Paq

Ok, so due to stupidity/reaction, i ended up with a few hairline fractures in my hand, nothing major, or so i thought...

went to doctor after coercion from many people and had 3 xrays,a 15 minute discussion with the doctor, then to another doctor for a discussion and a hard cast.

total cost: $1165 and $253...

seriously...what...the..hell???

and what is so bad is that the doctor's statement i received when i paid the copay for my insurance did not even have a price and the lady thought i was just out of my mind for asking for a price of just the office visit.

How are we supposed to know what we are getting into before we walk into the doctor's office!??!? I could understand it when my ER bill was $2500 for a bad fever, dehydration and pneumonia treatment..as someone put it, they basically charge enough so that you do not go to teh ER for something not immediately life threatening, as in, something you could just go to the doc for...

BUT SHEESH, when it is $1400 for a hairline fracture that did not require resetting of a bone...what are we supposed to do?!?

sorry, rant over...comments?

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ziadel

my knee-jerk reaction is to start complaining about the litigous (is that even a word?) nature of our society, as most of what you are being charged is most likely to cover the hospitals mal-practice insurance...

but yeah, health-care is ridiculously expensive, I guess if you were so inclined you could move to canada and get free-healthcare, but if you were up there from what I have been told your hairline fracture would have taken a solid week to adress

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maleficent

In recent history (like the past two years) doctors in NJ went out on a one day strike to protest the high cost of malpractice insurance. Yes, doctors do make a lot of money, but they also paid a lot of money to go to school to get their MD and most of 'em went on student loans so are paying back that money) What the doctors pay in malpractice insurance is obscene, it honestly makes you wonder why many of them want to practice medicine and don't just go into research.

And before y'all jump on the Let's kill all the lawyer's bandwagon, lawyers do serve a purpose, health care costs are not the fault of lawyers.

What you paid isn't bad, considering all you got, 2 doctors, xrays, and a cast. I don't have the numbers at the ready, but look at the figures for having a baby costs, and this is just plain old childbirth - no complications.

There's no such thing as "free healthcare". It's not this magic thing that just gets handed to you -- Someone is paying for it-- guess who? The taxpayer... Gotta wonder how often taxes go up because of healthcare costs.

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Paq

my friend in canada and my friend in norway both broke their arms within my knowing them and had service on the same day...

but i do realize how much of this goes to malpractice insurance...
just very aggravating and easy to see how a major medical bill can put you so far in debt.

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cyrnel

Paq, most of the line items are provided at a negotiated rate between the insurance company, the hospital, and their medical groups. The parties agree on the "full retail" and then on the discounted insurance amount. This is different from what you'd pay as an individual without insurance and complicates understanding the amounts. For fun, call later and ask for the same items as if you didn't have insurance. Sit down first.

Luckily, most medical facilities provide a poor-boy discount or alternate payment plan for the uninsured/unimployed. If you're uninsured and short on funds it's good to let them know ahead of time. Different doctors have different opinions on discounting. Ask for alternate treatments and the implications. It isn't uncommon for a doctor to use different treatments that work just fine and that will cost you much less if they know funds are limited.

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Paq

these ahve me as self paying right now bc i did not have an insurance card...


not joking

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flstf

The medical industry is out of control. Whether it's the high cost of malpractice insurance and/or doctor charges the costs all get payed by us eventually.

As your post points out there seems to be no cost control other than what is dictated by the insurance companies. An industry without competition leads to much higher costs. What incentive do they have to charge reasonable prices for their services? IMHO this will lead to government provided healthcare soon.

greytone

Let me pipe in from the doctors' perspective. You would be amazed at what it costs to provide medical care. The malpractice insurance is actually a fairly small percentage, but because of the litiginous nature of society and because of the bureaucratic oversight from both governmental and private agencies there is a lot that is done that is probably not necessary a lot of the time. For instance, part of that fee went to the radiologist who read the Xray. I think it is good that all xrays are overread by radiologists because they pick up disease that would be missed elsewhere. On the other hand, the orthopedist could probably do just find with bone films almost always. The biggest part of healthcare cost is labor. You saw two doctors and had services from another MD. But I bet you, or your chart, or your acount came into contact with over 20 other employees. In my office we have about 4.5 full time employees per provider (MD or midlevel caregiver) and we run about 75% overhead. When I was in school docs ran around 50% overhead and took the rest home as their pay. My income is down 20% over the last 3 years despite working harder every year. I now make about the same per hour as someone working in a supervisor role with a local utility. I would not want to do what he does (climbing poles in ice storms) but I was in school until I was 30, and I work very hard and long hours, even in individual patients don't see it. Frankly, the pay had better start going in the other direction, or in the next decade we will have a real crisis. I expect to see doctor strikes and work slowdowns at some point.

