Health Care

I am doing a discussion board for my health and aging class and have been given the following info to discuss. Any thoughts (with resources) would be greatly appreciated.

Take this week to learn about and discuss health care in this country. Become familiar with existing programs—Medicare, Medicaid, various medical plans, prevention programs, and community based services. What are the strengths and weaknesses of the existing programs? What services are covered, and which ones are not? What is the "coverage" for services such as Occupational Therapy and Physical Therapy? Are medications covered? What about preventative treatment such as the government recommended shingles vaccine? Novak believes that the health care system of the future needs to improve the availability, accessibility, and coordination of services to older people. How would you go about doing this?

Bumping. I would have assumed there would be a lot of comments for this one.

I don't know enough about the American health care system.

tim290280 said:

Bumping. I would have assumed there would be a lot of comments for this one.

I don't know enough about the American health care system.

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The major problem with the US system is that it's just so damn confusing, nobody understands enough about it, lol. You need to look into how so much of it is employer based insurance, which is fueled by tax-breaks for business owners.

The strengths of medicare/caid? None... the weaknesses, they are broke. Here's one:

http://www.ssa.gov/OACT/TRSUM/index.html

Basically, medicare spent more than it took in last year, and will essentially be bone dry within the decade.

How to improve it? Get the government out of the way, let doctors and insurance providers compete over patients and lower their prices. Look how effective the US health care system was before the government got involved more and more, quality has gone down and cost has risen.

Like education, I like the voucher based system which means people aren't left out on the street. But, for what that is worth, I GUARANTEE you that no doctor is going to let somebody die on their watch if they have a serious condition and they can't pay. No emergency doctor or surgeon is going to refuse to treat someone brought in to them with a gun shot or stab wound (or heart attack, SAH, etc) until the person has paid. They will treat first, collect their pay later.

To increase availability? Get the government out of the way and allow more physicians to practice. The regulations required to open up medical schools are absurd, and the ways the regulations work in getting license's are pretty crazy. I'd shorten medical schools to 2 years instead of 4, where the students can learn the science components during the fall and winter, while their summers they spend doing their clerkship training. I would not change the amount of content required to learn though, this can be condensed, and students should be required to learn it on their own time. Class work should NOT be spent on things like anatomy, physiology, biochem, the students should be given the resources for these and then told to "go learn it", and take routine exams (and of course their licensing). Class work should be spent on things which deal more with clinically practicing, anybody can take a book and learn the content in it, they don't need somebody reading it to them.

This is a really really broad subject, but the thing is that it goes well beyond what meets the eye. Things like the government's spending (especially foreign, obviously) play incredible roles, as does the rising debts and deficits, and devaluing dollar.

This could easily be a doctoral thesis.

Thanks a bunch IS! That will be very helpful for the discussion board. To be honest, its not something that I have studied much at all but now as I age, it is something that I become more interested in learning about.

The Creator said:

Thanks a bunch IS! That will be very helpful for the discussion board. To be honest, its not something that I have studied much at all but now as I age, it is something that I become more interested in learning about.

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No problem, essentially, nobody can rightfully argue that the system is viable right now, or will be in the future because of the costs. The costs must go down, and only things like laser/plastic surgery are going down.... hmm... why might this be?

Ironslave said:

To increase availability? Get the government out of the way and allow more physicians to practice. The regulations required to open up medical schools are absurd, and the ways the regulations work in getting license's are pretty crazy. I'd shorten medical schools to 2 years instead of 4, where the students can learn the science components during the fall and winter, while their summers they spend doing their clerkship training. I would not change the amount of content required to learn though, this can be condensed, and students should be required to learn it on their own time. Class work should NOT be spent on things like anatomy, physiology, biochem, the students should be given the resources for these and then told to "go learn it", and take routine exams (and of course their licensing). Class work should be spent on things which deal more with clinically practicing, anybody can take a book and learn the content in it, they don't need somebody reading it to them.

This is a really really broad subject, but the thing is that it goes well beyond what meets the eye. Things like the government's spending (especially foreign, obviously) play incredible roles, as does the rising debts and deficits, and devaluing dollar.

This could easily be a doctoral thesis.

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Excellent post overall. The american health care system is hopelessly complex.

