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Old 12-10-2004, 03:29 AM   #41 (permalink)
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Quote:
Originally Posted by MrSelfDestruct
I'm quite happy paying twice as much for my preferred insurance plan, seeing as the doctor assigned to me when my expenses were paid for by Social Security disability benefits had obviously learned English fairly recently, and had an office in an area that I would like to avoid even driving through after dark.

I'm quite happy with my current physician, who takes as much time as necessary to talk to me about whatever the current problem is, and whose office is less than 10 minutes from my house.

I've made up my mind on the issue of socialized versus private healthcare.
Well I'm happy for you. You had a choice and you're happy with it. Same thing here in Sweden. You can use the doctors at your local hospital and not pay anything for it. (Well that's not totally true, for my last surgery I paid 150 Swedish crowns, which would be around 20 dollars.) However you also have the choice of going to a private doctor if that makes you feel better and you can afford it.

Thing is, socialized wellfare in Sweden works. I'm not saying it's a perfect system or anything, but it seems to me a lot of people here disregard it just because they think socialized means Russia och Cuba. It does not necessarily do that, and certainly not in this case.
I don't mind paying higher taxes when I get free (And good) healthcare for it, but I also understand that other people might not share my opinion and I respect that.
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Old 12-11-2004, 04:39 PM   #42 (permalink)
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connyosis: There's nothing wrong, in theory, with a socialized medical system. It would work to bring health care to everyone, undoubtedly. The problem with a mandated, socialized helath care system is that it disqualifies excellence in favor of inclusion. For instance, lets say you know an oncologist, who's really good at getting tumors. In a free enterprise system, that doctor can rise to emminience, garner money for research, develop new treatments, or guide the health care market to better treat people. Unfortunately, the cost of that treatment is higher, but that's because that doctor's better. It's the same reason a Porsche is more expensive than a Ford. One is hand made in Stuttgart by expert craftsmen, one's mass made in Detroit by assembly line workers.
Under a socialized system, that same oncologist wouldn't be able to excell, since the dictates of what that docutor could and couldn't do would be mandated by the governing body that ran the health department for the country. If they tried anything out of mandate, they'd be brought up on charges, fined, and probably fired for doing what was right, as opposed to what was mandated by the federally approved treatment plan.
The best thing you can hope for, in a perfect world, is a sort of split between the two. On the one hand, you have the federally subsidzed health care, that takes care of everyone, and on the other hand, you have the private practice, that allows for the innovations to improve the first system in the long run. But every time I read what I just wrote there, I keep coming back to the phrase "tying to have your cake and eat it too", so I don't know if any health care system can survive like that. That, and, as a semi-professional cynic, I've seen too many people try and abuse help when it was offered to them to think that you could expect everyone to use the system properly.
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Old 12-11-2004, 05:46 PM   #43 (permalink)
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I'm not really sure what you're saying, do you mean that doctors working under a socialized system wont get money for research? If this is what you mean than that's totally wrong. For instance 8 swedish doctors have gotten the Nobel prize in medical research, five of these come from "Karolinska Institutet" which is not a private hospital, but one of Europe's largest research hospitals. (http://info.ki.se/index_en.html)

If I go to my local clinic with a sore throat a doctor there will look at it. Now he may be a really good doctor or he maybe an ok doctor, and for this check up I will pay about 15 dollars. When it comes to extreme surgery or treatments you don't go to your local clinic. For example, I was born in a medium sized town. The doctors on this local hospital realized that I needed advanced surgery that could not be performed there,and I was flown to Karolinska. For this my parents paid the equivalent of 20 dollars.

What I'm trying to say that is even though we have a socialized system, we are not restricted to our local hospital. If I for instance got cancer, I could ask to be treated at Karolinska and that would be just fine. No higher costs for me compared to choosing a hospital closer to where I live.
I'm also trying to point out that being a private doctor does not in any way mean you are a better doctor which seems to be what a lot of people here think...
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Old 12-18-2004, 02:20 PM   #44 (permalink)
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Maybe this is worth reviving the thread

Quote:
Originally Posted by kutulu
So my wife and I just had a baby. We have ok insurance and in the last few weeks all of the bills have been coming in. The first thing that sticks out is the flatout price gouging for certain things.

I really think there should be legislation introduced that forces the hospitals to provide the same services at the exact same prices. The govt would not be imposing any actual prices, just stating that everyone pays the same amount.
Help may be on the way. I just found out about this (it's my home town).

