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Health Care Myth

Jan 15, 2009 - 37 comments

Healthcare System




Socialized Medicine


Tom Daschle


universal healthcare


healthcare reform

I really enjoyed watching this 5 minute video clip from Tom Daschle talking about the U.S. Healthcare System. If you have a few minutes to watch it, pay particular attention at the ~3:30 mark. Enjoy!

Warm wishes,

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Avatar universal
by PlateletGal, Jan 15, 2009

Get 'em Tom !!!!

I think France was rated #1 as far as the best healthcare system in the world. Japan has an interesting healthcare system..... it isn't socialized medicine either. I would hope that the conservatives who are against "socialized" medicine would at least compromise and look at Japan's healthcare system.

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by J T Junig, MD PhDBlank, Jan 15, 2009
It is difficult to simply say one system is 'better';  you first must decide on the metrics used for the measurement.  The most commonly-used measure of 'best' uses infant mortality numbers; in the US we have a very large number of people who become pregnant too early in life, who do not go in for prenatal care-- even when it is available for free.  If a person becomes pregnant at 15, refuses to get prenatal care, uses drugs, and then after delivery brings the baby home and leaves the baby alone to go out to party... and the infant dies from neglect... is this an accurate reflection of the US healthcare system?  Some would say 'yes'-- and I understand their point-- but other people including myself would place more emphasis on personal responsibility, and say that the infant mortality is higher in the US DESPITE our health care system, not BECAUSE of it.

Likewise, other measurements use the population's life expectancy. But if the population is obese from a penchant for fast food, is that the fault of the 'healthcare system'?

The US healthcare system struggles under the burden of a constant influx of people from countries with high poverty rates-- something without comparison in Canada, Japan, or Finland, for examples.  And while the care is not perfect by any means, a great deal of money and resources are used to try to treat these populations.

Most government-funded systems use some type of rationing--  US consumers who are used to getting their torn ACL fixed in a couple weeks would be frustrated by a system where the same repair, if available at all, requires them to wait for over a year.  In the US, a large percentage of the health expenditures occurs during the last year of a patient's life--  US consumers will have a very large adjustment to make, to accept the idea of 'letting go' much earlier in the fight for life.  If grandma is 80, and breaks her hip, are we ready to hear that she is not eligible for surgery because of her age-- and so she will be given pain killers and sent to YOUR house, so that you can care for her while you wait for the DVT or pneumonia to finally take her life and end her suffering?  If your dad develops kidney failure from a strep infection, and is in vibrant health but 70 years old, are you ready to let him die, since he is too old for dialysis?

No matter where the US 'rates', look at the advances in healthcare on all fronts-- and no matter what you picked, it most likely occurred here in the US.  And watch the people who can afford to pay for their own care, who have the option of whether to stay in their home countries or seek out the best care elsewhere... when they get REAL sick, they only migrate in one direction.

Avatar universal
by PlateletGal, Jan 16, 2009

The world health report 2000 - Health systems: improving performance

Avatar universal
by PlateletGal, Jan 16, 2009

Although I couldn't actually find the World Health Organization's ranking of the world's health systems report on the WHO's website, I did find the information on another website. The results of this report were released in 2000 and apparently the World Health Organization no longer produces a ranking table because of the complexity of the task.


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by swampcritter, Jan 16, 2009

If you measure health care by how happy people are with it, then the US health care system would certainly not score very high. From inability to get insurance, from the problems of finding health care in the area, then when you have insurance constant denials of coverage...

Also, many people equate health insurance with free health care. It isn't, of course.

But national health care doesn't seem to be the answer either. The US already has experience with federal / state partnership to deliver health care -- Medicare and Medicaid. Every person who is older gets Medicare, every poor person gets Medicaid. Yet, few people really consider these good, even though future government liabilities for them are in the tens of trillions.

Swampy will plug his own journal here on expectations for health insurance and costs involved.

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by allaboutmary, Jan 17, 2009
Dr. J

I agree that U.S. has excellent health care, the problem is .........everyday less and less people have access to it. I guess the real question is .......Is it still considered great health care when only the lucky and wealthy have it ?

