The Health Care Debate

[LenexatoKCMO]

There are plenty of real problems in the health care industry that the vested interests just don't want to talk about. 

An enormous amount of expense in hospitals for instance relates to the mountains of bureaucratic paperwork and compliance that the feds have imposed on them - Hospitals have hands down the most ridiculous compliance burden of any industry- why did they have to impose such an onerous compliance regime?  Because it had become nearly universal practice for hospitals and medical groups to steal from the state and federal medical insurance programs - fraudulent billing, etc.  KC's own baptist med center was one of the benchmark cases.  The nation's hospitals and medical groups were stealing BILLIONS from taxpayers for years and now that they are discovered their massive compliance costs are a big part of why that plastic barf bucket costs you $35 when you check out of the hospital.  Ask around and see how many MDs you can find that are willing to talk about that little piece of escalating health costs. 

Another big health care cost is the lack of doctors and nurses.  The lobbyists would have you believe that this is due to MDs being driven out of business by malpractice insurance costs.  1) the actual number of doctors affected by this is tiny; and 2) the doctors that do legitimately get driven out of business have had multiple cases of gross negligence found against them.  If the public saw the records of the doctors that do truly get priced out of practice, they wouldn't want to go to them.  However, if we do want to take a look at one of the big reasons for shortages of doctors, perhaps we should ask med schools why they are increasingly filling their slots with more foreign students who have no intention of remaining in the US than they do actual native students - could it possibly have anything to do with the fact that they can often get more tuition out of the foreign students?  If there really is a massive shortage of health care providers than perhaps the light should be focused on the academic system that pumps them out, not on the tiny handful who prove themselves incometent to practice every year. 

I haven't even gotten started on the Insurance and Pharmaceutical industries yet. 

[aknowledgeableperson]

An enormous amount of expense in hospitals for instance relates to the mountains of bureaucratic paperwork and compliance that the feds have imposed on them -  

My wife was employed in the home health care field in its infancy.  At that time she would spend so much time actually seeing the patient and then due some paper work afterwards to document the visit.  By the time she left the field she would spend the same amount of time seeing the patient but would spend a greater amount of time afterwards documenting the visit.  Just think spending more time on paperwork than seeing the patient.

And that is just the beginning.  She would have to release a patient after an alloted number of visits even though the patient was not well enough.  Then after a few days the patient would be sick enough to go to the hospital for a multi-day stay, go home, and then the visitis would start over.  If she could have continued seeing the patient a hospital stay might have been avoided.

[scooterj]

Chumpy Bush is coming to KC today (AF1 lands at the Downtown Airport in about 45 minutes) to promote his health care plan in Lee's Summit.    Whoopty.

(On a side note, it's screwing up my lunch plans, since my friend works at a building on the ground sof the Downtown Airport.    Because Bush's approval rating is so long security is tighter than ever.  His company is under lockdown with access through only one entrance and the Secret Service has set up metal detectors and searching everyone.  Once AF1 lands they wil be on total lockdown and no one will be allowed in or out and the bridge will be closed.)

[Maitre D]

I'm going to say it, and people don't like to hear it, but it's true.

The US is a very diverse country.  With that, we have some people who are very poor.  Poor people in general seem to have a habit of consistently making poor personal health choices.  Smoking, drinking, drugs, chronic obesity, and a number of other small things.

The US is not a whitebread Euro nation.  We simply cannot afford to give some people health insurance.  Some people cause too many problems for themselves.  The cost to give these people healthcare so they can chain smoke and eat McDonalds well into their golden years is just too costly.

POST OF THE YEAR. 

I, like millions of other working Americans, absolutely REFUSE to subsidize the poor behavior of others.  Any universal plan that isn't tied heavily to behavior modification & personal responsibility, is bound to be an ineffective money pit.

[KCMax]

POST OF THE YEAR. 

I, like millions of other working Americans, absolutely REFUSE to subsidize the poor behavior of others.  Any universal plan that isn't tied heavily to behavior modification & personal responsibility, is bound to be an ineffective money pit.

