Wednesday, July 20, 2011

Medical Links: Cash-Only in U.S., Rationing in U.K.

1. Cash only doctor in Minnesota: She accepts cash, checks, eggs or pie, but no insurance:



2. GracePoint Healthcare near Nashville offers "modern medicine the old-fashioned way," i.e. "patient-centered" instead of "insurance-driven" with a cash-only, self-pay policy for same-day or next-day appointments, individualized no-rush appointments, and housecalls after hours and on weekends.  Various payment plans are offered, including a basic option for $49 per month and $40 per visit (with most lab fees included), which is about the same monthly cost as a cell phone. Even with one office visit per month, the monthly cost would be about the same as most cable or satellite TV plans.  

3. Meanwhile, the U.K.'s National Health Service (NHS), in an effort to save money, has started to ration access to non-urgent surgery like hip replacement operations by not allowing smokers and overweight patients to get on the waiting list until they go through some "reeducation" training.   

48 Comments:

At 7/20/2011 9:07 AM, Blogger Brian said...

They have them in Texas as well. My wife just had 8 grand in surgery to repair her stomach walls after three c-sections. No insurance, no credit cards. Cashier's check only.

 
At 7/20/2011 10:46 AM, Blogger Hydra said...

"Various payment plans are offered, including a basic option for $49 per month and $40 per visit (with most lab fees included), which is about the same monthly cost as a cell phone."


Does that include renal keratonephroplasty?

 
At 7/20/2011 10:46 AM, Blogger Hydra said...

Is that cashiers check before, or after the surgery?

 
At 7/20/2011 10:50 AM, Blogger VangelV said...

This would be considered illegal in Canada where all access is supposedly equal and most private payments are deemed as advantageous to the rich, who can use money to jump the rationing ques.

 
At 7/20/2011 10:51 AM, Blogger Benjamin said...

On the other hand, even with Great Britain's socialist, lazy ethos, they spend one-half what we do on medical care. Japan spends about one-quarter.

For such huge savings, maybe I will quit smoking before that non-emergency hip replacement....

btw, if you need surgery and do not have medical insurance, I recommend Thailand. I had two surgeries there with good results (as far as a layman can tell). About 10 percent of USA prices.

 
At 7/20/2011 10:59 AM, Blogger Larry G said...

"rationing" verses "jumping the queue".

1. - most private insurance - "rations" - every time they refuse to cover a procedure or deny coverage.

2. - any rich person anywhere under any health care system - govt-controlled or otherwise can and do "jump the queue" whether they be in Canada, the UK, India or the US.

this is the big lie being propagandized here and in other places - that universal health care FORCES you to take ONLY that care and to be subject to nasty rationing or "death squads".

If you have the money and you want to go "bare" without insurance..or not use the govt-provided option and pay out of your own pocket for higher quality healthcare - there is no law that will put you in jail for exercising that personal prerogative.

 
At 7/20/2011 11:03 AM, Blogger VangelV said...

On the other hand, even with Great Britain's socialist, lazy ethos, they spend one-half what we do on medical care. Japan spends about one-quarter.

For such huge savings, maybe I will quit smoking before that non-emergency hip replacement....


What savings? If you want to get even trivial care from a physician be ready to waste an extra hour or so waiting. That is after you have to wait several days or weeks to get in to see the doctor. And let us note that it is easy to 'save' if you do not have to do tests to protect yourself from law suits. That extra expense has nothing to do with medicine and everything to do with the dysfunctional legal system in the US.

Then there is the unavailability of resources to provide those that need hip replacements or timely access to something as basic as an MRI.

 
At 7/20/2011 11:20 AM, Blogger VangelV said...

2. - any rich person anywhere under any health care system - govt-controlled or otherwise can and do "jump the queue" whether they be in Canada, the UK, India or the US.

Only if they have the connections to jump to the front of the line, as politicians do, or if they are willing to leave the country to get a procedure done. A Canadian cannot just go out and pay money to jump a queue. If I want an MRI I have to wait in line like everyone else. (The irony is that if I have the cash I can get an MRI for my dog the same day on the same machines.)

this is the big lie being propagandized here and in other places - that universal health care FORCES you to take ONLY that care and to be subject to nasty rationing or "death squads".

