ITA it is scary as all hell.

crystal wrote:

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this is hard.  after seeing the medical system here, i have a different view point than i had before.  here, it costs me 25 euro to see the doctor.  the government sets the price.  so, no matter which doctor i see (specialists have different prices) it will be 25 euro before insurance.  the doctors here do not make much.  but, there are still doctors and they get over it.  maybe the doctors in the US make way too much as it is?  who knows, maybe they deserve it?  they don't seem better to me than the doctors here though, at least not what i have encountered this far.  there is no shortage of doctors here either, even though they aren't as highly paid.

now, i'm not sure if setting the price would be right for the US, i'm just saying that maybe the health care industry makes way too much money on sick people.  i sometimes wonder if it would be better to again use insurance as something to help in an "emergency".  so, don't cover well visits or even if you are sick, but if you break a leg you are covered.  that way, we go back to caring how much each doctor is charging and create some competition between the doctors.

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one thing you need to keep in mind is that doctors are making a little bit more than what you pay them directly at the visit - the price they are quoting to you is what the patient pays, and if your system works like mine you can even get most if not all of that reimbursed.  but the doctors also get a supplement from the govt healthcare system.

doctors don't totally rake in the dough, like say a beverly hills plastic surgeon - but i would bet at this moment, considering total compensation net of all the costs (like US malpractice insurance etc.) a European doctor probably makes more than an American doctor.  they probably have a nice house and can afford a nice car etc.

(our base visit price in Lux is about EUR 30.)

muffy wrote:

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crystal wrote:

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this is hard.  after seeing the medical system here, i have a different view point than i had before.  here, it costs me 25 euro to see the doctor.  the government sets the price.  so, no matter which doctor i see (specialists have different prices) it will be 25 euro before insurance.  the doctors here do not make much.  but, there are still doctors and they get over it.  maybe the doctors in the US make way too much as it is?  who knows, maybe they deserve it?  they don't seem better to me than the doctors here though, at least not what i have encountered this far.  there is no shortage of doctors here either, even though they aren't as highly paid.

now, i'm not sure if setting the price would be right for the US, i'm just saying that maybe the health care industry makes way too much money on sick people.  i sometimes wonder if it would be better to again use insurance as something to help in an "emergency".  so, don't cover well visits or even if you are sick, but if you break a leg you are covered.  that way, we go back to caring how much each doctor is charging and create some competition between the doctors.

---

one thing you need to keep in mind is that doctors are making a little bit more than what you pay them directly at the visit - the price they are quoting to you is what the patient pays, and if your system works like mine you can even get most if not all of that reimbursed.  but the doctors also get a supplement from the govt healthcare system.

doctors don't totally rake in the dough, like say a beverly hills plastic surgeon - but i would bet at this moment, considering total compensation net of all the costs (like US malpractice insurance etc.) a European doctor probably makes more than an American doctor.  they probably have a nice house and can afford a nice car etc.

(our base visit price in Lux is about EUR 30.)

 

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This is all interesting to me. What is the big difference between Canada and Euorpe? Is there a long wait to time get into specialists in Europe?

 

CoffeeQueen wrote:

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muffy wrote:

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crystal wrote:

---

this is hard.  after seeing the medical system here, i have a different view point than i had before.  here, it costs me 25 euro to see the doctor.  the government sets the price.  so, no matter which doctor i see (specialists have different prices) it will be 25 euro before insurance.  the doctors here do not make much.  but, there are still doctors and they get over it.  maybe the doctors in the US make way too much as it is?  who knows, maybe they deserve it?  they don't seem better to me than the doctors here though, at least not what i have encountered this far.  there is no shortage of doctors here either, even though they aren't as highly paid.

now, i'm not sure if setting the price would be right for the US, i'm just saying that maybe the health care industry makes way too much money on sick people.  i sometimes wonder if it would be better to again use insurance as something to help in an "emergency".  so, don't cover well visits or even if you are sick, but if you break a leg you are covered.  that way, we go back to caring how much each doctor is charging and create some competition between the doctors.

