White House appears ready to drop 'public option'

[MossadConspiracy]

Revert said

You either get insurance through your employer or you get Medicaid...if those options aren't available to you you have to pay, hence my statement. Also company insurance policies aren't free, in many case the employee does pay for their insurance whether it be through Union dues or some other kind of fee.


I agree about your opinion on the European Welfare state, but to be fair the US Welfare system is no better, it encourages the same things as the every where else.

There are more options than that. Some of which I mentioned already, some of which I didnt. For example, some states have insurance cooperatives like the ones that the republicans want Obama to support instead of a govt insurance company. Some states have low-cost insurance similar to what Obama had originally proposed. I am insured by Family Health Plus which is a NYS plan along those lines. Some states have pay-or-play (well, one state does). And of course for people who really do have a desperate need for healthcare because of conditions that will kill them without care, they become automatically qualified for different programs (such as medicare for ESRD patients of any age or Ryan White funds for HIV+ patients etc). Also, children and pregnant women have WIC, programs like child health plus, lower medicaid qualification, the different CHIP progs, etc, meaning that kids essentially have universal coverage in this country with the exception of illegal immigrant kids (though they mostly do qualify for coverage).

The point is, when you say that 40 or 50 million people in this country are not insured, that also means that 250 million people are insured. So to fall in love with crappy European healthcare systems that have a huge number of disadvantages (no incentives or support for innovation and research, no incentives for specialized training, no incentives to adopt new technology, crappy hospital conditions, long waiting periods, etc) is kind of like throwing out the baby with the bathwater. Why not make the US healthcare system better while preserving the things that make it the best

ws

sumiyia said

no i'm not. 60-70% of the poor do not qualify for medicaid because of the eligibility requirements. we got lucky. several others don't have the opportunity to get their employers to cover their health insurance. these people are caught right in between and don't get any healthcare at all. those that are paying more than they can afford get crappy healthcare. those who are loaded get private doctor visits at home and get whatever prescription drugs they want. not only is healthcare not available to all, but the quality of service falls well below the "reasonableness" you suggested. and the fact that i happened to get the best service in MY experience when i was on medicaid, doesn't mean that medicaid service is "excellent."

First of all, healthcare in the USA is never crappy because of the infrastructure that we have here. I've spent alot of time working at a public hospital where over 90% of the patients are medicaid recipients or uninsured (mostly illegal immigrants), and i've worked at a large referral hospital with a huge catchment area that brings in many people with good private insurance, and i've worked at a hospital on the upper east side that takes care of bernie madoff and all the other 10-million-year-old rich people who live there. While there are some differences between these hospitals, in terms of the basics of care they are all very high quality. In any of them, you can get an MRI or an endoscopy or even an invasive surgical procedure within a few hours at most, if its deemed that you need one. Thats what defines good care, not how nice the hospital looks or whether a doctor comes to your house or whatever. That level of care isnt available to anybody in Europe except those who are truly super-rich that can opt out of their country's NHS and pay out of pocket for everything. People in Europe are denied coverage for dialysis when they are too old, and are therefore left to die with a 100% certainty. In this way, a homeless drug addict with no insurance in brooklyn has better healthcare available to them than an upper middle class european in any country in Europe.

What the USA should do is make it possible for all Americans to have what the homeless illegal immigrants in NYC have, rather than what the Europeans have which is much worse

ws

[Kona_Silat]

The solution is don't give care to illegals. Let them die in the waiting room.

[Revert]

MossadConspiracy said

There are more options than that. Some of which I mentioned already, some of which I didnt. For example, some states have insurance cooperatives like the ones that the republicans want Obama to support instead of a govt insurance company. Some states have low-cost insurance similar to what Obama had originally proposed. I am insured by Family Health Plus which is a NYS plan along those lines. Some states have pay-or-play (well, one state does). And of course for people who really do have a desperate need for healthcare because of conditions that will kill them without care, they become automatically qualified for different programs (such as medicare for ESRD patients of any age or Ryan White funds for HIV+ patients etc). Also, children and pregnant women have WIC, programs like child health plus, lower medicaid qualification, the different CHIP progs, etc, meaning that kids essentially have universal coverage in this country with the exception of illegal immigrant kids (though they mostly do qualify for coverage).

I've looked into several options most fo them you've mentioned and in one way ro another i didn't qualify. SO that left me with zero insurance. Its the same for the other 40 or 50 million uninsured American residents.