As I said, you are free to leave the country and pay for care somewhere else. While that is an option for those who are well off, the poorer segment of society is usually screwed.

If you have the money and you want to go "bare" without insurance..or not use the govt-provided option and pay out of your own pocket for higher quality healthcare - there is no law that will put you in jail for exercising that personal prerogative.

But in a place like Canada there is a law that prohibits physicians to provide much of that care.

 
At 7/20/2011 11:56 AM, Blogger Mike said...

Larry,
"this is the big lie..."

I don't think so. This is the big disconnection between the political ideologue and the rest of us. I don't have tons of money, certainly not enough to jump any queue (unless I wanted to liquidate retirement savings). But I can afford to pay for decent health insurance of my choice and seek treatment where I choose.

Fact is: the number of wealthy who will jump queue and go without insurance is about the same as the number of people who fall in the crack - those who truly (through no fault of their own) can't afford to be insured, but not poor enough to already be covered with government help. The huge bulk in the middle will pay the price and the reduced payments will stall medical innovation.

Since nobody else will answer my ObamaCare question, I'll ask you, Larry, since you seem to be a proponent.
What happens to those who refuse to pay their fine for not buying health insurance when this mess kicks in?
I went to jail when I was a kid for not paying a $50 speeding ticket...
I envision yet another 'new class of criminal', but I can't find any information regarding ultimate enforcement. It is true, however, that you do get health care in prison.

 
At 7/20/2011 12:08 PM, Blogger juandos said...

"this is the big lie being propagandized here and in other places - that universal health care FORCES you to take ONLY that care and to be subject to nasty rationing or "death squads""...

Are you kidding?!?!

Supposedly non-existent death panels removed from ObamaCare

'The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday'...

 
At 7/20/2011 12:37 PM, Blogger Steve said...

@ juandos:

Do you really believe that allowing Medicare to pay for you to have a voluntary conversation with your own physician about when, and under what circumstances, YOU might prefer to change your medical-care desires is something that should be called a "death panel"?

A lot of people who've seen loved ones suffer through useless, invasive and painful end-of-life 'care' would call those conversations "life-affirming". Do you oppose Hospice, also?

Do dying patients have the obligation to endure whatever doctors tell them might extend their life 1 day? If not, who do you think should talk with the patient to help them understand their right to continue, or end, interventional treatment?

 
At 7/20/2011 12:45 PM, Blogger Benjamin said...

Vange-

Why are medical outcomes roughly the same in all developed nations, despite huge differences in costs? Why does a Japan get roughly same results as USA?

You say wait times are longer in Japan than in the USA, even for routine medical visits. Cite some evidence.

 
At 7/20/2011 1:35 PM, Blogger Benjamin said...

Jaundos-

Actually, to cut costs we need to pull the plug on old people rather quickly.

If we go to a free market, euthanasia will become a popular option for the elderly.

After all, do you want to $250k to live another three months in agony, or give it to your kids?

I just hop we advance to the point we let old people have opium.

And, in a free market, if you are old and have no money, then you are dead already.

 
At 7/20/2011 1:40 PM, Blogger juandos said...

"Actually, to cut costs we need to pull the plug on old people rather quickly"...

Heck pseudo benny, pay for the gasoline and I'll drive out to California and pull your plug...:-)

Jussssst kidding!

Actually there aren't that many people I've seen who were in the throes of terminal agony that wanted to commit suicide...

 
At 7/20/2011 2:01 PM, Blogger Steve said...

@ jaundos 1:40pm:

"Actually there aren't that many people I've seen who were in the throes of terminal agony that wanted to commit suicide..."

But how many of of those might decide to stop agony-prolonging treatment if they knew that was an acceptable course of action?

 
At 7/20/2011 2:03 PM, Blogger Mike said...

Benjamin,

"Actually, to cut costs we need to pull the plug on old people rather quickly..... Why does a Japan get roughly same results as USA (despite huge differences in costs)"?

You'd be strung up for saying something like that about seniors in Japan.

Perhaps you've answered your own question, cultural differences can be a major factor in costs. We want our old people to go away and not be a bother....many (if not most) of the other developed cultures still live with, and care for, their elderly.