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by flmagi, Jan 17, 2009
There is a large group of Americans that fall threw the cracks in the health care system. These people are between 18 and 65, no children or grown children, unemployed, self-employed or under-employed or employed by companies that don't offer insurance. These people can't afford the price of insurance on their own, yet are not eligible for Medicare, unless they have dependant children.  I don't know what the answer is to the health care problem, but there is a problem. This large group of Americans does not have access to care without giving up something important, like food, shelter or heat, and that's just for the more minor medical situations. Myself, like so many others, if faced with major medical situation, like cancer, know that we will most likely not be eligible for treatment.
The United States has great health care.....if you have access to it.

Avatar universal
by PlateletGal, Jan 17, 2009

I think the U.S. has good healthcare, but not as good as it used to be. The reason why I say this is because the average primary care physician has only 6 MINUTES to spend with his/her patient ! That is unacceptable. And what happens as a result is that patients are forced to reschedule follow-up appointments, spend more money and more time, and waiting longer for a diagnosis and/or proper treatment.

I also believe that the healthcare is some states is far superior than other states. I know in my state if you have to go to the ER, chances are you will spend hours waiting. My husband was very ill with a flu like virus (temp 102) and he pretty much spent the night in the ER.. waiting to be seen by a physician ! When my grandmother needed to be hospitalized, they didn't have a bed for her... so she was in the ER all night long until one was made available.

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by Jaybay, Jan 17, 2009
On the 6 minute patient time, how much of that dismal patient time is because as a nation, we go running to the doctor for every little hangnail?  For children, how many parents ever adopt a wait-and-see attitude for every fever that comes along?  How many demand antibiotics for a viral cold?  All those useless visits take time and resources.  Of course, over the years we've been programmed to see not just our family doctors, but specialists to rule out the possibility of this, that and every other illness.  We're not content to use over-the-counter meds like Advil or benadryl.  No, there's always something "better" that is prescription strength so off we go to the doctor for a headache and runny nose every Spring and Fall.

We the People have placed a lot more demand on the medical system than existed when I was a child.  Our hospitals in Houston are closing OB units all over town because of the demand for indigent (free) care.  How does someone slip through the cracks when our public hospitals, by law, must treat anyone who comes to an ER?  We have a tremendous number of illegal aliens here and their care has brought us to our knees in taxes for the hospital district and schools.  They go to the ER for any and everything when there are very low-priced urgent care clinics all over town.  Why spend $30 and get in and out in an hour when you can wait 12 hours and get care for free?  I've often wondered why hospitals don't set up urgent care facilities right next to the ER and have the triage nurse decide which patients go there and which are truly emergency cases  The same people will always go to the ER no matter what, so why not put in a room for minor emergencies that isn't staffed by an expensive trauma surgeon?  Does that make too much sense?

Seniors at 65 don't "get" Medicare; they are forced into taking Medicare.  Even you are still working at 65 and have great insurance, your policy is canceled because the government says that's the way it has to be.  Then you're on your own for medigap coverage.  You're also probably going to have to find a new doctor because more and more don't accept new medicare patients due to the dismally low reimbursement rates.

Third-payer parties began the downfall of our medical care starting with Blue Cross coming into the workplace as a benefit for upper management.  Naturally everyone else had to have that "free health care" so it went to all the workers.  Then came the government programs for non-working people.  When the person who holds the purse strings is not the consumer, this is what happens.  The normal marketplace pricing goes completely out the window and the doctors work for the insurance companies and government agencies rather than the patients.  It's not the doctors' fault.  It's our own fault for falling for the insurance and government program scams.  If a doctor didn't have to pay staff members to file insurance paperwork, and you paid him directly for each visit, just how much less do you think that fee would be?  How "fair" is it that people with insurance (or rather, the insurance company) is charged more by a hospital than a person with no insurance for the same procedure?  As a consumer with insurance, all we see is our co-pay and rarely do hospitals even send out itemized bills to the patient these days.  We don't see the unintended consequences of intervening between the provider and the consumer with third party paying systems.

Sure, we've got problems with our system, but more rules and more government and more payers are not the answer.  A little common sense on the patient side of the coin would take a lot of pressure off the system as a whole.  Just my opinion, so flame away.  :-)

Avatar universal
by PlateletGal, Jan 18, 2009
"On the 6 minute patient time, how much of that dismal patient time is because as a nation, we go running to the doctor for every little hangnail?"

I'm not sure but I can tell you how many times patients follow-up repeatedly with their PCP and that takes many appointments, much time and lots of co-pays. $$$

It is unfortunate that this country is losing our primary care physicians. They aren't getting paid enough and they are boggled down by bureaucracy.