MossadConspiracy said

The point is, when you say that 40 or 50 million people in this country are not insured, that also means that 250 million people are insured. So to fall in love with crappy European healthcare systems that have a huge number of disadvantages (no incentives or support for innovation and research, no incentives for specialized training, no incentives to adopt new technology, crappy hospital conditions, long waiting periods, etc) is kind of like throwing out the baby with the bathwater. Why not make the US healthcare system better while preserving the things that make it the best

ws

I agree that European systems wouldn't work in the US, people aren't mentally ready for that.

To suggest they are crappy though. I feel you're doing that based on your biases as a Medical Professional in the USA. I lived both systems and can say Nationalized healthcare works for people like me.

A system needs to be in place where the uninsured who fall into the grey areas are covered. This is what Obama should be aiming for. You have to understand that Nationalized Healthcare especially in the UK was put in place for specific reasons.

Neither system is perfect but to someone like me i know which i prefer.

Kona_Silat said

The solution is don't give care to illegals. Let them die in the waiting room.

If they die someone has to foot the bill of disposing of the body, usually the city. Typical Right Wing rhetoric.

[MossadConspiracy]

Revert said

I've looked into several options most fo them you've mentioned and in one way ro another i didn't qualify. SO that left me with zero insurance. Its the same for the other 40 or 50 million uninsured American residents.



I agree that European systems wouldn't work in the US, people aren't mentally ready for that.

To suggest they are crappy though. I feel you're doing that based on your biases as a Medical Professional in the USA. I lived both systems and can say Nationalized healthcare works for people like me.

A system needs to be in place where the uninsured who fall into the grey areas are covered. This is what Obama should be aiming for. You have to understand that Nationalized Healthcare especially in the UK was put in place for specific reasons.

Neither system is perfect but to someone like me i know which i prefer.



If they die someone has to foot the bill of disposing of the body, usually the city. Typical Right Wing rhetoric.

yeah but people like you are a minority. obviously a system where everybody is given health insurance for free by the government is something that would benefit people who dont have insurance but what about everybody else?

[Jaysh]

Kona_Silat said

The solution is don't give care to illegals. Let them die in the waiting room.

Typical heartless Republican jabber.

Excellent replies by MC. I agree with almost all of what he said.

Revert, won't the public option help you? (I haven't read the entire thread so I don't know if you already addressed this.)

You see, nationalized health care will kill medicine. It will have short term benefit but long term detriment, since America will cease to be the leader in medicine, and the world will go leaderless in medicine.

[Revert]

MossadConspiracy said

yeah but people like you are a minority. obviously a system where everybody is given health insurance for free by the government is something that would benefit people who dont have insurance but what about everybody else?

I agree we are a minority i think ( i might be wrong) that uninsured people only account for 10-15% of the total population. I don't know if Free health care would work for everyone as the US is a lot bigger than all these european countries so thats a lot of peopel to cover.

I'm offering my perspective based on living in both systems. I do think that reform is in order but not an overhaul. The system needs to work for everyone. And everyone needs to be covered. Medicaid needs to work for more than unemployed low earners, i'd even put into a fund from my paycheck to cover the 40 million uninsured people. Whatever it takes.

Jaysh said

Typical heartless Republican jabber.

Excellent replies by MC. I agree with almost all of what he said.

Revert, won't the public option help you? (I haven't read the entire thread so I don't know if you already addressed this.)

You see, nationalized health care will kill medicine. It will have short term benefit but long term detriment, since America will cease to be the leader in medicine, and the world will go leaderless in medicine.

Public health care would be ideal for me. When my insurance does kick in, its not going to be all that good. My co pays are really crappy and the coverage is really low. But its a Union plan so what do you expect?

[Jaysh]

Revert said

Public health care would be ideal for me. When my insurance does kick in, its not going to be all that good. My co pays are really crappy and the coverage is really low. But its a Union plan so what do you expect?

What do you mean by 'public health care'? The public option or nationalized health care?

[FMROMMEL]

Jaysh said

Typical heartless Republican jabber.

Excellent replies by MC. I agree with almost all of what he said.

Revert, won't the public option help you? (I haven't read the entire thread so I don't know if you already addressed this.)

You see, nationalized health care will kill medicine. It will have short term benefit but long term detriment, since America will cease to be the leader in medicine, and the world will go leaderless in medicine.

Yes, nationalized medicine in the US will be bad for the US and for the rest of the world.

A few points about US medical:

1) In most nationalized systems they start counting the infant mortality rate at 3 months old. The US counts its infant mortality rate a the time of birth. I am stating this because many statistics are biased twords nationalized healthcare.

2) I magine if you were in a car accident and had multiple trauma's. In the US,regardless of you being rich or poor, old or young, you will be given the best medical care the world has available (regardless of cost). You will be billed for it, you may go bankrupt but you have a better chance of survival. In many nationalized systems you may be treated with lesser standards of care...its free..........if you live.

