Socialized Medicine

[pslamont]

Starting anew topic to move this discussion out of another thread.

I studied Medical Ethics in college and learned about several socialized medical systems, comparing them to US medical care. It is a shame that the USA is the only industrialized nation without universal healthcare. In fact, in terms of results (as measured by morbidity and mortality rates) Cuba has the most reliable system! They are very low tech, but have a preventitive care health clinic in every neighborhood the way most US cities have elementary schools.

As for the USA, it is not the medical field but the Insurance Company's lobbyists keeping things as they are. It's a shame really. I have been a health care professional for many years and never ever met a physician who would not prefer to work in a socialized or universal health arena.





Just another day in P A R A D I S E !!

[Kapohocat]

(trying to help Pam bring this to local issues...)
Medical professionals who can work with rural medicine would be great too.

HMSA quest is a bit like socialized medicine but many of the doctors in Hilo dont like it.

[LeeE]

Yes.

Bravo.

Aloha,
Lee
http://members.cruzio.com/~lionel/event

[Bullwinkle]

I have seen several national schemes, whereby the local entity paid for medical school, in return for a commitment to practice in the area and be part of a low cost local health care system for a period of time.

the other driving factor is, in most national schemes the physician (gp) gets a flat fee per year per patient ... the incentive is to have healthy patients

in a pay for service system the opposite is true

[pslamont]

Bullwinkle,

Problem with the flat fee per patient system has it's problems. It was in operation in San Diego with several insurance companies. I pitied the patients who had this insurance. Physicians carried thousands and thousands on their rolls collected a nice monthly check from the insurance company and kept patients waiting up to 6 or 8 weeks for an appointment.....

I still say the evil entity here is the insurance companies....

HMSA and Kaiser both operate very differently here on island than most insurance companies on the mainland. Our only real disadvantage here is the lack of available services.

Just another day in P A R A D I S E !!

[mgeary]

Like everything, there are pluses and minuses:

I heard a presentation by the Chief of Cardiology at Mass. General, Boston. The presentation wasn't there, but he was from that institution, and taught medicine to Harvard medical students. He said (and this was in the late 1980's) that 14% of all medical costs in the U.S. went to insurance billing, accounting, collections, and related paperwork. There are fleets of clerical workers in every hospital, clinic, and doctor's office whose sole function has nothing to do with providing medical care.

On the other hand, I've heard anecdotal stories about the thousands of Canadians who come to the U.S. every year to get medical treatment. Why would that be. Also anecdotally, rich people from around the world, including many heads of state, come to the U.S. for their medical treatment. Why would that be?

Also, the morbidity/mortality statistics pslamont cited to start the thread may come from a variety of things, including lifestyle choices, that may or may not have anything to do with socialized medicine.

Insurance sucks, that's fer sure. I think we can all pretty much agree on that. (Sorry all you insurance professionals reading this.) You're wagering on a negative outcome, whether it's life insurance, homeowner's, medical, whatever.

Aloha! ;-)

[DrJ]

Ahh a topic very near and dear to my heart. I'll try not to write a novel. []

My first contention is that socialized medicine requires the government to take it over. When was the last time that government did anything that was efficient or cheap?

Another thing is that it is not 'free.' To pay for a system like this would require higher taxes. Personally I would rather have that money in my pocket and get to choose a medical group/insurance company rather than be assigned one by a beauracrat. Medicare is currently running in the red and the feds just released a report last week I believe that said it would require a 20% increase in taxes to support it. Social Security needs 122% increase otherwise it will run out in 2019.

Doctors in most socialized medical systems are overworked and underpaid. They get paid a flat rate no matter how much do for a patient, so what motivation exists to go the extra mile? Waiting lists for doctors are also very common in these types of systems. Britain is suffering from a shortage of Dentists and the current wait is 6 months to get on with a dentist. I've heard of similar things happening on the BI because of some insurance groups there.

And the thing that gets me the most as a new chiropractor is that the likelihood of a socialized medical system including alternative medicine is next to zero. You're right that insurance lobbyists have too much control. The 2 biggest lobbyist groups in Washington are the pharmaceutical companies and the insurance lobbyists in that order. Do you think drug companies want you to go to get acupuncture or an adjustment? They'd rather stuff you full of Celebrex...

There are benefits. I'm not completely negative about the whole concept, but other people have already talked about it.