 
At 7/20/2011 2:31 PM, Blogger juandos said...

"Do you really believe that allowing Medicare to pay for you to have a voluntary conversation with your own physician about..."...

Steve if you really think there's anything about being a medicare recipient that's voluntary then can I sell you a bridge I own that goes over the Mississippi river from Missouri to Illinois?

"YOU might prefer to change your medical-care desires is something that should be called a "death panel"?"...

Do you have a more accurate name for it?

"A lot of people who've seen loved ones suffer through useless, invasive and painful end-of-life 'care' would call those conversations "life-affirming". Do you oppose Hospice, also?"...

Call it whatever you want but at the end of the day its what it is, someone else calling the shot for you...

Personally I wouldn't be caught dead in a hospice if I have any say in the matter...

"Do dying patients have the obligation to endure whatever doctors tell them might extend their life 1 day?"...

Not anymore than you do in your present condition assuming you have nominal health right now...

"If not, who do you think should talk with the patient to help them understand their right to continue, or end, interventional treatment?"...

Who says the patient needs to talk to anyone about anything?

I mean do you ask someone for permission to live another day in your present condition?

Of course not!!

Steve I can't help but get the impression that somehow since an adult is dying (and not suffering from some form of dementia) they should be treated like children for want of a better way to put it...

Steve what did dying people do before the advent of ObamaCare or other socialized medical programs?

 
At 7/20/2011 2:36 PM, Blogger Benjamin said...

Mike-

In any event, what is the point of keeping people alive past their expiration date?

If people spend their own money to do so, fine (though inadvisable).

Right now, we are compelled by law to spend money to keep the carcasses alive for a few more weeks or months.

Death panels are a great thing.
Euthanasia is a great thing too. In a free market, the elderly will choose to pass away quickly, doped up into a pleasant stupor. I know I would.

Otherwise, don't complain when healthcare costs consume 25 percent of GDP.

But please don't pretend to be resting on lofty morals and ethics and praising free enterprise for health care.

Free enterprise in health care will mean pulling that plug at the first sniffle, when 82-year-old visits the hospital.

Just face up to it.

 
At 7/20/2011 2:37 PM, Blogger juandos said...

"But how many of of those might decide to stop agony-prolonging treatment if they knew that was an acceptable course of action"...

Steve if the person is mentally cognizant that person can make choice for him/her self...

In my own experience I've yet to see a person who was in immense agony, knew they were dying wanted to hurry the process along...

I've only seen that on television...

Where there's a spark of life there's hope even if the odds are trillions to one against any possibility of living much longer...

 
At 7/20/2011 2:41 PM, Blogger juandos said...

"In any event, what is the point of keeping people alive past their expiration date"...

pseudo benny who gets to make that decision other than the person in question?

I mean think about it... You might have a neighbor or a family member who may think that you've outlived your usefulness by decades...

Do you want that person or persons to unilaterally make the decision that, "its time to pull pseudo benny's plug"?

 
At 7/20/2011 2:48 PM, Blogger arbitrage789 said...

The UK does have "Harely Street"

http://www.harleystreetguide.co.uk/

 
At 7/20/2011 3:11 PM, Blogger Mike said...

Benjamin,
All I said was, perhaps you answered your own question...and introduced a fair point about the problems in comparing costs with other nations/cultures.
Why so defensive?

I agree with you about end of life options and think we should be free to choose a dignified exit. However, you're flat-out crazy if you think someone else making that choice for me is a great idea.

Talk about lofty morals...if you trust in the narcissistic bureaucrats, who deem themselves wise enough to say who gets a chance and who dies, you must consider yourself worthy to be their peer.
I'd be careful forecasting what you'll be thinking when your time comes (or the time of someone you love)....and try not to act so tough, Benjamin, you aren't credible as bad-ass Nostradamus.

 
At 7/20/2011 3:38 PM, Blogger Benjamin said...

Mike-

Okay, I'll tone down when trading posts with you. Look forward to more posts by you.

 
At 7/20/2011 3:42 PM, Blogger Benjamin said...

Jaundos-

Keeping my carcass "alive" for a extra week or month is not going to make my life richer. If I get to 80, I have lived my life already, or should have.