3) Why is it that many Canadiens come to the US to get thier medical care...and pay for it to boot? They do this because Canada does not have the latest and greatest technology at thier disposal. Simple things like enough MRI machines....

[Jaysh]

FMROMMEL, are you a moronic Republican?

Even though I oppose nationalized medicine, some of the stuff you said is garbage:

FMROMMEL said

2) I magine if you were in a car accident and had multiple trauma's. In the US,regardless of you being rich or poor, old or young, you will be given the best medical care the world has available (regardless of cost). You will be billed for it, you may go bankrupt but you have a better chance of survival. In many nationalized systems you may be treated with lesser standards of care...its free..........if you live.

False.

3) Why is it that many Canadiens come to the US to get thier medical care...and pay for it to boot? They do this because Canada does not have the latest and greatest technology at thier disposal. Simple things like enough MRI machines....

False.

You do understand that Obama is not fighting for nationalized health care, right? You do know it's just the public option, right?

Stop watching Glen Beck. You're a Republican moron.

[sumi]

this is completely anecdotal, but i've talked to quite a few people who have lived under both systems (namely NHS and in the US), and all of them have preferred NHS hands down because they dont have to pay anything, wait times are nill, they get great service, etc etc.

does being employed in the medical field as a doctor influence some of your views on this issue, MC/jaysh?

[mekrob]

and all of them have preferred NHS hands down because they dont have to pay anything

Yes, the system is completely free. No one pays for it.

[Jaysh]

sumiyia said

does being employed in the medical field as a doctor influence some of your views on this issue, MC/jaysh?

Yes, but not because of financial reasons. Only due to admiration of the American system in place, such that they are the undisputed leaders in the world in this field. Also, I've interacted with classmates who have done rotations in Europe, and they can't believe how chill it is for both the residents and attendings. They just don't work as hard as Americans, nor do they work their residents as hard. The residency programs in America are unparalleled. They just churn out better doctors, period. Even the UK can't compare.

[sumi]

Jaysh said

Yes, but not because of financial reasons. Only due to admiration of the American system in place, such that they are the undisputed leaders in the world in this field. Also, I've interacted with classmates who have done rotations in Europe, and they can't believe how chill it is for both the residents and attendings. The residency programs in America are unparalleled. They just churn out better doctors, period. Even the UK can't compare.

so i guess it would be kind of like making legal services available to everyone for free?


edit: guess its not a new idea http://www.forbes.com/2009/07/31/hea...al-reform.html

edit2: the link above is satire. but others have seriously made this argument.

[Jaysh]

sumiyia said

so i guess it would be kind of like making legal services available to everyone for free?


edit: guess its not a new idea How About A Nationalized Legal System? - Forbes.com

edit2: the link above is satire. but others have seriously made this argument.

yes, it's like that. also, that's a genius article in the way it was delivered. however, it's actually NOT what obama's plan is anyways.

[MossadConspiracy]

sumiyia said

this is completely anecdotal, but i've talked to quite a few people who have lived under both systems (namely NHS and in the US), and all of them have preferred NHS hands down because they dont have to pay anything, wait times are nill, they get great service, etc etc.

does being employed in the medical field as a doctor influence some of your views on this issue, MC/jaysh?

if you follow the politics in Europe, the issue of healthcare is a component of every national political campaign in every European country and they usually bring up all kinds of failures and problems. So obviously there are problems there now.

In addition every country in Europe faces rising healthcare costs the same way we do. Utilization is going up, their populations are getting older, etc, and there is only so much they can wring out of their system by breaking doctors backs or making their hospitals as bare bones as possible. And taxes can only go so high, even in socialist countries, particularly since their populations of young productive workers (tax payers) are going down in most of these countries. Their healthcare systems are not sustainable. America's would be even less so if it converted to their way of doing things. These welfare states that they made are not going to be permanent, and most of them depended on US subsidization in various ways anyway

Thats why i dont support single payer. Also, the most important thing from the perspective of patient care is to cut costs and provide superior care.

As for your friends who lived in socialist countries, the question is really what kind of ppl are they? If they are healthy young adults then obviously going to a primary care doctor for free when you want is an easy and convenient system. But if they are patients with complicated chronic diseases or people who have ever needed complex or advanced medical care and experienced it on both sides of the atlantic then they would have a different story.

I also know people who have been effected by nationalized healthcare

http://www.nytimes.com/2009/08/16/we...gewanted=print

this article is very sympathetic to NHS but it also mentions many of the problems with it