I think social medicine is a bad idea for a lot of reasons. There certainly are positives, but I think they are outweighed by the negatives. However, if we are headed that way, I wish we would do so soon enough I could get my 20 years in with the federal government. Besides, then I will put in 40 hours a week and be home by 5 and not have to worry about being sued and still make about what I do now.

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BigBen

Look at my location. Full Stop.

Yes, our taxes are high.

Yes, our politicians are full Pinko Liberals (so am I as far as the yanks are concerned )

Yes, you get free healthcare. And fuck you to all who say you have to wait for a bone-set or cast. You are lying, or repeating a lie an HMO told you.

We wait for the things that are not painful, or really serious. We just choose to define what really serious is to maximize Social Marginal Benefit.

I am happy with my system, and I am really sorry that you got hosed with yours. Hope you aren't in too much pain. If it makes you feel better, someone in a location and financial position worse than you would have probably just had to 'walk it off' and suffered long-term effects.

Again, I love this community (TFP) and the members who have interesting things to say. As a global community, we have to take the good things from everyone, and help work out the bad.

I don't want to get into a "Our healthcare system is better than yours" flamewar. I have seen enough of those, and the rhetoric that is spewed forth from political agendas covers up the real pain that people go through on a daily basis.

I cherish my good health, I read literature to keep informed on healthcare issues, and pray when I go to sleep that people will work together to make this place better instead of fighting to further their own agendas. I don't know..... it is the best prayer I have come up with yet.

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F-18_Driver

Government-provided health care is the PROBLEM, not the solution:

Link

Remember that physicians who accept Medicare are required to charge ONLY the government-approved fee. Then they have to wait 30-60 days to receive it. Also, some states require that physicians accept Medicare in order to practice there. I can't think of another industry that allows the government to fix prices in this way. Certainly not the insurance or legal industries.

So I challenge any businessperson to tell me how doctors are supposed to pay increased workmen's comp, increased professional liability, increased salaries, increased rent, increased utilities, increased equipment, increased supplies, and continuing education, when their Medicare income is going to be cut by 30% over the next six years. As the article says, many of them will get pissed off and retire. Supply and demand will then raise fees, unless we import physicians from other countries. That hasn't always worked so well.

I can tell you a few ways doctors stay afloat:

1. Herd people through like cattle.
2. Pad bills
3. Go flat-out dishonest, and bill for things not done.
4. Set fees through the roof for anyone who doesn't have a plan with fee limits (sound familiar?) It resembles the cliche about how much bargaining power you have when your tire is flat, you have no spare, and you're 50 miles from the next gas station.

So make no mistake: Workers of today are funding retirees. This should scare the crap out of all you twenty-somethings who are going to be supporting a huge number of baby boomers in a few years, courtesy of your state's elected representatives, who coincidentally have a much better health plan, paid for by you.

Most people in the 20-30 age range haven't noticed, because they rarely have to go to a doctor. Or they're too busy getting worked up about causes like gay marriage, or the role of "womyn" in today's society. But I digress.

It should be noted that a few years ago, the total compensation package for the head of Traveler's Insurance was $52 million. For one year.

I'll end this rant now. Is it apparent that I disagree with the statement about "no cost controls?"

jorgelito

So does anyone have a handle on our (US) healthcare industry? I want to get a clear picture (as possible) so maybe we can have a meaningful debate. Seems to be alot of information and misinformation.

Here's what I know or think I know (Please add or correct the info as necessary).

1. US pays the most for health care (our govt.) - versus other countries
2. Doctors say they aren't getting paid enough
3. Patients say costs are too high
4. Certain lobbyists complain malpractice insurance is too high
5. Certain lobbyists say we are too litigious (But are we really?) which drives up insurance.
6. Hospitals complain of staff shortage
7. Others complain of too much labor

So, which is it? These "facts" seem to contradict each other

What are the real factors driving up costs? Is it litigation? DO detractors not think litigation is warranted? Where's the accountability then?

From personal expreience, I believe there is definitely major, major staff shortage. I could never understand this (I live in California where there is an acute nurse and staff shortage)

If doctors complain they're not getting paid enough and patients complain costs are too high, then where is the equilibrium? Or is the "middleman" to blame (insurance companies).

Are the insurance companies really not making enough profit like they're always crying about? I don't kow, but I suspect it to be like oil companies: You'll always make a profit, just depends how much is enough I suppose...

