle down and make that happen first.

 

 

 

a little of topic but just wanted to say to FG,

 

 

i think i read somewhere that one of the biggest symptoms most debilitating of sleep apnea is cognitive impairment/loss of memory. in case you're interested here are a few links:

 

http://www.medicalnewstoday.com/articles/292359.php

 

https://www.sciencedaily.com/releases/2012/03/120314101240.htm

[[li...]]

benzohno,

 

That seems like a fantastic arrangement.

 

I'm paying so much for so little ...

 

I have to deal with something close to 'single payer'. Either way, when you give the state that much control, sooner or later it will start to control and regulate medical practice. 'he who pays' ...

 

 

[[re...]]

America spends more money on health than any other country in the world, but we rank 37th in the world for overall health.

 

The fourth leading cause of death here is medical error/medication complications. I'm afraid you might be mistaken that things are better here. You may have some obstacles, but we have a whole set of problems you don't have.

 

 

Agree.

 

Doctors are at the mercy of a third party payor for their medical decisions for a patient as

Well as how they are paid.  The visits are very short and not prevention oriented but disease management. Although they are trying to steer toward prevention. It's not working because of lack of time the physician spends with you.

 

I don't remember the last time I had a physical where the doc actually did a hands on

 

 

[[re...]]

Just a comment re: single payer...

 

I'm a senior, on original Medicare.  I have never met anyone who was not happy with Medicare!

 

I have. A lot

 

I used to visit patients on Medicare.

There are items that aren't  covered (teeth, etc)

Premiums and copays are high for those on limited income.

Costs of prescriptions are high (or not covered)

[[bu...]]

Just a comment re: single payer...

 

I'm a senior, on original Medicare.  I have never met anyone who was not happy with Medicare!

 

I have. A lot

 

I used to visit patients on Medicare.

There are items that aren't  covered (teeth, etc)

Well, for $122mo, it's pretty amazing how many things ARE covered.

 

Premiums and copays are high for those on limited income.

 

For about $60mo, I have medigap plan that covers deductibles and copays, as well as expands other parts of the coverage. (It also pays the membership fee at the fitness center as a wellnes benefit,)

 

Costs of prescriptions are high (or not covered)

 

My Part D is about $30/mo.  No  deductible, and my co-pays are $1-3.

 

So for about $200/month, I have hospital, medical, and Rx coverage.  Seems pretty awesome to me.  And I have never had to file a claim or submit any paperwork, and I have never had a claim denied.  And over the years, I have had  kidney stone surgery, a heart catheterization, diagnosis and therapy for COPD, 2 hand surgeries, and cataract lens surgery on both eyes, in addition to annual physicals, and the occasional infection/disease visits that most everyone gets.  I see any doc I want, and don't need a referral to see a specialist.

 

Nope, really don't know how anyone could be unhappy about that.

 

[[be...]]

I pay $0/month for my premium free Medicare part A and B. Scripts cost me $2.95 each, no deductible, $10 for primary but $50 too see a specialist. Not that bad....

[[li...]]

Reba,

 

'The visits are very short and not prevention oriented but disease management. Although they are trying to steer toward prevention. '

 

Would you really want a prevention oriented approach ? What would that mean ? Health education ? Up to a point, health education but they get it wrong so often ...

 

Doctors are good at dealing with diseases, not health !

[[be...]]

Reba,

 

'The visits are very short and not prevention oriented but disease management. Although they are trying to steer toward prevention. '

 

Would you really want a prevention oriented approach ? What would that mean ? Health education ? Up to a point, health education but they get it wrong so often ...

 

Doctors are good at dealing with diseases, not health !

 

Well liberty my pdoc focuses on me to be heathy. But you're right. Medical schools focus on diseases. I just had lunch with a friend ER doc and he said you're called a bad doctor if you don't give opiates to ER patients . So they don't want a bad reputation so they hand them out. But now that is changing cause of the epidemic here. Sad and pathetic.

[[co...]]

U.S. Healthcare is a Global Outlier, and Not in a Good Way

Jeff Desjardins

on August 17, 2016 at 11:30 am

 

Historically, the United States has spent more money than any other country on healthcare.

 

In the late 1990s, for example, the U.S. spent roughly 13% of GDP on healthcare, compared to about a 9.5% average for all high income countries.