If you search for other articles on this situation, you'll see that the hospital sued this whistleblower.

Link

http://www.hospitalpricegouging.org/update1_092304.html

Quote:
Sick of Hospital Bills - 09/23/04Article from Time Magazine Online


Helped by two whistle-blowers, the lawyer who beat Big Tobacco is on a new crusade — to fight what clinics charge the uninsured


Richard Scruggs is corporate America's worst legal nightmare. In the 1980s and early '90s, he made millions litigating asbestos claims and went on to national fame for beating Big Tobacco, representing the whistle-blower Jeffrey Wigand, subject of the movie The Insider. Scruggs' tobacco suits netted his practice an estimated $1 billion, money that bought him toys, from a $100,000 Bentley to a Falcon jet — and turned him into the dart-board face of tort reform. At 58, he works out of a small firm in Oxford, Miss., with his son Zach and two other lawyers. Scruggs has given up the Bentley for a more modest BMW. "He got it out of his system," an associate says. And Scruggs insists that his latest crusade — against nonprofit hospitals he says are gouging the poor — isn't about the money, at least not for himself. "It would be greedy for those of us who made a lot of money off tobacco not to use it for endeavors like this," he says.

Since June, the courtly Scruggs and a group of other trial lawyers, including ex-tobacco litigators, have filed 48 class actions against more than 400 nonprofit hospitals, including some of the largest and most prestigious health-care providers in California, Illinois, New York and Texas. They have anted up $1.5 million of their own funds to pursue the cases. More suits are being filed almost weekly, all with a similar complaint: that the hospitals are charging the uninsured grossly inflated prices, dispensing a tiny fraction of their revenues in charity care, engaging in abusive collection tactics and, in some cases, using accounting gimmicks to mask their wealth and enrich executives. "It offends my sense of justice that they've gotten away with this," Scruggs says in his gentle Mississippi drawl.

The tricky thing about Scruggs' challenge is that he's taking on widespread industry practices, not just a handful of allegedly corrupt hospitals. The hospital industry's main lobbying group, the American Hospital Association (AHA), says the cases are "without merit." The main contention of the lawsuits is that nonprofit hospitals aren't spending enough on charity care — a condition of their tax breaks. But the AHA points out that hospitals spent $22.3 billion on uncompensated care last year and billions more in "community benefits." The trial lawyers, the AHA insists, are diverting focus from the real crisis: a record 45 million Americans without insurance, ERs clogged with indigent patients and costs rising faster than Medicaid and Medicare reimbursements.

Yet Scruggs and Co. are riding a wave of challenges to the nonprofit-hospital sector. The IRS is probing dozens of those institutions over questions of excessive CEO pay, insider transactions, sweetheart loans and conflicts of interest on hospital boards. Congress recently held hearings on hospital billing and abusive collection tactics. The attorneys general in Illinois and Mississippi have been investigating similar issues. In Mississippi, the U.S. Attorney recently sued Baptist Health Systems, accusing it of paying kickbacks to doctors and filing fraudulent cost reports. (Baptist denies the charges.) Bills are also pending in California and Illinois that would clamp down on some collection tactics and force hospitals to provide more charity care.

A big issue in the Scruggs lawsuits and the state probes is soaring hospital charges. You've heard of the $10 aspirin? It's that pricey because hospitals mark up costs an average of 232%--as much as 673% at the 100 priciest institutions, according to a recent study by the Institute for Health and Socio-Economic Policy. Hospitals do this largely because insurers negotiate discounts off the list price, creating incentives to inflate charges. That expensive aspirin also subsidizes other items and services — a widespread practice.

Yet the uninsured are typically the only ones forced to pay sticker price. The lawsuits complain that hospitals then aggressively pursue patients for the full charge, sometimes garnishing wages, placing liens on homes, and in some cases lumping the bad debt into their calculation of charity care, a controversial accounting practice. "There's nothing charitable about it," contends Scruggs, noting that medical debt is a leading cause of personal bankruptcy.

In 2001, Laverne Dumas, one of the plaintiffs in a suit against Provena Mercy Center in Aurora, Ill., went into the hospital for a severe sinus infection and was sent a $12,338 bill that included $650 a day for the room and $6 for each ibuprofen pill. Uninsured and living mainly on her husband Joe's $800-a-month pension at the time, she says she tried to negotiate a payment plan, but the hospital refused. Provena won a judgment, and today the couple pays $100 in monthly installments, with scant hope of paying off their $27,000 in hospital bills (owed not just to Provena). Says Joe, 63: "We didn't go in expecting charity, but we didn't expect exorbitant prices either."

