one payer health care

[CroatianSensation]

Never heard about sterility as a side effect...in my case some may say that's a good thing!  ;D
There's a myriad of other side effects especially when they put me on steriods.
(My family and friends run for the hills when that happens.)
If you don't mind me asking, what meds do they have him on?
Yes stress is one of the factors that can bring on an attack. I left my last full time gig
due to this in hopes it would help.  I haven't had a major meltdown in some time now
which is nice but there's still that 800 lb. gorilla in the room offering me some
saltines and easy cheese.
Wish I could show him the door permanently.

 

[sodderboy]

I was wondering if any doctors recommended non-western alternatives to your Crohn's treatment?  It seems that the chemical and butcher wings of medicine have the treatment monopoly in the states.  Just a empathetic suggestion.  I have a friend, a butcher (?!?) similarly suffering and he is having some hope with alternative treatments.  Or have you petitioned the pharma directly for your meds?

Scott, there are plenty of alternative solutions that merely require removing kilo-pages of legislation from the federal and state registers.  Croatian-sensation is getting reamed with his state's taxpayer funded SCHP.  Look at CA and NY.  They are going broke trying to provide "socialized" medical care for the poor and elderly, and the feds want to increase the enrollments in these programs!  Retirees I asked are paying between $400 and $700 per month for Medicare supplemental insurance.  Not having that relegates seniors to a more "clinic" experience.

I watched Obama's freevee show the other day; the most I have ever watched him.  What a lying sack!  Even he has not read any of the legislation.  He is the typical liberal discussing helpless patients ignorant of the fact that they are given the same test multiple times, or that there are no alternative doctors/ treatments/ opinions.

Things are broken, and his solution is more government intervention rather than less.  wrong direction  Like all liberal programs, the intentions are all that are scrutinized and the results ignored and liabilities pushed into the future- Medicare/aid and Social Security especially.  Another bomb is the "tobacco settlement"- such a trial lawyer- legislator orgy in the name of health, that today is only state debt liabilities and a few cute freevee commercials.

I HATE United Healthcare.  I would prefer my old "Mutual of Omaha" policy.


I find it ironic that so many intelligent, talented DIY'ers believe that their and their families' health is better served by "managed care" by either government or corporate bureaucrats.  Our parents and ancestors- how did they ever survive without a huge government to care for their health?!?

Mike

 

[JohnRoberts]

I have changed my eating habits endlessly.
I exercise everyday.
The only thing that quells it IS a drug that costs money that I don't have unless I have insurance.
John, I bet the last round of drugs you bought cost less than $9000.00 for an 8 week dose....
that was the initial cost of my medication without insurance.
Blue Cross used to send out EOB's (estimate of billing or some sh*t) that showed you
what some poor schmuck without insurance would be billed for the same treatment or
what I could be billed if I somehow lost my insurance.
I am not fat.
I watch what I eat.
Maybe I should give up eating?
As I said the insurance and drug companies are just as bad as the politicians.
Phonies and thieves. DRUG ADS SHOULD BE BANNED.
Most folks don't give a sh*t about or care to know about these things until they
happen to them personally. 
So yeah. That's my story and I'm sticking to it.

I would be one of those schmucks without health insurance.

Crohn's points out another aspect of modern medicine. That is one of the long list of things they don't understand about the human body.

$9,000 medicine certainly makes the argument for pooling medical costs across the entire population, but I remain uncomfortable about what we will end up with.

If the choice is between a medicine that very few could afford as an individual, and depending on being judged worthy to receive subsidized medication by some government bureaucrat, it's easy to see how the latter sounds more attractive than the former.

My point is nationalized health care is not the panacea that everybody thinks it is. Other nations that have nationalized health care ration that healthcare often by delaying access to doctors, and putting patients in queue for expensive procedures. Our public health trends (25+% obesity) will lead to increasing demand on any public system.

I am in favor of a safety net for catastrophic health needs, and reforming the current health insurance system, but the "public option" is a trojan horse for wiping out the private healthcare system as we know it. This grand experiment, without a really shining model to follow is IMO irresponsible.  For my new Italian friend, it is perhaps instructive that former Prime Minister Silvio Berlusconi recently travelled to Cleveland, Ohio for heart surgery. Where will people go after the US gets "fixed" by the government?

