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Frazzled wrote:

Gibbsey wrote:

Ahtman wrote:A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.

Which shows the entire problem with the healthcare industry, also doctors and hospitals regularly overcharge for services which results in insurance companies having to negotiate claims

If only the government could order that properly. Imagine a world where the government set those prices and costs, where someone couldn't over charge because of their greed. We could have $10 dollar visits any time. In fact all our healthcare would only cost $10. Wait, what did you say-unintended consequences, whats that?

what does that have to do with what i said?

Overcharging a bill can mean that the services were overcosted, it can also mean that they are charging you for 4 sets of something when you only used 2. This is what gets negotiated.

Elmodiddly wrote:What people don't realise is the whole system is being paid for, not just the 30 seconds to see the doctor.

No, we realize that. In that regard, it's no real different than the billing hours charged by software consultants, lawyers or CPAs. They all have receptionists, aides, and the like too.

The UK system is funded by the Government but that is maintained by NHS contributions from our pay, we have no say in the matter.

Otherwise known as taxes. Spin it however you want, if the government is taking your money, it's a tax. Rose by any other name and all that.

If the US went into that type of system it would be better for everyone as the costs even out but as a side result you could be supporting those who don't work and the insurance industry, as they know it, would collapse due to the medical insurance companies no longer being needed.

The costs would also even out in a regulated private system, arguably better. First, what has the government ever run that really works well, without a ton of bureaucratic overhead? Almost without exception, private business works better and cheaper than government agencies, because they have a reason to.

Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.

I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.

Ketara wrote:

Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.

I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.

And also freeing up valuable dollars er pounds that would have been spent on a higher standard of care because the rich now have theirs and screw everyone else. Just because everyone can be served does mean it doesn't suck.

Frazzled wrote:

Ketara wrote:

Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.

I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.

And also freeing up valuable dollars er pounds that would have been spent on a higher standard of care because the rich now have theirs and screw everyone else. Just because everyone can be served does mean it doesn't suck.

While you have a point it is better than the poor being left without health care and people being denied by health insurance companies, while i do think that the NHS could be improved with more funding.

The difference with the system in the US is the poor go without coverage and everyone else except the rich get decent coverage. The rich can affort better healthcare than everyone else.

Poor go to emergency rooms now. Poor have Medicaid.

Redbeard wrote:
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

I didn't say that it wasn't a tax, I know it is but I do take this bit a little bit bemusingly. What private system behind the NHS? I know a LOT about the NHS and I know what it can and does do, I also know what it doesn't do very well but what is this private system behind the NHS?

Elmodiddly wrote:
I didn't say that it wasn't a tax, I know it is but I do take this bit a little bit bemusingly. What private system behind the NHS? I know a LOT about the NHS and I know what it can and does do, I also know what it doesn't do very well but what is this private system behind the NHS?

The one Ketara also mentioned. The one where you can pay to go to a doctor outside the NHS, and get better treatment.


Frazzled is right, in this country, the poor can go to emergency rooms. That's another sign that there's a problem with the system, I've never said that the US system is good. It's been proven that trips to the ER are more expensive than even a minimal routine visit, and this is another way in which the US system is inefficient. Because they wait until they need to go to the ER, the poor don't get the preventative care that would eliminate those ER visits at a lower cost.

The US system is horribly flawed. What I really dislike is how the solutions, especially from those in countries with nationalized healthcare all seem to revolve around making the government fund the system. Most nationalized healthcare systems aren't as good as the private system in the US (provided that you can afford it). The problem with the American system isn't how it is funded, but rather, how much everything costs. The solution to this does not involve moving the costs around, it requires that the costs (largely overhead due to the insurance, legal and pharmaceutical industries) be eliminated.

Frazzled wrote:Poor go to emergency rooms now. Poor have Medicaid.

Except the ones that earn enough to not be eligible or are excluded for a different reason and dont earn enough to easily afford healthcare

Frazzled wrote:Poor go to emergency rooms now. Poor have Medicaid.

The former is not a fix, any more then buying bottles of aspirin because you need the cotton is a wise way to roll. People who do this tend to wait longer to get care, thus making for a more expensive trip; and of course this is no way to treat a chronic condition.