 

However, in recent years, the difference has become more stark. Last year, as Obamacare continued to roll out, costs in the U.S. reached an all-time high of 17.5% of GDP. That’s over $3 trillion spent on healthcare annually, and the rate of spending is expected accelerate over the next decade.

High Costs, High Benefit?

 

With all that money being poured into healthcare, surely the U.S. must be getting better care in contrast to other high income countries.

 

At least, that’s what one would think.

 

Today’s chart comes to us from economist Max Roser (h/t @NinjaEconomics) and it shows the extreme divergence of the U.S. healthcare system using two simple stats: life expectancy vs. health expenditures per capita.

 

U.S. Healthcare is a Global Outlier, and Not in a Good Way

The Divergence of U.S. Healthcare

 

As you can see, Americans are spending more money – but they are not receiving results using the most basic metric of life expectancy. The divergence starts just before 1980, and it widens all the way to 2014.

 

It’s worth noting that the 2015 statistics are not plotted on this chart. However, given that healthcare spend was 17.5% of GDP in 2015, the divergence is likely to continue to widen. U.S. spending is now closing in on $10,000 per person.

 

Perhaps the most concerning revelation from this data?

 

Not only is U.S. healthcare spending wildly inefficient, but it’s also relatively ineffective. It would be one thing to spend more money and get the same results, but according to the above data that is not true. In fact, Americans on average will have shorter lives people in other high income countries.

 

Life expectancy in the U.S. has nearly flatlined, and it hasn’t yet crossed the 80 year threshold. Meanwhile, Chileans, Greeks, and Israelis are all outliving their American counterparts for a fraction of the associated costs.

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Happy New Year!

 

I see the graph didn't translate.

 

Sometimes I just can't leave it alone.

 

http://www.visualcapitalist.com/u-s-healthcare-system-global-outlier-not-good-way/

[[li...]]

A couple of things I suspect:

 

Defensive medicine (possibly related to liability), excessive diagnostic procedures, prescribing too many drugs (also a matter of consumerism?, marketing?, expectations, drugs are needed to combat the side effects of drugs).

Too many invasive medical procedures ('just to be sure').

 

Infections in hospitals.

 

If there is an abundance of money, healthcare will be expensive. Many people on psychiatric drugs. Bad for your health in most cases.

 

Unhealthy lifestyles. Many people in poverty, excessive obesity, high stress in a competitive society.

Lack of social/economic stability for many people.

 

Not just the healthcare system I suspect 

[[co...]]

Capitalism, maybe?

[Guest [ch...]]

Life expectancy is a function of many things - diet, exercise, lifestyle - and is therefore a poor metric for measuring the quality of healthcare. A more direct measure of healthcare would be to compare survival rates of people diagnosed with specific diseases. By this measure, U.S. comes out on top. For example see https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm

 

 

 

[[Fl...]]

Life expectancy is a function of many things - diet, exercise, lifestyle - and is therefore a poor metric for measuring the quality of healthcare. A more direct measure of healthcare would be to compare survival rates of people diagnosed with specific diseases. By this measure, U.S. comes out on top. For example see https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm

 

I was going to say that there is a lot more to life expectancy than just healthcare.

 

Americans are fat, fat, fat. All the healthcare in the world can't counteract all of the damage we are doing to our own bodies.

[[pr...]]

Life expectancy is a function of many things - diet, exercise, lifestyle - and is therefore a poor metric for measuring the quality of healthcare. A more direct measure of healthcare would be to compare survival rates of people diagnosed with specific diseases. By this measure, U.S. comes out on top. For example see https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm

 

I was going to say that there is a lot more to life expectancy than just healthcare.

 

Americans are fat, fat, fat. All the healthcare in the world can't counteract all of the damage we are doing to our own bodies.

 

 

yep, that are fat. probably because they stick to the SAD diet. (standard American diet)  i think all of us benzo survivors become healthier and healthier because we are on this never ending search to heal ourselves and most of change our diet to a cleaner or paleo type of diet. i know i am pretty healthy if i didn't have benzo damage. i never get sick. i don't get the flu and i am pretty sure i don't have any infections or auto-immune diseases. well, except for that MS diagnosis but that is a diagnosis i've always been unsure about -- and doctor's who don't comprehend this syndrome. so. you know.

[Guest [mu...]]

Life expectancy is a function of many things - diet, exercise, lifestyle - and is therefore a poor metric for measuring the quality of healthcare. A more direct measure of healthcare would be to compare survival rates of people diagnosed with specific diseases. By this measure, U.S. comes out on top. For example see https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm

 

You’re absolutely right that life expectancy is more complicated than merely looking at our quality of health care.