One thing's for certain, NO ONE (doctors, patients, nurses, hospitals, govt., people) is happy with the current situation except maybe the insurance companies who I am not convinced are losing money.

Another thing's for certain: Costs will definitely increase as someone noted before, as the baby boomers get older and start "paying" for their unhealthy lifestyles (obesity up for example, etc) or rather, we start paying for their unhealthy lifestyles. Preventative care MUST be part of a solution, I don't think anyone group can bear the costs of reactive care. It doesn't seem to make economic sense.

I think this is an unavoidable issue that needs to be addressed.

Can any one crunch the numbers or can add or dispute what I am saying? What d'y'all think?

*EDIT* I don't mean to come off as anti-insurance industry: My opinion is based on second-hand info and anecdotal evidence.

It would be really great if someone who works in health insurance could lend some perspective to this discussion and help clear the air.

Janey

um... dont know where you get your info from. I went to the hospital ER for a broken arm. It was xrayed, set and in a temp cast within 45 mins. the follow up three days later saw a fibreglass cast put on (bright green) there was no wait. Plus the tylenol 3's were complimentary. my out of pocket: $10 for the green colouring on my cast. (it would have beeen free if i chose white or gray).

This was at the Toronto East General Hospital.

By the way, last December 23rd I was diagnosed with breast cancer, and had my operation there (same hospital) on Jan 6, and was scheduled for my radiation treatment from march 1 through march 18 (i had to wait for my surgery to heal). All done to schedule, and at no out of pocket for me.

So what ever stories you hear about waiting times up here are obviously sensationalist.

flstf

I'm certainly no fan of government control and I realize that most things provided by the government will cost more because of the bloated bureaucracy, etc.. But I am beginning to believe that health care may be an exception. Surely you can't be saying that reduced Medicare fees is the only problem with health care costs.

There is something fundamentally wrong with the health care system. I'm not smart enough to know what but I believe the legal profession (malpractice suits) and insurance company costs (CEOs making $52 million) have something to do with it. For some reason the costs continue to go up faster than inflation, there seems to be no competition or if there is I have not found an easy way to get price comparisons for services.

I also believe that most people don't care that much about the total cost of their injury/illness after the copay and deductible is remitted so there is not much incentive to shop for services. However this will soon change as more companies start to pass on the higher insurance costs to their employees or dropping coverage altogether.

I have read elsewhere that we have some of the highest health care costs in the world and still have millions of people who are not covered. I have also read that the very poor can get emergency treatment but I have known several middle class people forced into bankruptcy after being laid off because of medical bills in order to try and stay in their house. How much worse can total government control be?

You listed a few ways that doctors pass on their high costs to patients but did not give any ideas for fixing the system or making health care more competitive and affordable. Doctors at least can find some ways to pass on these costs but who do we pass them on to? Eventually the patients wind up paying for all the legal, insurance and overhead costs.

Paq

ok, let's bottom line it from my, the patient's, perspective.

1. I am not saying doctor services are not appreciated, nor do i think they should not make an assload of money for their services, as stated, you went to school till you were 30...AND you had to remember what you learned

2. I understand that the patient never really sees what is going on in a case like mine. All we see is a doc come in, look at an injury, send the person to xray, read the xray and probably send to a specialist who will treat based on the problem. Total time physically with the doctor..about 5 minutes.

3. rich and upper class generally have great health care insurance, but more and more people are currently without insurance for one reason or another. Let's say i'm middle class or so and my job does not offer health insurance bc i physically cannot get enough hours per week to qualify(the place is not open for that long if you do certain jobs) and i am obviously employed and have a good credit rating. Now, if i were poor/unemployed/uninsured, i could go to the emergency room, get charged an assload, and probably throw away the bill, what threat is a debt collection agency, really, and hte ER is forced to give care to someone in need. Since i am employed and i feel morally responsible to pay my bills, I am hit with a $1500+ bill smack in the face. I can probabyl set up payments, etc, but i cannot negotiate for a lower bill as an insurance company can, and an unpaid debt like this would kill my credit rating and send me in a downward spiral. No offense intended to the poor who are billed and cannot pay, not saying everyone does it, just that it does happen.