As I have suggested before the rest of the world is subsidized by the high prices we pay for drugs here. I wonder what that Crohn's medication cost in Canada? This will surely end that free ride, which means drug costs will go up for the rest of the world, but perhaps much worse, many new drugs will just not be developed, with no promise of profit.  I believe drug companies have already made that adjustment and are working full speed on stuff like weight loss pills, but knowing how the drug companies think it will more likely be medicine that patient will need to take forever so they can be healthy while fat.

Medicare is a good example of what this could end up like and that is under funded already.

I don't suggest the current system is OK, I have major criticisms and am already outside that system. I argue that the proposed government takeover will damage what little is good about the current system. 

I realize I am guilty of what I accuse others. I am making assumptions about the unknowable motives and intent of our political representatives but these 1,000 page bills are written by lobbyists and power brokers, not true representatives of we the people. Certainly not representing my thoughts.

JR

PS: OK here's another idea... Before any congressman can vote on a bill they must pass a written test about what is actually in that bill.  This test should contain say ten or twenty questions generated by advocates and opposition covering what they think are the important points.  The congressman can't vote on any bill until he can prove he knows what is actually in that bill.

PPS: Re: Crohn's I recall a friend years ago who had Crohn's, very unpleasant. Certainly do your own research and don't depend on the medical community for much. This has been around a while and they haven't made much progress. Diet doesn't seem to be the cause but certainly could be an irritant. Exercise shouldn't have a direct effect, but indirectly helps manage stress.  I suspect your life is one long experiment to find what works... Is there an internet group of other people with Crohn's who can share personal results? That might be useful. Good luck. 

 

[iomegaman]

As far as what meds my brother is on for his Crohns...

My bro is on Aminosalicylates, Folic Acid, takes fish oil, and calcium, and a remicade infusion, which is the expensive treatment about 3 grand a bag once every two months...he was officially diagnosed in 2006 while he was on active duty, so for him the gov't picks up the tab...

He said the Aminosalicylates actually help put it into remission and he swears by the fish oil and folic acid...

He is trying to get off the remicade infusion because its such a pain but it is a process...

 

[CroatianSensation]

Yeah the Remicade....when it first came out...was $9000+ a bag...it's dropped since but it's, in my
opinion insanely expensive.
The sh*t does work and is easier to deal with than being on steroids but it's also starting to
wear off quicker.
I turn into a crazy person on steroids. (well, at least crazier than I am normally.  )
The folic acid is to counter act the other drugs which sap the folic out of your system.
I too take a multi vitamin, fish oil and have started taking Turmeric as I've read it's a
natural anti-inflammatory.
I agree with John on the point that at least with my disease they seem to treat the symptoms instead of
curing the disease.
The crap I've had happen to me is seriously messed up...all of which I'm told are a part of
Crohn's.  Most think it's just a intestinal problem but it can manifest itself in many ways.
Sores, rheumatoid arthritis symptoms, fistulas (I won't go into details..but they hurt like a bastard..especially where I've had em.) and some other bogusness.
I try joking about many of the situations I've found myself in as making light of it takes some of the
edge off.
Like the time I went into surgery for some fistulas only to find the insurance company had set me
up at a teaching hospital!
There I am staring at the floor, ass in the air with a room full of students all watching the doc operate on my backside.
I had been given an epidural so I was wide awake.....at this point I asked the anesthesiologist to give me something to "lighten" my mood which thankfully he did.
I spent the rest of the procedure cracking jokes. 
"If you want a peek leave a quarter at the  backdoor..."

 

[Scodiddly]

Things are broken, and his solution is more government intervention rather than less.  wrong direction   

See, I don't follow.  We've tried the "less regulations" thing for the last 8 years, and things are even worse now.  And those regulations don't appear out of nowhere, they come about to solve existing problems. 

Our parents and ancestors- how did they ever survive without a huge government to care for their health?!?

Our parents and ancestors lived shorter lives with more chronic problems as they aged.  Broke your hip?  You'd probably end up spending the rest of your life in bed - good news is you'd probably die from the flu or some similar disease before too much longer.  We have much longer and better lives on average, the only downside is we have to keep working longer and longer.

