Health Care reform from a Doctors perspective

[St_Francis]

So every single person with a heart condition, cancer, diabetes and the like should completely rely on charity? Anything that’ slikely to cost any money? What’s the point of insurance?

Insurance is a gamble: the purchaser is saying he will get sick and the insurance company is saying he will stay well.

Those who have diabetes, etc., will be covered up to the level of their bet with the insurance company, and then they’re finished. They won their bet, but the casino will kick them out.

Most everyone who has insurance will not get sick, so the problem we have in this country is not so much the insurance companies but the way they skewed the market forces in the health care sector, along with what government intervention has accomplished. Add to that the facts that we suddenly decided that having babies was bad for the earth or some such nonsense and also had sudden rises in levels of very expensive illnesses and you have the recipe for disaster.

 

[pathia]

Insurance is a gamble: the purchaser is saying he will get sick and the insurance company is saying he will stay well.

Those who have diabetes, etc., will be covered up to the level of their bet with the insurance company, and then they’re finished. They won their bet, but the casino will kick them out.

Most everyone who has insurance will not get sick, so the problem we have in this country is not so much the insurance companies but the way they skewed the market forces in the health care sector, along with what government intervention has accomplished. Add to that the facts that we suddenly decided that having babies was bad for the earth or some such nonsense and also had sudden rises in levels of very expensive illnesses and you have the recipe for disaster.

Cancer causes 1 in 4 deaths in the country, that’s just the people that DIE from it, more than 25% of the population will get it in their lifetime. Heart disease is about another fourth, a bit more than cancer. That’s over 50% of all deaths being caused by chronic conditions. Suddenly your ‘most everyone will not get sick’ doesn’t make any sense. Most people WILL

My father had to put a second mortgage on the house to pay for my mother’s cancer. The insurance company dumped her. I see no free market solution, you cannot when the costs are this astronomical, even if they were reduced to half what they are now, it’s still be a ton of money.

 

[St_Francis]

Cancer causes 1 in 4 deaths in the country, that’s just the people that DIE from it, more than 25% of the population will get it in their lifetime. Heart disease is about another fourth, a bit more than cancer. That’s over 50% of all deaths being caused by chronic conditions. Suddenly your ‘most everyone will not get sick’ doesn’t make any sense. Most people WILL

Cancer rates and cardiac disease have grown in this country, and so have the treatments for them. This is why insurance has gone up so much in cost.

My father had to put a second mortgage on the house to pay for my mother’s cancer. The insurance company dumped her. I see no free market solution, you cannot when the costs are this astronomical, even if they were reduced to half what they are now, it’s still be a ton of money.

If we applied free market principles, then costs would go down. For example, if a town has only the one MRI that the state government allows them, and the people getting MRIs are not aware of the cost much less having to make a decision based on cost, then the MRI owner can charge pretty much what he wants to charge.

If we apply the two free market principles lacking in my example and allow as many MRIs as people want to put in and also create a scenario whereby people are cost-conscious, then the price of an MRI will go down.

Right now, the government enforces all sorts of non–free market activity in medicine. They put a strangle-hold on supply, which means there are all sorts of mini-monopolies that would not be allowed–look at what happened when Bill Gates did stuff like that. They create rules about pricing which benefit the insurer and work against the uninsured person who has to bear the burden of creating a profit. And the government gives away treatment to a group based *solely *on perceived income *which raises the rates for others *because so many people then *overuse *what few facilities the government has allowed.

That’s one whole area of what causes the costs to be so high.

I’m not saying that if we applied free market principles the costs would come down so much that you could get chemo for the price of a candy bar or anything like that, but costs would come down considerably.

Right now, the government wants to do more of what it has been doing. Well, that’s the definition of insanity, right? In order to solve a problem, the government needs to look at the *causes *of the problem, then work on that.

As long as health care is a part of our economy, we will have problems. When health care was part of our religious institutions rather then our market institutions, we didn’t run into these problems, but of course health care was much more basic back then.

 

[royal_archer]

So every single person with a heart condition, cancer, diabetes and the like should completely rely on charity? Anything that’ slikely to cost any money? What’s the point of insurance?

The point of insurance is that you buy it before you get sick and you pay for the proportional risk. You don’t pocket the cash for years and then try to get insurance when the moderate risk turns into an absolute reality.