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by peggy64, Jan 18, 2009
Jaybay, you hit the nail on the head. Perfectly said.

We have become such a dependent people that we think someone else should "fix" our every little problem and for free at that. Now, note I said every little problem, like you said running to the ER just because I have a cough of hemorrhoids, or a splinter. We need to become more independent. However, I do not see that happening as we like things handed on a silver platter.

The thing is, someone, somewhere has to pay. That would be us working people.  

Flame away!!

Avatar universal
by PlateletGal, Jan 18, 2009

Nobody thinks that people should "fix" our problems for free. We all pay into the system and many of us have health insurance. Many employers now are supporting a more socialized medicine approach because they can no longer afford health coverage for their employees and their family members.

This is a moral issue... IMO. And I think there is something very wrong when people are dying because they have no health insurance. Nobody is excluded.. including you, peggy64. One of my friends was just laid off this week.

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by peekawho, Jan 18, 2009
And even if you do have health insurance, it sometimes leaves a lot to be desired.

We have Blue Cross PPO.  Mr. Peek has it through his work (I have an HMO through mine).  When he had his accident last year, OUR portion of the bill was $3000!  (Initially it was $6000, but we got it reduced).  Granted, this was our OOP max for the year, but it still stung.  

$3000 in copays, and we have full insurance.  We can afford it, but what happens to people who can't?  

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by mags59, Jan 18, 2009
We lose our homes and die.

Avatar universal
by PlateletGal, Jan 18, 2009


You are right. We are paying more for less healthcare when we could be paying less for more. The choice is not easy to make !

Avatar universal
by PlateletGal, Jan 18, 2009
oops -- left out the "Ha Ha !"  ; ^ )   Some people still just don't understand how bad the problem is and what the consequences will be.

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by peekawho, Jan 18, 2009
I sure don't go to the ER.  Not with a $200 copay for using it.  I wait and go to an urgent care if I feel I really have a problem.  Or I see my doctor, if the problem is in regular business hours.  

But at $50 a pop even for Urgent Care, I usually just wait out whatever I feel is wrong.  

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by Ranaesheart, Jan 18, 2009
Coming from a medical background understanding the insurance, doctor and patient side of things .. truth abounds in all the posts above.  Insurance carriers are out to be profitable and thus exclude many from coverage or put riders on policies or raise premiums that force out those who have been insured for a lifetime or find themselves shopping for insurance when a job is lost or they are unemployed.

Additionally, the general public could be more prudent in the number of trips to the physician's office as well as looking at the total dollar amount charged rather than just their copay amounts.  Patients have long been uncaring about a $500 new patient office visit when they only have to pay $15.  If they had to pay the $500, they would have been asking a lot more questions on the cost of the service as well as the number of services needed.

Personally, after paying into the system and being insured most of my life, I have found myself in a profession and city where jobs are being outsourced to other countries and unemployment abounds.  Working temp jobs here and there, without insurance benefits or a salary high enough to afford insurance in these times of ever increasing inflation, leaves me hoping and praying nothing major or catastrophic happens.  As I suffered yesterday through the worst migraine I've had in 5 years, and cycles of vomiting that briefly relieved the pain and then began building to the next vomiting episode, I so longed for insurance and the ability to get a shot to put an end to the viscious cycles I was plagued with.

While the USA may have plans and be touted as a pretty good healthcare system, albeit with some problems .. I ask if you would feel the same if circumstances changed whereby you did not have insurance, could not qualify for it (as my sister and her husband) or could not afford it?  In my BIL's case, he had insurance through his employer, a small company, and the insurance rates were raised out of the limits of reality.  The employer offered to purchase individual family policies, but with a previous heart attack, he received a rider for all heart conditions, blood pressure, vascular system, stroke, etc and his policy would cost $450.  My sister, who has macular degeneration, controlled hypertension, a childhood heart murmur and had bronchial treatments when ill, is uninsurable.  My sister now says "We can not afford to LIVE here, we can afford to DIE here."  She is looking at options of moving to Canada or to a state that is addressing this situation.  

It can happen to anyone.

IMHO .. I would welcome national healthcare .. where my friend in London can go seek care when he is sick, obtain the medications necessary to get well .. rather than falling through the cracks.  That is how I measure success ..

Most respectfully submitted .. do know it is all from our own vantage point.  