4. all i really wanted before i went to a doctor was to find out what the cost of treatment would be, within a range. I understand that something else may be wrong or the doc may have t odo quite a bit more than i may think, but i was hoping that i could get a price range so i could prepare myself for the shock. So, i called around...every single person sounded like i was the most socially uncouth person to ever pick up a phone...convos were normally something like, "hi, I think i have a broken bone in my hand, how much would a visit be to have it checked out and treated" "well, SIR, an office visit is...hold on...(4-5 minutes pass...seriously, this person writes up these things every hour of every day, do they really have to check to see how much you are charged for a visit)...$115 for the visit, and about...(3 minutes pass..ok, so you don't bill for xrays as often, but sheesh) $95 for an xray (actual prices) and as for treatment, it depends on what they will end up doing" reasonable, "Any idea if they have to put a cast or splint or something, any range of prices, anything" "no sir, It depends on what treatment route they take" "thank you" This went on for 4 offices in almost the exact same manner, with visits rangnig from $90-150 and xrays remarkably steady near the $100 mark. Ok, fine, $200 or so to be checked out plus treatment cost..i'm set to go, i can guess it will probably be another $400-500 for treatment...i guess...

Yeah...i guessed wrong and i had no clue where it came from. just BAM, here is $253 for office visit fr first doctor, then $135 for new patient admin for other doctor, then $525 for one roll of fiberglass tape for my cast, then $535 for another roll of fiberglass tape for my cast. by roll of tape, i mean, they charged for repair of metacarpal with manipulation, twice, as in, that charge appeared two times..and considering i only have one broken bone..

if you ever have an hour or so to kill and want to conduct an experiment, call around to various doctor offices and try to get a straight price on anything. seriously, they could have said to me, "well, a splint would be xxx and a cast would be XXX, but again, i do not know what they will do, so you could be charged moer or less" and i would not be so sticker shocked when the freaking bill came. I mean, would you take your car in to have it repaired without getting a cost estimate. I mean, sure, you would have to have it fixed anyway, but wouldn't you at least like to knjow how much money you aer about to spend.

I also find it odd that doctor's services are the only services i can think of offhand where you cannot get a price schedule. even lawyers tell you how much money per hour for their services...I can't see how any privately owned business can get away with hiding prices for services.

I don't begrudge the doctors, but i do have an issue with the whole system. We are one fo the wealthiest nations in the world and yet, we cannot provide basic health care. That, to me, is just sad, and i honestly do not know what will have to change in order to make this all work. Some say social healthcare, some say total privatization, some blame lawyers, some blame insurance companies, i just don't know what to say other than dont break a bone...ever...

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greytone

Let me respond to a few of the good points that were made above. We really can't tell you what your costs will be ahead of time because we really don't know. There are so many variables. We have a very complicated way of charging for our services which was forced on us by medicare. I have tried to understand how to "code" according to these rules for the past ten years and I still can't get it right according to people who come in to audit. I am constantly told I undercharge according to the rules that eveyone uses ( medicare and all the private payors) and when I try to correct it I get audited by medicare and told my charges have to fit a bell curve or they are going to prosecute. The complex nature of my patients who all have multiple diagnoses just doesn't matter. When I walk in a patient room I really don't know what level of charge is going to be appropriate. More importantly I don't know what tests I am going to have to order.

The real problem with health care is that there a lot of problems. In general people get very good health care here in the US and in other countries. Where we compare poorly with other industrialized countries is often due to cultural differences we have here.

Normal economics just don't work in healthcare because the purchace choices are not made by the payor. Managed health plans try and correct this to some degree, but we hate that as patients and providors. Where the money is spent by patients and doctors but the overwhelming portion of the money comes from insurance companies (including medicare and medicaid). Many patients pressure providors for care that is really not necessary and is not cost effective. Sometimes this is caused by advertising. More often it is based on what they know from the popular press or friends and family.

Insurance is not affordable for individuals because of our income tax laws. Insurance is tax deductible for your employer but not for private people. Decades ago employers got around rising tax rates by offering other benifits. This has led to people finding it inconcievable that they are responsible for their own healthcare. More importantly, those that want to get a plan are priced out of the market by insurance companies who only want healthy customers or big contracts.

I honestly don't know what the answer is. Socialized medicine is the easy answer, but I don't believe it is the best. We need an overhaul of laws overseeing insurance plans. They can not be allowed to cherry pic only the best patients and leave the rest for government after they are forced in bankruptcy. We need a populace with better science education so they are better health care consumers. We need more of the money going directly from employers to employees and letting them make choices. We need tort reform to prevent CYA test ordering and lower malpractice costs in a number of states. We need an overhaul of much of the private and public bureaucracatic nonsense that doctors and hospitals have to deal with. You would not beleive how much of our time and recourses go to making nonproductive pencil pushers happy.