 

[sodderboy]

The federal register increased by tens of THOUSANDS of pages over the last 8 years!  How can you say that there was less regulation, especially in "healthcare".  That stupid Medicare drug gimmie was the least of it.  Bush got some more HSA legislation in that turd of a bill, but it was largely hobbled in the states, especially those like NY.
My wife's grandmother spent the last 10 years of her life in bed with a broken hip in the gold standard for "healthcare for all"- the Soviet Union.  If you were in the Party, they would send you to Europe for hip surgery.  Similar to today, where politicians and the rich come to the US from around the world for the best in medical care.  They don't go to the liberal darlings Cuba, Canada, or the UK when their heart needs to be stopped for some time for repair!

Think about the innovations that have come from the evil "market based" model versus those that were state funded- heart surgery, transplants, vaccines, prosthetics, radiology, recovery, rehabilitation, etc.  Human genome?  And not because middy-phiddys (MD/PHD) are money hungry.  They want solutions to impossible problems.  Their research is funded by businessmen who are willing to take a walk on the risk-reward continuum.

Managed care companies?  They have the best congressmen that money can buy, especially in the big liberal states.

Yes, it's broken, but the answer is not to have politicians slap more baling wire and gorilla tape on it.  I think that the philandering evil Newt Gingrich calls it a "300 million payer" system.  Time for people to buy their own HSA or healthcare policy, surgery, wart removal, whatever, THEMSELVES.  Not the guv and not their employer.  That's what I find ironic about this discussion on a DIY site!
Mike
Mike

 

[JohnRoberts]

DIY....    +1

JR

 

[JohnRoberts]

Things are broken, and his solution is more government intervention rather than less.  wrong direction   

See, I don't follow.  We've tried the "less regulations" thing for the last 8 years, and things are even worse now.   And those regulations don't appear out of nowhere, they come about to solve existing problems. 

There is a concept in the military that we are always training and outfitting the army for the last war not the next one...  The Sarbanes-Oxely over regulation of business was in reaction to frauds (Worldcom, Enron, Tyco...) That were already illegal, or those folks wouldn't be in jail right now. You can't make behaviors illegal after the fact.

Fast forward to Bernie Madhoff.. Arguably the largest investment fraud in history. Where was the SEC? What he was doing was already illegal. Even worse whistle blowers handed that fraud to the SEC on a plate years ago, and they just ignored it.

There is a limited place for government regulation to insure public safety and in finance to insure equal access to information. The credit meltdown was caused by derivatives that didn't neatly fit into existing brokerage clearing systems, so distortions occurred between perceived value and actual value.

During all of this congress, the folks you are depending on to micro-regulate our economy, were throwing fuel on the fire, using this too easy source of credit to pump up Fannie and Freddie for political ends. 

Our system needs a few tweaks and some accountability for folks who didn't do their job... but I'm not sure how much accountability to expect from our Treasury Secretary didn't even file his own taxes properly.

I watch entirely too many congressional hearing on TV, and these guys are not our saviors, we need to help ourselves (and throw out the bums).  Adding regulations will never prevent fraud, it is only fighting the last war.

JR

PS: I am more than willing to criticize the Bush administration for too much spending, and apparently sloppy enforcement by several regulators, but in his defense he tried to clamp down on Fannie and Freddie years before we had to take them over, but congress resisted and kept the music playing way too long.

 

[Scodiddly]

Think about the innovations that have come from the evil "market based" model versus those that were state funded- heart surgery, transplants, vaccines, prosthetics, radiology, recovery, rehabilitation, etc.  Human genome?  And not because middy-phiddys (MD/PHD) are money hungry.  They want solutions to impossible problems.  Their research is funded by businessmen who are willing to take a walk on the risk-reward continuum.

Hmm... you mean all that medical research came from private industry? You sure about that?  I could have sworn that most of that stuff came from medical research at those bastions of liberal craziness, aka colleges and universities.

The free market does do pretty well at making money.  It's not so good at improving life for the whole population.

 

[JohnRoberts]

Think about the innovations that have come from the evil "market based" model versus those that were state funded- heart surgery, transplants, vaccines, prosthetics, radiology, recovery, rehabilitation, etc.  Human genome?  And not because middy-phiddys (MD/PHD) are money hungry.  They want solutions to impossible problems.  Their research is funded by businessmen who are willing to take a walk on the risk-reward continuum.

