Interesting take by a liberal physician who now opposes Fed.gov medical care

But having an omnipotent unassailable one size fits all third party like the federal government control and define the physician-patient relationship is not foolish????????

 

Depends exactly why an MRI is necessary.

 

Not by my experience.

 

Yeah it's working great in the UK I hear, where the death rate waiting for a doctor is up 57%.

https://www.theguardian.com/society...uffering-direct-result-nhs-wait-time-failures

And the death rate is only 4 times higher.

https://www.dailymail.co.uk/health/article-195277/NHS-death-rates-times-higher-US.html

Sounds ****ing awesome.

Why don't we do that.

 

Tell us how much of that is on drugs.

 

I'm confused. Are you saying having a third party bouncing around in the doctor-patient relationship is foolish but having a third party defining and controlling the doctor-patient relationship is not foolish? Why is that?

 

That story talks about increased wait times at NHS hospitals, and blames it on underfunding by the government. It's not some sort of general indictment of national health-care systems.

As noted previously in this thread, and mentioned in the article, the problem was also record-high admissions, because this was in the midst of a norovirus outbreak in Britain:

NHS England’s latest statistics graphically illustrate how the health service struggled to cope in January as it came under unprecedented strain as a cold winter and the worst flu outbreak for eight years led to the most intense demand it has faced.

So you take a temporary, worst-case scenario, and try to portray it as normal.

And even in this worst case scenario, 77% of patients were admitted within the standard time frame. Counting all forms of treatment -- not just hospitals -- the number receiving on-time admission rises to 85%.

A review of current data is here:
https://www.nuffieldtrust.org.uk/resource/a-e-waiting-times#background

It shows two things: nearly all patients are admitted within the four-hour window. It also shows that "admission" and "treatment" are two different things. The median wait time between arriving at the hospital and being treated is under an hour, comparable to U.S. emergency departments.

Wait times have gotten worse in Britain in recent years, due to increased demand and accusations of underfunding the system. But don't cherry-pick the worst-case scenario and try to pass it off as the norm.

Seriously? A single, un-peer-reviewed study from 2003, that compared death rates at just two hospitals, and acknowledged major differences in the patient base?

The article claimed the study would be published in peer-reviewed journals later that year, but I find no evidence that it ever was.

 

I don't see the difference.

 

What we have had since the implementation of medicare and medicaid isn't free market or private. Government has been influencing and damaging the market in healthcare and health insurance since the 1960s and before, with tax incentives that made it advantageous for business to offer insurance, by under pricing medicare services causing providers to cost shift the loss on those services to other private insurance provided services. The FDA increasing the cost and time to bring new drugs to market and discouraging innovation in the drug market. These examples are a tiny drop in the bucket of government regulation and interference that makes the market in healthcare in the U.S. completely unfree.

Obamacare's control of the "private" insurance market is the textbook definition of fascism. The controls and regulations placed on the "private" market means it is the next door neighbor of the only slightly more controlled, government controlled medicare/medicaid services.

The nature of insurance is that it is a cost sharing hedge against future events. The mandate and getting rid of pre-existing conditions makes the resulting commodity not insurance.

The private system is broken by the government intervention in that system. Obamacare just made that worse by adding yet another layer of bureaucracy and regulation onto the already egregious burden imposed by government in previous years. A true free market solution would get the government out of the healthcare and insurance businesses entirely, leaving insurance companies and healthcare providers actually free to offer services to people who want to voluntarily purchase them. The only legitimate role of government in healthcare or any industry, is to protect the participants from force or fraud.

 

"Completely unfree"? Hyperbole much?

And now "fascism"? Get a grip.

Setting up competitive marketplaces where private insurers can voluntarily compete for customers is the most free-market way I can think of to solve a problem that the market wasn't solving by itself.

It's still insurance, it just comes with the requirement that everyone have coverage. And the reason THAT is necessary is because we're not just going to let people die in the streets. So to avoid free riders, you need to push everyone into the system.

Assertion without much evidence.

Again, that sounds great in theory, except for the part where we aren't willing to let people die in the streets because they can't afford health care.

