Thursday, June 21, 2007

Socialized medicine? What are the pros and cons?

One only has to listen to the talking heads, read the newspaper, surf the net - particularly the medical blogs at any given time or work in the medical field to know that we are in a health care crisis in America.

Thank God for insurance and I am grateful that we have it.

I naively used to believe that all insurance companies always worked on the subscribers behalf and in conjunction with the doctors. I used to believe in Santa Clause and the Easter Bunny too.

My company has made some small mistakes (although repetitively) in not paying the 90% to the non PPO providers that are affiliated with the PPO hospitals but they have a good turn around time for reimbursements and they have covered thousands of dollars. They do provide better coverage than what I know some people to have. Still - the med bills pile up.

The physicians also have their concerns regarding insurance companies.

Dr. Richard Schoor, a urologist down in Smithtown : Suffolk County Long Island, NY and author of The independent Urologist Blog and Dr Schoor's Urology Blog, has written some interesting posts regarding his experiences with insurance reimbursements. Here are a few posts he wrote Back in March of this year: "Here's A Good One"
"5 Reasons For Denials"
"Never Say Die"
"Payment Not Guaranteed"

The insurance companies seem to be an adversarial system that looks for opportunities to deny claims or deny insurance applicants regardless of their legitimacy and everyone loses but the CEO's and directors, etc., whose wallets get fatter with each denial.

Doctors have given up many years of their lives pursuing a medical career. They have paid their dues. They work very hard with long days, on call nights and weekends, with a lot of responsibilities and pressures along with having to be ever vigilant in protecting themselves from malpractice suits. They are God's instruments of healing on earth - a truly noble profession.

It isn't right that they should be cheated out of fair compensation for the hard work they do or that they should have to waste precious time resolving insurance denials, etc.
when the time could be better spent with their patients or their own families.

It isn't right that people should be denied insurance coverage or have to fight for reimbursement on claims that should be paid. Sadly - many people don't even know to challenge a denial and that they have paid more money on a claim than they should have.

God forbid someone has a truly catastrophic medical illness causing astronomical medical bills so that even with insurance they could lose their home or not be able to continue their good medical care..

I don't pretend to be an informed politician, physician or insurance worker but I am a concerned voter, patient and insurance subscriber.

Having worked in the health field for 20 years I have witnessed the financial effect insurance companies have had on our hospital system. I have listened to the physicians complain about the ridiculously low or non reimbursements and their frustration with HMOs and treatment of their patients.

A little over a year ago, one surgeon personally told me he was involved in a lawsuit with Aetna because he was breaking his contract with them because they weren't paying enough. He wasn't happy with MDCR either.

Our ED never turns anyone away, not even the uninsured. We always had to hand charity care forms to the self pay patients. I didn't want to embarrass anyone, so I offered it as financial assistance from the state- if they qualified. If the hospitals in NJ don't offer that to the self pay patients then the hospitals can lose money from the state.

I felt sorry for many of the people that didn't have insurance. Some of them were hard working but didn't have benefits. They were the people that fell between the cracks in that they couldn't afford their medical bills, etc. but they weren't poor or sick enough to qualify for public assistance programs like MDCD, SSI, etc. The charity care program covers the ED, in patient and out patient but not the private physicians.

I remember a patient presented to the ED with chest pain and the ED Doc wanted to admit him for observation but he signed out AMA. Why? Because he didn't have any insurance and he was concerned about the medical bill. Neither the medical staff nor his family could convince him to stay.

Even if covered by insurance – co-pays and deductibles can add up quickly. I experienced that myself last year and am on 4 different medical payment plans I set up with the hospital, etc. as a result of hitting catastrophic while simultaneously losing both jobs. The radiologists, anesthesiologists and ED docs don't participate with my plan and so the catastrophic level for them was even higher. One good thing and only because I pushed the ins reps about it is that instead of my ins co. paying them at 75% they have agreed to pay at 90% because the hospitals I used are participating and it is not my fault if the doctors don't. However, I have to review every EOB and call to remind them each time. They apparently don't want to let go of that money!

I have some questions for my friends across the pond, as you Brits say. :) Is the NHS system better than what you know of our American health care system? Are you completely happy with the NHS? Is it a huge burden in your taxes? Are there any drawbacks?

One night I had a patient come in to be registered to be seen in the ED for a dog bite. She told me she refused the rabies shot because she could get it for free when she flew home to England the next day. She smiled and was quite pleased about that. Ha! My first rabies injection cost $5,000.00 and then there were less expensive ones to follow because it is a series of injections. I didn't have to pay a dime because I was insured but not everyone is over here.

How about my Canadian friends? You have socialized medicine. Are you happy with your health care system? Do you pay for your prescriptions?

Years ago I read an article in Reader's Digest that did not paint a good picture of socialized medicine in Canada. Waiting months to get necessary surgeries, not enough state of the art equipment and that Canadians were coming across the border to the U.S. to have surgery done.

How about the doctors in countries with socialized medicine? Are they compensated well for all the years they have invested in medical school to practice in their profession? Are they happy with the system?

Is every facet of health care REALLY better in the countries that have socialized medicine?

Everyone complains but no one seems to have an answer.

Doctors and any other medical professionals must unite to become a part of the solution to effect change, taking health care in a better direction. Do they have representation in Washington?

Shame on the doctors who have betrayed their Hippocratic oath by becoming a part of the system that denies appropriate health care to people in need life saving surgeries, etc.