 

[royal_archer]

Cancer causes 1 in 4 deaths in the country, that’s just the people that DIE from it, more than 25% of the population will get it in their lifetime. Heart disease is about another fourth, a bit more than cancer. That’s over 50% of all deaths being caused by chronic conditions. Suddenly your ‘most everyone will not get sick’ doesn’t make any sense. Most people WILL

My father had to put a second mortgage on the house to pay for my mother’s cancer. The insurance company dumped her. I see no free market solution, you cannot when the costs are this astronomical, even if they were reduced to half what they are now, it’s still be a ton of money.

We are mortal. We will die. I know that is a hard concept for some to grasp but history has proven that with only a very few exceptions, people die. When we get old we need to expect that our time will come and we will be called home. Most of this nation’s medical costs are spent in those final months attempting to postpone the innevitable. With all of the latest medical innovations one can spend enourmous amounts of money trying to get extra months, weeks, days. When insurance companies or governments are picking up the bills people seem to loose all perspective for costs.

It is understandable to treat these conditions more agressively in young patients where their chance of long term survival is good. But the percentages you are refering to are primarily for patients who are at the end of life. For those in the latter years of life; even if there were a magical million dollar pill for one condition, the patients could not expect to have a long life because in those latter years, multiple conditions are existing and the end of their days is innevitable.

 

[royal_archer]

Got this in the mail and it seemed relevant:

This is beautiful! Try not to cry.

She jumped up as soon as she saw the surgeon come out of the operating room. She said: ‘How is my little boy ? Is he going to be all right ? When can I see him ?’

The surgeon said, ‘I’m sorry. We did all we could, but your boy didn’t make it.’

Sally said, ‘Why do little children get cancer ? Doesn’t God care any more ? Where were you, God, when my son needed you ?’

The surgeon asked, ‘Would you like some time alone with your son ? One of the nurses will be out in a few minutes, before he’s transported to the university.’

Sally asked the nurse to stay with her while she said good bye to son. She ran her fingers lovingly through his thick red curly hair. ‘Would you like a lock of his hair ?’ the nurse asked.

Sally nodded yes. The nurse cut a lock of the boy’s hair, put it in a plastic bag and handed it to Sally.

The mother said, 'It was Jimmy’s idea to donate his body to the University for Study. He said it might help somebody else. 'I said no at first, but Jimmy said, ‘Mom, I won’t be using it after I die. Maybe it will help some other little boy spend one more day with his Mom.’ She went on, ‘My Jimmy had a heart of gold. Always thinking of someone else. Always wanting to help others if he could.’

Sally walked out of Children’s Mercy Hospital for the last time, after spending most of the last six months there. She put the bag with Jimmy’s belongings on the seat beside her in the car.

The drive home was difficult. It was even harder to enter the empty house. She carried Jimmy’s belongings, and the plastic bag with the lock of his hair to her son’s room.

She started placing the model cars and other personal things back in his room exactly where he had always kept them. She laid down across his bed and, hugging his pillow, cried herself to sleep.

It was around midnight when Sally awoke. Laying beside her on the bed was a folded letter The letter said:

'Dear Mom, I know you’re going to miss me; but don’t think that I will ever forget you, or stop loving you, just 'cause I’m not around to say ‘I Love You’. I will always love you, Mom, even more with each day. Someday we will see each other again. Until then, if you want to adopt a little boy so you won’t be so lonely, that’s okay with me… He can have my room and old stuff to play with. But, if you decide to get a girl instead, she probably wouldn’t like the same things us boys do. You’ll have to buy her dolls and stuff girls like, you know. Don’t be sad thinking about me. This really is a neat place. Grandma and Grandpa met me as soon as I got here and showed me around some, but it will take a long time to see everything. The angels are so cool. I love to watch them fly. And, you know what? Jesus doesn’t look like any of his pictures. Yet, when I saw Him, I knew it was Him… Jesus himself took me to see GOD ! And guess what, Mom!? I got to sit on God’s knee and talk to Him, like I was somebody important. That’s when I told Him that I wanted to write you a letter, to tell you good bye and everything. But I already knew that wasn’t allowed. Well, you know what Mom ? God handed me some paper and His own personal pen to write you this letter. I think Gabriel is the name of the angel who is going to drop this letter off to you. God said for me to give you the answer to one of the questions you asked Him ‘Where was He when I needed him ?’ 'God said He was in the same place with me, as when His son Jesus was on the cross. He was right there, as He always is with all His children. Oh, by the way, Mom, no one else can see what I’ve written except you. To everyone else this is just a blank piece of paper. Isn’t that cool ? I have to give God His pen back now. He needs it to write some more names in the Book of Life. Tonight I get to sit at the table with Jesus for supper. I’m sure the food will be great.