You already do if you have any kind of health insurance plan.

[Maitre D]

You already do if you have any kind of health insurance plan.

The level of subisidization doesn't even approach what will happen with a universal plan that isn't heavily incentivized.  I trust you see the point.  If not, I can't help you.

[KCMax]

Of course it doesn't. Its nice to pick and choose healthy people.

Either way you like it, you're paying for the decisions of others, whether its through your private health care plan, or whether its through higher prices for medical care at the hospital which has to raise prices to cover the uninsured people that only come in for emergency care because they can't afford preventative care. If you're going to pay for it either way, why not make it more cost-efficient rather than the mess of a hodge-podge system we have now?

[Maitre D]

Of course it doesn't. Its nice to pick and choose healthy people.

Either way you like it, you're paying for the decisions of others, whether its through your private health care plan, or whether its through higher prices for medical care at the hospital which has to raise prices to cover the uninsured people that only come in for emergency care because they can't afford preventative care. If you're going to pay for it either way, why not make it more cost-efficient rather than the mess of a hodge-podge system we have now?

That's a red-herring that I reject:  "Look, it's already expensive, let's make it organized, and more efficient!"  Mularkey!  That's what liberals say about EVERY domestic issue we face:  more fed control.

45M people have no health insurance in the USA, and a huge huge chunk of them are low-wage Hispanics who provide cheap labor for industry.  They do NOT hit the emergency rooms in any appreciable numbers.  If they (or the rest of the poor) are given carte blanche access to hospitals-doctors etc, there will be a WAVE coming in clogging up the health facilities.

Only then will working Joe American realize, "Nobody said this would happen"

[KCMax]

Maybe they say that because the administrative costs of Medicare and Medicaid, as well as government run health care in Canada, are a fraction of the administrative costs of our private health care system. Its way more efficient.

And I never advocated carte-blanche access to health care. There's a way to provide more access to health care without giving away the farm.

[LenexatoKCMO]

I'm going to say it, and people don't like to hear it, but it's true.

The US is a very diverse country.  With that, we have some people who are very poor.  Poor people in general seem to have a habit of consistently making poor personal health choices.  Smoking, drinking, drugs, chronic obesity, and a number of other small things.

The US is not a whitebread Euro nation.  We simply cannot afford to give some people health insurance.  Some people cause too many problems for themselves.  The cost to give these people healthcare so they can chain smoke and eat McDonalds well into their golden years is just too costly.

I am no fan of nationalized health care but this has to be one of the most logically unsound arguments I have ever seen.  Have you ever been to Europe?  You think the entire continent is populated by rich white folks?  They have plenty of their own socio-economic stratification and the immigration of poor people from outside the more developed countries is every bit as big an issue there as it is here.  If you are going to attack the Euro health systems, attack them on the grounds that they are  rediculously expensive, inefficient, and offer a reduced standard of care - not on  the falacy that Europe is some sort of rich, aryan paradise. 

[Highlander]

I am no fan of nationalized health care but this has to be one of the most logically unsound arguments I have ever seen.  Have you ever been to Europe?  You think the entire continent is populated by rich white folks?  They have plenty of their own socio-economic stratification and the immigration of poor people from outside the more developed countries is every bit as big an issue there as it is here.  If you are going to attack the Euro health systems, attack them on the grounds that they are  rediculously expensive, inefficient, and offer a reduced standard of care - not on  the falacy that Europe is some sort of rich, aryan paradise. 

Yea, I was hoping that was more or less evident to all.  You might get the idea that Europe consists of an entirely white homogenous population if you read a 1937 geography text book but the reality today is very different.  Come to London sometime....you'll wonder where the English are.  Minority populations in Europe are large and growing.  Several countries in Europe, if current birth rates and cultural trends continue, will have a majority muslim population by mid century.  It's also erroneous to think that Europeans are all fit (you should visit Scotland) and you would feel much better if you owned AJ Reynolds stock and you visited here because smoking is much more prevalent than in the states.  Also, like the states, people here do age which increases the health care needs of people.

POST OF THE YEAR.  