---

one thing you need to keep in mind is that doctors are making a little bit more than what you pay them directly at the visit - the price they are quoting to you is what the patient pays, and if your system works like mine you can even get most if not all of that reimbursed.  but the doctors also get a supplement from the govt healthcare system.

doctors don't totally rake in the dough, like say a beverly hills plastic surgeon - but i would bet at this moment, considering total compensation net of all the costs (like US malpractice insurance etc.) a European doctor probably makes more than an American doctor.  they probably have a nice house and can afford a nice car etc.

(our base visit price in Lux is about EUR 30.)

 

---

This is all interesting to me. What is the big difference between Canada and Euorpe? Is there a long wait to time get into specialists in Europe?

 

 

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i don't know what the "typical" wait would be, but i've been to 2 specialists since i've been here.  one took about a week and a half to get in to and the other got me in in 2 days.

 

muffy wrote:

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CoffeeQueen wrote:

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I have no answers either. I really am worried what will happen here. It is broken here for sure. Will it be worse or better when it is all said and done?

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i am betting it will be worse - my personal opinion is that is because they are only addressing a small part of the problem, and IMO they need to hit ALL problem areas simultaneously to get an effective change - because they are all so interconnected... this means addressing Insurance issues, Drug Company issues (no other country in the world let drug companies rape their citizens the way we let them rape americans...), and IMO as importantly tort law to stop all those ridiculous law suits and tame malpractice insurance.

seriously - a guy recently won $2 million because his penile enhancing drugs gave him a hard-on for a few days. that is really fucked. (pardon my french...)

 

problem is they probably wont significantly touch insurance, drugs or tort law because 1. they are too powerful politically and 2. americans are still too against having "too many" laws, so they instead let these entities free reign to screw them in the name of "free enterprise".

 

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>>(no other country in the world let drug companies rape their citizens the way we let them rape americans...)<<

In Canada, I pay nothing to see a doctor. Nothing to see a specialist. Nothing but my private room charge to have a baby (and my insurance pays that).

If my kids are sick, I can get them in to see a doctor that day. For a well-check visit, I can also usually book for that day or soon after.

The stuff you hear about long waiting lists are generally for "non-essential" services. If I was sick with something terrible, I'd be seen right away. I may bump someone getting a knee replacement.

I do pay higher taxes in theory but when we were living in Massachusetts, my taxes were just as high but I didn't necessary see a return for it.

That said, there are still long waits for services for some things. There is ER overcrowding. There are long waits often for long term beds. Rural doctor shortages. etc

Our doctors are paid by the gov't but I'd still count them among the higher paid members of society.

It isn't a perfect system. There are lots of improvements that could be made. But I do feel very comfortable that if my kids or myself got sick, we'd have the coverage we need, with the doctors we need and we wouldn't lose our house or our lifestyle.

I've said it a gazillion times on this board alone about what else needs to happen in this country, besides reforming the insurance companies, drug companies, etc..  Until they reform the abuse of the medicaid/welfare system, nothing's going to change.

Prime example.  A 30 year old patient came in the other day to pre-admit for surgery.  We have to ask all kinds of questions on the assessment form, past surgeries, current meds, home life, etc..

My friend Cathy is doing the assessment and she gets to the home life section and here's the conversation:

Girl:  Oh, I don't work, I'm on disablity (which means she's on medicaid)

Cathy:  Okay, what disability do you have (because the girl listed no health problems in that section of the assessment)

Girl:  I have asthma

Cathy:  Okay, what medicines are you taking (because again, she listed no medicines)

Girl:  I don't take medicine for it

CathY:  What about an albuterol inhaler (which is what's prescribed for ASTHMA attacks)

Girl:  Oh girl, I haven't used that thing in 5 years    

So could someone please explain to me why I'm paying for her hospital bill?????