Was Provena overly harsh? Patrick Coffey, a lawyer for Provena, says the Dumas signed forms promising to pay their bills and "agreed that the charges were fair. We reject the notion of any legal basis or merit to their claims." But the state of Illinois revoked a tax exemption for a Provena hospital based on findings that the hospital wasn't providing enough charity care; Provena is appealing.

The AHA says hospitals must set the same charges for everyone. Secretary of Health and Human Services Tommy Thompson wrote to the AHA in February, however, saying the suggestion that hospitals must charge list prices "is not correct and certainly does not accurately reflect my policy." A Texas hospital administrator is blunt about why hospitals pursue the medically indigent: "The driving force is to badger them so they don't come back."

Scruggs was vaguely aware of such problems but didn't have the basis for a case until a couple of whistle-blowers from Georgia contacted him last March. Dr. John Bagnato and Charles Rehberg, the administrator of Bagnato's private practice, had spent hundreds of hours probing hospital finances — particularly those of Phoebe Putney Memorial, a hospital in Albany, Ga., where Bagnato was chief of surgery. Bagnato's private practice, Albany Surgical, had tried to open an outpatient surgery center across the street from Phoebe, and eventually he and Rehberg suspected the hospital of meddling in state rules that had blocked the plan. (Phoebe denies interfering.) Inspired, the pair began investigating hospital finances. The deeper they delved, the more they became convinced that Phoebe and other nonprofits weren't living up to their charity mission.

Probing Phoebe's IRS tax filings, they found that CEO Joel Wernick was paid $707,000 (including benefits) in Phoebe's 2002 fiscal year and had an interest-free loan from the hospital for $85,300. The filings also showed that Phoebe had more than $300 million in net assets and reported offshore entities in the Cayman Islands worth some $15.5 million. At the same time, Phoebe had sued citizens in the Dougherty County area, one of the nation's poorest, hundreds of times over a five-year span, making the hospital one of the region's most litigious parties. Phoebe garnished the wages of patient Virginia Franklins, 49, even though she made $7 an hour pressing men's dress shirts and had no house or car to her name. After that, Franklins says, "I couldn't afford to pay my bills." She now lives off welfare, caring for a 13-year-old niece as well.

Phoebe says there's nothing improper about its finances or executive compensation. The offshore entities are legal investment and insurance vehicles that have saved the hospital money, officials say. On its website, Phoebe notes that it spends $46.6 million on charity care, and officials stress that patients are informed by hospital signs and other means that they may be eligible for free or discounted care. CEO Wernick, who repaid the loan, calls the class action against Phoebe frivolous. It implies hospitals "are indifferent to the plight of the uninsured," Wernick continues. "That's just not the case."

Bagnato and Rehberg say they are not on a vendetta against Phoebe, though their feud with the hospital took some ugly turns. Aiming to draw attention to what they felt were unscrupulous practices, they sent faxes to local politicians and businesses last fall and winter, including one that showed a cartoon of a fat "Phoebe Exec" puffing on a cigar, with a caption saying, IS THERE REALLY CORRUPTION AT PHOEBE? Around the same time, they say, their office at Albany Surgical was bugged. Rehberg's wife Wanda reports coming home one day and finding the door lock jammed. She saw a phone-company employee outside attempting to install a line that the couple had not requested. Rehberg and Bagnato don't accuse Phoebe of bugging their office or orchestrating other surveillance, and a hospital spokeswoman denies any involvement. But Phoebe slapped Rehberg and "coconspirators" with a defamation suit for sending the faxes, claiming they harmed the hospital's reputation.

Rehberg, meanwhile, says Phoebe tried to intimidate him by sending a couple of private eyes to accost him in a parking lot last month. According to a complaint Rehberg filed with the FBI, the men jumped out of a Jeep, claimed they were former FBI agents, blocked his vehicle and demanded he come with them to sign documents granting him "immunity" from lawsuits in exchange for cooperation. "Think about your wife Wanda and family," Rehberg says he was told, and "keep quiet about all this." A father of 8-year-old twin girls, Rehberg, 44, a former hospital CFO, had never faced anything like this. Phoebe admits it sent the men but denies trying to strong-arm Rehberg.

