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  • "the largest single transfer of wealth .. in American history"

    that's what former Secretary of Labor Robert Reich thinks about the proposed changes in medical care

    http://www.baltimoresun.com/news/opi...017-story.html

  • #2
    We need a single payer system in this country, plain and simple. I think all of my eight internal medicine partners agree. A good friend who was very high up in one of the major credit card companies and now joining the Dark Side i.e. Kaiser, and who knows a butt-load about IT, economics and economic theory, agrees. Our current system is so FUBARed, and it was so FUBARed before Obamacare. Any Republican fantasy about saving the day via "market forces", deregulation, allowing insurance companies to sell across state lines, or use of HSAs (I've had one for 15+ years, but I can afford one), etc is just that....pure fantasy. We spend twice as much per capita on health care as Canada, for example. If we kept spending as much but cut out the 10% that goes to profit and inefficiency in the US compared to countries like Canada, France, Germany, etc, we could just about insure all Americans. Read T.R. Reid's "The Healing of America". On the other hand, Bernie Sanders' notion of free health care for all is also fantasy. Someone has to pay. Tons of moving parts....tort reform to reduce how much we spend practicing defensive medicine. Reducing what we pay pharmaceutical firms for drugs that have been out for years and have gone off patent. Better implementation of evidence-based medicine so as to reduce dollars wasted on non-beneficial testing and treatment. Reduction of spending on futile end-of-life heroic ICU and hospital care. Reduction of hassle-factor time to which we are subjected by Medicare and commercial insurers every hour of every day in the office. Accountability for unhealthy behaviors like smoking, i.e. you smoke, you pay more, and BTW, your cigarettes will now cost $15/pack. ONE EHR (electronic health record) in the country, not two dozen. And more, but I'm getting weary thinking about it on my day off.

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    • #3
      Respect!

      Originally posted by DrJay View Post
      We need a single payer system in this country, plain and simple. I think all of my eight internal medicine partners agree. A good friend who was very high up in one of the major credit card companies and now joining the Dark Side i.e. Kaiser, and who knows a butt-load about IT, economics and economic theory, agrees. Our current system is so FUBARed, and it was so FUBARed before Obamacare. Any Republican fantasy about saving the day via "market forces", deregulation, allowing insurance companies to sell across state lines, or use of HSAs (I've had one for 15+ years, but I can afford one), etc is just that....pure fantasy. We spend twice as much per capita on health care as Canada, for example. If we kept spending as much but cut out the 10% that goes to profit and inefficiency in the US compared to countries like Canada, France, Germany, etc, we could just about insure all Americans. Read T.R. Reid's "The Healing of America". On the other hand, Bernie Sanders' notion of free health care for all is also fantasy. Someone has to pay. Tons of moving parts....tort reform to reduce how much we spend practicing defensive medicine. Reducing what we pay pharmaceutical firms for drugs that have been out for years and have gone off patent. Better implementation of evidence-based medicine so as to reduce dollars wasted on non-beneficial testing and treatment. Reduction of spending on futile end-of-life heroic ICU and hospital care. Reduction of hassle-factor time to which we are subjected by Medicare and commercial insurers every hour of every day in the office. Accountability for unhealthy behaviors like smoking, i.e. you smoke, you pay more, and BTW, your cigarettes will now cost $15/pack. ONE EHR (electronic health record) in the country, not two dozen. And more, but I'm getting weary thinking about it on my day off.

      Comment


      • #4
        "Market forces" without serious regulation is "the check is in the mail" of the Republican Party.

        Comment


        • #5
          Originally posted by DrJay View Post
          We need a single payer system in this country, plain and simple. I think all of my eight internal medicine partners agree. A good friend who was very high up in one of the major credit card companies and now joining the Dark Side i.e. Kaiser, and who knows a butt-load about IT, economics and economic theory, agrees. Our current system is so FUBARed, and it was so FUBARed before Obamacare. Any Republican fantasy about saving the day via "market forces", deregulation, allowing insurance companies to sell across state lines, or use of HSAs (I've had one for 15+ years, but I can afford one), etc is just that....pure fantasy. We spend twice as much per capita on health care as Canada, for example. If we kept spending as much but cut out the 10% that goes to profit and inefficiency in the US compared to countries like Canada, France, Germany, etc, we could just about insure all Americans. Read T.R. Reid's "The Healing of America". On the other hand, Bernie Sanders' notion of free health care for all is also fantasy. Someone has to pay. Tons of moving parts....tort reform to reduce how much we spend practicing defensive medicine. Reducing what we pay pharmaceutical firms for drugs that have been out for years and have gone off patent. Better implementation of evidence-based medicine so as to reduce dollars wasted on non-beneficial testing and treatment. Reduction of spending on futile end-of-life heroic ICU and hospital care. Reduction of hassle-factor time to which we are subjected by Medicare and commercial insurers every hour of every day in the office. Accountability for unhealthy behaviors like smoking, i.e. you smoke, you pay more, and BTW, your cigarettes will now cost $15/pack. ONE EHR (electronic health record) in the country, not two dozen. And more, but I'm getting weary thinking about it on my day off.
          Thank you...
          Like most of the civilized world.