Hmm... you mean all that medical research came from private industry? You sure about that?  I could have sworn that most of that stuff came from medical research at those bastions of liberal craziness, aka colleges and universities.

The free market does do pretty well at making money.  It's not so good at improving life for the whole population.

Come on who do you think pays for the lion's share of that research... (hint drug companies based on their expectations of profit). Federally funded research is often pilot research and a drop in the bucket.  Colleges don't fund pure research.

JR

 

[ENS Audio]

My Dr. hates dealing with these insurance companies so much that his office rather provide a big discount for paying out of pocket (which is actually cheaper than having to pay my deductable).  I am curious to know if anyone elses doctor/physician offers a discount for via "paying out of pocket".  Also let's say if this national health care plan passes, would it be just as difficult as it is right now to buy prescription drugs from Canada?  Or would it be easier??

 

[JohnRoberts]

I wish.. my experience is without insurance you end up paying the full inflated list prices, that insurance companies don't. I pay cash and get no complaints for sure.  I haven't tried negotiating a lower price for cash (I should have in hindsight).

I've read that some doctors have dropped medicare because it literally prohibits them from seeing elderly patients more than X times a month. I guess that means there is already rationing going on in that public sector healthcare.

In countries with socialized systems it's illegal for doctors to see patients outside the system. If the new system  doesn't outlaw the private healthcare system here, there may be a parallel system with gap insurance or whatever, to cover the shortcomings of nationalization. Not unlike the gap insurance to cover the donut hole in medicare.

i realize the proposals now are crafted to sound benign, like they are actually somehow increasing competition by having a government subsidized competitor (give me a break).  I am suspicious that the plan is to get us a little pregnant and let nature run it's course. I am not a believer in big government.

JR

 

[JohnRoberts]

Soylent green is on TV today... I think some combination of that and "Logans Run" would solve the excessive expense of prolonging life.

Ooops gotta go the light in my hand is glowing...

JR

 

[sodderboy]

Think about the innovations that have come from the evil "market based" model versus those that were state funded- heart surgery, transplants, vaccines, prosthetics, radiology, recovery, rehabilitation, etc.  Human genome?  And not because middy-phiddys (MD/PHD) are money hungry.  They want solutions to impossible problems.  Their research is funded by businessmen who are willing to take a walk on the risk-reward continuum.

Hmm... you mean all that medical research came from private industry? You sure about that?  I could have sworn that most of that stuff came from medical research at those bastions of liberal craziness, aka colleges and universities.

The free market does do pretty well at making money.  It's not so good at improving life for the whole population.

Scott, who funds the universities at large?  Not the government.  Look at the names on the buildings of most, and I am always saying MOST not all, research facilities- they are the names of evil capitalists who gave the scratch to have a building with their name on it.

My wife was one of three surgeries on a routine day for an innovative heart surgeon, but an anguishing day for three families.  One Saudi dude, my wife, and a grandma who only spoke spanish.  Anyone who has accompanied a loved one through surgery knows that you bond with the other families, even if it is only for one day. 
Each patient had their heart stopped and repaired.
We found the doc and paid for him out of pocket, around $13,000.  GHI picked-up the 100K plus hospital bill.
The Saudi dude paid out of pocket for the whole thing, including a "concierge hospital room" at an extra $3k per day.
The grandma paid nothing, and she had a social worker with her the whole time to translate and explain things.  Courtesy of the NYS/NYC taxpayer.

The surgeon took no insurance except Medicare/caid because he had to to be able to practice his non-invasive techniques.  I do not want further shackles placed on people like this.

And you say that the myriad of free-market innovations over the last 100 years have not improved life for the whole population?  Where you livin' brother?  Habana?  It has improved life for the entire globe.
Mike

 

[Scodiddly]

Scott, who funds the universities at large?  Not the government.  Look at the names on the buildings of most, and I am always saying MOST not all, research facilities- they are the names of evil capitalists who gave the scratch to have a building with their name on it.