Why is that system not keeping a check on that kind of stuff? 

CoffeeQueen wrote:

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mctex wrote:

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muffy wrote:

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CoffeeQueen wrote:

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I have no answers either. I really am worried what will happen here. It is broken here for sure. Will it be worse or better when it is all said and done?

---

i am betting it will be worse - my personal opinion is that is because they are only addressing a small part of the problem, and IMO they need to hit ALL problem areas simultaneously to get an effective change - because they are all so interconnected... this means addressing Insurance issues, Drug Company issues (no other country in the world let drug companies rape their citizens the way we let them rape americans...), and IMO as importantly tort law to stop all those ridiculous law suits and tame malpractice insurance.

seriously - a guy recently won $2 million because his penile enhancing drugs gave him a hard-on for a few days. that is really fucked. (pardon my french...)

 

problem is they probably wont significantly touch insurance, drugs or tort law because 1. they are too powerful politically and 2. americans are still too against having "too many" laws, so they instead let these entities free reign to screw them in the name of "free enterprise".

 

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>>(no other country in the world let drug companies rape their citizens the way we let them rape americans...)<<

What other country in the world comes up with the medical advances that we do? What's ridiculous is that we allow pharmaceutical companies to sell a drug here at an exorbitantly high price but to the rest of the world under a different brand name much more cheaply, because that's all their markets will bear.

Make those reforms, and kiss that cheap/good European healthcare goodbye! ;)

>>seriously - a guy recently won $2 million because his penile enhancing drugs gave him a hard-on for a few days. that is really fucked. (pardon my french...)<<

I had no idea I was already fluent in French. LOL! Because I totally agree with you here.

>>americans are still too against having "too many" laws, so they instead let these entities free reign to screw them in the name of "free enterprise".<<

You know, this thinking has thrown my entire politics upside down.

When I was young, I used to be more socialist/democratic in my political stance -- by far. There were a lot of world forces that I didn't understand, but it seemed as though they weren't fair to the little guy. As a fan of the little guy, I thought these world forces should change their ways.

And then I started to realize once I understood these world forces that they actually made sense... and I also realized that people who wanted to protect people from these world forces were in a sense saying that they weren't smart enough to take care of themselves. I took issue with that... because I am.

However, I've finally come to realize that not everyone is wired the same way as I am. Whether or not one agrees with it, there are solid economic reasons that these things happen the way they do. We (MS) are a perfect example. We have discussed them here, time and time again. And yet we seem to have the same conversation over and over.

I'm not making all of this shit up because it supports my politics (on the contrary, my politics flow from this shit). It's simple economics. There are arguments to be made, and larger and very important discussions to be had, within the context of economic theory... but we as a country are so far from that, the whole thing seems hopeless.

And because people refuse to educate themselves about these basic economic forces that drive the world in which we live, I draw the ultimate conclusion that not everyone wants to control their own destiny. And I'm ultimately accepting that. (As the kinder, gentler Tex. ;) ).

It is true that everyone will be able to get life-saving care under a larger health plan, and I think that's imperative.

But I also realize the cure for cancer has probably just been pushed back farther than most people recognize.

It's sometimes a little hard to watch people shoot themselves in the foot.

 

 

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I am agreeing here, but one question. How does one control their own destiny with an issue this big? Maybe I am reading that incorrectly.

 

I worry we are shooting ourselves in the foot too, but do you think the current system is working? Do you think we should let it be because the road we are about to go down is much worse?

I understand the grand scheme of things. I will admit I do not know some of the political ties in regards to who is making money off of what. I know it is out there, but could not write it out for you.

 

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mctex wrote:

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This is *EXACTLY* what's going to happen. EXACTLY. 

The best doctors will not participate in all of this nonsense. As it stands, they already don't.

So they will operate on a cash-only basis, thus putting the final nail in the coffin that ensures that only the wealthiest Americans get the best health care.