I don't know the solutions to our health care problems, but this frequently cited example is not a good one. It should remain the very last safety net, not the only possible option.

Ahtman wrote:A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.

This isn't uncommon, but not nearly as common as other pricing issues. The biggest pricing issues is actually undercoding.

See, when a doctor/private practicioner wants to use a more expensive test for diagnosis the health insurance company fights the doctor to make them prove that the test is necessary. This is because the insurance companies don't want to pay for anything either. What this typically leads to is the doctor undercoding so a less expensive test is used(even if the more expensive one really is necessary) because it saves time and hassle.

Frazzled wrote:

Ketara wrote:

Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.

I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.

And also freeing up valuable dollars er pounds that would have been spent on a higher standard of care because the rich now have theirs and screw everyone else. Just because everyone can be served does mean it doesn't suck.

How does that work? The NHS is funded by the taxpayer. We don't pay again upon entering the NHS ward.

The people who choose to go private are still paying for NHS care as well. No money is lost to the NHS when they go private, indeed the opposite occurs, because they're paying for their treatment privately instead of on the NHS. This frees up money on the NHS, and places less of a strain on the system.

Therefore, when I go private, I've already paid for the NHS. I've paid for healthcare I'm not using. Instead, I'm choosing to pay twice, and more money to boot, in order to ease the burden placed on the national system.

Ketara wrote:
The people who choose to go private are still paying for NHS care as well. No money is lost to the NHS when they go private, indeed the opposite occurs, because they're paying for their treatment privately instead of on the NHS. This frees up money on the NHS, and places less of a strain on the system.

Therefore, when I go private, I've already paid for the NHS. I've paid for healthcare I'm not using. Instead, I'm choosing to pay twice, and more money to boot, in order to ease the burden placed on the national system.

Wait, so you think it is a good thing that you are paying for an extra service that you choose to use because the service that you're forced to pay for isn't good enough for you to use? And don't tell me that you're "choosing to pay twice in order to ease the burden placed on the national system". I don't think I've heard of anyone being that altruistic. You're choosing to pay twice because the NHS isn't very good. It's either too slow, or doesn't provide adequate options, or it is flawed in some other way that makes you choose to pay this extra money. Easing the burden on the NHS might be a positive side effect of your choice, but it's not the reason you're doing it.

Redbeard wrote:The correct 'fix' is to regulate the industries where the money is going to, not to change where the money come from. Treat insurance and pharmaceuticals as commodities, like water, electric, and gas. Cap malpractice awards. Change the underlying financial rules that the healthcare industry operates under, and it will become affordable again.

One of the better proposals in the HCR was to regulate where the insurance companies could spend their money. Right now a tremendous proportion is being spent on advertising and marketing, which results in less money for actual care, and higher premiums. By capping the amount spent on advertising and marketing, you'll see a greater proportion of the total premiums charged being used to treat people.

I think a similar thing could probably work for drug companies. Unfortunately, as we all saw, the drug companies had their claws in the HCR...

Elmodiddly wrote:No easy answer.

Definitely, it's an extremely difficult subject, where setting the right policy requires constant analysis and consultation with a wide range of experts. Even then you basically have to accept that you'll need to keep jigging and correcting things. Unfortunately that's made almost impossible when ideological warriors come in on both sides, with little or no interest in what's being discussed or how the system actually operates and instead just spout their tired old rhetoric.

That might spout stuff like, say... "If only the government could order that properly. Imagine a world where the government set those prices and costs, where someone couldn't over charge because of their greed. We could have $10 dollar visits any time. In fact all our healthcare would only cost $10. Wait, what did you say-unintended consequences, whats that?"


Automatically Appended Next Post:

Redbeard wrote:Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.

It's no dirty little secret, it's an explicit feature of the system. If you have enough money that you'd like to pay for shorter waiting times on non-emergency treatment and a nicer, bigger room, then you do that, and you take pressure off the system.

What's more, having a base level of care means that private insurers have to make sure they're really offering something worthwhile for people to take them up.


Automatically Appended Next Post:

Frazzled wrote:Poor go to emergency rooms now. Poor have Medicaid.