Oh, I almost forgot to tell you. I don’t hurt anymore. The cancer is all gone. I’m glad because I couldn’t stand that pain anymore and God couldn’t stand to see me hurt so much, either. That’s when He sent The Angel of Mercy to come get me. The Angel said I was a Special Delivery! How about that ?

Signed with Love from God, Jesus & Me.

(Let’s see Satan stop this one…) Take 60 seconds and repost this, within the hour, you will have caused a multitude of believers to pray to God for each other. Then sit back and feel the Holy Spirit work in your life for doing what you know God loves ‘When you’re down to nothing, God is up to something.’

 

[Traditional_Ang]

Not knowing the exact history of the drugs you are on but knowing the typical reason for Drugs to be more expensive in the US. If these drugs follow the typical pattern:
I am guessing that those drugs were invented in the United States and are covered under US pattents. Which is why they are trying to recoup their development costs here. That development was funded by investors knowing that people were willing to pay for life saving drugs and knowing they would have a return on their investment. Otherwise, they would have invested in other opportunities with a better rate of return. In short the capitalist system made those drugs available. Under a government run system those drugs would not likely be available. Those other countries do not have to honnor American Copy rights and typically steal the formula or force the manufacturers to sell them at just over cost. As a result those foriegn countries get medicines subsidized by the US consumer.

What the left is proposing in socialized medicine would not make future drugs like this cheeper, they would prevent them from existing.

Royal:

Unlike the PR of China, the EU actually honors US and International Patent Law. It’s just that countries such as France subsidize R & D Costs for Pharmaceutical & other companies in the EU.

I think Pathia’s case highlights some real problems with our Health Care System - Esp. with the Insurance Industry. and, These problems would have to be resolved no matter whose plan was passed.

Your Brother in Christ, Michael

 

[Traditional_Ang]

The point of insurance is that you buy it before you get sick and you pay for the proportional risk. You don’t pocket the cash for years and then try to get insurance when the moderate risk turns into an absolute reality.

Royal:

I think you need to review your earlier discussions with Pathia. You’ve described exactly what the Insurance Companies did in her case. They took her father’s money, and when it turned out she was going to cost them some money, they cut him off - Same for when his wife, her mother, got cancer. and, Another Insurance Company did the same not too long ago. That’s why Pathia is so bitter about this.

I’m a bit familiar with this, because a situation of mine is in the Congressional Record. I had an Acoustic Neuroma in 1994 which my HMO tried very desperately not to diagnose and then not to treat and then not to pay for (after they agreed to pay for it). I was very lucky that I knew a Past-President of the CA Bar Assoc., or I wouldn’t be here now. It was only after threatening my PCP and the HMO with him that they decided first to diagnose the tumor, then to treat the tumor, and then to pay for the tumor.

I had to threaten the PCP & the HMO no less than 4 times. One specialist actually quit over the HMO’s refusal refusal to diagnose my condition, and another over their refusal to appropriately follow-up after the surgery - This included trying to get me discharged when I was having Spinal Headaches & couldn’t even lift my head off the bed to eat, let alone get up to use the restroom.

I’m sorry, but some of them are every bit as bad as advertised.

Your Brother in Christ, Michael

 

[royal_archer]

Royal:

Unlike the PR of China, the EU actually honors US and International Patent Law. It’s just that countries such as France subsidize R & D Costs for Pharmaceutical & other companies in the EU.

I think Pathia’s case highlights some real problems with our Health Care System - Esp. with the Insurance Industry. and, These problems would have to be resolved no matter whose plan was passed.

Your Brother in Christ, Michael

It sounds like her beef is with the french government then. So why is she trying to destroy our health care system?

Many of the problems discussed here were caused by the government welfare programs in the first place. To expand these failed programs will only make things worse.