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by RockRose, Jan 18, 2009
I think the coolest thing that's happening in health care is ProMed centers,  and now Walmart is offering clinics in some of their flagship stores.

Imagine.  How convenient!!  How inexpensive.  

If ProMed can test your urine for a bladder infection,  run the lab tests and give you an Rx for $79,  that's the wave of the future.  No waiting in forever lines,  no paying a huge copay and your insurance paying even more.  

There's a kiosk in our mall that does professional teeth whitening for $100.  Same exact thing dentists charge $500 for,  and you don't have to make an appointment and take off work.  You just go to the mall,  takes 20 minutes.  

THAT is the wave of health care for the future,  in my opinion.  I even see that malls and walmarts may have sonogram machines for people who are curious about the gender of their babies,  and OBs will be used for health concerns.  If we make people pay for optional health care things they just want and don't need,  then private businesses will battle for that business and health care won't be the mess that it is.

Avatar universal
by VaBreeze, Jan 18, 2009
"Seniors at 65 don't "get" Medicare; they are forced into taking Medicare.  Even you are still working at 65 and have great insurance, your policy is canceled because the government says that's the way it has to be. "

I am not 65, but disabled and Medicare did not require me to cancel my policy.  I have both coverages and did not have to get PartB because I already have it under my current policy.  

What stinks about the US govts. way is making someone wait 2 yrs. to have necessary surgery while on their programs.  Those who aren't lucky enough to have other insurance don't have a choice...unless they are dying.

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by ILADVOCATE, Jan 18, 2009
  I am constantly getting denials for coverage for medications for life threatening dystonic and dysphagic spasms under Medicare Part D. I have contested them and won but many people wouldn't know how to but I have knowledge of benefits appeals and I explain to my provider how to document my eligibility, which is never a financial issue, but because they won't cover an "off label" prescriptions. But within my arenas for example mood stabilizers, many medications are approved for one use and used by physicians for many other purposes. Zofran which I had to appeal coverage for is used primarily for nausea from chemotherapy. But for me it controls life threatening respiratory spasms from advanced tardive dyskinesia and is a good adjunct anti-psychotic agent for schizophrenia. Both of those have been clinically confirmed in multiple studies. The glycine which is an antipsychotic in Phase II FDA study is not covered because its a "supplement" but Medicaid which I recieve through the Medicaid Buy In for Working People with Disabilities (a program more people should know about) will cover other supplements. But its a confirmed antipsychotic for me and as I've posted it will be documented clinically. And 50 studies bear it out. I couldn't tolerate Clozaril and as a person with advanced tardive dyskinesia I have no other choices. Everything is working. And its all neccessary. And all standard medications were tried first. So why shouldn't it be covered?
    But I should in any way complain. Medicare and Medicaid together provide comprehensive health care coverage. I am used to the denials and getting cut off repeatedly due to inexplicable reasons and have contested them and won. But many people accept these denials. Most other health care insurance, if people have it, may not cover many options at any level of appeal. Everyone should recieve the most up to date treatment but if a medication is not on a "formulary" a person may be out of luck. And if people have no health care insurance they can go without treatment. And the results can be devastating. And though a form of national mental health parity was passed it won't go into effect until January 2010. Insurance agencies can have seperate co-payments for mental and physical health care until then. Clearly we need some form of national health care insurance. I know president elect Obama has stated he will enact one. But the question is will he live up to his promise? And how comprehensive will it be? We should all be asking that and writing our legislators as well.

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by peggy64, Jan 18, 2009
I think what ranaesheart said is very valid. How can the drs office charge 450.00 to the insurance company, then write off most of it. I have checked out my statements and the bill might be 150.00. I pay my 30.00 co-pay, BC pays 60.00, drs office writes off the rest.

Why not just charge up 90.00 to start with?  More accountability should be had from the dr office. It irritates me also, when you go to the dr, they say, I don't know, send you home, still in misery, but they still made their money.

Could I go to McDonalds, order a Big Mac, they tell me, we are out, that will be 5.00? I don't think so. Why do drs get to do this?

