Health care: Problems and solutions
Ilya Shambat
question becomes not only "if health care reform" but "what kind" and
"why." The following is an analysis of the problems with American
medical system as gained from multiple standpoints, and some proposed
solutions to the same.
- The lack of basic general government care is a problem especially
for the working poor, but now increasingly for the middle class and
even wealthy Americans. People continue to lose all that they've
worked for in order to care for a sick relative or themselves. There
must be an option for basic general government-funded medical care
that is available to all Americans.
- The single-payer option will not be acceptable to people who want to
choose their own doctors. People who want to choose their doctors and
are willing to pay for it should be able to do so as they presently
are.
- I recommend the Australian model, in which public health care and
private health care are available side by side. Everyone is taken care
of at a basic level; those who want choice or extra quality can pay
for it. This will fulfil the demands both of the need to provide basic
health care to all, and of the demand for consumer choice by those who
are willing to pay for it.
- While this is not often discussed in policy circles, the main reason
for the exhorbitant prices of health care in America is that the
number of doctors is far too low to meet the demand for health care at
a reasonable price even now, not even to consider the demands it will
have when the baby boomers come to old age. This shortage is
maintained by AMA's practices of not graduating enough students and
not licensing enough foreign doctors. As the demand for medical care
continues to grow, the supply remains at an exceptionally low level.
This leads to demand meeting supply at an exhorbitant price - the
price that will remain exhorbitant, whether the government or the
consumer pays for it, for as long as this problem persists.
- The shortage of doctors also means that doctors are overworked and
overstressed. This leads them to make more errors than they would
otherwise. These errors result in malpractice lawsuits, which then
result in extremely high malpractice insurance premiums. This cost is
then passed on to the consumer, adding more to the already outrageous
prices.
- This structural problem can only be resolved by there being more
doctors in America. The growing demand for health care must be met
with growing supply of medical professionals. This will result in more
available health care; lower prices of health care; and a better
lifestyle for doctors than their current overworked, overstressed,
error-prone lifestyle which is just as bad for their patients as it is
for themselves. America should graduate more doctors; it should also
allow more foreign doctors to practice in America. This will redress
the major structural problem with American medical system that is
responsible for the overly high prices of medicine in America. The
result will be in more available treatment; more affordable health
care; and better life for doctors themselves.
- American medical system has an added problem of being incentivized
for expensive and wrongful practices. These involve: Lack of
preventative medicine (as treatment of the disease is more
profitable); needless expensive machines which need to be replaced
with newer models each year; overuse of machines and machine-based
testing; overprescription of antibiotics; forcing people against their
will on life-support machines; and overdiagnosis and overmedication of
mental disorders with expensive and dangerous multi-drug combinations
(the latter, at taxpayer expense).
- Preventative medicine funded by government should be available to
all Americans. This will result in less need for catastrophic medical
treatment, lower costs, and greater health of the population.
- The prohibitive price and length of medical education makes it
accessible for only a few people, excluding many others who would
make qualified professionals. Students graduate with $500,000 in debt
after putting in up to ten years of 18-hour-day education, not
including living expenses. Very few can actually carry this burden,
and it excludes many who would make good doctors. Those who do take on
this burden need to pay it off; they must charge prohibitive costs to
their patients; and the price spiral continues to rise.
- There should be more medical schools in America, leading to greater
competition among the medical schools and resulting in both more
admissions and lower price of tuition. The lower price of medical
education will make possible for doctors to pay off their loans by
charging less exhorbitant prices for their services.
- The practice of overdiagnosing and overmedicating mental disorders
with dangerous and expensive multi-drug combinations at taxpayer
expense is the case of pharmaceutical industry scamming the taxpayer.
ADHD is overdiagnosed and over-treated in American children with drugs
that are addictive and often carry severe, even lifelong, effects.