I feel there are better options though. I personally have an HSA (Health Savings Account) supplemented with a high deductible health insurance plan in case of something going really wrong. It's affordable enough that as a student it's been a great option. You should take a look at this as well.


p.s. I'm not against traditional medicine at all. I've benefited from it myself. I just want to make sure that people don't think I'm against medicine or drugs... just government insurance.

[ArtM]

Personally, I feel there is already too much government interference in the health services field.

That is, our current medical system is too socialized.

ArtM

[DrJ]

quote:

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wow, wow wow, just a minute there! You sound like a GOP member trying to scare Americans away from Socialized Medicine. All the Canadians I have met have said quite the opposite, especially the one's I have talked to here in Hawaii.

For years I worked as a Waikiki Beachboy, and have come into contact with countless retired Canadians who spend as much as six months at a time here. The overwhelming majority all say they'd love to live here. But can't because they say they don't wanna give up their Canadian Health Care Insurance for sky high premiums that offer less for the buck!

Why is the USA the only industrialized nation in the world that doesn't offer universal health care? I'd say the medical field has some pretty strong lobbyist working in their corner, don't you agree Dr. J? It's a shame too!

---

I'm replying to this here since it is the more appropriate thread.

Beachboy, I'm not sure how you assume my political party persuasion from an opinion or that it would have bearing on my opinion. As a member of the alternative medical field I am more affected by socialized medicine than most because it is my livelihood. I don't have the powerful AMA (American Medical Assoc) and Pharmaceutical companies and lobbyists protecting me. They would prefer to put us Chiropractors out of business and have tried. (Check http://www.chiropractics.com/kcs/html/ch-history.html for the Supreme Court case we won against them in 1987)

My parents moved to Canada (Vancouver Island actually, which is an amazing place if any of you head that direction) when I was just starting college. I lived there for a short time then went off to college. I base most of my opinion on socialized medicine from what I experienced from my short time there and from what my parents experienced for 8 years living there and the Canadians that befriended us there. Take it or leave it... it's just my opinion afterall.

I totally agree with everyone that the current system is horrible. It's expensive and it doesn't cover what it used to, but I think the last thing we want is for the government to take it over.

My solution.

First, no more insurance groups. It helps keep bad doctors in business because people have to see them bc they're in a group. Insurance should give us the option to choose docs so it weeds out the bad ones. We, as consumers, should demand it. Someone wanting to earn our money will step up and do it and then the rest will follow suit.

Then you can fix the tort and malpractice laws. If your OB/GYN is paying $100k/year (that's what my OB/GYN instructor pays and has never been sued!) in malpractice insurance just in case something goes wrong... who do you think he passes the bill along to? There should be some compensation, but it's getting out of control. It makes doctors practice defensive medicine. Then they order unnecessary testing, just in case, that drives up the medical costs even more.

Along that line, we should be able to import our medicine from other countries like Canada. Pfizer makes the same pills that the Canadians take, but they pay 1/3 of the cost. Why are we demanding it to be cheaper. It's not because of their socialized medicine, (free market cost is cheaper) it's because of tort laws passed in government that need to be changed.

Lastly and most importantly, we need to promote a preventitive health care system. We are in the habit of waiting till we get sick or have something serious like a heart attack happen to be healthier. Our obesity percentage is out of control. It amazes me what some of my patients eat every day. I'm not saint when it comes to food.. but when breakfast is coffee and lunch is McDonalds and dinner is Coke and frozen pizza....and the most exercise most people get is from walking to there car then to their desk, it's no wonder health care is expensive.

I could go on, but my main point is that we need to look outside the box. There are tons of options out there that will save you money on health care, beside having the government try and take it over!!!! Look into preventitve care, HSA's, get private insurance vs. employer provided and pocket what he would've paid for it, go to your local Chiropractor (Yeah... thats a pretty biased suggestion), etc etc etc

p.s. I told you a novel was forthcoming. Sorry for the long post []

[gtill]

Sub the whole state to Kaiser!

The Canadian Health Care Monopoly has it's classes of coverage! You pay so much and become a #1 client, You pay a little less and become a #2 client, pay nothing and become a # 3 client! Guess who waits longest, but they have the least to do!

But an emergency would override all classes! That's basically how Kaiser works today, Your choice how much to spend for coverage! But you'l always have some help!