And they come with no warning,
nature loves her little surprises.
Continual crisis!

Wednesday, September 26, 2007


The UAW and GM came to an agreement. Now it just remains to be seen if the rank and file accept it.

Given that a main stumbling point, and a matter of competativeness, was the health care issue, mostly for retirees, can we have another national discussion of comprehensive, universal (and hopefully single payer) health care? One that doesn't have people screaming on both sides. Because here are the facts, our US Health Care System, as currently working (ie. private insurer and payer model) is now a major drain on the economy and is a disadvantage in our global competativeness. It is time for that terrible thought, single payer health care. If you have more money and can pay for extra stuff, go ahead. For the vast majority of people we need to have "socialized" medicine. And, yeah, most countries get it right. It's only when conservatives for those countries to shift to a private payer system (like they did in England and are trying in Canada) that it goes awry.

For those that cry, "It'll mean rationing!" Just WTF do you think is going on right now? Only the rationing is done by economics, the poor get little, the wealthy get all they can stand. In the future, the poor will get more, and the wealthy can afford to get the extra service that the "socialized" part won't pay for.

"It'll mean long waits." You are clueless. Try and get an appointment with a new doctor and let them know you have Medicare coverage. Six month wait here we come!

"It'll raise taxes!" Probably no more than what you're paying into your current health care plan. Most of us are paying for our health care. Not much of a change.

"It'll mean a large government bureaucracy!" It'll mean less than the jobs that are in private industry, economies of scale you know.

"It'll mean inefficiencies!" Medicare, 'nough said.

"Doctors will stop practicing!" Have you been paying attention to what's been going on with malpractice insurance?

"New wonder drugs won't be produced?" Okay, let's end the government's sponsorship and tax breaks. After all, it should be completely private, right? Yeah, companies and goverments will continue to research new treatments and drugs. And when was the last wonder drug introduced? I'm not talking lifestyle drugs, I'm talking about something with the impact of penicillin, something that changes medicine at a fundemental level, a paradigm shifter.

Really, there aren't many reasons not to do a wholesale reform of the health system. The current situation is an example of private markets gone bad.


ThatGreenyFlower said...

Wholesale reform, YES! "Socialized" medicine, YES!

Here's the deal: most private providers where I practice won't even SEE Medicaid/Medicare patients because the reimbursement is so poor (seriously: if I bill a dollar as a primary care physician, and I'll get $0.55 from Medicare as reimbursement). So, lacking resources to find a place that will, many of them don't get care at all. Many wait until their health problems are dire and then they end up by default on dialysis, having a leg amputated, hospitalized on antibiotics...what have you. Because they didn't know where to go for care before.

There are Community Health Centers that will see all comers, but even they have started competing for "customers" with private insurances to help them stay afloat.

We must start thinking like a nation and less like a bunch of individuals all living on the same dirt. The division of wealth, the massive gulf between the Haves and the Have-Nots makes me just SICK.

ThatGreenyFlower said...

P.S. Many physicians don't want a single-payor system because it means that their incomes will go down. In truth, mine can't go down any more (as a primary provider working for a state agency), so I am not one to complain about this. I have a significant problem with cardiologists making $700,000 per year, anyway, when it's primary doctors who are holding people's bodies and souls together in the first place.

...Just my twenty-two cents.

Steve Buchheit said...

Greeny, thanks. I was wondering hwo you'd think about this. I'm glad we see eye to eye (mostly, the details may get a little off) on this.

Here in NE Ohio we have had emergency rooms close up because of the poor overusing them as primary care facilities. A few others have gone private (ie. a private company rents space form the hospital and runs the emergency room). Our local hospital just did this (we found out after I had to take my wife there). I can tell you that the service was crap compared to when we've used it before. But, it wasn't crowded. On a Fridays night, and they only have 4 people using it. Every time we had gone before, the triage wait (even for a broken leg) was an hour at least. Free marketers would say this this was great. For someone who just called an ambulance because his wife passed out for no discernable reason (was a reaction to her new thyroid medication and sugar) it was a frustrating experience. I wanted to choke the doctor on call. On top of it, he made a BS diagnosis. One of those, "I don't know, but this will make them stop asking questions" answers.

At least before, when I broke my leg, it was a "we can't do the surgery" answer (when they were wrapping up my leg, if it would have continued, I probably wouldn't be walking right now). Fortunately the doctor that became my orthopedic surgeon (Dr. Kellis) was walking through the ER just as my attending was seeking an opinion. He reset my ankle which gave me a chance to walk again.

Steve Buchheit said...

Forgot to mention that I seem to remember as the country discussed "Hillary Care" and decided to go with managed care and POP systems it was because 1) they were our best solution to keep medical costs down (well that didn't happen) and 2) they focused on preventative care which was found to be cheaper and more effective. Over a decade later and we're back to discussing a "catastrophic health care insurance" model (health saving plans, ratcheting up co-pays, and a "consumer controlled cost model" - consumers keep cost down by not using the system, essentially).

ThatGreenyFlower said...

I should also mention that I am a "Have." I felt guilty leaving that unsaid.

And yeah, I hear you about the ER situation. Ours has people on carts lining the hallways due to inappropriate use.

Camille Alexa said...

I pay thousands of dollars a year for individual health insurance. I cannot afford simple visits to the doctor. No wellness care or maintenance visits are covered. No dental, maternity, reproductive, optical, etc. I have a deductible so high, IF I ever meet it and IF the doctors/facilities I want are in my plan, the insurance company still categorically denies every claim which passes its collective desk. I keep it in fear that having it will make the difference between going broke or losing my house if a major health problem arises.

Socialized medicine, pleazse. Anyone who says otherwise without an actual viable working model to present is an idiot.

Oh, and even though I pay thousands each year for my private health insurance, most doctors won't even see me as a patient for the same reason as the medicare deal. It's madness, people.

Steve Buchheit said...

Camille, yep. Every time I hear people talk about how the private insurance model is the best I always think that these people have never actually had to use it for anything other than office visits ever three or four years.