People who get depressed for real-world reasons or who have a
temporary life crisis are diagnosed with lifelong disorders and put on
medication for life at taxpayer expense - frequently expensive and
dangerous multi-drug combinations that do them more harm than they do
good, including severe harm such as health destruction and early
death. These practices must be put to scrutiny and, if not ended, then
at least curtailed to a level that is significantly less expensive for
the taxpayer, less harmful for children and less dangerous for adults.
- Corruption in American medical system is a growing problem. Doctors
cover up their medical mistakes and involve police, coroners, and
lawyers and judges, in their coverups. There must be direct,
insightful and uncompromising scrutiny of corrupt practices, leading
to their exposure, punishments for those who partake in these
practices, and the end of these practices that continue to result in
death and disability of countless Americans.
- Severe abuses continue to take place in the in-patient mental health
system. The definition of patients as mentally ill and the resulting
lack of credibility given to them in court of law, along with the
unchecked credibility given the mental health professionals, creates
an environment in which corruption, abuses of power, and injurious and
destructive practices have the inherent capacity to reach extreme
levels. There must be constant and diligent scrutiny of in-patient
centers to balance and check this capacity for corruption and abuse
that is a logical effect of this reality.
- Severe abuses also take place in the nursing home system, including
physical violence and even murder. These practices are rarely
investigated and, if found out, are covered up. This system must
likewise be scrutinized against these and other abuses. America's
senior citizens deserve better treatment from their country than that.
I am respectfully putting this to the attention of the voter and the
officials involved in hope that this be taken into consideration.
David
"Ilya Shambat" <betterm...@gmail.com> wrote in message
news:872ab6a4-3dd3-40a4...@12g2000pri.googlegroups.com...
Our Lady of Epektasis
Rhiannon
> As the Obama Administration is considering health care reform, the
> question becomes not only "if health care reform" but "what kind" and
> "why." The following is an analysis of the problems with American
> medical system as gained from multiple standpoints, and some proposed
> solutions to the same.
>
> - The lack of basic general government care is a problem especially
> for the working poor, but now increasingly for the middle class and
> even wealthy Americans. People continue to lose all that they've
> worked for in order to care for a sick relative or themselves. There
> must be an option for basic general government-funded medical care
> that is available to all Americans.
I have no vested interest in what health care system you end up with but
just to correct a few points...
> The single-payer option will not be acceptable to people who want to
> choose their own doctors. People who want to choose their doctors and
> are willing to pay for it should be able to do so as they presently
> are.
Canada has a singler payer system and we choose our own doctors. We can
also get 2nd and 3rd opinions without paying for it.
> I recommend the Australian model, in which public health care and
> private health care are available side by side. Everyone is taken care
> of at a basic level; those who want choice or extra quality can pay
> for it.
Canadians get both choice and extra quality without paying extra for it.
> The practice of overdiagnosing and overmedicating mental disorders
> with dangerous and expensive multi-drug combinations at taxpayer
> expense
I'm bipolar and neither overdiagnosed nor overmedicated but in context with
this post you might be interested to know that I have never paid for mental
health care either. Not my therapist, not my CBT therapy at the Mood
Disorder Clinic, nor my psychiatrist of 13 years and she is one of the best
in the province.
--
Rhi
slunky
> I'm bipolar and neither overdiagnosed nor overmedicated but in context with
> this post you might be interested to know that I have never paid for mental
> health care either. Not my therapist, not my CBT therapy at the Mood
> Disorder Clinic, nor my psychiatrist of 13 years and she is one of the best
> in the province.
and look at you now. The nuttiest foul mouthed woman in asd.
--
-slunky
saavik
> On Fri, 24 Jul 2009 11:26:39 -0400, "Rhiannon" <rhia...@rogers.com>
> wrote:
>
>
>> Ilya Shambat wrote:
>>
>>
>>> I recommend the Australian model, in which public health care and
>>> private health care are available side by side. Everyone is taken care
>>> of at a basic level; those who want choice or extra quality can pay
>>> for it.
>>>
>> Canadians get both choice and extra quality without paying extra for it.
>>
>
> cataract surgery.