Frankly, I don't want to live if I become a burden on others, or my society.

My own standard: If I can't feed myself and wipe my fanny anymore, it's time for some serious pot, coke , and Johnnie Walkers. I want to know what it is like to be George Bush jr. before I die.

 
At 7/20/2011 3:58 PM, Blogger VangelV said...

Why are medical outcomes roughly the same in all developed nations, despite huge differences in costs? Why does a Japan get roughly same results as USA?

These are good questions. While I am not an expert let me give you some explanations that are plausible.

First, outcomes are not measured equally. Let us look at some differences.

As many have pointed out the US considers low birth weight babies viable and includes them as part of the mortality data. That does not happen in most other countries, who ignore those deaths and do not consider a delivery as viable unless the baby survives.

The mortality data is also skewed by deaths due to violence in the US. The American government has criminalized many voluntary activities and has the highest incarceration rate of any country. Those that are incarcerated are not protected well so they wind up with AIDS, hep C, and other diseases that lead to early deaths. Then there is the issue of gun deaths. By making drug dealing lucrative the US government has ensured that gangs will fight for territory in order to protect market share. The conflict kills many gang members who wind up as part of the mortality statistics. (As do victims who happened to be in the wrong place and the wrong time.) Then there are the people killed by the federal, local and state government, which have well armed goons that are used to enter premises and kill ordinary citizens.

Let me add obesity to the picture. The US is a country in which the poor are suffering from high obesity rates. Higher obesity means lower life expectancy.

If you adjust for these factors you will find that the US gets a better relative outcome than is implied in the statistics.

Then there is the cost. As I pointed out, the US health care system is forced to spend money on useless tests that other countries do not incur. That has nothing to do with health care and everything to do with the legal system.

Get rid of the lawyer driven costs as well as the high regulatory reporting costs and the US does not spend nearly as much as other countries. What you get is a much better performance for direct dollars spent than is being reported.

(And note that I have not yet mentioned the IP issues that have to do with the use of drugs. Add that to the picture and the performance of the US comes out even better.)

You say wait times are longer in Japan than in the USA, even for routine medical visits. Cite some evidence.

I said that they were longer in Canada than in the US. I have cited lots of studies previously that show people dying on waiting lists even as the equipment that they were waiting for was accessible by their pets.

 
At 7/20/2011 4:02 PM, Blogger juandos said...

"Frankly, I don't want to live if I become a burden on others, or my society"...

Well pseudo benny talk is cheap...

I'm pretty sure that most all of us have at the very least thought the samething you've just commented but when it really gets to making the decision then it seems all previous thoughts of just 'chucking it' tend to fade away...

 
At 7/20/2011 4:25 PM, Blogger Mike said...

Benjamin,
You aren't offending me, I just don't think even you believe what you're saying.

For example, let's say that carcass is now your mother (or somebody you care for) and s/he has a stroke as you're boarding a plane for Thailand. Due to circumstances, you don't even find out for 2 days and, for various reasons (weather, availability, cost, obligation, etc.) you can't get a flight for a week.
I'm pretty sure you wouldn't want a bureaucrat making that decision for you in your absence.

And Juandos is right, just as 20-year-old Benny would make some bad choices according to 40-year-old Benny, you haven't the slightest idea what death-bed Benny will say about this discussion.

 
At 7/20/2011 4:56 PM, Blogger Benjamin said...

Mike-

Well...I think I know my mind on this one. I am 56 now. Frankly, this is gravy already--my brother cancelled his ticket at 50.

I want to make it to 70.

I have to wrap up some ends, get to Thailand in couple of years, make sure my family will be financially set.

I hope to stay active and productive--gentleman farming--until I die.

But really, I have had a good long life already. No, I am pretty sure if it is adult diapers in a bed 24/7, I want out.

You guys probably think I am some sort of leftie loafer, from my anti-GOP, anti-military ranting.

But man, I just can't stand not being productive, making furniture, sweeping shop, farming whatever.

And I detest people who draw SSDI early, or loaf on taxpayer's dime. I am not a friend of the Dems either.

I admire the Mormons a lot for their productive lifestyles.

And I don't want to sit around not being productive in adult diapers.

 
At 7/20/2011 5:10 PM, Blogger Steve said...

