Healthcare...

[Army_of_One]

Originally Posted by Highwayman

Army, I don’t care for any of the options in your poll. I don’t think the system is fine as is. Now I’m a free market, less government kind of guy but there are some things that the government could be doing. Running health care isn’t one of them. I’ve have enough doctors making poor decisions without a government bureaucrat helping them.

The government could do something about stemming the flood of malpractice lawsuits that suck millions from the system and the cost gets passed on to the rest of us. You can’t get rid of those lawsuits completely because many are justified but many aren’t and we pay for it. I’ve seen surveys that say 9 out of 10 doctors practice defensive medicine like running extra tests to protect themselves. I agree, and DR's pay a fortune for malpractice insurance. I think some doctors just stay away from certain area's because the malpractice insurance is so high.

Free market folks have complained about excessive lengths of trials for new drugs driving up costs and not saving lives by getting to the market sooner. Recently Pfizer had to withdraw a new cholesterol drug it was testing in the last year of the trial because of a high body count. Several drugs that had been approved later get recalled because things turn up after they were put on the market. So do we allow drug companies an unregulated environment to sell any concoction that they can stir up? On the other hand we can’t regulate the prices down either because it discourages new research.

I’m all for doctors and health care folks making plenty of money but there still has to be some oversight. Unfortunately it seems like a situation where if the government doesn’t do it then it won’t get done.

Good points.

[lurker]

We could go back to the time when Doctors gave patients a bottle of opium & soda. They didn't get well but they felt much better.

[Outofdodge]

Originally Posted by Army_of_One

Speaking of Hillary...one of her big ideas is gov't healthcare...what does everyone else think?

I think maybe this thread might be starting to die but you told me you wanted my thoughts and I have been trying chime in on several fronts but just too many places to chime in so here we go plus I have been busy. This is going to be a very long post and will probably be done in at least two parts over two or more days (sorry).

First background. I have worked in healthcare since 1978. I started in the Clinical Laboratory, spent a couple of years running a heart lung machine and have since the late 1980's worked in the finance and administrative realm of healhcare. From 1978 until I was terminated in 2003(ok they don't call it firing at my level, they call it not being a "fit") I worked in the Investor owned hospitals. Since I left Dodge City I have been working at a large Catholic run system in Central Indiana while consulting on hospitals in Michigan and Southern Indiana. The opinions shared are mine and while some are "standard" industry opinions, others are not and my colleages and I have had many a whisky fueled debate over them.

I think we start with an understanding that the government, though the Medicare, Medicaid, Civil Service, and military health services is already the largest payor of healthcare services in the country. Someone gave me negative rep for my other post to Army but I did find it strange that someone who gets his healthcare essentially 100% taxpayer provided would invite comment on Ms. Clinton's interest in healthcare. The taxpayer pays 1.something percent of every dollar earned in their payroll check as a Medicare tax. Their employers match this dollar for dollar, and if they are self employed they pay it themselves with a reduction in their taxable income for this extra portion.

There is not a national Canadian health plan, that some call socialized medicine. There is government paid health care but it is not a national system. Each Canadian province develops it's own rules and it's own payment methodologies/levels. The basic benefits are the same but the system in Alberta is different than what is in Quebec. The horror stories of waiting years for surgery and routine tests are a little overkill but one does not trounce into a hospital and get an MRI on a whim. Bottom line, Canadian citizens have cradle to grave coverage with little out of pocket expense. It's a good system but not a perfect system and those little outliers make every cold blooded conservative cringe. Part II of this post will try to touch the surface of the social issues in healthcare and will cover this more.

The costs of litigation are a part of the cost of healthcare as are many factors. Every trade publication and study within the industry (hospital) I recall reading minimizes the effect of litigation and jury awards on the overall costs. However a quick google search came up with lord only know how many links from insurance companies, physician groups, and mostly conservative groups decrying it's cost while of course the law groups downplayed it's cost. The most recent reliable study I have read came out of Price Waterhouse, a national accounting and consulting firm, which placed the addtional costs on hospitals @ 1% while assigning 4% to physician increased costs and about the same amount to drug companies and other suppliers. Litigation and liability has it's place both as a punitive tool and an incentive to improve the overall quality of healthcare in general but it's not hard to find examples of frivolity either.

The costs of healthcare does affect the econonmy. Currently it accounts for over 13% of the US GNP. That is more than the "social medicine" countries. Yet Americans have fewer hospital stays, shorter stays, less exposure to preventive medicine, and in many demographic areas have worse mortality than the "socialized" countries. I posted in an earlier post in another thread that the foreign auto plants in the US pay their non-union workers the same pay and benefits of their unionized American counterparts. What they (the foreign plants) don't have is the huge retiree costs healthcare costs. My cost per employee in my hospitals to cover them with insurance has typically risen 10-11% per year for several years. This is cost that I can not use to pay higher wages. For whatever reason historically, right or wrong, employers have paid most or all of the costs of healthcare insurance for their employee and dependents. Individuals buying health insurance really get reamed. One year after leaving dodge I resigned my job in Indy and decided to open my own consulting business. I had engagements for 13 months lined up but the cheapest I could find insurance benefits "close" to what I had in a group plan was to COBRA my old policy @ $1,398/month. After a few months my employer asked me back and I did not dicker nor blink before saying yes.