>
> Even some of your courts have stated that the waiting lists are
> unacceptable and are allowing private medical service firms to offer
> "extra" quality for a price.
>
>
Oh yes? and how many years must an *uninsured* Americans (of which there
are about 47 Million) have to wait for medical procedures?
Up to 60% of personal bankruptcies in the USA are due to medical bills.
Even for people with insurance, because 'co-pays' can amount to 10s to
100s of thousands (for people with chronic or severe conditions). And
unless one is *extremely* wealthy, there is no real choice of doctors or
treatments. It is the HMOs that determine what doctors you may see, and
what treatments you may have. So even if you are insured, and you need
some treatment that they can deny, often for the most spurious of
reasons, you are SOL.
As for these wait times, I have known many, many people who have had
these and other medical procedures which were provided in a timely and
professional manner. In cases where wait times were found to be
excessive (and they were always for non-life threatening conditions),
the courts ordered the provinces to fix the problem and they did, are
doing, just that.
Get yourselves educated folks and don't let the billion-dollar insurance
industry lead you around by the nose.
Our Lady of Epektasis
> Get yourselves educated folks and don't let the billion-dollar insurance
> industry lead you around by the nose.
Right on.
I was uninsured and mentally ill for YEARS and it sucked. Now I am
finally on Medicaid but it's been a bitch getting there.
Herman Rubin
>>> Ilya Shambat wrote:
And just what do you think the government can do about
the lack of personnel? Face it, there is no way that
we can get "adequate" medical care for all. Right now,
we have an extreme shortage of both doctors and nurses.
I have the usual type of medical insurance because I
essentially have no choice; it is included in the
"salary" for all Purdue employees. I do not have the
type of major medical I would like, and there is a
major problem with getting what I would like to get
and could afford; time is a big problem.
Now the present prepaid medical care, mistakenly called
insurance, adds to the cost. Insurance should be for
rare events; moderate sized companies carry much of their
insurance for automobile accidents. These personal
bankruptcies for medical bills are due to the lack of
THAT kind of insurance.
The one who benefits from medical attention is the
patient, and he should be the one who decides. But
if he is getting it "free", one of the important
factors in the decision is missing. This means in
effect that the decision will have to be made by
the one who has no direct interest in the individual
outcome, but must fit things into the budget.
Many doctors now will not take patients on Medicare
and Medicaid because these will not pay their costs.
And the record keeping costs will not go down with
government insurance; who ever heard of a government
reducing the amount of paperwork needed.
--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
hru...@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558
saavik
that will have to be fixed. As to the "how", there are dozens of
successful examples of which the USA could cherry-pick the best out in
the real world, since every developed country except USA has universal
health care for their citizens. Go out and find what works.
Matthew Russotto
Herman Rubin <hru...@odds.stat.purdue.edu> wrote:
>
>The one who benefits from medical attention is the
>patient, and he should be the one who decides. But
>if he is getting it "free", one of the important
>factors in the decision is missing. This means in
>effect that the decision will have to be made by
>the one who has no direct interest in the individual
>outcome, but must fit things into the budget.
There's not just one but TWO middlemen with the current system of
employer paid insurance. With that sort of separation between
provider and patient, it's no wonder the system doesn't work well.
>And the record keeping costs will not go down with
>government insurance; who ever heard of a government
>reducing the amount of paperwork needed.
They seem to be trying to come up with a system that's the worst of
all world. Add more government insurance, keep private insurance
around with more restrictions... and oh yeah, if anyone tries to get
out of the system, tax them punitively.
--
It's times like these which make me glad my bank is Dial-a-Mattress
Our Lady of Epektasis
> On Fri, 24 Jul 2009 14:40:18 -0400, saavik <saa...@sympatico.ca> wrote:
> >As for these wait times, I have known many, many people who have had
> >these and other medical procedures which were provided in a timely and
> >professional manner. In cases where wait times were found to be
>
> Does anyone in Canada know what the term "average" means? As in "Average
> wait time"?
stfu douchebag!
saavik
> On Fri, 24 Jul 2009 21:50:23 -0500, russ...@grace.speakeasy.net (Matthew
> Russotto) wrote:
>
>
>> They seem to be trying to come up with a system that's the worst of
>> all world. Add more government insurance, keep private insurance
>> around with more restrictions... and oh yeah, if anyone tries to get
>> out of the system, tax them punitively.