Is there ANY kind of system in place that acts as a watchdog on behalf of the doctors and the patients??? If there isn't - then shouldn't there be? God knows we have investigative committees for everything today. Should we not have one that will respond to red flags that go up in the insurance system for every denial they issue? One that will PENALIZE THE INSURANCE COMPANY FOR DENYING UNFAIRLY? These companies should be fined when they have unfairly denied a claim, not rewarded with higher incomes at the expense of someone else. And I will go one step further with this idea. I think the insurance employees that erroneously and unfairly deny payment of qualifying claims who work at ALL levels should be held accountable and penalized not rewarded with a higher salary or advancement. We are talking about people's lives and lively hood here!

Politicians must stop taking contributions from the insurance and pharmaceutical lobbyists and start working for the good of the people that elected them to their positions in the first place.

I believe BOTH parties have dropped the ball regarding health care in America and I sincerely hope the people will get out and protest with their votes regarding our current health crisis with the 2008 presidential election.

So what precipitated this post? Michael Moore! I am NOT a fan of Michael Moore and have considered him to be the extreme far left which is the antithesis of what my political beliefs are. He has been known to distort the facts.

However, his documentary (Sicko) and the resulting discussions have me thinking about all of this again. So… Kudos to Mr.Moore, if his documentary brings this issue to the forefront in time for the presidential elections.

We all know our American health care system needs revisions. In addition to some of the problems I mentioned earlier, they are predicting MDCR will go bankrupt with the influx of baby boomers reaching retirement age. Then what?

Hospitals in inner cities are closing because they aren't making enough money because they are providing services to a poorer population who is either on MDCD or uninsured. What happens to those people in need of treatment? The ones that have or can afford transportation will seek treatment in another facility. And will the strain of extra patients from that population then cause a domino effect of inner city hospital closures? Not to mention the strain on EMT's and paramedics traveling greater distances.

Insurance premiums are increasingly more expensive while coverage and reimbursements decrease for both patients and medical providers.

I do take issue with the comparison of Cuba's medical system vs ours because those people have been exploited under that system. If it is so wonderful then why do some of the Cuban people risk the lives of their children and themselves to cross the ocean to come to the United States?

Scalpel, an ED Doc and author of the "Scalpel or Sword" blog in his May 20th post "Sicko" linked to another interesting post along with pics revealing another side to Cuban hospitals and clinics that were not shown in the Sicko documentary.

Here is a review from Michael Kling from "Econlog" who was at the premier last night.

Another interesting post by Michael Kling "Reforming Our Beliefs Concerning Health Care"

This next post on socialized medicine is from Panda Bear,MD and emergency medicine resident.

Post called "Soothsayer" by Shrodingers Cat an ED Doc from M.D.O.D. blog

Post called "More Solutions, Long Post" By Dr Schwab a surgeon and author of Surgeonsblog.

REALLY want to know the pros and cons of socialized medicine. Does socialized medicine work as well as is was presented in Mr Moore's documentary? We know he misrepresented Cuba's health care system by not presenting all the facts. Mr. Kling in his post linked above sheds light on the kidney transplant denial.

I am a bleeding heart conservative republican and I believe in free enterprise and national sovereignty, etc., but I do want to know if the citizens in the countries he discussed are as happy with their health care system as the people he interviewed in his documentary?


Sisyphus said...

Oh boy, SeaSpray! You have certainly given me a lot to look at here. My head aches ;) I just want you to know that I have read your post and I am thinking about it and will follow up the links and try and put an answer together from my perspective as a Scot across the pond. I started to write a reply but it became a post in itself, so if you want a very simple answer, without all the rambling polemic of the problems that currently exist in our system, my own personal opinion is that I am content (not necessarily happy but nothing is perfect) with what we have. I would not want what you have in the US. If I can precis an answer that includes my reservations about our system and how it could be n=made better (because there is no point moaning if you don't suggest improvements) then I will post another reply. You and I could drink pots of tea discussing this one :)

peggy said...

i e-mailed a really smart blogger I know in canada about their system - she says she feels lucky to live in canada and doesn't understand our system. She also mentioned that she has heard horror stories about long waits for not so serious procedures. I'd rather wait than pay, that's my opinion!

Even if there are problems with socialized healthcare, i think the point is that we can use these other countries as a model, and improve where they need improvement. We're the USA, for heavens sake.

SeaSpray said...

Hi Sis - it seems we have something in common - Scottish ancestry.

My maternal grandparents were born in Scotland. Dundee and I want to say Firth of Fourth?

James Lawson MacDonald and Isabella Taylor MacDonald. (He called her Bella - I like that.)Her father had been an Irish sea captain and her maiden name was Cunningham.

They didn't know each other in Scotland. They left their large families to come over here in the 1920s and a lot of their siblings did too. Some settled here in the states and others, my grandfather's Macdonald brothers settled in Canada. Two of her sisters also came over and one settled in Florida and the other in New York state.

I have a lot of relatives but don't know any of them. It seems that once my grandparent's generation died out that the families all lost contact with each other, except for my uncle maintaining contact with the Scottish family across the pond.

I can't imagine the courage and determination it took to leave your families and the familiar to come to another country knowing you may never see your relatives again. They also must have been s-o-o-o excited! I also can't imagine the heartache and concern their families had for them especially the parents! Although, maybe because it was a different time it was even expected....

It must've been so exciting and perhaps a bit daunting to come in through the now infamous Ellis Island.

My grandparents met in New England. She was a cook for one of the Universities in Massachusetts and he was a mason. They married and came down to live permanently in NJ.

They never did see their parents again although they maintained correspondence.