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warrrreagl

The only thing that really interests me here is wondering whom you punched in order to break your hand....

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VitaminH

We got to hear the whole story in chat, the punch was warrented if you ask me.


Oh, and me being almost a pharmacist, I'd just like to point out that greytone has pretty much hit every nail right on the head. Being in the healthcare world gives you a different perspective on things. I think the problem lies in all parties involved to some dergree, but I feel the heart of the problem is in the insurance companies. They are making GOBS of money.

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Bill O'Rights

As just an average schmuck, that doesn't know squat diidly about what I'm talking about...that would be the first place that I'd point my finger.

What I find interesting, about this whole discussion, is that two of our Canadian members, BigBen931 and Janey, have come forward to completely blow apart the myths/lies/propoganda regarding their socialized health care. I wonder who propagates this information. I wonder who would have the most to lose under such a system.

Like flstf, I'm no fan of governmental control in most arenas. It goes against my libertarian nature. However, along with my personal ideology, goes a belief that everyone has a basic right to quality healthcare. I've got a lot of thinking to do.

I don't pretend to have any answers, solutions or magical fixes. That's going to have to come from people a lot smarter than myself. It's also going to have to come from people that have the best interests of the patients in mind, and not personal loss or gain.

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Janey

It's true, I am basically what is called a small 'C' conservative in Canada. That is, I think the less gov't involvment in our affairs the better. I am fiscally conservative in my own household, and think the gov't should be as well, but at the same time believe that gov't is our tool for managing those aspects of our nation for which we as citizens can pool our resources and invoke economies of scale. Several things fall in this area:

- healthcare for one,
- liquor sales (I'm sorry, but i really support and like the LCBO. I've seen private systems like in Pittsburgh and really really appreciate the LCBO) I just don't like the tax structure around liquor sales.
- military/defense/Search & rescue/coast guard and all the infrastructure that includes

- energy providers (does anybody recall that electricity and gas companies were made into publicly owned companies at the end of the 1800's for a reason? FERC 888 & 889 notwithstanding, handing the reins back over to private interests has been nothing short of painful very similar to the HMO experience. Just look at Enron, and the california power problems etc -but that is another thread topic).

I'm sure that the government bureaucrats cannot manage the health care system as well as dedicated (corporate oriented) professionals would be able to, but the prevalent alternative of handing the entire system over to HMOs or insurance companies who have a vested interest in profits, rather than utilizing economies of scale is very very very scary from my point of view.

The fact that we have 30-odd million citizens, a portion of whom can contribute to the total package (as taxpayers), should be a no-brainer to manage. And we do have some room (ok a lot of room) to improve here, I admit that. But with the amount of 'normal' health care that I mayself and my family is tallying up , it would be very depressing to have to face bills on top of it all.

Janey

Another anecdote to illustrate the so called 'Canadian' experience:

On March 30, my father felt dizzy, and started to vomit a 3 am (he is 77). My nephew drove him to Mt Sinai (toronto) ER. He was put into an examination room under observation until 3 pm. After blood work, Ultrasounds, and an MRI (all before 3 pm) he was admitted to the general patient floor, because there was no obvious problem identified. From March 31 to April 8 he remained under observation, and received a catscan, another MRI, more ultrasounds and extensive blood work. Most of this was performed with the assistance of the th Chinese translation service that Mt Sinai has.

He was released after they identified that his type 2 diabetes has progressed to the point where his diet was causing major problems with balance, and a GI bleed. He is now home, and gaining back his strength, but i wanted to relay what is probably a common older person situation nowadays.

His medication load has almost doubled, and since he is elderly, the gov't covers the cost. Also, there was no cost for the semiprivate room for the duration of his stay.

Kudos to Mt sinai for their wonderful service and professionalism.

flstf

Thank you for your posts from a provider's point of view. It must be very difficult to do business in this environment with all the insurance and government paperwork as well as the legal problems and patient demands for ill conceived treatments. You guys seem to have to walk a tightrope and I am beginning to appreciate the difficult nature of your profession.

The following comments are "cherry picked" from your last post.

For some of the above reasons as well as others, many of us are beginning to think that the system is getting to the point of being beyond fixing as it now stands. For most of the fixes listed would require legislation that probably has little chance of passing because of various lobbying groups pressure. Perhaps it is time to rethink the entire medical (and medical insurance) industry and consider having the government provide it. Maybe the nature of health care just doesn't lend itself to capitalism and competition.

Paq

I am sorry if i came across as doctor bashing, I honestly don't mean it that way and i don't have any animosity towards them, i am just upset at the system under which they are forced to work.