>>
>
> the contrary is just lip service.
>
>
That's paranoid non-sense. Why on earth would they not?
As I said, I'm in Canada where we have universal health care, but I have
supplemental insurance for such things as prescriptions and massage
therapy, and travel outside the country. But I know that an accident or
a heart attack or a gallbladder operation, etc., isn't going to bankrupt
me and my family, even without the supplementary insurance.
saavik
>> these and other medical procedures which were provided in a timely and
>> professional manner. In cases where wait times were found to be
>>
>
> Does anyone in Canada know what the term "average" means? As in "Average
> wait time"?
>
>
>
may be talking "average", but here, we are concerned with "worst case",
so that no one, no INDIVIDUAL, need wait excessively. That is the goal
and it is taken seriously by the hospitals and by the gov't. Their
*jobs* depend on it.
Rhiannon
Hello there fellow crossposter :-) I didn't realize until after seeing some
new names Ilya had crossposted. Droog is anti-Canadian and anti-Socialism
which makes our universal
healthcare his especially tender sore spot. No Canadian can tell him (an
American who has never lived here) that socialized health care works in our
country, instead we must all be drinking dosed Kool-aid. You nailed it with
your response btw. He takes every _worst_ case scenario and calls it
"average". Easier than admitting we're right.
--
Rhi
slunky
>> Do you have any real knowledge of what the actual wait times are? You
>> may be talking "average", but here, we are concerned with "worst
>> case", so that no one, no INDIVIDUAL, need wait excessively. That is the
>> goal and it is taken seriously by the hospitals and by the gov't.
>> Their *jobs* depend on it.
>
> Hello there fellow crossposter :-) I didn't realize until after seeing some
> new names Ilya had crossposted. Droog is anti-Canadian and anti-Socialism
> which makes our universal
> healthcare his especially tender sore spot. No Canadian can tell him (an
> American who has never lived here) that socialized health care works in our
> country, instead we must all be drinking dosed Kool-aid. You nailed it with
> your response btw. He takes every _worst_ case scenario and calls it
> "average". Easier than admitting we're right.
Who's "we"?
--
-slunky
%
hi gang its % , don't listen to anything Rhiannon says ... ever
Matthew Russotto
CyberDroog <Cyber...@ClockworkOrange.com> wrote:
>On Fri, 24 Jul 2009 21:50:23 -0500, russ...@grace.speakeasy.net (Matthew
>Russotto) wrote:
>
>>all world. Add more government insurance, keep private insurance
>>around with more restrictions... and oh yeah, if anyone tries to get
>>out of the system, tax them punitively.
>
>the contrary is just lip service.
Depends on the "they" you mean. The Democrats are certainly not
united (if you're feeling charitable, in their beliefs. If you're
feeling uncharitable, in their benefactors. If you're feeling
Machiavellian, in their interests)
Matthew Russotto
CyberDroog <Cyber...@ClockworkOrange.com> wrote:
>On Fri, 24 Jul 2009 14:40:18 -0400, saavik <saa...@sympatico.ca> wrote:
>
>>these and other medical procedures which were provided in a timely and
>>professional manner. In cases where wait times were found to be
>
>Does anyone in Canada know what the term "average" means? As in "Average
>wait time"?
Can have several meanings, but the median is probably the most useful
measure, as a few outliers can skew the mean, particularly as they are
inherently one sided.
Matthew Russotto
saavik <saa...@sympatico.ca> wrote:
>
>Do you have any real knowledge of what the actual wait times are? You
>may be talking "average", but here, we are concerned with "worst case",
>so that no one, no INDIVIDUAL, need wait excessively. That is the goal
>and it is taken seriously by the hospitals and by the gov't. Their
>*jobs* depend on it.