 

[royal_archer]

Royal:

I think you need to review your earlier discussions with Pathia. You’ve described exactly what the Insurance Companies did in her case. They took her father’s money, and when it turned out she was going to cost them some money, they cut him off - Same for when his wife, her mother, got cancer. and, Another Insurance Company did the same not too long ago. That’s why Pathia is so bitter about this.

I’m a bit familiar with this, because a situation of mine is in the Congressional Record. I had an Acoustic Neuroma in 1994 which my HMO tried very desperately not to diagnose and then not to treat and then not to pay for (after they agreed to pay for it). I was very lucky that I knew a Past-President of the CA Bar Assoc., or I wouldn’t be here now. It was only after threatening my PCP and the HMO with him that they decided first to diagnose the tumor, then to treat the tumor, and then to pay for the tumor.

I had to threaten the PCP & the HMO no less than 4 times. One specialist actually quit over the HMO’s refusal refusal to diagnose my condition, and another over their refusal to appropriately follow-up after the surgery - This included trying to get me discharged when I was having Spinal Headaches & couldn’t even lift my head off the bed to eat, let alone get up to use the restroom.

I’m sorry, but some of them are every bit as bad as advertised.

Your Brother in Christ, Michael

I have had several different insurance companies and have also been under the government system. The only time I had problems like this is with the government system. If private insurance companies act in an illegal manner at least you can take them to court. In prior discussions with other posters when I suggested they sue, they responded that they did something that invalidated the contract.

 

[pathia]

I have had several different insurance companies and have also been under the government system. The only time I had problems like this is with the government system. If private insurance companies act in an illegal manner at least you can take them to court. In prior discussions with other posters when I suggested they sue, they responded that they did something that invalidated the contract.

Being born invalidated the contract? That’s all that got me with.

It sounds like her beef is with the french government then. So why is she trying to destroy our health care system?

Many of the problems discussed here were caused by the government welfare programs in the first place. To expand these failed programs will only make things worse.

You do realize that Orphan Drugs ONLY exist because of the government, right? There’s no way to make money on them, they ONLY make money because the government covers most of the R&D with grants and tax breaks. Orphan drugs help hundreds of thousands of people with very rare conditions. You would pull all of the money for those and let them suffer just because there’s no profit in curing them because government interference is evil?

 

[royal_archer]

Being born invalidated the contract? That’s all that got me with.

You do realize that Orphan Drugs ONLY exist because of the government, right? There’s no way to make money on them, they ONLY make money because the government covers most of the R&D with grants and tax breaks. Orphan drugs help hundreds of thousands of people with very rare conditions. You would pull all of the money for those and let them suffer just because there’s no profit in curing them because government interference is evil?

Those drugs are not ecconomically viable. In other words the resources required to develop them could be more efficiently used elsewhere. While I understand the recipients of those drugs being appreciative. The many more people who will continue to suffer and die from other diseases or who suffer or die from other preventable causes may not agree with the decision to expend those resources on drugs that don’t offer the same cost to bennefit ratio.

This of course brings it back to the title of the thread. Doctors are scientists. They may be experts in their technical field but the are not the best people to determine how to allocate resources.

 

[pathia]

Those drugs are not ecconomically viable. In other words the resources required to develop them could be more efficiently used elsewhere. While I understand the recipients of those drugs being appreciative. The many more people who will continue to suffer and die from other diseases or who suffer or die from other preventable causes may not agree with the decision to expend those resources on drugs that don’t offer the same cost to bennefit ratio.

This of course brings it back to the title of the thread. Doctors are scientists. They may be experts in their technical field but the are not the best people to determine how to allocate resources.

They are not viable because the conditions are rare. So every single person with a rare condition, should just die? What a monstrous thing to say.

Money does not instantly equal success. You could throw 200billion or 5trillion at cancer. The 5trillion is not likely to have any more success. Finding cures requires intelligence, a lab and doctors to station it, but most importantly it requires luck and random chance.

So are you saying the scientists should all be locked in and only study the most profitable drugs they can find and nothing more, ever? What about their free will to study what they wish?

 

[royal_archer]

They are not viable because the conditions are rare. So every single person with a rare condition, should just die? What a monstrous thing to say.

I am not the one saying anyone should just die. I am also not the one asking the government to forcibly take money from one group and play the life and death shuffle.

Money does not instantly equal success. You could throw 200billion or 5trillion at cancer. The 5trillion is not likely to have any more success. Finding cures requires intelligence, a lab and doctors to station it, but most importantly it requires luck and random chance.