Avatar universal
by LeftCoastChick, Jan 18, 2009
I'm very lucky in Canada, health care is provided by each province. The most I've paid in monthly insurance is 58/mo  - I have an employer who now pays 1/2 of that. I can't imagine having to pay for a doctor's visit or tests. In my province we even have Pharmacare,  what you pay for most prescriptions depends on how much you make, but you still have some coverage. I'm on long term disability until I get ok'd to go back to work, I pay on average $5CDN for a prescription, I have one drug not covered, but waiting for approval, that one I've been paying 100/mo. If I didn't have coverage at all, I would be paying 400+ a month just in meds. Psychiatric drugs for low income are fully covered.
There may be longer wait lists for elective surgeries, but compared to my american counterparts who pay thousands, I don't mind waiting.:)

Avatar universal
by PlateletGal, Jan 18, 2009
"How can the drs office charge 450.00 to the insurance company, then write off most of it. I have checked out my statements and the bill might be 150.00. I pay my 30.00 co-pay, BC pays 60.00, drs office writes off the rest."


Do you know why the physicians are doing this ? They had no choice. If they didn't raise their prices, then the insurance companies wouldn't give them squat.

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by monkeyc, Jan 18, 2009
As someone living in a country where access to medical treatment is available for all and would be dead at least 5 times over now if it was not for the public system the misconception presented up the page about waiting lists and the like is astounding to me.  Its disingenous at best to use waiting lists as a comparisons to the US system because Australia where I am has a safety net and people are treated in order of need - the option exists to pay for Private Health insurance and indeed there are tax incentives for those earning over a certain income to do so which provides private hospital treatment and more immediate access for non life threatening surgery but the reality is the medical system is there for all and no bill is presented nor means testing done when you go to the hospital - I had a resection last year that would have cost me over $150'000 in the US due to complications and costme$30 for scripts after I left hospital and thats it.

The system is not perfect, waiting lists exist and horror stories always appear as in any system but no patient has ever been turned away from an emergency room because they had no money or died because life threatening conditions were not covered by their HMO

And don't even get me started on how much you all pay for medication - thats truly terrifying to those of us living in a subsidised world.

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by ott70, Jan 18, 2009
My personal experiences or observations from this last year from multiple doctor visits:

- I asked for some blood tests to check some uncommon pathogens (mycoplasmas, bacteria, etc). The submitted charges on the bill was $1629. The eligible charges per insurance was $87. That right there is a defining WTF moment for my experience with medical charges and insurance, and how I pity anyone who does not have healthcare. That discrepancy in charges screams "broken wheel" to me.

- The drug companies really control our doctors. If you have a regular doctor who hesitates from whipping out his prescription pad, then that doctor is a diamond in the rough.

- I spent hours in an ER down in Arizona while on vacation. Most horrible experience I've ever had at a clinic / hospital. It reminded me of an ER episode. On the flipside, I have had an ER visit in Colorado and was seen to relatively quick.

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by hbananas, Jan 18, 2009
At age 65 the government doesn't force people into Medicare--their employers do.  The employer buys into a group plan that has language requiring employees to get Medicare as their primary insurance and the employer's plan being secondary.  If that language wasn't present, the group plan would be more expensive, and the employer and employees would not want to pay for it.  Just another of the many factors that go into the equation.

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by Jaybay, Jan 18, 2009
Of course the employers and insurance companies only carry a person to age 65.  Why would they keep providing a benefit that the federal government already presents?  That's what I mean about being forced onto medicare.  At 65, you have no choice unless you can afford a private policy.  If you have that kind of money, you don't worry about co-pays.  As the member above noted, he is on disability but not yet 65.  When he turns 65, his policy is gone and it's Hello Medicare.  The carrier will offer medi-gap coverage, but it won't be the same policy he's used to.

All the above posts illustrate to me how dependent we've become on someone else paying our medical bills, whether it be the government (our working neighbors and family members) or an insurance company.  Much as we may not like to hear it, medical providers, pharmaceutical companies, medical supply providers, etc., are not philanthropic entities.  They are businesses as are insurance companies.  We budget for houses, cars, groceries and every luxury, but most people budget nothing for health care because someone else is paying the bill.  

I'll say it again: as long as someone other than the consumer is involved in a transaction, it's a free-for-all of higher and higher prices and lower and lower coverage.  The consumer and provider spend all their time fighting the middle man for money, while he strives to keep it.  How is that good business?  Keep the transaction strictly between the doctor and patient for all but catastrophic events like surgery, and I'll bet my Obama stimulus check that doctor's prices will fall.