I, like millions of other working Americans, absolutely REFUSE to subsidize the poor behavior of others.  Any universal plan that isn't tied heavily to behavior modification & personal responsibility, is bound to be an ineffective money pit

 

You already bankroll people's bad choices.  You pay for prisons and most incarcerated individuals are there because of poor behaviour.  Lot's of examples like that.  Anyway, it wasn't my parents choice to get old but their medical needs are increasing every year and there are lots of thin, athletic, non-smokers in the same boat. 

I believe some form of national health care will eventually no longer be an option, it's a matter of time.  Our current system is unsustainable due to the incredibly high costs of medical care in this country.  We might debate the causes of that cost (and they are certainly something we should attempt to control), but it's pushing into a national system because we as society simply cannot afford to leave so many people uncovered and exposed to financial ruin.  I'm no huge fan of the European system, mostly because I have to live and experience it, but the US system is in many ways equally flawed.  Europe's system is essentially health care rationing based on seriousness of illness and age/prognosis of the patient while ours is health care rationing on the basis of the patient's financial wherewithall. 

[Maitre D]

You already bankroll people's bad choices.  You pay for prisons and most incarcerated individuals are there because of poor behaviour.  Lot's of examples like that.  Anyway, it wasn't my parents choice to get old but their medical needs are increasing every year and there are lots of thin, athletic, non-smokers in the same boat. 

But I already pointed out, that's not an argument FOR national healthcare.  I get the idea I pay for bad behavior.  But would I pay for more?   You have to prove to me that I would bankroll LESS bad behavior without any drop in my current healthcare....for me to agree we need it.

I believe some form of national health care will eventually no longer be an option, it's a matter of time. 

They said that 10 years ago.  And 20 years ago.  And...

Our current system is unsustainable due to the incredibly high costs of medical care in this country.

So is social security.  Hey wait - wasn't that a national program designed to "safeguard" all citizens?

We might debate the causes of that cost (and they are certainly something we should attempt to control),

Not attempt - SHOULD - control.

but it's pushing into a national system because we as society simply cannot afford to leave so many people uncovered and exposed to financial ruin.  I'm no huge fan of the European system, mostly because I have to live and experience it, but the US system is in many ways equally flawed.  Europe's system is essentially health care rationing based on seriousness of illness and age/prognosis of the patient while ours is health care rationing on the basis of the patient's financial wherewithall. 

You & others are going to have to convince the majority...I'm talking, the bulk of the populace....that this will be good for them.  And in order to do so, it must be either (1) cheaper or (2) better quality healthcare FOR THEM.

The day Americans agree to sacrifice their well-being for "so many others".... is the day I'll buy you a steak dinner.

[Gretz]

POST OF THE YEAR.  

I, like millions of other working Americans, absolutely REFUSE to subsidize the poor behavior of others.  Any universal plan that isn't tied heavily to behavior modification & personal responsibility, is bound to be an ineffective money pit.

I'm going to say it, and people don't like to hear it, but it's true.

The US is a very diverse country.  With that, we have some people who are very poor.  Poor people in general seem to have a habit of consistently making poor personal health choices.  Smoking, drinking, drugs, chronic obesity, and a number of other small things.

The US is not a whitebread Euro nation.  We simply cannot afford to give some people health insurance.  Some people cause too many problems for themselves.  The cost to give these people healthcare so they can chain smoke and eat McDonalds well into their golden years is just too costly.

Maybe we could just deny these people emergency care too.  It's their own fault that they are poor and unhealthy afterall.  Better yet, let's move them all to Madagascar...

[Maitre D]

Maybe we could just deny these people emergency care too.  It's their own fault that they are poor and unhealthy afterall. 

Is it mine?

[Joemoney]

Maybe we could just deny these people emergency care too.  It's their own fault that they are poor and unhealthy afterall.  Better yet, let's move them all to Madagascar...

Don't give me any ideas.