As far as medical education the government should step out of the way completely and let the medical profession regulate the education of doctors. I am not sure about all your timelines IS, I am not med student or doctor so I can't comment. I know your degree is involved in medicine somehow (sorry, i don't fully remember). So obviously you will have a better understanding than me. However there are other measures to increase the availability of doctors rather than condensing time spent in schools. The main problem is the cost of a medical education. Obviously one wants to reduce the amount of time schooling to a minimum, however turning it into a 2 year cramfest could be detrimental to learning.

One of the other big factors in availability is recognizing the qualifications of foreign doctors. I know Chinese neuro-surgeons working as nurses in retirement homes. Creating a more effective testing and internship procedure for migrant doctors would go a long way towards increasing access to medicine.

Those videos are great! Thanks for those and thanks for the post ryeland.

I only have one comment to make. Health insurance doesn't cover much when you have a debilitating disease that results in years of treatment or long periods off work. This is an important factor in health care, especially employer funded schemes.

Medical Malpractice lawsuits are ridiculous right now.

tim290280 said:

I only have one comment to make. Health insurance doesn't cover much when you have a debilitating disease that results in years of treatment or long periods off work. This is an important factor in health care, especially employer funded schemes.

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So? You can negotiate in your insurance issues of chronic diseases, both before you develop the condition, or even when you have it.

But more so, if someone you knew had a debilitating disease, would you help them out? I would...

Ironslave said:

So? You can negotiate in your insurance issues of chronic diseases, both before you develop the condition, or even when you have it.

But more so, if someone you knew had a debilitating disease, would you help them out? I would...

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According to the stats 1 of the 6 people you know need help with health insurance (and yes I know how meaningless simplified stats are).

I've had to go into hospital for a couple of proceedures, so has my mum, all under private cover. That was fine, except I couldn't work (mum is retired so similar) for months and health insurance only covers a part of any medical care. So lucky it didn't require me to take more time off work.

Thank-god everyone is young, healthy and has a good steady job lest we see the gapping holes in the system

tim290280 said:

According to the stats 1 of the 6 people you know need help with health insurance (and yes I know how meaningless simplified stats are).

I've had to go into hospital for a couple of proceedures, so has my mum, all under private cover. That was fine, except I couldn't work (mum is retired so similar) for months and health insurance only covers a part of any medical care. So lucky it didn't require me to take more time off work.

Thank-god everyone is young, healthy and has a good steady job lest we see the gapping holes in the system

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This was not what I implied, and did not answer my question. Things happen, it's unfortunate, but it's part of what happens in life. If the situation was reversed, and someone you knew was sick, would you assist and help them with their bills? I would.

^^ Sorry to answer your question, probably not. If it were my parents or siblings, yes, but friends then less likely.

The why is pretty simple, I don't believe in handouts (I believe in handups). The reason I made my above point was to show that not everyone is going to be surrounded by the generous or ulturistic. And when someone finds themselves with a long term health problem, health insurance has a gaping problem with it.

tim290280 said:

^^ Sorry to answer your question, probably not. If it were my parents or siblings, yes, but friends then less likely.

The why is pretty simple, I don't believe in handouts (I believe in handups). The reason I made my above point was to show that not everyone is going to be surrounded by the generous or ulturistic. And when someone finds themselves with a long term health problem, health insurance has a gaping problem with it.

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Well, if you don't want to contribute to your friends voluntarily, maybe they don't want to contribute to you (or anybody else) voluntarily as well? Why is it right though to take it from them involuntarily, through force (government)?

Health insurance does have gaping problems, everything in life does.

Ironslave said:

Well, if you don't want to contribute to your friends voluntarily, maybe they don't want to contribute to you (or anybody else) voluntarily as well? Why is it right though to take it from them involuntarily, through force (government)?

Health insurance does have gaping problems, everything in life does.

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Interesting point, and I hadn't thought of it that way. The direct answer is that I'd say that by paying indirectly you are paying for your own security net while also subsidising those around you in society i.e. performing a public good which is why we have government. So you contribute because not every service or operation can be covered by private health insurance, the public health service essentially covers and serves everybody. You also help those less fortunate.

I have several friends who refuse to get private cover because they believe it is the government's role to provide societial improving services (in essence this is true, but only as long as there isn't a business doing it). This annoys me as it means that people who could be covering themselves with private insurance essentially are creating a burden on a larger system designed for the less affluent and to fill the gaps of the private industry. Instead the public health industry has to serve all masters due to essentially a selfishness by socialists.