They had 3 children and my mothers older brother - Hector Archibald MacDonald- named after the Scottish General (I think he was a general-famous for something)is the only one who kept contact with our Scottish relatives but he passed away in 2003 and so that contact is lost. Although, I could go through some of his old correspondence and get an address. His daughter, my cousin Lee lived in England for a year and while there took a train to Scotland and stayed with our relatives out in the country for a bit but I don't think she kept up the contact.

Family names - MacDonald, Lawson, Taylor,Stark, Cunningham and there is one more that I can't recall right now. My maternal grandparents died when I was 9 & 10 and so I never got to appreciate them or their history as an adult. :(

I do remember they called me their bonnie lassie or their wee little girl (I hear the rrrrs rolling)and grandpa would sing London Bridges to me in Gaelic or tell me about the wee ghosties and goblins. He also used the word bloody a lot. Bloody this and the bloody that. :)
And when the wanted me to be quiet they would say wheeesht (don't know how to spell that). Grandam made the best meat pies, apple pies and roast lamb with mint jelly. :)

Gee - I digressed. Hearing you are Scottish made me feel more connected to them for a bit.

Pots of tea and long, interesting conversations would be wonderful! :)

I did a lot of reading about this yesterday and Sally a Canadian blogger answered some questions for me in PANDA BEAR'S post. She was saying how a doctor up there is sought by head hunters all the time but that he wouldn't want to be a part of our system.

My private Doc is from England, went to Canada - as did his parents (his dad also a physician)and then the settled here in the states. I remember him telling me he wasn't happy up there and really felt a pull to come here but i don't remember why.He is a man of great faith in God and I think it had something to do with a spiritual leading. In the end - he knows that he made the right decision.

BTW - this doc is awesome. Every visit is always extended because we invariably get off on some spiritual tangent. He even prays with his patients although he does not advertise that. That only comes about if the spiritual connection is made and if the patient requests it or he feels a lead to do so. I love it because it is truly treating the whole person. :) Another interesting thing. He was with a partner and I liked them both very much but when they went into solo practices - I had to choose. So the other Doc was very fast and my Doc took his time and I detected a bit of a Scottish accent in his British one. Turns out - he is English but he said I had a good ear because they lived in a part of England near Scotland and they also had lived in Scotland for a bit.

I would be interested in your perspectives on your health care system the perks and pitfalls - if any, but don't knock yourself out.

Thanks Sis and sorry so wordy. Also, I know long posts run the risk of not being read because people are too busy unless of course they come from you doctors as you all have good info or funny stuff and know how to right. i put up a long Father's day post but took it down twice because it was personal but I might put it back because in the end we blog for ourselves and it is a journal of sorts sometimes. of course SeaSpray's Secret Place is where the real stuff will go and even then - I still wouldn't put the most secret of the secret- those things I keep locked deep down in my heart. :)

Hi Peggy - I have been busy reading all kinds of things and agree there has to be answers. Nothing is infallible but it has to be better than this, especially the fact that with every denial the insurance companies,CEOs etc. get richer. I very much believe in free enterprise, independence etc. but not when it causes others to suffer or die unnecessarily.

I just want to understand it more before I make any final conclusions.

patientanonymous said...

Wow...okay...again, lots to think about. I'm Canadian--you know that.

Our system is basically as you put it "socialized." That means that it is paid for with the exception of Dentistry and Eye Care. The eyes were taken care of up until just recently but for some reason they nixed that.

Now...crap...I'm not sure if it varies between provinces. I think it may because what I receive and what is billed to the government via the little card I have to show for with every doctor I see is a provincial card.

I have tried to look into how my provincial system is funded but I have yet to actually figure it out. I believe there is some Federal funding, some Provincial funding and some private funding from companies that pay taxes to the government (again both Provincial and Federal--so in effect the public pays--no, sorry--the company's confusing.) We all pay taxes to the government but you pay a personal tax here but it goes to different social programs. I think company taxes go to different social programs like health care. Oh head is hurting now too!

I think that is right.

Now you also asked about medication. In my province, if you have a good employer you can get decent benefits that will probably cover the majority of your drugs. As far as I understand it, it's not like the NHS. It's all up to the individual. If you're unemployed (again in my province...) you may qualify for an independent funded program. Again, more money from the government, who knows where it comes from...taxes...budgets, blah, blah, blah...

A lot of poor people can be left out in the cold but at least as far as health care in general, emergencies, surgeries all of that--it's all covered. You just need "that card." I think the only problem is if you are an immigrant and you don't have a certain status in order to apply for it. But still, I don't know how that would work. If you've lost a limb or something--well, I'm still sure you could show up at an ER.

There are some rumblings about privatized clinics and things popping up to try and reduce wait times for certain procedures but they are for things like MRIs and such. Not emergency procedures because that would lead to something called, what I believe is "double billing." You could bill privately for something that is mandated to be billable to the government. Or something. Again, I am not a doctor so I am just going by my basic knowledge.

Now there are varying views on this. I happen to think that it won't help the bogged down wait times and just paying for it won't reduce or fix the problem. Other people think I am wrong. We are in a lot trouble here but perhaps it's not all to due with certain things. We need more staff but that entails more money. We need more equipment but again...more money.

The government doesn't seem to be paying attention. When the "Baby Boomers" all start kicking the bucket and getting sick we are going to be in trouble for sure. Bye bye resources. You think the wait times are long now?

I haven't really had *too* much of a problem with wait times for things--either emergent problems or procedures. Perhaps I have been lucky. I have heard real horror stories.

I hope I have given you some insight into what happens "up north?"

And yes, I drink tea too--currently pints in a pub as I am responding to your post but either will do.