 

Not much. How small does a cage have to be to make the inhabitant unfree? Government exerts some level of control on nearly every aspect of healthcare and health insurance. That means you have to get permission or follow government rules to provide or receive healthcare.

Fascism is an economic system in which the government controls the private entities that own the factors of production. A good example of this is Obamacare.

What you're describing is a free market except for the government coercion that fined people for not participating, defined the products that could be offered, defined the service providers the people were allowed to use. That government coercion that you forgot to mention turns a free market into a fascist system

You don't know the definition of insurance or fascism apparently. Obamacare wasn't necessary to keep people from dying in the streets. There were already government interventions that were supposed to do that and Obamacare didn't do any better at achieving that objective than the previous attempts did. What all the government attempts at "fixing" healthcare have achieved is the horrible system we have today.

So Obamacare didn't add another layer of bureaucracy onto a healthcare/health insurance system that already had significant government imposed regulations, requirements and restrictions?

Government intervention in a free market healthcare system isn't necessary to keep people from dying in the streets. It would be an easy and I suspect (though I haven't done the math) cheaper solution to provide those that qualify for it, an HSA with a high deductible insurance plan. This would leave the market free and allow the recipient of the government sponsored insurance the freedom to choose his own healthcare options. Putting the power and the payment into the hands of the individual actually buying the service would return the healthcare market to a semblance of other markets where prices and services are published and consumers have the information and power to make their own informed decisions. There is a market in the U.S. today that is doing this to an extent. There are direct care clinics popping up all over the country that don't take insurance but offer their services at a reasonable subscription price. All the ones I've looked into charge between 50 and 100 dollars a month for unlimited office visits. They publish their prices and the services offered. If the government allowed it (there is a bill in congress now that may fix this) a person with an HSA and a high deductible insurance plan could pay for the direct care clinic from their HSA, making for a very cost efficient solution that doesn't require any direct government intervention in the market.

 

Not true in the least. The free market was so working. 90% of the population were satisfied or greatly satisfied with their medical insurance. Obama and the Dems wanted Obamacare as a major foothold in the control of the populace. Better or cheaper healthcare was simply a ploy. There was, by best estimates, 3 million to 7 million people who could not afford health insurance and really wanted it, not the 60 million you claim. Most of the uninsured, which was far less than your 60 million did not need or want insurance.

Obama did not pursue free markets. He was forced into free market concessions as his disastrous medical plan became evident. That is why he greatly lessened the requirements for company and union provided insurance and why he kept modifying other rules and requirements as people became more aware, like his disastrous plan for Medicare Advantage when he discovered that Medicare Advantage folks had to be told by law of the bad things coming right before the 2012 election.

 

Yes, the healthcare market has flaws, we agree. It has so many flaws that the model should be abandoned.

Why would we go to some form of universal healthcare? Because other nations around the world have it, and it works. And it can be fine tuned for the US.

I agree that government is inefficient and wasteful, but intelligent beings should be able to design a system that will be somewhat more efficient. It can be done. Vigilance and oversight are necessary.

 

It works in other countries sir, and it will work here. Healthcare for profit is a foolish model. Unless, of course, one happens to be in that business, one profits from the business, as the insurance industry does.

 

Many markets have flaws. The market for food has flaws. Demand inelasticity is what should be prevalent in the food market, but because there is a relatively low barrier to entry and adequate de-regulation/freedom, there are more businesses selling food, meaning more competition, making the market essentially elastic. I believe we can do this with healthcare. Today there isn't a low barrier to entry in the healthcare market. This market is riddled with regulation and corporatism. I believe it is best we try a free-market solution, before we try any socialism. And I'm also not to sure if the people of this country will like M4A, in my opinion. Sure the polls are there, but when you poll people on taking away their private insurance and replacing it with a govt single payer plan, support for M4A drops significantly. But anyway, polls are just polls, it's still early, and all of this is subject to change in the near future.

 

Government employees are an interest group that looks out for their own:

Horror: VA failed to stop pathologist who misdiagnosed thousands — and showed up drunk for work.