Worst case, in every system, is that the person dies waiting for a
critical treatment. It's not a meaningful distinguisher; it will
happen in every single system.
saavik
> In article <4a6b0379$0$20336$576...@unlimited.newshosting.com>,
> saavik <saa...@sympatico.ca> wrote:
>
>> Do you have any real knowledge of what the actual wait times are? You
>> may be talking "average", but here, we are concerned with "worst case",
>> so that no one, no INDIVIDUAL, need wait excessively. That is the goal
>> and it is taken seriously by the hospitals and by the gov't. Their
>> *jobs* depend on it.
>>
>
> Worst case, in every system, is that the person dies waiting for a
> critical treatment. It's not a meaningful distinguisher; it will
> happen in every single system.
>
>
you know it, or should, if you parse my post properly.
%
>
> Thanks, that was good.
i never wait for anything is that average enough for you ,
and the US is getting government run health care no matter who says what ,
so you might as well start lumping the idea if you don't like it
saavik
>>> Does anyone in Canada know what the term "average" means? As in "Average
>>> wait time"?
>>>
>>>
>> Do you have any real knowledge of what the actual wait times are? You
>> may be talking "average", but here, we are concerned with "worst case",
>> so that no one, no INDIVIDUAL, need wait excessively. That is the goal
>> and it is taken seriously by the hospitals and by the gov't. Their
>> *jobs* depend on it.
>>
>
> ailments.) They were published in the 2009 annual report card from the
> Wait Time Alliance.
>
> And yes, I also know that you don't consider waiting a year for a hip
> replacement to be excessive in the least.
>
>
Here's an uptodate site maintained by Ontario Ministry of Health. Go
have a look - it gives a realistic assessment of wait times for all
kinds of "elective" surgeries from angioplasty to hip replacement. On
the bottom right-hand corner of the page, click on Wait Times in Ontario
and follow the steps. Bear in mind that among all these procedures,
non-elective (ie. emergency) surgeries of the same types are also
taking place, but are not included in these stats.
http://www.health.gov.on.ca/en/default.aspx
I haven't looked, but I'm certain there is equivalent info available for
other provinces.
If there is an equivalent database available for the USA, or any state
thereof, I'd like to see it.
Of course, do bear in mind that 47 million Americans (15 Million more
than the entire population of Canada) are uninsured, and their
wait-times are FOREVER.
Margo
%
i just tell my doctor when i'll be available
saavik
> On Sat, 25 Jul 2009 09:07:04 -0400, saavik <saa...@sympatico.ca> wrote:
>
>
>> CyberDroog wrote:
>>
>>> Does anyone in Canada know what the term "average" means? As in "Average
>>> wait time"?
>>>
>>>
>> Do you have any real knowledge of what the actual wait times are? You
>> may be talking "average", but here, we are concerned with "worst case",
>> so that no one, no INDIVIDUAL, need wait excessively. That is the goal
>> and it is taken seriously by the hospitals and by the gov't. Their
>> *jobs* depend on it.
>>
>
> ailments.) They were published in the 2009 annual report card from the
> Wait Time Alliance.
>
> And yes, I also know that you don't consider waiting a year for a hip
> replacement to be excessive in the least.
>
>
previous post are defined as "The time by which 9 out of 10 patients
have completed their procedure".
I encourage you to read the definitions that go along with the charts.
%
> On Sun, 26 Jul 2009 21:04:39 -0400, saavik <saa...@sympatico.ca>
> wrote:
>
>> I must emphasize that the wait times cited in the tables linked in my
>> previous post are defined as "The time by which 9 out of 10 patients
>> have completed their procedure".
>> I encourage you to read the definitions that go along with the
>> charts.