Sheesh - do the math on that assertion.  Maybe there are some buildings that were at least partially paid for by single contributors.  Getting ones name on a building doesn't actually require paying for the whole thing.  Then there's property around the building, upkeep, not to mention paying salaries to those who work there.  The reason that the universities and colleges are so involved is that private industry is rarely ever funding the pure bottom line research that the actual products are built upon.  And if (as John is saying) the drug companies were the main money behind this research it wouldn't happen at the schools at all - it would happen in private facilities where there's no requirement for publishing of the research as there is at public institutions.

And you say that the myriad of free-market innovations over the last 100 years have not improved life for the whole population?  Where you livin' brother?  Habana?  It has improved life for the entire globe.

The free-market innovations have certainly improved things.  What I'm saying is that most of the innovations in medical care were not privately created, but were created by public institutions.

But we're getting rather far afield from the question of publicly funded and widely available health care.  To me it's a no-brainer.  We gave up on relying 100% on private fire companies and police decades/centuries ago.  And a significant majority of Americans support public health care now, which to me is the most important thing.  What is the government if it ignores the will of the people?

 

[JohnRoberts]

I don't agree with your view of public vs. private contributions to improvements in healthcare, and that matters but lets back away from that for the moment.

I think everybody agrees that healthcare is off the track (insurance-hospitals-etc), and needs reform, but where we disagree is how to proceed.

Everybody supports a safety net to help people with extraordinary situations when they can't help themselves, but not free band aids for illegal immigrants. Picking up your analogy for public vs. private police services. I favor public assistance when say a major hurricane, tornado, earthquake, whatever, destroys some community, but I don't want them to mow my yard.

So the disagreement comes down to what to do, not whether something needs to be done.

If we explore this from an "ideal world" outcome perspective. What would be good; universal coverage for all- citizens or not, unlimited SOTA (brand name) medicine,  unlimited access to specialists, free second or third opinions if desired, spare-no-cost life prolonging therapies during the inevitable end of life decline, and probably some stuff that hasn't been invented yet (stem cell, genome testing, artificial organs, etc). 

While we are (were) arguably the richest nation, I don't know that we can count on that not being diminished by the recent expansion of government and plans for more. EVERY other nation that has attempted to deliver on the promise of government provided "whatever it takes" healthcare, has fallen short in almost every key area, and they have the advantage of being able to piggy back on our disproportionate healthcare spending that subsidized new drug development. 

I don't dispute the argument that there is inefficiency in the current system, and more than a little collusion/gamesmanship between insurance companies, hospitals/care providers, and drug companies. What I can't believe is that the government is going to magically fix that. For a glimpse into publicly provided healthcare look at the veterans administration hospital system, and medicare/medicaid.

As I have said many times, look at their feet (what they do) not the head fakes (the words). There is a patterns of government encroachment into formerly private industry. Banking is now dominated and arguably controlled by government, and two of the big three car companies are under their thumb. So far they have failed with a carbon cap and trade bill that will give them considerable influence over our energy supply, and now they want to wrap their arms around healthcare.

I want reform but I worry about their version of reform. I am sure the utopian future that some may lust after is an impossible dream, and for us to get the best that we can do we need less government participation not more. A sign for me that deals are being made that are not in our interest is how the big drug companies and even the AMA are holding hands with the government. This may be out of business judgement that the democratic steam roller will succeed with these programs like it has with others, but it makes me nervous to see them singing from the choir.

I am hopeful we (the public) will wake up in time to take our country back before it is too late.  Finally to answer your question about the will of the people. We are not a simple democracy, precisely to avoid the tyranny of the masses... I predict the majority wants free beer too.  We need to protect the best healthcare system in the world, and make it better, not kill the golden goose by pursuing an impossible goal.

Life is hard and then we die...  Our constitution promises us liberty and pursuit of happiness, not happiness, and free beer.

My comments are full of personal opinion and speculation so I may be wrong, but we need to be realistic about the endpoints we expect, and unintended consequences of changes made.

JR

 

[ENS Audio]

I wish.. my experience is without insurance you end up paying the full inflated list prices, that insurance companies don't. I pay cash and get no complaints for sure.  I haven't tried negotiating a lower price for cash (I should have in hindsight).

I've read that some doctors have dropped medicare because it literally prohibits them from seeing elderly patients more than X times a month. I guess that means there is already rationing going on in that public sector healthcare.