Another point I would make is that I've never seen health insurance as "an optional extra". People place internet connections and cable TV higher on their priority list of expenses. These people are also what is wrong with the public health service.

tim290280 said:

Interesting point, and I hadn't thought of it that way. The direct answer is that I'd say that by paying indirectly you are paying for your own security net while also subsidising those around you in society i.e. performing a public good which is why we have government. So you contribute because not every service or operation can be covered by private health insurance, the public health service essentially covers and serves everybody. You also help those less fortunate.

I have several friends who refuse to get private cover because they believe it is the government's role to provide societial improving services (in essence this is true, but only as long as there isn't a business doing it). This annoys me as it means that people who could be covering themselves with private insurance essentially are creating a burden on a larger system designed for the less affluent and to fill the gaps of the private industry. Instead the public health industry has to serve all masters due to essentially a selfishness by socialists.

Another point I would make is that I've never seen health insurance as "an optional extra". People place internet connections and cable TV higher on their priority list of expenses. These people are also what is wrong with the public health service.

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Can't you have a safety net by negotiating the risk of developing a debilitating disease before? Also, can't you have a somewhat high deductible (ie, $8,000 or something), which will drive down your premium tremendously.

I'm still willing to help the less fortunate, but what I have a huge problem with is helping those who go to the emergency room with a sprained ankle, or kids who see their family doctor to get a sick note to miss a test, or the medical bills for the obese type 2 diabetic. I don't want to pay these bills, I would rather take that money and donate it to people who I believe really need it.

It's not the government's job to take care of you, or make other people take care of you with their labor/money, it's yours. (Not saying this to you Tim individually, just in general).

Rand Paul makes a great point when he is answering a question, there is absolutely NO way that in emergency cases any doctor would ever leave anybody on the street. One thing those in favor of Universal Health Care always cite is the "baby count", in stating that infant mortality rate in the US is far worse than other developed countries. This couldn't be any sillier, Dr. Bernadine Healy, former head of the Red Cross explains how the the US counts their infant mortality MUCH more precisely than these countries do.

http://health.usnews.com/usnews/health/articles/060924/2healy.htm

Point of this is, it's silly to think a doctor would refuse to provide care for someone who really needs it. Can anybody honestly go into the AMA's annual convention, stand up and ask the hundreds/thousands of doctors there "raise your hand if you would allow a baby, or any person to die a death that could be prevented on your watch because they can't afford to pay for care"..... I guarantee not one single hand will go up.

Ironslave said:

Can't you have a safety net by negotiating the risk of developing a debilitating disease before? Also, can't you have a somewhat high deductible (ie, $8,000 or something), which will drive down your premium tremendously.

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Yes and no. Private health care still only covers so much. As an example I was only covered for about a month's worth of physio after my knee operation. Even at the top level I was only getting another month. I needed at least 6 months closer to 12 months to be back healthy. Now what if this was something more serious for long periods(one that springs to mind is oxygen tanks for cancer and lung patients)?

I'm still willing to help the less fortunate, but what I have a huge problem with is helping those who go to the emergency room with a sprained ankle, or kids who see their family doctor to get a sick note to miss a test, or the medical bills for the obese type 2 diabetic. I don't want to pay these bills, I would rather take that money and donate it to people who I believe really need it.

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I agree completely. But we also have to remember that if you have a cold or flu these days you have to see a doctor to get the time off work or school validated. Stupid "rule". Ditto the sprained ankle, everyone is scarred of being sued so the use of first aid is pretty much discouraged. People have used their own idiocy or ignorance as an excuse and the greater society has been forced to compensate, which in turn has ruined things like health care.

It's not the government's job to take care of you, or make other people take care of you with their labor/money, it's yours. (Not saying this to you Tim individually, just in general).

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I agree again, but once again the continuance of this argument leads to anarchy. Without the government taking care of people there becomes a social divide which eventually leads to civil war (not that I'm saying this will happen, but it can lead to socialist agendas passing into law, Obama being elected, etc).

Rand Paul makes a great point when he is answering a question, there is absolutely NO way that in emergency cases any doctor would ever leave anybody on the street. One thing those in favor of Universal Health Care always cite is the "baby count", in stating that infant mortality rate in the US is far worse than other developed countries. This couldn't be any sillier, Dr. Bernadine Healy, former head of the Red Cross explains how the the US counts their infant mortality MUCH more precisely than these countries do.

http://health.usnews.com/usnews/health/articles/060924/2healy.htm

Point of this is, it's silly to think a doctor would refuse to provide care for someone who really needs it. Can anybody honestly go into the AMA's annual convention, stand up and ask the hundreds/thousands of doctors there "raise your hand if you would allow a baby, or any person to die a death that could be prevented on your watch because they can't afford to pay for care"..... I guarantee not one single hand will go up.