SeaSpray said...

Hi PA - Thanks for your response. This is interesting and I will come back to comment. I have a graduation party to go to shortly. Love a party! :)

Have a great day! :)

Chrysalis Angel said...

Boy, Seaspray this is a post...I think as a cancer pt. I would most definitely have to say I'm happier in this country. I talked with a gentlemen from England who moved here, and he says it's great in their neck of the woods - as long as you aren't seriously ill.

As far as our Ins. goes here..the whole health care system is a mess, regardless. I've had to pay out of pocket expenses for good physicians I chose, because they were both 2nd opinion doc.s I trusted and liked better. The stupid insurance told me they wouldn't pay them..they would only pay the first ones I saw. I said- so I can see a quack and you'll gladly pay them, but I find a qualified, reputable physician and because I found them second, you refuse to pay them? That was correct! I was disgusted and told them so, I told them these other two good doctors deserved to be paid. Soooo...I paid them myself! Stupid, stupid Insurance companies. They refuse now to pay second opinions and yet, everywhere you turn they tell us to be smart and check and recheck before letting someone cut into us. Rob's's a mess.

SeaSpray said...

Pa - thank you so much for that additional insight. So it comes down to provinces - some offer better care than others. When you say poor people left out in the cold? What did you mean. They might be homeless but will still have health care or no health care?

So Canadian health care isn't this utopia that Michael Moore painted it to be. When you have a chance and if you care to - watch his documentary (it does have some humorous moments)as i would be curious to know your opinion of his representation of your countries health system.

If he weren't biased and truly was up front with all the facts - I think we'd all want to move to Canada! Sally, also a Canadian - commented on my questions in PANDA BEAR MD and gave her perspective. So you are saying there are problems and our system has problems and so I guess it comes down to which works better in the end and for what reasons.

I am frustrated with the idea that people are denied needed surgeries and suffer because of it or are denied access to insurance because of prior medical conditions. That hasn't happened to anyone I know but I do believe it happens.

If it is true as told in the film (and I believe it is to some degree or at least where ever they can get away with it)that the companies see denials as their profit - then that is NOT good for the providers or the patients! thanks PA!

Hi Angel - so it seems all health care plans have their problems. We Americans need to really look at this issue.

We can send people to outer space and bring them back,etc, why can't the powers that be and financial/business experts sit down and reason this out? pros and cons of everything and tally it up. I know there are so many variables and resistance or apathy, etc but it seems we should be able to figure something out.

I am sorry that happened to you Angel. You would think they would want you to have the other opinions because what if the others said - NO, you don't need surgery you would be saving the company money?

I hate how they are set up (and I believe Rob addressed this) so that doctors have to rush patients through and can't spend the time they want with them unless they are willing to cut into their salary and really - why should they have too? They have families to support today.

The doctors that don't participate can because they make more money but the ones participating in plans get paid less per patient and so have to shuffle everyone through in order to make the money. Can't blame them.

I didn't know that until this winter after reading it on some blogs - Dr rob was one of them.

Thanks Angel!

patientanonymous said...

Hi SeaSpray, this is kind of funny--in a lot of ways. I keep having to scroll down to your comment and I am currently bent over my MacBook standing up as I am having trouble with my internet connection dropping and my provider says it's not my modem, it's my AirPort Base Station. But my connection is so slow with a direct connection so that makes no sense. I need some technical assistance!

My cables and crap won't reach far enough for me to sit down anywhere...okay, moved some junk and I'm kind of sitting and probably won't break anything: except some vertebrae.

On that note, onto some healthcare I may need? Nice segue?

I'm hardly an expert and have lived only in my province all my life so I don't know if there is much variance between all of them. I would say, perhaps not? At least in terms of services--although the East Coast might be lacking...they're always left out in the cold it seems (okay, now you and everyone else knows I'm not from the East Coast haha.)

I think the biggest problem is for areas that are underserviced. Or underserved? I'm tired and my use of the English language is failing me.

I live in a city and even I have had problems finding regular MDs. It is worse if you live in smaller regions. A lot of new doctors just aren't interested in going there to live and work. But if they do, the quality (providing they are decent MDs) should still be fine. The MDs are all paid by the government. There still may be resource issues as well--not just people but equipment etc...(see my point about the East Coast.)

Yes, homelessness is a problem but I think there might be some kind of safety net. Or not? Community outreach perhaps to assist? God, I feel stupid for not knowing this but I am not a health care professional and do not work in the industry.

Yes, I should see Moore's film. I didn't see his last but seeing as this one is more up my alley it would be interesting. Especially if he is calling our system a "Utopia?"

Well, I would hardly go that far but I am still a champion of it. It does frustrate me at times but perhaps I am one of the luckier people out there.

I am not sure what you mean about "insurance." Health care specifically or "Life Insurance?" Sort of an investment, type.

If you don't have benefits to pay for drugs etc...there are private companies that will cover you but I don't know about pre-existing conditions. No doubt, like all insurance companies they would take that into consideration and jack up your premiums.

As far as the latter, oh, they totally increase your premiums! I don't have any Life Insurance. Not worth it as I don't really have any benficiaries and again, with all of my problems the premiums would be ridiculous.

SeaSpray said...

Hi PA - I hope your internet connection has improved and yes that was a funny image. :)

Moore didn't call your system a Utopia but I think he presented the health care systems of Canada, France, England and Cuba that way so that was my interpretation of the film.