@ juandos: the provision we're talking about ALLOWS the patient to request this counseling if they want it (it is not forced), and ALLOWS Medicare to pay for that appointment. That's all.

It is voluntary in the same way that a requesting an appointment with your GP, paid for by Medicare, is voluntary.

"Do you have a more accurate name for it?"

Yes, compassionate end-of-life counseling. Question: your elderly parent has a serious or terminal illness, and you've never talked about when and under what circumstance they might wish to change the current treatment course, or take/not take the 5th round of chemo, or if they want to fight until the end or perhaps move to hospice at some point.

Would you like to ability to have that conversation? Would you like the ability to have that conversation with a doctor, or family counselor in the room? Would you like Medicare to pay the doctor for that appointment just like Medicare would pay the doctor to deliver another round of chemo?

That is not "calling the shots for you", that is not mandating that you stop treatments to save money, that is not a death panel.

"Who says the patient needs to talk to anyone about anything?"

Nobody, but if the patient WANTS to talk to their doctor about such things, this provision would allow Medicare to pay for that appointment.

"I mean do you ask someone for permission to live another day in your present condition?"

No, and there's nothing in this provision that is even close to your assertion. Stop creating fear-mongering strawmen.

"I can't help but get the impression that somehow since an adult is dying they should be treated like children for want of a better way to put it..."

Then you're getting the wrong impression. They are being treated like adults, and give the opportunity to voluntarily ask, if they want, to talk to someone about their end-of-life concerns, if they have any. That's all.

"if the person is mentally cognizant that person can make choice for him/her self."

It is always their choice about whether to continue treatment. Some people want to fight until the bitter end - they can. Some people might want to know what other options there are - now they can.

"In my own experience I've yet to see a person who was in immense agony, knew they were dying wanted to hurry the process along..."

It not hurrying the process along, it is deciding for yourself when to stop futile but painful treatment. I would wager you've never seen anyone dying from a terminal illness if you've never seen anyone decide that a peaceful last month at home is better that an agonizing last 3 months in an ICU.

 
At 7/20/2011 6:37 PM, Blogger Che is dead said...

"... the provision we're talking about ALLOWS the patient to request this counseling if they want it (it is not forced), and ALLOWS Medicare to pay for that appointment. That's all."

Actually, it requires participating physicians to initiate a "conversation" and to cover specific non-curative options for the patient's consideration.

If planning for the eventuality of a disabling injury or disease, or a terminal illness is important - and I agree that it is - why should physicians be waiting until the patient is old and senile and potentially grappling with such an event. Why aren't the liberals insisting that these "conversations" take place when people are in their late 40's or 50's when their minds are sharp and they have adequate time to consider what course of care would be in their own bets interests and consistent with their values? Because they are hoping that vulnerable seniors with terminal conditions and illnesses can be persuaded to accept inexpensive palliative care or hospice.

When George W Bush made hospice care available under Medicare he did not insist that vulnerable seniors be "consoled" to consider hospice care as an option, precisely because to do so would have been unseemly and unethical.

 
At 7/20/2011 6:48 PM, Blogger Che is dead said...

"Why are medical outcomes roughly the same in all developed nations, despite huge differences in costs?"

They are not. The U.S. survival rates for every kind of cancer are far above countries with socialized health care. Further, the U.S. rates #1 in "responsiveness" meaning that not only will you get more effective care for major illnesses but you will get it in a timely manner. As for there being "huge differences in costs", the difference in health care outlays in the U.S. reflects the fact that people are allowed to spend whatever they want and can afford for treatment under our system, that is not the case under most socialized health care schemes that ration access to physical care and pharmaceuticals.

"Why does a Japan get roughly same results as USA?"

Same results with regard to what? Health care in Japan is heavily rationed resulting in log waiting times and in many cases denial of care. As a result, those that can afford it carry private insurance policies in case of a medical emergency.

 
At 7/20/2011 6:52 PM, Blogger Stephen said...

Is paying cash in the UK and not using the national insurance banned or something? What am I missing?

 
At 7/20/2011 6:57 PM, Blogger Benjamin said...

Che is Dead-

Average life span in Japan is 80.7, the USA 77.1 and in the UK 77.7.