[Joemoney]

I am no fan of nationalized health care but this has to be one of the most logically unsound arguments I have ever seen.  Have you ever been to Europe?  You think the entire continent is populated by rich white folks?  They have plenty of their own socio-economic stratification and the immigration of poor people from outside the more developed countries is every bit as big an issue there as it is here.  If you are going to attack the Euro health systems, attack them on the grounds that they are  rediculously expensive, inefficient, and offer a reduced standard of care - not on  the falacy that Europe is some sort of rich, aryan paradise. 

It's not logically unsound.

First, the countries in Europe that do provide high quality, national health care are very "white bread."  The countries where most of the poor are located (Baltic, Turkey, other eastern European nations) do not have healthcare, or if they do, they have a 3rd world quality healthcare system.

Secondly, the poor in Europe are, for the most part, much different than the ones in America.  They are less unhealthy, and have less tendencies for unhealthy habits.

To put it simply, in America, we have more people who are a drain on society, than who are not, compared to Europe.  Don't look at just income though, the CULTURE of our poor, makes it far more difficult to help them, compared to Europe.  They really don't have many "dangerous ghettos" in most of Europe (yes they have dangerous places, but nothing like the US).  The poor in Europe make better choices for themselves.  Their poor are more "traditionally cultured," while America's poor have been corrupted by the white trash culture (for whites) and BET culture (for blacks).

The only way universal health care would work in the US is if two things happened, 1.  the quality of healthcare would have to drop DRAMATICALLY, 2.  we would need to implement "mommy government" like policies to protect the people from themselves to lower the overall cost and improve public health (which defeats the purpose of America, a land of the free).  Universal health care is simply not meant for America.  That's not what this country is about.  It's supposed to be a utopia of freedom (from taxes, from intervention, and government babysitting), not a utopia of statistics (living standards, wealth equality, "social justice", etc).  And I put the term "social justice" in parenthesis because I hate the context in which it's used.  True social justice is me not having to pay for someone else's mistakes in life.

And to pittsburghparoyal, you're a wise man.

[Highlander]

It's not logically unsound.

First, the countries in Europe that do provide high quality, national health care are very "white bread."  The countries where most of the poor are located (Baltic, Turkey, other eastern European nations) do not have healthcare, or if they do, they have a 3rd world quality healthcare system.

You are absolutely out of your mind.  Visit Bradford or Leeds in the UK or Marseilles in France or southern Spain, or Naples.....I think you would find all the minorities and poverty you would ever wish to see.  But, hey, don't take my word for it, I've only lived here for 9 years. 

Secondly, the poor in Europe are, for the most part, much different than the ones in America.  They are less unhealthy, and have less tendencies for unhealthy habits.

They walk more, I'll give them that.  Obesity is a real problem in Scotland and England.  Throughout Europe, people smoke more than in the states and alcoholism is a major problem in many countries (Czech Republic, UK, Ireland, Germany).

To put it simply, in America, we have more people who are a drain on society, than who are not, compared to Europe.  Don't look at just income though, the CULTURE of our poor, makes it far more difficult to help them, compared to Europe.  They really don't have many "dangerous ghettos" in most of Europe (yes they have dangerous places, but nothing like the US).  The poor in Europe make better choices for themselves.  Their poor are more "traditionally cultured," while America's poor have been corrupted by the white trash culture (for whites) and BET culture (for blacks).

Yea, it's true the continent is much safer than the US but again, I would not call smoking and drinking problems as wise choices.  

The only way universal health care would work in the US is if two things happened, 1.  the quality of healthcare would have to drop DRAMATICALLY, 2.  we would need to implement "mommy government" like policies to protect the people from themselves to lower the overall cost and improve public health (which defeats the purpose of America, a land of the free).  Universal health care is simply not meant for America.  That's not what this country is about.  It's supposed to be a utopia of freedom (from taxes, from intervention, and government babysitting), not a utopia of statistics (living standards, wealth equality, "social justice", etc).  And I put the term "social justice" in parenthesis because I hate the context in which it's used.  True social justice is me not having to pay for someone else's mistakes in life.