You've tried this argument before, that you wouldn't want to have two tiers of healthcare so you couldn't have a public/private hybrid, and it's just ridiculous. The split is not in the quality of actual care, but in the waiting time for non-emergency care, and in how pleasant your stay in hospital is (shared or private room, for instance). Meanwhile you have a system where people who don't have insurance are denied non-emergency care entirely...


Automatically Appended Next Post:

Redbeard wrote:The US system is horribly flawed. What I really dislike is how the solutions, especially from those in countries with nationalized healthcare all seem to revolve around making the government fund the system. Most nationalized healthcare systems aren't as good as the private system in the US (provided that you can afford it). The problem with the American system isn't how it is funded, but rather, how much everything costs. The solution to this does not involve moving the costs around, it requires that the costs (largely overhead due to the insurance, legal and pharmaceutical industries) be eliminated.

Except that much of the increased costs comes from the waste in your current private insurance system. They spend a stupid amount on marketing, and just as much on fighting legal battles to deny treatment (because no matter how costly those legal battles are, they're cheaper than actually providing healthcare). If you had a base level public system, the insurance companies would have to offer an appealing level of service for the amount they charge - suddenly they're dealing with selective consumers and not a captive market.

Also, decoupling private insurance from your employer would go a long way to improve competition in the market.


Automatically Appended Next Post:

Redbeard wrote:Wait, so you think it is a good thing that you are paying for an extra service that you choose to use because the service that you're forced to pay for isn't good enough for you to use? And don't tell me that you're "choosing to pay twice in order to ease the burden placed on the national system". I don't think I've heard of anyone being that altruistic. You're choosing to pay twice because the NHS isn't very good. It's either too slow, or doesn't provide adequate options, or it is flawed in some other way that makes you choose to pay this extra money. Easing the burden on the NHS might be a positive side effect of your choice, but it's not the reason you're doing it.

I did my ACL a couple of years back, and went to hospital. I was given x-rays to ensure no bone had fragmented, then I started to a specialist, while I waited a couple of weeks for the swelling to go down so I could have an MRI. When I got the MRI result, he said the padding had been ripped up pretty badly and I'd have to avoid walking as much as possible, until I could get surgery - which would take about a month. I said that was too long, as I was going to India in two months, and he replied it'd be different if I had private insurance. I told him I had private insurance, and he said he'd be able to perform the surgery himself the very next day. In recovery I got a private room, and that was that.

Thing is, if I was to get very sick and need emergency care, I would be taken to the nearest hospital and treated, because it doesn't matter if I have private insurance or not, I would be treated by the same doctors, as quickly as any other system. After I'd been stabilised, and was about to spend a week in a hospital ward, they would find out if I'm on public or private care, because then I'd get a nicer room and stuff like that. But in terms of the quality of actual care, it's the same.

Redbeard wrote:
Wait, so you think it is a good thing that you are paying for an extra service that you choose to use because the service that you're forced to pay for isn't good enough for you to use?

The service is good enough for me to use. I do use it. I personally, am not rich enough to afford to do otherwise. I can get a doctors appointment whenever I need it, and when I fell ill with nerve pain, I had it all sorted within a month. The waiting time is longer for more complex procedures, but if you have a more serious condition, they bump your priority notch. For example, my mother is currently a cancer risk, and she had special dispensation which meant that she never had to wait longer than a week between each stage of the process (appointments with specialists, scans, etc). The NHS is not as good as it could be, no government service ever is. But it is adequate, and available to all.

And don't tell me that you're "choosing to pay twice in order to ease the burden placed on the national system". I don't think I've heard of anyone being that altruistic.

Two of my family friends do. They like the better service as well, but they claim this as their primary reason. As highly moralised , decent people, I believe them. What proof do you have they lie?

You're choosing to pay twice because the NHS isn't very good. It's either too slow, or doesn't provide adequate options, or it is flawed in some other way that makes you choose to pay this extra money. Easing the burden on the NHS might be a positive side effect of your choice, but it's not the reason you're doing it.