>
> people really are in the dark ages in some respects. American pets get
> MRI's faster than Canadian people do.
and soon you will too and even longer cause there's more people , yay
saavik
> On Sun, 26 Jul 2009 20:58:54 -0400, saavik <saa...@sympatico.ca> wrote:
>
>
>> Here's an uptodate site maintained by Ontario Ministry of Health. Go
>> have a look - it gives a realistic assessment of wait times for all
>> kinds of "elective" surgeries from angioplasty to hip replacement. On
>> the bottom right-hand corner of the page, click on Wait Times in Ontario
>> and follow the steps. Bear in mind that among all these procedures,
>> non-elective (ie. emergency) surgeries of the same types are also
>> taking place, but are not included in these stats.
>>
>> http://www.health.gov.on.ca/en/default.aspx
>>
>
> medical associations. You know, the people who actually do the work, and
> the waiting, not the bureaucrats who are trying to put the best face on
> the issue.
>
>
>> I haven't looked, but I'm certain there is equivalent info available for
>> other provinces.
>>
>
> which citizens in which provinces are considered to be most important?
>
>
>> Of course, do bear in mind that 47 million Americans (15 Million more
>> than the entire population of Canada) are uninsured, and their
>> wait-times are FOREVER.
>>
>
>
>
I know from direct experience that the 'wait times' are nothing like the
ones you are touting. In this case, I will trust the info provided by
the hospital system itself because I have concrete experience that tells
me it is accurate.
You'll excuse me if I say that *your* charity is the last thing I would
ever want to have to depend on.
%
LOL , that's telling him , he whines like this all day everyday anyway ,
i think he's having emotional doubts about fatherhood
saavik
>> previous post are defined as "The time by which 9 out of 10 patients
>> have completed their procedure".
>> I encourage you to read the definitions that go along with the charts.
>>
>
> people really are in the dark ages in some respects. American pets get
> MRI's faster than Canadian people do.
>
>
It is a fact that Canadians live longer and healthier lives than
USA-ians, in part because Canadians have the opportunity to seek
preventative or early treatment ac
cross the board.
It is clear that you are scared to death of the fact that our system
*works* because it seems to run contrary to your sense of self as to
what an American must be. Fortunately, not all Americans have such
fragile egos as yours.
%
not to mention he will see ,
government run health care ,
no matter what he says because ,
his land of the free is forcing it on him
saavik
>
>
> LOL , that's telling him , he whines like this all day everyday anyway ,
> i think he's having emotional doubts about fatherhood
>
>
>
Tim Merrigan
>hi gang its % , don't listen to anything Rhiannon says ... ever
And that means? I don't listen to Ilia, he's a known troll and I have
him KFed. I mostly don't listen to Rhiannon because he only comes to
Callahans when he's following a cross posted thread, and I don't
listen to people who use symbols as their user names because they're
usually spammers (though this one appears to be a troll).
P.S. any further comments on this thread will only be posted to
Callahans.
--
I pledge allegiance to the Constitution of the United States of America,
and to the republic which it established, one nation, from many peoples,
promising liberty and justice for all.
Feel free to use the above variant pledge in your own postings.
Tim Merrigan
slunky
> On Sat, 25 Jul 2009 12:11:43 -0700, "%" <per...@gmail.com> wrote:
>
>>hi gang its % , don't listen to anything Rhiannon says ... ever
>
> And that means? I don't listen to Ilia, he's a known troll and I have
> him KFed. I mostly don't listen to Rhiannon because he only comes to
> Callahans when he's following a cross posted thread, and I don't
> listen to people who use symbols as their user names because they're
> usually spammers (though this one appears to be a troll).
>
> P.S. any further comments on this thread will only be posted to
> Callahans.
Not this one.
--
-slunky
last_per...@yahoo.com
> And just what do you think the government can do about
> the lack of personnel? Face it, there is no way that
> we can get "adequate" medical care for all. Right now,
> we have an extreme shortage of both doctors and nurses.
And some of the ones we have look like this:
(see Ask a Doctor pic at right)
http://ehealthforum.com/health/mens_chat.html