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I have no doubt of this. But if someone has to have life saving treatment from something like a car accident and ends up with a medical bill stretching into amounts that they will never pay back, you'd better believe that I'd support public health care.

tim290280 said:

Yes and no. Private health care still only covers so much. As an example I was only covered for about a month's worth of physio after my knee operation. Even at the top level I was only getting another month. I needed at least 6 months closer to 12 months to be back healthy. Now what if this was something more serious for long periods(one that springs to mind is oxygen tanks for cancer and lung patients)?

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Any insurance now isn't really private, it's crony-private. Even the US in it's supposedly "capitalist" health care system subsidizes about 50% of health care costs through medicare/caid. There's no system like there is for car or house or life insurance. But, why can't these things be negotiated ahead of time? (just like with your car/house insurance, you negotiate what happens if your house burns down, or you get in a severe car accident).

As already mentioned, you would be unlikely to contribute through charity to a friend who is in need of care, and that's fine, it's your money and your right. But, why is it okay for you to take their money indirectly and involuntarily through taxes?

What if the person who has to be on 24/7 home oxygen is someone who smoked 2 packs of cigarettes a day? What if the person who is in the hospital on life support who through medical costs and their presence occupying a bed/room costs the system a thousand dollars a day was a drunk driver who got in an accident and killed someone? Why should I be forced to spend my own earned money on these people?

I agree completely. But we also have to remember that if you have a cold or flu these days you have to see a doctor to get the time off work or school validated. Stupid "rule". Ditto the sprained ankle, everyone is scarred of being sued so the use of first aid is pretty much discouraged. People have used their own idiocy or ignorance as an excuse and the greater society has been forced to compensate, which in turn has ruined things like health care.

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Of course they do, but why should I pay for their visit to get this note, especially if they're faking sick? If someone is out of school for a week, that's their problem, not mine.

I agree again, but once again the continuance of this argument leads to anarchy. Without the government taking care of people there becomes a social divide which eventually leads to civil war (not that I'm saying this will happen, but it can lead to socialist agendas passing into law, Obama being elected, etc).

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It doesn't lead to anarchy The role of government is to protect our right to live, which includes jailing criminals or those who harm us by infringing on the rights of others, or against other nations when provoked. People are going to start a civil war because they're angry that they aren't being taken from other people and given to them?

I have no doubt of this. But if someone has to have life saving treatment from something like a car accident and ends up with a medical bill stretching into amounts that they will never pay back, you'd better believe that I'd support public health care.

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Again, it doesn't make sense that you are unlikely to voluntarily contribute to a friend who needs it, but you support this? Why? Why can you have insurance against your house burning down, but not against health problems? (and the cost of most houses are a HELL of a lot more than almost all medical costs). Again, what if it was a drunk driver who killed a mother and 2 children? Should it just be up to the wealthy people in society to take care of us all?

Ironslave said:

Should it just be up to the wealthy people in society to take care of us all?

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It is a great deal more than money that makes our society work. Joe CEO cannot run his company without the people working under him. He can't get his product shipped out to millions of customers without the guy who paves the road.

A century ago when many people lived out in the wilderness providing completely for themselves the idea of no taxes made sense. In today's world with 6.796 Billion people on this planet, the capacity to live isolated from the rest of the world is greatly diminished.

The public and societal infrastructure that exists is what allows Joe CEO to make his fortune. He is being taken care of as much (if not more so) as anyone else.

Ryeland said:

It is a great deal more than money that makes our society work. Joe CEO cannot run his company without the people working under him. He can't get his product shipped out to millions of customers without the guy who paves the road.

A century ago when many people lived out in the wilderness providing completely for themselves the idea of no taxes made sense. In today's world with 6.796 Billion people on this planet, the capacity to live isolated from the rest of the world is greatly diminished.

The public and societal infrastructure that exists is what allows Joe CEO to make his fortune. He is being taken care of as much (if not more so) as anyone else.

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I don't understand this post at all...

1) Who said that Joe CEO doesn't need workers?

2) Nobody here ever said we expect to pay no taxes, the conservatives/libertarians here are more against wasteful big government spending.

3) What does paving roads have to do with how lousy socialized health care is?