Thank you for the additional insights into your Canadian health care system. The internet is an amazing tool. I love it because we don't have to abide by what the media presents but can research info ourselves which one would hope would be a catalyst for honest journalism but alas - propaganda is alive and well. I am not inferring that Mr Moore is a journalist because of course he is not but merely observing that we have a medium, literally at our fingertips to search out the truth if we choose to.

No- I am not talking about life insurance but about health insurance. We pay premiums for health insurance hear to varying degrees depending upon the type of plan we have.

You are taxed for your health care benefits - we pay premiums. It is cheaper if you have group insurance as from an employer because they pay most of it, but they are still pricey - again depending on the plan. However, the people that itemize for their tax deductions can claim them on federal and state taxes along with other medical deductions. It helps on the state but has to be a certain percentage of your income to qualify for fed deduction and most people don't meet that criterion.

We also have social services to help the sick and Medicaid for the poor. tax payers help to support Medicaid and some other services.

Providers can not bill beyond what Medicaid reimburses them and so they lose money when they participate in the plan. Many doctors still do participate but some definitely don't.

The problem in this country regarding the poor is that many can't afford medical bills and medicine but they aren't poor enough to qualify for the Medicaid program so they fall between the cracks.

Then we have Medicare which starts when people are 65 - I think - they may have changed that -not sure. people can have that in addition to their other insurance but many just go with the Medicare.

A person can be insured but if their bills become astronomical because of a serious condition, they can be in jeopardy of losing everything because the bills mount up to more than what the insurance plan will cover.

This varies for everyone depending on what plan, etc. people have.

I think the thing that really irks me is that it seems that if these companies deny claims to either the provider or patient, that they (the company or that person) prosper.

I realize that a company needs to make a profit to exist and continue providing the coverage but we need some checks and balances.

That is my opinion anyway and admittedly, I have much to learn.

Michael does a good job at tugging at the heart strings and no doubt there will be people who take it as gospel and not see or care about the bias.

However, if we as a nation truly want to improve our health care system then we have to do so from facts based on truth and and reform with integrity for the good of all parties involved.

patientanonymous said...

Woo. This might be the post that garners the most responses for you? I went over to that "Panda place" as I kind of found it by accident. I'm sorry but I got a little lost. Not to mention the heated debate and off topic discussion about bra sizes and IQs.

Why is it that every medical blog I go to these days people seem to be more argumentative? Are you noticing that? Maybe it's just me but I am tempted to simply stick with the people I know and all the other fellow nutters.

Sorry, now I'm getting off topic.

There were two posts and the second one had 81 responses?! My brain just couldn't deal with that! I sort of skimmed stuff but found a nurse from Canada that knew a lot more than me. Of course. As they often say, "Leave it to the professionals."


You responded to her.

As far as the NHS wait for Sisyphus *sigh* As they say again, "I wouldn't touch that with a bargepole." Not that it's bad topic but may I repeat:


I don't know nuffink about it.

SeaSpray said...

I just discovered Panda's site and blogrolled him. I read through every one of those comments.

I don't like to see people attacked like that. By her own admission BRN does stir things up sometimes and these folk just went into overdrive. Evidently Panda deleted one of her earlier posts because she used the "F" word and I don't recall if there was anything else. She was bugged about and commented in Scalpel's blog but then must've gone back to set the record straight and she can get a bit heated and the others came in to defend Panda and I don't remember what else. I went in and said Hi to her to try to change the negative direction and let her know everyone wasn't against her. I think she does have a big heart - just gets her dander up sometimes.

I read everything they had to say about health care and appreciate your input too. U R NOT dumb! :)

Jeff said...

You don't need to go outside US to explore socialized medicine.... join the military.
None of the service branches charge the soldier or her family for care. Emergency medicine is excellent, preventative care is generally very good and the range of services includes dental & vision & plastic surgery.
The system is "rationed" by priority based on need.... the more life threatening the quicker the response... and some appt times for elective procedures can be weeks/months out.
The doctors make a decent salary (pay charts are public record and most docs are O-4 to O-6) , student loans are usually paid off by military, free or subsidized housing for doc & family, chance to work overseas (not just in combat zones) and no malpractice premiums.
The military & VA run an excellent socialized medical system with generally reasonable cost controls, computerized record keeping, cradle to grave coverage and an excellent professional development system of continuing education.
The problems at Walter Reed were housing related…. the medical treatment was never compromised.
The challenge is that comprehensive medical care is expensive and policy makers from both the right and left in this country do not see any way to apply the successes of the military system to civilian life. The danger is that most civilian docs I know consider military medicine a professional slum because of the relatively low pay and will fight hard to keep the chance to make 6 or 7 figures. No matter what the cost to our larger society.

patientanonymous said...

Thanks, SeaSpray, I feel I R DUM a lot. I want a brain either size of my province (or my country...) I want to know more!

I was going to say "everything" but omniscience and omnipotence would surely have its drawbacks...

I'm still having a hard time trying to find some med blogs I like. *sigh*

I found a good paramedic/EMT blog (was it a couple?) why can't I remember last night? And no, I wasn't drinking lol.

Okay, two--just looked at my blogroll. I've been looking for some of those for a while as PA considered becoming a paramedic once. Yes, I've had way too many fantasies about career changes!

And yes, I'm completely going off topic from your post. But I do think that was excellent of you to try and diffuse the situation. You're a good girl! And I can't believe you read every response! I need that Adderall...

SeaSpray said...

Hey Jeff!

Interesting comparison- using the military as an example. That is one I have never considered and that has been right in front of us all along. In all the info I have read on this topic - no one has mentioned our military medical system.