I do understand that an upfront cost is very hard to determine bc of the extremely wide range of treatments, but it would be nice to be able to get something so you can expect to kow what to pay.

For instance, in my case, i knew about the $253 for office visit and xray, so i had that money put aside already just in case i had complications with my insurance company. and i was expecting about $300-500 for the orthopaedist based on costs for similar procedures done on my friends, but bam, $1200 later, here i am..

Like i said, not really blaming the doctors as they are in the same boat i am, just on the other side.

and yes, i have had the thought that the current system is beyond repair. I fear the drug companies keep pushing hte private citizen to ask about, enquire, request, demand that doctors prescribe a certain drug for an ailment they don;'t know they have, but have been lead to believe they do by a 20 second commercial. I do not know when drug companies decided they should advertise, but i believe it lead to a downfall in our healthcare system....much like when lawyers started advertising. that just seems sleezy to me.

Still, i fear there are far too many lobbyists, far too much money involved in keeping the status quo for there to ever be a major healthcare change in this country. I don't know that socialized healthcare is the answer as i do not think the tax increases would ever pass. As for insurance, i have been buying 3rd party insurance for years at a decent price, but it has almost doubled in the past 3 yrs while my deductible went up and my 80/20 went to 70/30, so i really am paying more for less....

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wakelagger

As a Canadian, there is nothing stranger and more unsettling than watching a drug commercial or a lawyer commercial on Fox 29 out of Buffalo which you can receive here in Toronto.
Doctors are in place to diagnose and prescribe medication. In no way should Joe Sixpack be allowed to recommend a medication to his doctor to prescribe to him. In no way should the doctor be influenced to prescribe this medication from drug-company kickbacks.
Thats like taking your car in for a tune-up, telling your mechanic you need a new muffler because your car is too slow (non-sensical form a car point of view, but thats intentional), and having Ford give the mechanic a free vacation for installing it and convincing the car owner that it was neceessary. Just the car is your heart, the muffler is Vioxx, the mechanic is your GP, and Ford is Merck and Co.
Hell, even driving into Detroit and seeing all the billboards for hospitals is eery. "Your baby will love St. Mike's Baby Ward" with babys in Anne Geddes like photographs sitting in flowers.
Anything to do with good health and living should not be a business from my point of view. A profit should not be made off someone trying to live.

jorgelito

That's the inherent problem in my opinion. There's too many variables and subjectivity. It is not easily quantified. Can the basics of economics even be applied productively in this "industry"? Socialization is tricky also as it could potentially invite bloat and inefficiencies or waste etc. There's got to be some balance. Just, what is it? *scratches head*

Paq

THIS IS EXACTLY HOW I FEEL!!!!!!

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Janey

Bingo! I feel the same way. When the american networks broadcast their doctor and lawyer commercials I feel that eerie sense of culture shock. It's just not something I see day to day, and then one night, when Global or CTV is not simulcasting a TV show, I get the American commercials.

I agree with you Wakelagger, as in my earlier post, I don't think that this sort of thing (health care) should be a 'for profit' business. It's one of the reasons that we have government, that is to manage the pooled resources of our society to get a living or live-able system in place.

F-18_Driver

That's pretty much my opinion--the system is darned close to being FUBARed. (Beyond recognition AND repair). Although this might be better placed in the politics board, the person who made himself a millionaire by screwing every OB in North Carolina (and raising prices for every expectant parent there) almost got elected vice-president. Unless votes can overpower the money trial lawyers and insurance companies are willing to spend, nothing will change. For the better, anyway.

I also disagree with providing health care for illegal aliens (try walking into a Mexican ER and demanding free treatment), but any attempt at reform will be greeted with cries of "balancing the budget on the backs of the poor."

I would also like to provide some counterpoint to Janey. I doubt that anyone thinks the entire country of Canada provides bad medical care, and she apparently lives in a place where the care is good. However, I've met a lot of Canadians who will tell you they don't have it as well:

Link

Link

There is NO shortage of similar cites. My worry is that a nationalized system of health care will put us in the same boat.

jorgelito

We already are in the same boat without national health care. Wait times here in the US are pretty bad too.

Janey

Yes, compelling references, F-18 and I suppose that for every good story there will be a matching bad story. But as Jorgelito states, wait times are bad everywhere and I think youare already in the same boat. ( i can relate my ER wait at Providence Hospital in Columbia SC, and the subsequent $305 US bill for the prescription to purchase amoxocylin plus the cost of the drug itself). The counterpoint is well received, but again, I have to stand by my earlier real-life experience. Yes I do live in an area where health care is reasonably good. there are areas of Ontario where it is hard to get afamily doctor. Why? because all (ok the majority) of the doctors want to live in or around the GTA.