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by Savas, Jan 18, 2009
America may have some of the best doctors,  cutting edge research, top of the line medical equipment and wonderful medications.

but all of that is meaningless if Americans don't have access to them.

Which is the problem in America.

Lack of access for the majority.

We don't have access to these best doctors, top of the line medical equipment, cutting edge research and wonderful medications.

This issue is an embarrassment to our country, an indictment of our Government and the shame of our health care industry.

Avatar universal
by 3badcats, Jan 20, 2009
When did health care become such a greedy business?
Why aren't insurance and drug companies subject to some sort of national oversight?
People used to want to become doctors or dentists to help it is all about money.
I do dental billing and there is an insurance company called delta dental. Every year, our office has to submit a proposed billing schedule, because the world would end if everyone paid the same amount for the same procedure.
Many health care professionals treat those people who are on medicaid way differently that the lucky few who carry BCBS. Most dentists in my area of the country will not accept medicaid, nor will most psychiatrists. They dont have to.
Medicaid will pay the provider 16.00 for an office visit vs BCBS 36-40.00.And if a doctor screws up your care while you are on medicaid no one listens.
How much money does one person or one company need?
How much is enough?

Avatar universal
by Eric_da_Fish, Jan 21, 2009
Having lived overseas for many years, I have to say I hate the US health care system. We may lead in research and cutting edge treatment... but most people don't need that. They need everyday health care for common ailments. This is too expensive because of the layers of insurance bureaucracy that add most the costs. Doctors are pushed to see too many patients, so service *****, *****, *****. Overseas, at a major hospital, I was able to be seen within a week of scheduling. At my doctor's office overseas, I was able to go in without an appointment and be seen within 20 minutes (by another doctor).  In the US, I regularly wait 45 minutes to an hour past my appointment time until I am led back to the patient room. There a nurse plays the little game of take my weight, temperature, and blood pressure, before I am made to wait another 20 minutes or so.

Insurance companies should be abolished and doctors forced to accept market rates for medical care. Insurance companies are for-profit entities that simply want your premiums to make money from other investments. They are NOT a social service to pool risk and make health care affordable!

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by PPhelps, Jan 21, 2009
3badcats-You are so right.  Its all about greed.
Question though. What if delta dental denied the new schedule? Is that the reason why doctors/dentist offices no longer accept certain insurances? If they don't agree to pay the amount, we just won't accept that insurance any longer. It seems everytime I go to the doctors office anymore the list of insurance carriers they won't accept any longer get bigger and bigger.

Jaybay- I'm guilty of it, but only to shut my husband up. Sometimes I can just tell him he is being a little paranoid, and he'll wait it out. It drives me nuts. I hate going to the doctor. I have to schedule around my boss on when to go, and have to take time off work. My boss doesn't mind, and don't dock my pay or anything, so I guess that's why I feel so guilty when I have to do it.

My main b*i*tc*h regarding insurance is that some insurances require referrals to see specialists. You should be able to see any doctor you so choose. The problem is most doctors see only horses when a zebras right in front of them. They don't try to figure out the problem. They just slam a label of IBS on you, tell you to fiber up, and out you go. If people could go to the doctor they need to go to, it could save lives. I couldn't tell you how many women have been DX with ovarian cancer, that had been told for months and sometimes years they had IBS. I was told my contipation was IBS. Turns out I have Hashimoto's. I'm lucky that my insurance doesn't require a referral from my primary doctor. I was just able to go see a endcrinologist.

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by NTB, Jan 23, 2009
further on in that video series, Daschle is explaining that the way to solve the problem of the working poor who don't have insurance... is to force them to buy insurance. Brilliant! Another ivory tower rich guy who probably has no idea of the cost of things. Maybe he should ask his chauffeur or his butler about how far $200/month govt subsidy will go in buying health insurance... or even ask them how much a loaf of bread or a pound of ground round costs at the supermarket.

Though somebody might have to explain the word "supermarket" to him and the entire Washington DC bunch because the only word they know is "restaurant". Oh, and they know the phrase, "the lobbyist is picking up the tab".

Avatar universal
by PlateletGal, Jan 23, 2009

Wow ! China is now working to establish universal healthcare for their people.

BEIJING — China announced Wednesday that it intended to spend $123 billion by 2011 to establish universal health care for the country’s 1.3 billion people.