I have heard negative things about the local VA hospitals - that they aren't as good as civilian hospitals. BTW - that always bothered me because I believe our vets deserve excellent medical care in return for the sacrifices they have made that most of us don't have a clue about.

Mr Moore makes the point that our police departments etc. are funded and so why can't medicine be?

Our collective knowledge in so many areas is growing exponentially and yet it seems we are powerless to effect any positive changes in the health care system. My concern is that like social security - this system will break down before anyone has a solution.

It is interesting to read the comments of our Canadian and European friends and to see that they have differing opinions about there own system as well.

Off topic a bit -but I thought the plan the president had to privatize Social Security sounded promising. It would have given people the option to continue as they are or they could opt to invest in secure stocks that would yield more interest and thus increase our retirement benefits. That is my understanding of it anyway. Also, he cited a South American country in which this program is successful. (don't remember which one.) However, it is a moot point because his idea dropped like a lead balloon. Too bad.

And that is the problem. Everyone complains but no one seems to want to do something - not really. They don't want to ruffle the status quo.

I know that doctors work hard. They have paid their dues sacrificing years out of their life to attain the goals they have set for themselves. They work hard in their offices and the hospitals. they have a lot of responsibilities and pressures. They have some perks too. :)

I feel for them and get irritated when I hear how insurance companies screw around with them! But, they also need to be willing to work toward a better system.

Right now - until some better ideas can be implemented - I seriously think that the powers that be need to do SOMETHING to investigate and hold all responsible parties in the insurance companies to a measurable standard - fair and reasonable - when it comes to denials and percentages of reimbursements.

Free enterprise - they have a right to make money and should! But when their salaries increase because the patients or providers lose - it just seems there has to be more checks and balances.

WHO holds these decision makers accountable? There should be accountability and consequences if proven to be an unfair and possibly dishonest decision. maybe there is? I don't know.

I appreciated your informative comments Jeff - thank you.

Oh and I am someone who likes nicknames and so am getting a kick out of being called Spray. :) Someone in Urostream called me Sea and liked that too.

Now - I realize it is just a shorter version of typing but amusing never the less. ;)

PA - thank you for all your input as well. I know this isn't the most interesting topic to people but it is something we all need to face and pursue - in this country.

I found it interesting that your health care may differ in quality according to province.

I also find the fact that no one will go broke or lose their home if they should become so ill that they accrue astronomical medical bills.

You can go off topic anytime - I enjoy the dialog.

Yes, I did read Panda's posts and his entire 84 comments. They were interesting. :)

patientanonymous said...

No SeaSpray, I think this IS a great topic...I just wish I could contribute more to it!

But indeed, no one will lose their house in Canada over health care. Not at all.

For other reasons, though, for sure. Again, I don't know all of the ins and outs of the US system and you have done a good job of clarifying some of the things re: insurance but it kind of scares me!

Health is so precarious. You never know what may happen to you or yes, what if you have chronic conditions?

Again, we have some things that need attention but overall, I'm pretty happy with what we have. If had to start paying out of pocket for my medical services oh dear... I would not like it!

It would be a bitter pill for our country to swallow. And to be honest, even though I believe that nurse on the other board said our system was brought into effect in the 1960s, despite the fact that wasn't long ago, it's still long enough for people to get used to something and "forget." I mean, that's still a generation or almost two? One and a half depending upon when you were born?

Oh I don't math sucks and I don't/won't/haven't procreate/d haha!

But I think you catch my drift. It would be like taking candy away from a baby or something. Maybe that's a stupid analogy but once you put something in place like that for an entire country, you can't just pull the rug out. Oh,

Not that I'm saying that would happen...I'm just rambling to expand your comment section to rival Panda's *wink*

Is it time for bed yet?

SeaSpray said...

Your comments are always appreciated PA. Compete with Panda's comment section? Let's see... that would mean that I need more or something like that. Are you up for writing that much?? :)

patientanonymous said...

Well, I could probably flood the rest of your blog with meaningless drivel but I don't know about this particular post--want to know my bra size and IQ HAHAHA...sorry, I just couldn't resist that one (and NO...not making fun of the other blogger!)

I don't even know BRN that her? Well, I've seen her around but I don't really follow her blog. I just thought that tangent was so funny--it almost reminded me of my blog for a moment *wink*

I've lost weight so I'm not even sure about the former these days...I need to buy some more undergarments I think. And due to my meds, I think the latter has shrunken too...BA-DUMP-BUMP!

IQ tests are ridiculous anyway--too biased as they don't measure other things--like emotional intelligence (which apparently according to some "online tests" I am rather lacking?)


I told you


Wow..I was so close to giving up my bra size! Not that it matters or I care or it's top secret information but maybe the blogging world doesn't give a rat's patootie. Or maybe they do?

Alright, if you care and wish to know my bra size, email me.

IQ consistently measured at 130 ever since I was a child. That just barely nudges me into about the top 2% of the population. Whoopie...supposedly PA is smart.

As per one of my last comments...why do you get me to spill my guts on your blog? Or at least lately? Or at least TODAY?!

Maybe I should stay away from you--you're getting dangerous...

Just kidding, I take full responsibility. I think I'd better go over to my own blog that I am pondering deleting and start spewing out some stuff there!

Boy, you're really taking a hammering from me today...

SeaSpray said...

Hammer away PA - if I could, I would send you some tea or a pint and we could chat. :)

Sis or anyone - correction on my first comment. Hector Archibald MacDonald was a British General - not Scottish.

My grandparents came over here in the early 1900s not during the 1920s.

Mom set me straight on the facts. :)

CanadaProud said...