Given a preference, most doctors will gravitate to centres of population (read Vancouver, Calgary, Toronto, Montreal etc) rather than Saskatchewan, Brockville, or the Eastern Townships .

I hardly think it is a result of national healthcare, more the result of freedom of choice of location to set up practice (free enterprise)

While I do think that Saskatchewan Minister of Health John Nilson's statement that lack of MRI access is not hurting patients is purely political (he is just cya'ing) the entire province is only a million people and sometimes the market lags behind the need.

Also , consider the source. The Fraser Institute is a neo con think tank. I'm a small C concervative myself, but I always take what they say with a grain of salt.

I like to stick with my real life experiences. they carry more weight than statistics for me. And it has not always been in the GTA, but also a broken leg (skiing) at Mt Orford in quebec, and my brother's motorcycle accident in BC (interior north of Vancouver)...

BigBen

Amen Janey. As a Saskatchewan-ian-atonian-ite, I have to tell you I am proud to see us get this kind of exposure.

Hey, F-18, did you know we existed before you googled that info? I didn't think so. Please stop reading anything regarding the Frasier Institute. They think that Regan was a Pinko.

We have MRI's, and we have enough of them. Oh, your doctor can't get you in for an MRI very soon? May I suggest getting a new doctor that has the clinical skills to diagnose your problem with alternate forms of technology. I will not get into a quote war here, but let me ask you to look at the clinical literature that suggests that MRI's are overutilised, and add very little marginal benefit for patient care (as a general rule, don't misinterpret me here).

Might I also state, that even if I won the Bill Gates lottery and put an MRI on every corner in Saskatchewan (5 bucks if you pronounce it correctly) that would solve nothing. We would then need to recruit the radiologist and the MRI technicians to run the damn things. The capital costs of an MRI aren't prohibitive, it is the labour costs of the people doing the work.

I know, I'll just do the American thing, and give the doctors a blank cheque. Then when we have lots of MRI's, we will be out of money to provide the care. Oops. That would be JUST AS BAD.

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3.141592654
Hey, if you are impressed with my memorizing pi to 10 digits, you should see the size of my penis.

Paq

another perspective

dec 2003, i went to the ER bc of pneumonia and bronchitis that had me dehydrated and at 103 for a fever..
in feb, i received:
1 chest xray: $40
1 hospital bill: $2400
1 doctor's services bill 2 months later $694 from the doctor's personal office 200 miles away...

total cost, $3134 for 1 liter of fluid, 1 vial of antibiotics, a 3 hr wait in an ER waiting room, and a 3 hr stay in an exam room...

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Live.

Chris

BigBen

Oh, I get it. You are saying that your life is not worth $3134. Good point. I guess I never looked at it like that.

Can you tell me what your life IS worth? is it an even $3000? $1500? What about the exchange rate if you were travelling to another country?

Who are you to say that you were overcharged? The problem with healthcare is that when it counts, YOU DO NOT CARE WHAT IT COSTS, because the alternative is DEATH.

Please do not get on the topic of "my grandma had a stroke and it cost 1,000,000 dollars a day" or "Who does that doctor think he is, charging me ____ for only seeing me for 15 seconds?"

Healthcare is priceless, in the right circumstances. We are not comparing different models of sedans here. Just think about that for a second.

Or on second thought, you were not complaining at all, and simply voicing your joy for still being here and not dying that day, due to the wonderful care you recieved.

Was I right on the first part, or the second part?

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3.141592654
Hey, if you are impressed with my memorizing pi to 10 digits, you should see the size of my penis.

Paq

a bit of both
1. obviously mylife was worth that as that is what the hospital charged

2. healthcare is priceless which is one reason why i think it should not be a for profit business

3. I am not saying i was over or undercharged, merely that i was charged an arseload of money for trying to stay alive. I don't feel it should be a business to measure out just how much you are willing t pay to stay alive.

I am not sure exactly what i am getting at or what you are really asking as i was just showing a substantial amount of money for a short term service that your country would have probably have covered easily.

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Live.

Chris

jorgelito

As Paq and BigBen illustrates, that is one of the inherent difficulties and problems wih our modern health care system. Even in Canada et al it is still a problem (of a varying degree), but particularly so in the US. Applying standard economics is tricky, and quantification of "health care" as one person said: The price on life, is difficult if not impossible.