The Georgians tried to enlist government authorities to their cause but failed. Then Bagnato called an old medical-school friend from Mississippi, David Merideth. Also a lawyer, Merideth suggested talking to Scruggs and asked Bagnato to write up his findings, at that point encompassing dozens of hospitals, in a letter. "I knew we were onto something really good when I gave Dickie the letter and he kept studying it," Merideth recalled. Scruggs was outraged by the accumulation of hospital wealth and seemingly abusive collection efforts. "He wouldn't give it back to me for a while," says Merideth. "When he finally did, he said, 'Wow.'" Two weeks later, Rehberg and Bagnato chartered a plane to Mississippi and presented their research to Scruggs, including tales of conflicts of interest, of executives paid to head both the hospital and for-profit subsidiaries, and plenty of stories of aggrieved patients. By June, the suits were flying. "These hospitals claim they're charities but operate like for-profit businesses," says Scruggs. "We aren't challenging hospitals that are going broke."

Some veterans of the health-care business say the lawsuits are misguided. "Nonprofits can't deliver health care to their community by losing money," says Stephen Shortell, dean of the U.C. Berkeley School of Public Health. Moreover, to folks who do physically and emotionally draining health-care work, the notion of hospitals' hoarding their wealth and targeting the poor is insulting. "There's a lot of outrage over the suits," says Stephen Weyl, a New Hampshire lawyer and hospital-industry consultant.

In fact, many hospitals are revising their charity policies. In California, Sutter Health — a 27-hospital chain accused of spending less than 2% of its revenues on charity care — enhanced its policy last year, giving free care to patients earning up to 200% of the federal poverty guidelines. Provena has broadened its charity-care eligibility, and the AHA has been urging its 4,700 member hospitals to sign new charity and billing guidelines. Scruggs has already notched one victory. In Mississippi, the nation's largest rural hospital system settled with him last month, agreeing to provide an estimated $270 million in debt relief and discounts for patients, even though it wasn't sued. Scruggs calls the deal with North Mississippi Health Services a model, and says he would drop his challenges to hospitals that agree to similar terms.

So far, Bagnato and Rehberg have got nothing but trouble for their efforts. Bagnato says he's being "shut out" from surgery business decisions at Phoebe and suspects the hospital of "politely but pointedly directing patients away from Albany Surgical and me in particular." Phoebe calls that claim abhorrent. But Bagnato is convinced, "If they could get away with firing me, I think they would." Rehberg, who filed counterclaims against Phoebe last week, now has the same security guard who protected Jeffrey Wigand. "Given a choice," Rehberg says, "I prefer to sit in back and observe. But I can't quietly tolerate injustice." Neither, apparently, can Scruggs.
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Old 12-19-2004, 02:49 AM   #45 (permalink)
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sob has it right. The uninsured are the ones subsidizing the non payers. we basically have universal health care in the us, in the sense that anyone that needs treatment gets it, regardless of their ability to pay for it. look at the bums and illegals in the emergency rooms...

And conny, I think you've chased ustwo away. You seem to be reading posts as you want them to read, and not how they are written.
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Old 12-19-2004, 06:27 AM   #46 (permalink)
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Quote:
Originally Posted by stevo22
And conny, I think you've chased ustwo away. You seem to be reading posts as you want them to read, and not how they are written.
Please, tell me where I was wrong. Seems to me that Ustwo was stating that healthcare cannot be good unless it is private, that socialized healthcare everywhere is just as bad as in Russia. Well guess what? It isn't true.
I'm not saying that private healthcare is bad, not at all. If people are willing to pay, let them.
Ustwo also brought up a lot of things that has NOTHING to do with which system a country uses. How has socialized healthcare anything to do with what procedures are permitted for instance?
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Old 12-19-2004, 08:11 AM   #47 (permalink)
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Quote:
Originally Posted by connyosis
Ustwo also brought up a lot of things that has NOTHING to do with which system a country uses. How has socialized healthcare anything to do with what procedures are permitted for instance?
I'm not sure I interpreted this correctly, so I hope I'm not answering a question you didn't ask.

It is my understanding (and I'm going on anecdotal evidence) that there are very strict parameters for receiving care under a socialized system.

For example: Over 60? No heart transplant for you. Liver transplant? No, we've defined that to be "experimental."

Dental implants? No, this piece of plastic you cram in your mouth is good enough for you.

New hip? No, you're 70. Here, use this cane.