I can tell you from someone whose experienced both sides- I live in the US now but was born in Canada and raised there, and thank God for it. I was in a head on collision which left me in Therapy for over 2 yrs. I had multiple surgeries and plastic surgery too! NEVER PAID A DIME. Had this happened in the US Id have lost my home and been in debt to the hospital for life. I HAVE NEVER WAITED MORE THAN 3 DAYS TO SEE A DOCTOR. Understand that you cant just waltz into a specialists see your regular GP- whomever you like and choose and he discusses whats needed- thus saving you a trip if he can "fix" you. If its not a medical emergency, they prefer to give you some alternatives before sending you to the specialists- works perfect. The specialists I saw in an emergency were there for me immediately. When it was not an emergency- such as corpal tunnel syndrom in my wrist, we tried some alternative therapies 1st.
Now that Im in the US I cant get insured because Iv had skin cancer, back problems (which started here and was treated but the insurance would not renew it since I got treatment over a yr)...actually, I think its my right eye, left toe and ear thats covered if I pay the $750 high risk pool insurance. My son and Husband are covered- we pay 1/6 his salery each month just for piece of mind. When we had a situation and took my son to a specialist we found they didint excet the insurance and we owe several thousand now!!!!
ITs in sane. Any government who thinks so little of its citizens is pathetic. I have dealt with war vets coming home who cannot get the care they need and lost thier homes too!!! What kind of country would do that? The US! Truthfully,I wish Id never married an been home where its safe, id get the surgery I need on my back, and be stressfree of the bills long ago.

SeaSpray said...

Hi Canada Proud-Thank you for your comment. I know what it is like to have medical bills pile up and it is amazing to me that you had all that done and didn't have to pay anything. I am sorry for all that you have gone through and that it is a financial hardship now.

I do appreciate my freedom to see pretty much who I want. But even here not everyone can depending on their plan. It is so expensive. Dental too.

Too bad we can't have a medical system with the best of both countries. It is frightening to think anyone can lose their house because of med bills. Or that insurance companies refuse covering someone because of pre-existing med conditions.

I hope that some of this improves for you in some way. Also, maybe maybe this doesn't apply at all but sometimes you have to be persistent when you get negative answers from insurance companies and you get the RIGHT person and they listen and make things happen for you. I know it is probably more black and white then that but I am ever the eternal optimist in situations where people say no. Sometimes it just takes a little extra effort and someone will go to bat for you.

I wish you well and thank you for your interesting comment. :)

timNardoni said...
This comment has been removed by a blog administrator.
Anonymous said...

The United States doesn't have a healthcare system. We have a capitalist system that is based on the rich getting outstanding healthcare and the poor literally getting none.

I'm 25 years old, and since the economy is crap I have had two jobs for the past few years, since no one wants to give health benefits anymore. I haven't had any sickness type health problems. However, I did have two occasions in my adult life I've had to visit a hospital. Both were ER visits (of course, they turn you away anywhere else without insurance)

The first was a broken arm. That cost around $6000 and caused me to drop out of college.

The second was about 2 years later when I had an anxiety attack (from being broke, no less) that cost me $3500.

So collectively I was almost $10,000 in debt from two hospital visits, have no college degree, can no longer get loans for school, a car, house, credit card. Credit score went from 760 to 400 something in two years. I am really starting to despise my country...I'll be in debt for another few years. I'm looking at finishing my undergraduate by around 30 at this point...provided I don't need to go to the doctor again.

SeaSpray said...

Hi Anonymous - I am sorry that has happened to you. I have medical debt and so I know how you feel...and I have insurance. In my case...I just have had so many hospital visits and expensive tests and procedures that even my deductibles are piling up.

The health Care system is a mess and hopefully they will come up with a feasible solution.

In today's market...small employers don't want to pay for employee insurance.

It is a shame this is happening when you are trying to make something of yourself.

It is tough right now but I will get through it and reverse things. You will to.

I wish you every success with your education and career path.

Katty Rabbit said...

Hey, I was wondering about how alternative medicine, mostly herbalism, survives in socalized medicine enviorments? I heard that herbalists struggle in these type of enviorments.

SeaSpray said...

Hi Katty Rabbit - There are doctors who are open minded and willing to consider alternative medicine, at least in conjunction with mainstream practices, but... I do believe that traditional modern medicine isn't on board with alternative medicine. Doctors believe it to be downright quackery.

You ask a good question.

I am sorry I don't know the answer to that regarding socialized medicine.

The urostream blog had a post up awhile ago with in which she was venting her frustration with patients refusing modern medicine for the "cure" from other sources/countries and then die when in her opinion it could have been avoided. Other docs feel the same.

Our medicines do come from plants and herbs and I wouldn't discount other possibilities. It would depend on the situation, information available, quality of life desired, etc. A lot of variables.

Melodie Sterling said...

I'm so glad to see that many people don't get the socialized medicine program either. I have an HMO and almost died from a surgery which has resulted in me having a chronic illness. I have had difficulty getting a qualified doctor to see me and fix the problem because my medical group has a limited amount of doctors that they have contracts with. I've found out what needs to be done to fix the problem, but I've had to deal with the pain and hospital stays for over a year now. I wonder if socialized medicine would stop this kind of inconvenience for me and the other people who have had to dal with this, do you know?

SeaSpray said...

Hi Melodie-I'm sorry you've had such a difficult & challenging time w/your health. It must be so frustrating for you!

You ask a good question.

I don't know for sure... but from everything I have read in the med blogs... (Avid reader of medblogs for over 2 years now) does not sound like the care will be more accessible... but more like rationed.