And let's play out how that works next... so the government decides to restrict access to medicine to only those doctors who play in the system?

Hello, genesis of a world-class Caribbean health care industry! (Or, more realistically, India -- they already have the educational infrastructure in place.)

To the extent that other countries who have socialized medicine are using OUR technologies and OUR pharmaceuticals, it is not an apples-to-apples comparison. Those countries to not have the same R&D costs that we do -- it's a hell of a lot cheaper to build a house when you're borrowing someone else's stuff, no?

Let's think for a second about how technologies are actually developed.

First, some crazy researcher comes up with an idea that he thinks will work.

It's just on paper. And it's going to take millions of dollars to get the idea to a point to where it can even be tested. AND it might -- will probably -- fail.

How likely are you to invest in this technology, unless the payoff would be substantial enough that if it works, you would make a ton of money?

Said differently... how likely are you to lay your dollar down on a number on a roulette table if the payoff were only 10 cents for every dollar you gambled, instead of 25 dollars (or whatever it is)?

THIS is why you need to see substantial return to investment for healthcare investors. Because for every dollar they are hitting big on, they're losing shitloads elsewhere.

Without the huge payoff, why bother taking on the risk? There are plenty of less risky investment opportunities.

As for the insurance companies, it's really scary to me how few people understand how insurance works.

http://www.ehow.com/how-does_4564303_insurance-companies-money.html

Whether or not the insurance companies are too profitable is an argument that holds some merit... although it would really suck to get to a hospital somewhere to learn that your insurance company is bankrupt.

But how it is that people think they are going to be able to pay their monthly premiums for coverage, and then somehow, the insurance companies are going to be able to magically payout 10x that much for services rendered -- without understanding the economics behind it -- is beyond me.

I *do* think that we need to see some sort of reform to make sure everyone has a most basic level of coverage, sure.

But the unintended consequences in all of this will be that only the wealthiest will get the cutting edge stuff.

I'd bet money on it. ;)

I will say that I still think this might be what's best for the US as a whole.

But we should probably also realize that we are handing over our dominance of health care to some other part of the world in doing so.

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I think the article is a little biased (he is a fox news contributor).  I would counter with this article and study.  btw, looking at the site, I came accross this quote by Martin Luther KIng, Jr.:
"Of all the forms of inequality, injustice in health care is the most shocking and inhumane"

(and this from a man who led the Civil Rights Movement?....you would think that he could say the inequality between blacks and whites.) 

when my mom was sick, the cancer doctors did not hesitate to treat her (even without insurance) which leads me to believe that the profit  motive is not the only motive at work in health care.  Maybe compassion? 

which imo, we need alot more of.  People should not lose everything because they get sick.....
There was a hearing on C-Span with testimony of people who have lost their livelihood due to a series of events stemming from health insurance or health-related issues. It's beyond depressing and hard to hear but tells an important message.

regarding a cure for cancer -  the story of Jonas salk makes the case that cures will come- and most likely through government sponsored research.   "He (Jonas Salk) further endeared himself to the public by refusing to patent the vaccine for his personal profit, as he wished to see it disseminated as quickly and as widely as possible and patenting would have hampered this. When asked who owned the patent, Salk replied: "There is no patent. Could you patent the sun?" 

If you look at it through purely economic motive - the pharma companies realize the fallacy of curing a disease that brings them so much money. 
according to this story, "Pharma and biotech companies are less interested in cures and more interested in medications that require a lifetime of administration, according to scientists..."
 
I just think that sharing knowledge is so important.  why would anyone want to limit that from happening?  (the claim made that other countries profit from "our" discoveries). and also, these "discoveries" do not happen in a vaccuum.  there is alot of cooperation among scientists.  for example, of the top pharmaceutical companies  half are not american based. 

and as far as your contention that we will hand our "dominance of health care to some other part of the world in doing so" I leave you with this. 

 

-- Edited by Lizzy on Friday 23rd of October 2009 12:23:48 PM