          Comment


          • #6
            Originally posted by beebee View Post
            Thank you...
            Like most of the civilized world.
            Exactly.
            "A beautiful theory killed by an ugly fact."
            by Thomas Henry Huxley

            Comment


            • #7
              Give me the NZ medical system over the USA system any day. While there are amazing medical facilities in the USA, and I am sure the very best America has to offer, is probably better than what we in NZ can offer. However, those facilities are not available to a large number of Americans; whereas in NZ if you need it, and it is available, then it is available from the richest and most powerful, down to those at the bottom of the heap - on an equal basis. If I arrive at the ER bloing 190 on the peak flow meter at the same time as the Prime Minister arrives with a painful but simple arm fracture, the system will look after me first - immediately actually. Untreated my condition could become fatal - the Prime Minister's broken arm is just painful bit no risk to his mortality - unfortunately so some NZers would say.

              In saying that, also I acknowledge that many NZers complain about our medical system - as is true in probably every country in the world. This is because we have prioritized waiting lists. Medicine has evolved technology wise where we can do amazing things - we all want to be able to run marathons at the age of 100 - and today's technology allows us to realistically dream of such physical feats. But no country can afford to provide the very best in medical care / intervention options that technology can provide. So we ration the care available.

              For example, 20 years ago, when I was Associate Minister of Health and Minister of Immigration I was once faced with a decision of whether to grant NZ residence status to a 9 year old foreigner. This child was a hemophiliac with factor 9 deficiency. His small pacific island country had no treatment available but were told that there was treatment available in NZ. Unfortunately, as he was not a citizen or permanent resident, he was not entitled. Because of my then capacities, a media campaign was started to "force" me to grant his residence status and/or order the hospital to treat him. I was advised the treatment had a less than 10% chance of success and it would cost somewhere in the region of NZ$1 million to treat him. I did not grant him residence and the child died 2 years later. I was slammed by some in the media for being a cruel cold heartless bastard. The 60 minutes reporter said I must have lost a lot of sleep. I replied that I didn't because it was an easy decision to make. That was because if you take a million dollars out of the health care system then NZers will inevitably die. The decision would have been hard if the chances of success had been 50/50.

              And so back to the issue. What is more disgusting than Trump are the republican Senators who are prepared to carp over millions of US citizens and deny them any chance of quality medical care - just to score political points to reinforce their hatred for having had to "endure" 8 years of a black "muslim" president.

              8 years living n the USA, 4 years serving in the US Army has left me with a forever love of America (TNF message board battles aside). But in the last 6 plus months I have come to despair for the place the USA should be occupying as the leader of the free world. Sadly, the USA is a bit of a joke; partly because of that idiot in the White House - but (my opinion) mainly because so many Americans support his positions. China is laughing as they see their pathway to world #1 has been made so much easier.
              Last edited by Tuariki; 07-04-2017, 11:10 PM.

              Comment


              • #8
                Originally posted by Tuariki View Post
                Sadly, the USA is a bit of a joke; partly because of that idiot in the White House - but (my opinion) mainly because so many Americans support his positions. China is laughing as they see their pathway to world #1 has been made so much easier.
                I think you have that right. There are ignorant, simple minded dullards everywhere in the world, but somehow the USA seems to have cornered the market in a particular brand of exultant, vociferous and hateful ignorance that is so voluminous and so deeply and widely embedded in the culture that it has undermined the very nation they puport to be proud of.

                They have overwhelmed any chance of sensible governing with a high chance that they have managed to irrevocably damage the nation. Trump as an individual being president is neither here nor there given some of the woeful examples from history. However, as a President he is clearly a bold and unambiguous symbolic statement that USA is driven by the worst of the worst and is effectively a politically failed state.

                How can the USA be a beacon of hope when it is now clear to all that there is no real intent or process to improve the lives of USA citizens? Even in Australia, one of the USA's most arse-licking of lapdogs, there has been a significant realisation of the sad state of the union. Only the politicians and military who are heavily invested in potential post-career sinecures with american multi-nationals are 100% USA!, USA!.

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