No one really knows. There are a lot of ideas and opinions floating around among the medical blogs. They think the *free* health care will come at a *price*.

Where people can often go in and easily get tests, procedures and surgeries done... there could very well end up being waiting lists. That is why some Canadians come across the border for health care.

If you think about it..there will now be more people wanting more care and not enough finances to go around. The money has to come from somewhere. There would be cuts that could produce shortages of equipment or services. Some say that people with money may still be able to get better care. I think that is the case in England.. but not sure about that.

A patient came into the ED one night that was going to need to start the rabies series. When they heard what they would have to pay..they passed on it and were more than happy to get the shot for *free* when they flew back to England the next day.

It seems the simple things won't be a problem... but when it becomes more involved it could be difficult to have easy access to the more important medical care.

I have also heard that you don't want to be a breast cancer patient in England because patients have died waiting for their turn for tests and/or surgery. I am not meaning to single out England. it is the only nation coming to mind at the moment.

I have read other blogger's comments where some foreigners are happy with their socialized health care and where other's are not.

They say they will not put extra effort, i.e., expense into prolonging ones life either. Now many medical people would say that when it comes to the elderly population (that would have died of natural causes, but are kept alive on machines, meds and extraordinary means when life quality is not there)or brain dead etc..that is a good thing... but you know... at what point do you draw the line when budget is involved. Things always look good on paper... but when you are in the trenches... it is often a different story.

There is no doubt our medical system is broken. It needs a major overhaul.

I think they should be looking at the insurance companies who withhold payments to providers, can change the rules on a whim and will do whatever they can to hold on to their money to keep the stockholders happy.

People flooding into ERs for non emergent health care who don't have insurance.

Nothing is ever really free in this life and in this case... I hope it is not a matter of we will get what we pay for.. free = poor quality.

I believe the blogging docs should unite and become a grass roots movement and have their voices heard by the law makers. And I seriously hope..that the doctors that are included in the process do know what they are doing and will not sell out their profession and the rest of us out with compromises that will hurt us in the end.

GOD FORBID we end up with a huge universal health care plan that no one reads before passing!

Anyway... you will get far more info if you read some of the medical blogs. Here is WhiteCoat to start and this is a link to his most recent post about universal health care and he has written much more and has links to others.

Or this post of Throckmorton's Other Signs

Or Scalpel at Scalpel or Sword or Dr Rob at Musings of a Distractible Mind.

There are so many terrific medical blogs out there and I have some on my blogroll.

Kevin MD another one.

It is a shame you have to suffer additionally because you can't get the medical care you need. That is both disturbing and sad.

I heard recently... and now I can't recall where... but the patient had an emergent situation and with effort...they managed to get their insurance plan to allow the patient to be seen by someone who wasn't on the plan because it was the only way they could get the emergent help they needed. Perhaps because it was emergent is what made the difference.

Can you appeal? Document everything that has occurred from when this began. Can you demonstrate in anyway that being limited is hindering you from getting necessary care that is also costing them more money by prolonging a health issue that could be fixed, hence no more medical claims to them?

I hope you will soon be able to get the medical help that you need.

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preciouslysweet said...

What does socialized medicine mean to any country? wish I had the answer to that but I dont however as a child I lived in good old England. Loved it there but I did not love socialized medicine and even as a child I understood what it meant. Without going into a lot of rhetoric I will give a short explanation of my full emphatic resounding "No" to socialized medicine.

I needed some teeth worked on and as a military brat was able to use resources of any country I might be in which was at that time England. Day came and I was driven to the dentist. I remember a small dismal office with what I now term as messy and dusty. Not a long wait and I was led into the dentist. Not what you call a congenial man however he was what I was stuck with and so it began.

The first thing I remember of this ordeal is that he chewed tobacco. How did I know this? He spit it into trash can and then proceeded to place more in his mouth. Astonishingly he then without hesitation he placed his fingers into my mouth and began my examination. No washing his hands or anything. There I was squirming and sweating up a storm as he probed around in my mouth. To this day I am left with a serious gagging problem due to that exam. Not only did he not wash his hands the chewing tobacco smell and taste was definitely on his hands and that was not a pleasant thought.

I realize that this is but a short example of socialized medicine and its horrors however it is an example of what is in store for us if we proceed in that direction.

Do we really want the government involved in our health care? They can decide who gets to live or die. It will come to that. Please believe me when I say that I am not against changing the present system but drastic change that we are headed for does not seem the answer.

The 30 to 60 billion dollars that is needed per year to have socialized medicine is to me a huge amount of money and where does it come from? Our national debt is already on a high time low. Robbing Peter to pay Paul is not the answer.

Thank you for posting what you have. It has given me a lot to think and ponder on. I am not the brightest of baubles floating around but I can think for myself and see where we are headed if we head in the direction of socialized medicine. Could use a pot of tea myself...smiles.
Thanks for reading this all and good day to you.

SeaSpray said...

Hi Preciously Sweet - Thank you for your thoughtful comment.Your dental experience was both disgusting and frightful and he should NOT have been practicing. I am anxious every time I go to the dentist and that would've ruined it for the rest of my life. UGH! GAG. I am so sorry that you went through that.

I would expect that today ..anywhere one would go even in the socialized medical system that appropriate medical protocols are followed.

I am with you in that we should have targeted the most important concerns, worked on changing those and kept what is good. Not turn the whole system upside down! Nor should we betaking on all this added expense during this difficult recession. Our kids and their kids will also be negatively impacted by this debacle of a HC bill.

I should do an update about HC and put up more current links and will do that when I can.

Thank's for stopping by. :)

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