I would not call getting old a mistake, it's a fact of life and that alone will increase health care needs.  I'm hardly a liberal and yet I can see that you just can't have a huge portion of your population exposed to either NO health care or FINANCIAL RUIN because of health care.  Especially when our on utopian system is responsible for driving health care costs to the breaking point.  Yes, we are free from a lot of things that burden Europeans but I don't think we can sit around and watch people suffer and die.  There are ways to implement national health care without decreasing the quality of the care by making sure that supplemental insurance is available and affordable.  I do not advocate that health care has to be equitable, you should have the option to pay for supplemental insurance, I just think it should be available to everyone. 

And to pittsburghparoyal, you're a wise man.

[tat2kc]

With all the hype about how the U.S has the best health care in the world, its odd that we certainly aren't the healhest country in the world, and we certainly are not the longest lived. Cheer America all you want, but the reality is that the rest of western world is as healthy, if not more so than we are, and a good portion will outive us.

[Joemoney]

You are absolutely out of your mind.  Visit Bradford or Leeds in the UK or Marseilles in France or southern Spain, or Naples.....I think you would find all the minorities and poverty you would ever wish to see.  But, hey, don't take my word for it, I've only lived here for 9 years. 

That poverty is nothing like what is in the US.  And those people are nowhere as near as unhealthy as our poor.  They live off traditional meals, our poor scarfs down McDonalds and fried chicken.

They walk more, I'll give them that.  Obesity is a real problem in Scotland and England.  Throughout Europe, people smoke more than in the states and alcoholism is a major problem in many countries (Czech Republic, UK, Ireland, Germany).

The general rule you need to follow is, everything is the US is more extreme.  Our obesity is worse, our drug use is worse, the severity of other substance abuse is worse (since you haven't lived in the US, you might not have heard of the wave of meth addiction in the past decade, but it's gotten extremely bad).

Yea, it's true the continent is much safer than the US but again, I would not call smoking and drinking problems as wise choices.

In Europe people drink more consistently, but with less severity.  I once saw a recently study (in a newspaper) about this.  It showed that while Europeans may drink just as much as us, Americans drink heavier and binge drink.

Having a glass of wine every night for dinner is much less unhealthy than getting totally loaded one night a week.

I would not call getting old a mistake, it's a fact of life and that alone will increase health care needs.  I'm hardly a liberal and yet I can see that you just can't have a huge portion of your population exposed to either NO health care or FINANCIAL RUIN because of health care.  Especially when our on utopian system is responsible for driving health care costs to the breaking point.  Yes, we are free from a lot of things that burden Europeans but I don't think we can sit around and watch people suffer and die.  There are ways to implement national health care without decreasing the quality of the care by making sure that supplemental insurance is available and affordable.  I do not advocate that health care has to be equitable, you should have the option to pay for supplemental insurance, I just think it should be available to everyone.

It is a fact that most people without healthcare contribute very little to society.  This country rewards people who contribute.  If you don't have anything, you need to start asking yourself why.

Whenever I see a story about national healthcare in the news, they always show some story abouy a guy who got cancer, and had to quit his job, and his wife who also had to quit her job to take care of him, and because of that they do not have healthcare.  Yes good people who are down on their luck do exist like that, but that is NOT the face of the typical uninsured.  Most of them are uneducated losers who have never contributed to society and have consistently made poor person choices.

[Highlander]

All I can say about your ideas of drinking in Europe is that you should come over here sometime and try to keep up with the brits.  They'd drink you under the table.  People here and in Ireland drink a lot and they drink often.  That is why they call it a "drinking culture".  They also start at a much younger age than Americans.  

It is a fact that most people without healthcare contribute very little to society.  This country rewards people who contribute.  If you don't have anything, you need to start asking yourself why.

My parents slave to provide health care through their business to their employees.  It seriously erodes my fathers ability to compete with his much larger competitors (because they can secure insurance for large numbers of people much more cheaply than my father can).  If he quit offering health care, he'd lose his employees but he may lose his business if he doesn't.  His employees, not educated, but hard working people, have to select their jobs on the basis of affordable health care.  Our system, or lack of it, puts a huge strain on self employed people who do indeed make a big contribution to society.