 

However, the only disease categories in which the U.S. has better health outcomes are in treating a few cancers (mostly breast and prostate, but I’ll discuss this more below) - for all other diseases our treatment outcomes are actually poorer than those in other developed countries. More concerning still, for the first time in decades American life expectancy is actually dropping.

 

While aggressive screening practices in the U.S. have enabled us to catch some cancers sooner (which improves our survival statistics, as patients whose cancers are identified in the early stages are much more likely to still be alive after 5 years, even if the rate of overall cancer mortality is the same), it also catches more non-invasive, “stage 0 cancers.” Unlikely to ever metastasize or even become symptomatic, these non-invasive cancers boast a 100% 5 year survival rate. Identifying and treating non-invasive cancers (which never needed identification or treatment in the first place) is a distinctly American phenomenon, and has largely skewed the data in favor of the U.S. “winning the war” on cancer.

 

Here are some interesting articles about cancer statistics, if you want to check them out:

 

http://www.factcheck.org/2009/08/cancer-rates-and-unjustified-conclusions/

http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0

 

[Guest [mu...]]

Life expectancy is a function of many things - diet, exercise, lifestyle - and is therefore a poor metric for measuring the quality of healthcare. A more direct measure of healthcare would be to compare survival rates of people diagnosed with specific diseases. By this measure, U.S. comes out on top. For example see https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm

 

I was going to say that there is a lot more to life expectancy than just healthcare.

 

Americans are fat, fat, fat. All the healthcare in the world can't counteract all of the damage we are doing to our own bodies.

 

Interestingly, a recent meta-analysis demonstrated that those who are overweight (but not morbidly obese) actually live <i>longer</i> than their normal and underweight BMI counterparts. There was even research on Italian women that showed a BMI of 33 (which is technically obese) was associated with the longest life expectancy.

 

Of course poor diets and sedentary lifestyles play a significant role in modern disease, but we’ve all witnessed the fact that two people can have the exact same diet and lifestyle (for better and for worse) and still be at opposite ends of the weight spectrum. Weight gain itself is merely a <i>symptom</i> of poor health (although not always!), rather than the <i>cause</i> of it. To illustrate: studies have shown that obese men who exercise regularly have a lower risk of developing cardiovascular disease than men of lean or normal weight who do not exercise. Lack of exercise (which can lead to the symptom of weight gain), is the main predictor of ill health and early death - not body size. Same goes for diet.

 

Unfortunately, the fact that your weight does not truly predict a higher death rate or negative health experience (except for those on the extreme ends - underweight or morbidly obese - and even then it’s not by much) is simply too hard for people to grasp, as we’ve been conditioned for so long to be prejudiced towards bigger people. Sadly, I don’t see this changing anytime soon.

 

[[Fl...]]

Interestingly, a recent meta-analysis demonstrated that those who are overweight (but not morbidly obese) actually live <i>longer</i> than their normal and underweight BMI counterparts. There was even research on Italian women that showed a BMI of 33 (which is technically obese) was associated with the longest life expectancy.

 

Of course poor diets and sedentary lifestyles play a significant role in modern disease, but we’ve all witnessed the fact that two people can have the exact same diet and lifestyle (for better and for worse) and still be at opposite ends of the weight spectrum. Weight gain itself is merely a <i>symptom</i> of poor health (although not always!), rather than the <i>cause</i> of it. To illustrate: studies have shown that obese men who exercise regularly have a lower risk of developing cardiovascular disease than men of lean or normal weight who do not exercise. Lack of exercise (which can lead to the symptom of weight gain), is the main predictor of ill health and early death - not body size. Same goes for diet.

 

Unfortunately, the fact that your weight does not truly predict a higher death rate or negative health experience (except for those on the extreme ends - underweight or morbidly obese - and even then it’s not by much) is simply too hard for people to grasp, as we’ve been conditioned for so long to be prejudiced towards bigger people. Sadly, I don’t see this changing anytime soon.

 

That sounds like a lot of justification for something that is widely agreed to be unhealthy.

 

Our genes know that it is unhealthy to be overweight, so we are naturally attracted to thinner, healthier people. We don't want to pass on bad genes and unhealthy habits to our children. That is the reason why people are prejudice toward bigger people. If you want to blame something, blame nature.