And at least in the US, anyone who can pay for something better arouses cries of "Discrimination against the poor" because the poor can't pay for the more ideal treatment.
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Old 12-19-2004, 10:07 AM   #48 (permalink)
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Well, in Sweden we do not have those limits. If you need a new hip, heart, liver or whatever you can get it, no matter if you're 17 or 70. If you cannot get a transplant in the US because you are too old, I can understand socialized healthcare getting a bad rep, but understand (Not directed directly to you) that this isn't the case all over the world.

Also, this is not what Ustwo was talking about. He brought up the fact that "risky" procedures that are not allowed in the US are allowed in Sweden, and according to him this was a bad thing! Something being allowed is NOT the same thing as it being the default treatment, it is however a choice the patient has. Try the old tested treatment, or the newer, potetially risky but also potentially more effective one.
Now, what allowing these "risky" treatments has to do with having a socialized healthcare system is beyond me, but maybe someone else could explain?

I also think it is ridiculous that people bitch at people that can afford private doctors. If you can afford it and want it, you should be able to, but I also think it is a right that if you cannot afford it, you should still be able to recieve good healthcare.
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Old 12-19-2004, 12:05 PM   #49 (permalink)
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Quote:
Originally Posted by connyosis
Well, in Sweden we do not have those limits. If you need a new hip, heart, liver or whatever you can get it, no matter if you're 17 or 70. If you cannot get a transplant in the US because you are too old, I can understand socialized healthcare getting a bad rep, but understand (Not directed directly to you) that this isn't the case all over the world.
I'm not trying to be insulting here, so please don't be offended by this question, which admittedly has a hard edge:

Does Sweden provide health care for anyone in the world who can sneak into the country? If so, I predict long-term illegal immigration into your country.

Quote:
I also think it is ridiculous that people bitch at people that can afford private doctors. If you can afford it and want it, you should be able to, but I also think it is a right that if you cannot afford it, you should still be able to recieve good healthcare.
That's where we have a disagreement, although it's more a matter of degree than principle.

What I consider I have a RIGHT to is life, liberty, .... yada yada. While I know some impoverished people that I like very much, I still have a hard time with saying that they have a right to the labor of others, whether it be doctors, or taxpayers who are footing their bills.

I become even more hard-hearted when a person announces he has a right to a liver transplant at the expense of others, if he has destroyed his own through the use of recreational drugs or alcohol.

It's going to take a really great post from you to change my mind on that one.
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Old 12-19-2004, 12:37 PM   #50 (permalink)
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Quote:
Originally Posted by sob
I become even more hard-hearted when a person announces he has a right to a liver transplant at the expense of others, if he has destroyed his own through the use of recreational drugs or alcohol.

It's going to take a really great post from you to change my mind on that one.
I tend to agree with your logic, but the problem is in the details of implementing such a policy. Where would we draw the line. Do we deny coverage to all risky lifestyles? As an example, do we deny benefits to people who sit all day in front of a computer and get no exercise? Do we deny benefits to parents who knowingly pass on their bad genes to their offspring?

If we are all going to have to pay for it, then I think everyone should be covered. IMO, if we are going to exclude some people then we would be going down a slippery slope.
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Old 12-19-2004, 02:02 PM   #51 (permalink)
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Quote:
Originally Posted by sob
I'm not trying to be insulting here, so please don't be offended by this question, which admittedly has a hard edge:

Does Sweden provide health care for anyone in the world who can sneak into the country? If so, I predict long-term illegal immigration into your country.
Don't worry, I'm not offended. No, of course not. I'm talking about healthcare for swedish citizens.

Quote:
Originally Posted by sob
What I consider I have a RIGHT to is life, liberty, .... yada yada. While I know some impoverished people that I like very much, I still have a hard time with saying that they have a right to the labor of others, whether it be doctors, or taxpayers who are footing their bills.

I become even more hard-hearted when a person announces he has a right to a liver transplant at the expense of others, if he has destroyed his own through the use of recreational drugs or alcohol.
So...if you just happens to be poor, tough shit. Is that what you're saying?
If you get sick but cannot pay for good healthcare then you're on your own? Not a very nice attitude. Why are these people poor? Just being lazy or having bad luck in life?
I can see where this is coming from, if I make money on my own I want to keep them too. It's not like I enjoy paying taxes, but I think it's worth it for making sure no one goes without proper healthcare, education and so on.
I also do not like the thought of someone wasting my tax money because he/she has been smoking her entire life and now has lung cancer, but these people are a minority to the rest benefitting from them.
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