 

Can you explain in simple terms how a single third payer/controller can deliver the exact same care as before at lesser costs. If you wave your arms and say eliminate profits I want to see credible numbers including the buried costs that governments do -- like the $2 trillion the CBO estimated Obamacare would cost the taxpayer over 10 years just two years after its start when the CBO estimated it would save $200 billion over 10 years. And don't throw in any hidden rationing like today's Medicare has. I would also like to see how they will handle the expanded cost of care under Medicare for all when 10 to 20 million people will decide to go see their doctor every week.

 

As I've pointed out elsewhere, the only reason other countries can provide free healthcare for its citizens is due to the U.S. taxpayer paying for those country's defense.

Take away the U.S. defense umbrella for Germany, France, the UK and others, and they would have to decide to either continue to fund their healthcare, or abandon their healthcare and fund their own military.

As the charts from the world bank site posted by me and others show, Europe would not have the GDP to provide both healthcare and a competent military.

So it's important to acknowledge the U.S. taxpayer, who is essentially paying for Europe's supposed 'free' healthcare...

 

okay, let’s try this again.

Government health care is cheaper than what we have in the United States. So it makes no sense to say they can only afford it because they’re not paying full freight for their defense.

 

Thanks for hanging in there as we try to understand each other.

I'm not addressing U.S. costs of healthcare vs Europe's; I'm simply pointing out that if a country has to drastically increase spending in one sector, other sectors will suffer.

So here I go:

I think you'd agree most countries have limits on what their government is able to spend, depending on their ability to gather tax income from the corporations and citizens who provide the necessary resources to the government.

Germany’s defense budget is roughly €43 billion (U.S. $49 billion) for 2019, or about 1.2 percent of their GDP. Their healthcare spending was 11.3 percent of their GDP, about US$368.78 billion (€287.3 billion) in 2015.

To build their own military to levels where they would not need the U.S., Germany would need to dedicate up to 40 percent of their GDP (this is what the U.S. spent leading up to WWII.)

Obviously, this is not realistic. But Germany (and the rest of Europe) would certainly need to dedicate at least 10-15 percent of their GDP to military spending if the U.S. was to become isolationist and quit providing for the defense needs of others. This would eliminate their ability to pay for healthcare (indeed, it would eliminate infrastructure spending and most other government services.)

Or, Germany and other countries could simply become client states of Russia or China.

Interesting links regarding military vs healthcare spending:

https://www.forbes.com/sites/niallm...iture-in-comparison-infographic/#5350d7023020

https://www.washingtonpost.com/busi...ld-do-with-european-levels-military-spending/

In conclusion, every country has limits on deficient spending (maybe not the U.S. today due to the dollar being the world's reserve currency, but this won't last forever). These limits include a country's ability to spend on associated costs including military, infrastructure, healthcare and other social services.

It's one big pot, but if military spending sucks up the majority of a country's resources, other spending will need to be curtailed.

 

I make no claims to be able to predict the future in any particular detail.

However it is clear and documented how our present system fails in so many ways. Why should I defend the pathetic status quo when other countries have had success with a different model. The only factor that keeps us in the status quo is the political influence of those who profit from the status quo.

Only a fool is not willing to try a better model. A fool, or one with a vested interest in maintaining the status quo.

 

Yes, by all means let us acknowledge the US tax payer, and let us also acknowledge how he and the treasury have been plundered in the waging of our fraudulent war of terror waged for the last 20 years.

And let us acknowledge that just the $ that the Pentagon cannot account for, $22 Trillion or more, would easily fund an intelligently designed universal healthcare system.

 

That and the near 90% of the people who were satisfied or very satisfied with their "status quo." Why was it that our dissatisfaction rate was considerably less than the other countries with national health care? Why did our dissatisfaction rate go way up after Obamacare? Why are many Democrats, including some presidential contenders, telling Bernie et al to get off the medicare for all before they lose millions of voters?

 

The Veterans Choice program uses the feds and external specialist outside the VA to treat the patient..

 

Didn't answer my question....