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by StratRebel, Jan 25, 2009
"Question though. What if delta dental denied the new schedule? Is that the reason why doctors/dentist offices no longer accept certain insurances? If they don't agree to pay the amount, we just won't accept that insurance any longer. It seems everytime I go to the doctors office anymore the list of insurance carriers they won't accept any longer get bigger and bigger. "

Typically yes, insurance companies make things so difficult to file that most dentists have been smart enough to stay away from them.  Unfortuantly, doctors made a huge mistake 30 years ago and now are stuck with insurance only.

I am in the dental field, so I can only give you our perspective.  Most dentists run a small 1-2 dentist office with 3-5 staff.  If you pay cash, the average overhead (cost of just having you in the office) is around 65%, with a loss of 5% to collections (only at a dental office can you get service and not pay immediately, try pulling that at a gas station).  You then must remember that dentist probably took out a huge loan to build the practice (10%), and then student loans for 8 years of school(10%).  Add all that up and you only get 10% profit (take a guess at the profit rating of food, or retail sales...>30%?).

Now, bring in the insurance company who will usually require a 15-20% reduction in fees to be part of them and you see the problem insurance causes for offices.  In order to make a profit with insurance, a dentist must either spend less time with each patient (lower quality of care) or use cheaper materials...neither of which is a win for anyone except the insurance company.  This is why a lot of offices offer discounts for paying cash or credit instead of with insurance.

Medical vs dental insurance:
Medical has deductables to give incentives for people to stay healthy and save money, dental does not.
Dental has the same yearly cap it had 20 years ago (~1500-2000).
Many dental insurances do not cover dental prevention (sealants, varnish, and ultrasonic toothbrushes) because on average, most patients only stay with a certain insurance company for 1-2 years.  Dentistry is an almost completely preventable field, yet patients are lead away from prevention when their insurance does not cover it.

Next time you see the prices of dental care, complain about the insurance, not the dentist ;)  Insurance completely took over the medical field, for the moment dentists are fighting to keep insurance out of the dental field for many reasons.

Avatar universal
by PoohJoon, Jan 28, 2009
In response to JayBay: "For children, how many parents ever adopt a wait-and-see attitude for every fever that comes along?"

I personally believe that parents shouldn't take risks with their children, and I believe that the medical community should not attempt to influence parents to be less concerned over "seemingly" common ailments.  There are serious diseases out there that can be mistaken for something like a common cold and that's too big of a risk to take with your child.  But that is just my opinion.

On a side note, more pressure should be put on the education system to make mandatory schooling on preventative measures, and things like the importance of diet - teach people how to be healthy individuals instead of trying to band-aid problems.  Then there wouldn't be so many people with so many little problems that are such a drain on the health care system.  The education system is outdated and largely irrelevant (I'm not referring to post-secondary).
Everything in a society directly affects other aspects of a society and there seems to be a huge lack of synchronicity.
And just because we won't see a result to a change immediately does not mean the change should not be made: nothing to lose if we do, but loss to gain if we don't.

My 5 cents

Avatar universal
by medical_sociology74, Aug 11, 2011
In response to JayBay,

Your point on emergency rooms being overloaded with non-emergency cases was well taken. Most of the comments in this discussion are hitting on what sociologists call, "using the sociological imagination". Every comment represents another direction that affects medical care. Kudos to everyone for understanding that health care is multi-faceted, and every aspect of living life is affected by social forces, creating social problems that are too complicated to be solved with just one solution, one perspective, and one opinion. They have to be attacked from as many directions as possible.

In the town where I was born, there is a medical center that used to rank very high amoung national evaluation systems for excellent emergency care. WIthin this community today, this emergency room is often the only connection to any healthcare. 24 hours after my my uncle arrived at the ER vomiting, he was dead.  [no prior health problems]  Surgery could have saved his life, but instead, it ended his life. I have wondered if this particular ER had physicians/nurses/staff/radiologists less capable of diagnosing serious emergency situations because of the effect of fewer emergency situations upon the hiring decisions/budget decisions of the human resources department. It is similar to librarians. The better we 'think' we know our user group, the better we think we are adapting our services and collections to serve them.   I think my uncle was within a user-group that was no longer the norm of this facility. Embracing systems thinking would lead to this framework of thought: it wasn't their fault. They were making decisions and judgements within frameworks most famalair.  It was like living in a horror movie; if I could ever channel it into something that could help someone else one day, I would be happy to do so.

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