We are spending incredible amounts of money, for little result--in fact, we have lesser life spans than Great Britain.

The USA health care system is devised by providors and lawyers.

Cite: http://geography.about.com/library/weekly/aa042000b.htm

 
At 7/20/2011 7:00 PM, Blogger Che is dead said...

"most private insurance - "rations" - every time they refuse to cover a procedure or deny coverage."

Nobody denies essential or needed care like a socialist. Medicare has a denial of coverage rate almost twice as high as all private insurers combined:

"The Medicare denial rate found in the study was, on a weighted average basis, roughly 1.7 times that of all of the private carriers combined ..."

Further, Medicare's low payment rate shifts costs to private insurers who must make it up by charging higher premiums and limiting some treatment options for their customers.

Medicare is just another Ponzi scheme put in place by Democrats in order to purchase the votes of some Americans at the expense of others. If liberals were really concerned about health care for the elderly the very last thing that they would have done is to enact a program that will ultimately fail by design, just as millions of Americans are about to become dependent on it.

 
At 7/20/2011 7:09 PM, Blogger Che is dead said...

This comment has been removed by the author.

 
At 7/20/2011 9:37 PM, Blogger Harold said...

As far as average lifespan in Japan goes- the Japanese bureacracy has recently discovered that a lot of the 100+ year olds in Japan drawing pensions, are, in fact, dead. The families just never reported the deaths. Since the checks went into joint bank accounts...

And the US had two radically different lifespans, that is very politically incorrect to mention. Black males live average shorter lives by far than any other identifiable group, skewing the whole average down. A lot of these are by violence, not medical reasons.

And including infant deaths that other nations don't include as live births skews the average down.
Preemies in the US aren't neglected; huge amounts of money are spent keeping them going.

We spend more on health care, and get more in return.

Soon, nano-tech medicine and adult stem cell should bring us great advances- advances that WON'T happen if the government takes over. Lab grown new organs that don't require immuno-suppression drugs, lab grown teeth (which I'm eagerly waiting for) to replace ones that have been lost, all these are just around the corner.

My recent ancestors have lived into their 90's not taking good care of themselves. I plan on making it into my 100's. No tobacco use, moderate instead of heavy drinking, and keeping my weight under control should help, I hope.

A significant portion of our health care is under our direct control- living healthy.

 
At 7/20/2011 11:01 PM, Blogger Che is dead said...

Average life span in Japan is 80.7, the USA 77.1 and in the UK 77.7 ... in fact, we have lesser life spans than Great Britain."

"Average lifespan" can be calculated differently in different countries. Most calculations include things like homicides and fatal auto accidents but omit the deaths of premature infants unless they have survived longer than some arbitrarily set minimum amount of time. The U.S. counts all premature births and deaths when calculating infant mortality and avg. lifespan which lowers our average.

Homicides, fatal auto accidents and the like are not measures of the effectiveness of a country's health care system. So, "average lifespan" tells you very little when making comparisons.

 
At 7/21/2011 7:47 AM, Blogger VangelV said...

Average life span in Japan is 80.7, the USA 77.1 and in the UK 77.7

The Japanese numbers are propped up by SS fraud. Families have trouble making it so they keep the death of the elderly secret. How do you think Japan got all those centagenarians that wound up dying decades ago? And when you adjust for obesity, gun deaths, AIDS, and other non-medical issues, Japanese do not live longer than Americans. If Americans stopped shooting each other and were as thin as Japanese they would live a lot longer.

 
At 7/21/2011 11:06 AM, Blogger morganovich said...

lifespan calculations are also greatly influenced by how you handle preemie babies.

in the US, you take a breath, you are alive.

in most of the world, you need to live 24 hours, and preemies, with their much higher death rates, are not counted at all.

we get a lot more "0's" in our averages.

that has a significant effect.

 
At 7/21/2011 11:40 AM, Blogger Mike said...

Benjamin,
I totally agree that you should be able to make your own choice when your time comes....56, however, doesn't sound that close to death's door to me.

There's no way in hell you won't live to be 90...it always seems to work that way. You may as well start sizing Depends. And, with all the spicy Thai food, you may want to go with extra-absorbent.