That is why there are a lot of people making a lot of money researching the cost/bennefit/risk ratios of various investments. That is why businesses are less willing invest in high risk or low bennefit research. Where there is bennefit, people will pay and the companies will invest.

So are you saying the scientists should all be locked in and only study the most profitable drugs they can find and nothing more, ever? What about their free will to study what they wish?

They can study what ever they want. I have even done scientific research on my own time. The problem comes when someone wants to use force to make others pay for a study that they don’t want to pay for.

 

[rickAnthony]

IS health-care a ‘natural right’? The US Senate seemed to think so, based on the triumphant remarks of Sen. Reid when the bill was passed. So, then, where is it referenced or suggested in the Constitution? And when exercising this new ‘right’ it conflicts with another ‘natural right’ – say the right to gay marriage, as soon as the Congress or the courts manage to create that one, or the right to abort the baby in your womb, or the right to speak freely in opposition to health care (think about that one, for Christian Scienctists!), or the right to practice your religion or obey your conscience – which ‘right’ pre-empts the other? Oh? The Court will decide? Sad answer. Health-care is not a ‘natural right’ to be protected by our government. It may be a privilege – which government can grant, limit, or remove – but if we allow it to be so then we place political variation above human rights.

 

[sharmin]

HOnestly, I don’t understand how people can NOT see it as a right. Maybe not a constitutional right (not saying it isn’t, but just saying that I’m not even talking about that). But in a country with so much wealth as our country has, no one should be without health care. We should take care of our brother and sister. We do it with public schools. We should (imo) do it with a public health care system and join the rest of the civilized world.

 

[royal_archer]

HOnestly, I don’t understand how people can NOT see it as a right. Maybe not a constitutional right (not saying it isn’t, but just saying that I’m not even talking about that). But in a country with so much wealth as our country has, no one should be without health care. We should take care of our brother and sister. We do it with public schools. We should (imo) do it with a public health care system and join the rest of the civilized world.

In a purely phylosophical manner you are right. The problem comes down to the practical application. We have a large portion of our population who choose to sit back and leach off the declining numbers of people who actually work. Our country is not going to force people to work so the only incentive we have is the promise that working will improve your lifestyle. If people can get the good things in life with out working, many will not.

 

[royal_archer]

HOnestly, I don’t understand how people can NOT see it as a right. Maybe not a constitutional right (not saying it isn’t, but just saying that I’m not even talking about that). But in a country with so much wealth as our country has, no one should be without health care. We should take care of our brother and sister. We do it with public schools. We should (imo) do it with a public health care system and join the rest of the civilized world.

All other rights are something you have that the government cannot take away, they are not an obligation on others. No one disagrees that you have just of as much right to health care as to buy a newspaper, a caddy, or sing on the streat corner. Unfortunately some try to say healthcare is a right and then go to the next step of saying that it now becomes an obligation on your neighbors. To force one person to work against their will to the bennefit of another is slavery.

 

[peduzzi89]

I haven’t had the time to read every post in this thread, but I will say that while I agree that everyone should be able to get health care, this isn’t the right way to do it. I think the person who started the thread said it all. I mean this is a place where capitalism really works…if the competition is there, the quality is high. If you socialize it…the quality will drastically decrease. That is why so many people from Canada come down here to have more specialized surgeries. My mother is a nurse and even though she works her butt off for a fraction of the doctors’ salaries, she’s glad she can be getting her hip replaced by someone who got a hip fellowship at Johns Hopkins so she can keep on helping people at her job.

 

[scrapgirl81]

Who says doctors need to go to school for so many years. In Greece people enter medical training right in university and its around six years to be a general practitioner. Then after ten years they can apply fora specialist program. It would be far cheaper than the way we do it now. And I will add a nurse with a good computer and basic tests could handle most mundane cases in an office with some proper training a medical doctor should handle cases out of the norm in my opinion. Take a standard urinary tract infection the tests and symptoms are well known so why is a doctor needed for routine ones - as an example.

“99 times out of 100” it is just a UTI but it takes a trained and experienced professional to know when to suspect worse.

Also looking at your Greece example it still takes 16 years before you can even begin to study for a specialty, how is that less time?

Bottom line we can cut costs but quality and access to care will inevitably decline. There is no magic way out of that reality.