In countries with socialized systems it's illegal for doctors to see patients outside the system. If the new system  doesn't outlaw the private healthcare system here, there may be a parallel system with gap insurance or whatever, to cover the shortcomings of nationalization. Not unlike the gap insurance to cover the donut hole in medicare.

i realize the proposals now are crafted to sound benign, like they are actually somehow increasing competition by having a government subsidized competitor (give me a break).  I am suspicious that the plan is to get us a little pregnant and let nature run it's course. I am not a believer in big government.

JR

Well with your description of how medicare works, it almost sounds like the insurance companies themselves and yes I've heard the stories of doctors dropping medicare and in addition to that because insurance company XYZ wont cover "Persons" scripts that the doctor wanted to fill and as a result Dr. Quack cannot do the job of being a doctor and yes in some cases a doctor can find an "alternative" script to write but usually doesnt yield the same results.

I cant say these insurance companies are totally messed up in the way they dictate policy, for one nobody should have to pay for other peoples chronic health expenses because he or she was being to damn irresponsible but let's be real here if we are going to play the game of "free market" enterprise there needs to be a referee as in ANY game or sport. 

Another issue seems not so obvious is the issue of a person being put on "life support", I ask anyone to answer these questions and that is...... for every person to whom gets put on life support how many of those people were covered under some sort of health insurance policy?? 

Also, when does a doctor actually decide to "pull the plug" on a patient?  After the doctor determines there is nothing else that we can do to improve the patients situation OR does a Dr. decide to "pull the plug" when the patient's insurance policy runs out of funds???  I am very cynical about this particular aspect of our modern day health care system for being that its all about how much$$$ can we get out of someone that most likely had no chance of surviving to begin with.

Just to prove my "non-bias"
;D yes I do agree with the idea of "tort reform" (specifically hospitals) no hospital should have to go bankrupt even if a doctor messed up in a surgical proceedure but as in the movie "Back to the Future partII"  "The justice system works swiftly in the future now that they've abolished all lawyers" - Doc

So theres no need for the opposition to even have a voice on this issue, because if we dont believe in "big gov" we are really denying the concept of this society as of being a "Representational Government"...hence "We the people...."

Then again if we are really a "Republic" then all previous statements are irrelevant and so I'll shut up now and wait to get ripped on how all of my observations are crap. ???

 

[Scodiddly]

Thanks for the more thoughtful reply, John.

I agree on more than a few points about the problems we're facing.  I don't agree that the best solution is always private industry, "magic hand of the marketplace", etc.  I think in this case we're seeing the natural outcome of the free market - those who invest to make money have the best results, in that they make money.  The customer is of secondary importance in the free market model, and in areas like health care I think that's absolutely not the direction we ought to be heading in.

As inefficient and misdirected as the government can at times be, there are times when the primary focus should not be making money, it should be providing the service in question.  Hence our (still mostly) government funded and controlled military.  And I don't see the current government "control" of automakers, banks, and other "too big to fail" institutions as the result of any particular plot to gain control, I see it as the outcome of the push to remove regulations in general.

I'll restate what I think is the most important thing - a majority of the citizens of this country have decided that they are fed up with how health care has ended up under the free market approach, and they'd like the government to step in.  I can't think of any better example of elitism, "nanny state-ism", etc. than to have a few naysayers claiming that the people don't know anything, that we're better off not getting the federal government involved, etc.

 

[JohnRoberts]

Let me leave you with one more thing to chew on.. The unfettered (undistorted) relationship between customer wants and needs and free market capitalism, to satisfy those needs, has driven all the medical advances we currently enjoy. Only with free market capitalism is the customer really in charge. In countries where the medical establishment is state controlled, progress has stopped, and patients get what the government bureaucrats feel like parsing out to them.

I am one of the many without health insurance and hungry for a change.  I don't doubt the wisdom of the people. They after all drive the free markets  (the wisdom of numbers, etc) that got us here. That said I am not hungry for the kind of wisdom we are getting from this congress and this administration. The administration tells congress get me a bill for this or that, and then he signs it... Congress votes on insane spending WITHOUT EVEN READING THE BILLS...  If they don't read it, who is writing it..?

This is friggin madness... I won't accept it quietly.

If you think I'm being elitist, so be it. I want change, just not that kind of change.

JR