 
At 7/21/2011 11:45 AM, Blogger juandos said...

"@ juandos: the provision we're talking about ALLOWS the patient to request this counseling if they want it (it is not forced), and ALLOWS Medicare to pay for that appointment. That's all"...

Yeah, well OK Steve if that baseless thought gives you comfort amigo then run with it...

Regarding your question about the condition of the elderly parent, I'm not sure why you should believe a doctor whether one is on medicare or not...

First of all depending on medicare seems to be a fool's game anymore...

Second, since the elderly parent has already gone through a treatment course and the doctor says it still doesn't look good then what does the parent need the doctor for?

"Would you like to ability to have that conversation? Would you like the ability to have that conversation with a doctor, or family counselor in the room?"...

I don't need medicare for that conversation and I'm pretty sure the conversation is a waste of time and money but I'm only considering my case, my brother who passed away five years ago, my parents...

Doctors and conselors weren't necessary or more importantly not wanted since we were all adults and luckily we all had a grip on reality...

Personally I'm hoping enough people come to their collective sense and we'll hopefully dump medicare and medicaid...

Do taxpayers need to continue to finance corruption and fraud?

"Would you like to ability to have that conversation? Would you like the ability to have that conversation with a doctor, or family counselor in the room? Would you like Medicare to pay the doctor for that appointment just like Medicare would pay the doctor to deliver another round of chemo?"...

I have the ability to have that conversation even if I was dirt poor or worse...

I don't want medicare anywhere near me...

"No, and there's nothing in this provision that is even close to your assertion. Stop creating fear-mongering strawmen"...

Fear mongering? Have you not paid attention to how federal government programs evolve?

Look at the history of the Ponzi scheme called Socialist Security...

 
At 7/21/2011 3:41 PM, Blogger Hydra said...

But in a place like Canada there is a law that prohibits physicians to provide much of that care.

=================================
But this is a fault of th ecandian system, not of universal health care generally. I beleive in "Britain one is free to go hire a private physician - if you can afford it.

One way to manage this would be to put a tax on payments to private physicians and use that to fund public health care.

You would have an automatic feedback mechanism that would prevent either one from being out of control. Bad public health care would lead more people to private docots, which would mean more money to reducde the problems with public health care.

If Private health care is too expensive or too hard to get insurance for, more people will opt for public health care.

It is not as if health care is two competing systems: public and private. both systems have their failings and the issus is how to minimize the combinataion of failures, not to champion one system over another based on some ideology.

 
At 7/21/2011 3:45 PM, Blogger Hydra said...

I don't want medicare anywhere near me...


Maybe not now. But let me assure you that private insurance can be mush worse than anything you can imagine about medicare.

If I could get anywhere near a couple of medical insurance executives, they would be begging for medicare themselves after a short time.

 
At 7/21/2011 3:46 PM, Blogger Hydra said...

"And when you adjust for obesity, gun deaths, AIDS, and other non-medical issues, Japanese do not live longer than Americans."


so you think e need more gun control and obesity laws?

 
At 7/21/2011 3:48 PM, Blogger Hydra said...

But I can afford to pay for decent health insurance of my choice and seek treatment where I choose.

===============================

As long as they agree to sell it to you, and until they kick you off the rolls, yes, you can afford it.

Which is to say, exactly as long as you do not need it or do not use it.

 
At 7/21/2011 3:51 PM, Blogger Hydra said...

A significant portion of our health care is under our direct control- living healthy.

================================

Yes, and insurance is for that other portion: if they will sell it to you, and until they kick you off.

 
At 7/21/2011 6:34 PM, Blogger Ron H. said...

"so you think e need more gun control and obesity laws?"

No, he means that people like you, for who more laws and regulations are the obvious solution, need to consider more carefully what actually contributes to life expectancy numbers, beyond just the minor influence of health care coverage.

 
At 7/21/2011 6:42 PM, Blogger Ron H. said...

"Yes, and insurance is for that other portion: if they will sell it to you, and until they kick you off."

Insurance should be for those catastrophic events that could cause serious financial losses, not for those predictable or minor expenses you can budget for yourself.

Just like your auto insurance.

Just like your homeowner insurance.

Just like your disability insurance.

 

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