I don't have any solutions either, but disseminating and analyzing is a good start.

Here is my attempt to frame the discussion/debate:

(I have split) The main parties appear to be:

1. Doctors/nurses etc - health care providers
2. Patients - consumers

3. Insurance industry
4. Litigation industry

5. Government

The trick is how to distribute money for services and protect patients at the same time at a reasonable cost, maximize prodctivity, efficiency and increase overall health/well-being of a given society.

So, since everyone points the finger at the other: not paid enough, cost too much, insurance too much etc., compromise seems unlikely. But there has to be a way to compromise otherwise it's deadlocked no?

flstf

You hit the nail on the head with this one. If a life saving procedure will save your life it could be $300, $3000, $30000, $3000000, what difference does it make, you just want to live no matter what the cost. I guess in a capitalist system they should be able to charge what ever the market will bear. I can imagine laying in the ER after an accident and the attendant comes up and says "You know sir we can stop the bleeding and save your life, just how much is that worth to you today?"

Of course this would never happen in a civilized country but the cost of services does seem to be way more than most people can afford. As it has been pointed out in other posts, perhaps health care just doesn't lend itself to competition and capitalism and the government should provide it.

greytone

In no way did I think you came across as doctor bashing. I thought you made a good point without inflammatory comments. I just thought it would help if I tried to point out why it is the way it is.

Many of the posts coming from people in Canada since my last post point out the main reason I am opposed to socialized health care. I think it permanently confirms the point of view that health care is a "right" which I think is antethetical to the historical American point of view. This is not bashing; I just think we need to go back to the understanding that the only rights are life, liberty, and the pursuit (not acheivement) of happiness. Anything that is the product of another person's labor can not be someone elses right. That includes food, clothing, shelter, and healthcare. I understand that most people in the world disagree with this and I can respect that. But it frightens me that so many people here a drifting that way. I am still not sure if the end of the cold war meant the Soviet block becoming Westernized or the West becoming Socialized. That may be a little off the point, but it is the biggest reason I am opposed to a national healthcare system. But I am coming to realize that would be a better solutions than expanding medicare to everyone and leaving us private. Because that system with a monopoly payer would collapse.

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I was there to see beautiful naked women. So was everybody else. It's a common failing.
Robert A Heinlein in "They Do It With Mirrors"

spindles

It makes a huge difference if you don't have the money. Why should I have to pay $3000 for 3 hours? If I only have $3000 and no access to any other money how am I supposed to live if I pay it all on medical costs. Who bears the burden of the $3m procedure? Either me for the rest of my life or my family (if heaven forbid it fails). If you are going to charge so much, is there a money back guarantee??

By making health care unaffordable, you are forcing the lower paid workers to not go to the doctor.

I'm happy I don't live in your world.

Greytone - I say to you that health care is a right. One of the benefits of the high taxes I pay is that I get subsidised visits to the doctor, my child is immunised for free and in the case of an accident or emergency, I can get absolutely free access to health care (the doctor gets paid by the government). This does not take away from the fact that private hospitals also exist, with better facilities, if you are willing to pay / willing to pay for insurance.

The only reason you don't have a government run health care system is because the government is being oiled well enough for it to remain where it is.

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who hid my keyboard's PANIC button?

canuckguy

This thread is the one of the reasons I love this place, this is a very touchy and emotional issue to alot of people and I've read a lively and respectful discussion giving many different points of view. love it.
As for my view, well, as a canuck, when my wife gave birth last year, it was the first time (lucky) that i got to view our health care system up close and personal. No wait, just an amazing experience, private room for birthing, whirlpool tubs and all the wife-in-labour type devices. The only bill I had from the stay was the cost of the private room wife,baby and I stayed in after the delivery. And that was paid for by my work benefits. I think government can get to involved in our daily lives, but in situation like health care, I would rather have the government running it than private industry/for profit companies when it comes to my health or my families.

canuckguy

i agree with everything you just said, the LCBO is great example.

Janey

Think of it as an evolution of the human condition. I don't think that we in Canada equate healthCARE as a right with the rights of life & liberty. (I have a feeling that the happiness part is a bit too trite).

It's more along the lines of, as a society we are comming to believe (and remember, this is a relatively recent phenomenon being a post WWII concept) that we should all have access to good and reasonable healthcare. And so, why not? Why can't we as a society pool our resources, and have it managed so that reasonable, affordable and equitable health care is the primary directive, rather than profits?

No, I don't think it is an inalienable right. But I do believe that it is a reasonable expectation given the capabilities of our society. Incidentally, the same can be said about the education system.