I've had coworkers and bosses complain about people not being able to pay their bills. There is a significant number of people who are middle class in that they make a decent salary, own/rent a decent home, take vacations, buy new cars, etc that do not have insurance. If Nancy uninsured decides to buy a new car for 25K, she plans it, researches it, and then finances it at a level within her means. If Nancy uninsured takes her dog for a walk, trips, and requires surgery to fix her hip, without any input, research or planning, she just got on the hook for 25K+. She does not have that kind of money at hand but the hospital and everyone else has provided a service, paid it's employee;s and suppliers, etc and is now floating an interest free note on someone who wants to pay the bill but can't. This affects her ability to move moeny around the ecomony for goods and services, may even force her to file bankruptcy, and lastly it forces those who do pay, to pay a little more to make up for what she could not pay.

I gotta stop here, tommorrow I will go more into the cost.

[Army_of_One]

Originally Posted by Outofdodge

Someone gave me negative rep for my other post to Army but I did find it strange that someone who gets his healthcare essentially 100% taxpayer provided would invite comment on Ms. Clinton's interest in healthcare.

Army didn't give you that neg rep...Army doesn't give neg rep and if he did he would not be like a coward and not take responsibility for that neg rep as some may do.

Military healthcare (tricare) is taxpayer provided but I think MOST would agree that the soldiers earn that healthcare by what they sacrifice. Last time I checked there weren't any long lines of people waiting to get the 100% tax payer provided healthcare the military offers.....Hillary will offer healthcare to those that don't contribute to our society. You failed to address the Canadian tax rate associated with the cradle to grave healthcare. Maybe the mortality rate in Canada is lower than the U.S. but that just means you have more deadbeats living longer...yay.

Your insight on the healthcare system is great though....You have knowledge most of us will never have. I'm glad you are shedding some light on the subject.

[Highwayman]

Originally Posted by Outofdodge

...This is going to be a very long post and will probably be done in at least two parts over two or more days (sorry).....

I want to hear the rest of what OoD has to say. Input from someone in the healthcare business was something Hillary’s panel on healthcare reform was accused of not doing.

[Army_of_One]

Originally Posted by Highwayman

I want to hear the rest of what OoD has to say. Input from someone in the healthcare business was something Hillary’s panel on healthcare reform was accused of not doing.

I am waiting also. I love the insight he's given. Hillary doesn't WANT input from the healthcare business.

[Outofdodge]

Originally Posted by Highwayman

I want to hear the rest of what OoD has to say. Input from someone in the healthcare business was something Hillary’s panel on healthcare reform was accused of not doing.

I'm at work and can't really work on part II right now but you and Army are going to love it when I get around to assigning part of the blame for the cost of care on Ms. Clinton's failed Task Force.

[Army_of_One]

Originally Posted by Outofdodge

I'm at work and can't really work on part II right now but you and Army are going to love it when I get around to assigning part of the blame for the cost of care on Ms. Clinton's failed Task Force.

I'm wiping the drool from my face as I read this.......lololol

[Army_of_One]

Originally Posted by Outofdodge

I'm at work and can't really work on part II right now but you and Army are going to love it when I get around to assigning part of the blame for the cost of care on Ms. Clinton's failed Task Force.

I found this little quote on the 'net....

Ask any healthcare provider and they will tell you that since Hillary had her hand in healthcare, the amount of paperwork has increased tenfold. It is a shame that our physicians spend a good portion of their day filling out stupid forms for insurance and they are NOT getting any reimbursement for their time. The physicians and other providers should be using their time seeing patients. It will take approx 20 years to undue the damage that dips____ woman inflicted on our healthcare industry. And the 20 years is an estimate only if she doesn't get elected for anything else.

[Highwayman]

Originally Posted by Outofdodge

I'm at work and can't really work on part II right now.....

I appreciate the time involved to type everything up and I don’t mind if it takes a few days. Thanks.

I do have one question so far about the cost of litigation. You stated …..

....the addtional costs on hospitals @ 1% while assigning 4% to physician increased costs and about the same amount to drug companies and other suppliers.

Do you know if these figures are only for attorney fees, court costs, and settlements paid that aren’t covered by malpractice insurance? Or do they include things like increased malpractice insurance rates and extra tests and/or addition procedures ordered by a doctor for CYA?

With the GNP in the trillions and using your numbers litigation has to still be in the billions. I have no idea what percentage is frivolous but it’s still a lot of money that could be redirected to reduce our costs or paying for uninsured care.