I fail to see the flaw here. Yes, the private service is more efficient, and more luxurious. Some people might prefer to use it instead simply for that. However, considering the original point I was responding was that using private healthcare removes monies from the NHS, I fail to see how this is relevant. The NHS guarantees that if I lose my job and can no longer afford private, I'll still be treated. Why on earth would I resent paying twice? Its a safety net. Sure, if I can afford it, I'll take the more luxurious route, the same way I'll drive a porsche rather than an Aston Martin from Bobs second hand motors. I fail to see why the human tendency to seek out more luxurious conditions for itself is damning to the NHS though.

For being slow, as I've already said, in high priority situations, dispensations are granted guaranteeing faster treatments. The way you insist it must be 'flawed in some way' tells me that regardless of knowing very little/next to nothing about the NHS, you're frantically trying to make it out to be bad in some way. Why, I have no idea. Is this the stereotype where Americans call all forms of socialism communism or something?

I'll chime in on the private stuff too - the NHS acts as a downward pressure on the pricing options of private hospitals. I dont have insurance but sometimes when I have a holiday booked or dont want to wait, I'll pay out of pocket for treatments or consultants at a private hospital and it works out cheaper than paying for insurance and not using it for a year. For example, a trip to a consultant and a full MRI of a leg, getting a complete copy of it on a CDR at the end, with a waiting time of 5 minutes (walked in, chat to consultant about issues, MRI recommended, MRI done) cost £150 3 years ago without any insurance. How much would the same be in the states and how long would you have to wait after seeing the initial consultant?

legoburner wrote:I'll chime in on the private stuff too - the NHS acts as a downward pressure on the pricing options of private hospitals. I dont have insurance but sometimes when I have a holiday booked or dont want to wait, I'll pay out of pocket for treatments or consultants at a private hospital and it works out cheaper than paying for insurance and not using it for a year. For example, a trip to a consultant and a full MRI of a leg, getting a complete copy of it on a CDR at the end, with a waiting time of 5 minutes (walked in, chat to consultant about issues, MRI recommended, MRI done) cost £150 3 years ago without any insurance. How much would the same be in the states and how long would you have to wait after seeing the initial consultant?

What you describe is not really possible in the states unless you are a celebrity. However, after jumping through hoops and paying for several office visits, an out of pocket MRI costs between $3000-$5000.

I had an MRI done on my shoulder a few years back. I went to the doctor, waited perhaps a little longer than 5 minutes in a waiting room, was told to get an MRI, went downstairs, had the MRI done, and went back to the doctor to talk about the results. My out-of-pocket cost, I believe, was a $10 copay.

But, I work for a really big software company that has pretty good benefits and all. If I had to pay for it myself it would have cost the $3-5k as Olympia mentioned.

olympia wrote:

legoburner wrote:I'll chime in on the private stuff too - the NHS acts as a downward pressure on the pricing options of private hospitals. I dont have insurance but sometimes when I have a holiday booked or dont want to wait, I'll pay out of pocket for treatments or consultants at a private hospital and it works out cheaper than paying for insurance and not using it for a year. For example, a trip to a consultant and a full MRI of a leg, getting a complete copy of it on a CDR at the end, with a waiting time of 5 minutes (walked in, chat to consultant about issues, MRI recommended, MRI done) cost £150 3 years ago without any insurance. How much would the same be in the states and how long would you have to wait after seeing the initial consultant?

What you describe is not really possible in the states unless you are a celebrity. However, after jumping through hoops and paying for several office visits, an out of pocket MRI costs between $3000-$5000.

bs. I know people who have had MRI's scheduled and done within a week. In fact ALL the MRI's / CT scans were done in a week.

@frazzled, perhaps if it's for something serious like back cancer you can get an MRI quickly. Did the people you know have health insurance?

olympia wrote:@frazzled, perhaps if it's for something serious like back cancer you can get an MRI quickly. Did the people you know have health insurance?

2/3 health insurance, 1/3 had Medicare.

The thing is, MRI's are usually done within the week or even a day due to the fact that nearly every hospital has one. The delay in treatment we see is usually due to the patients themselves thinking they know more than the doctor or not wanting to go to the doctor's office.

We had a diabetic come in and cleaned him up and gowned him before we took him to an MRI machine to see if he had hit his head when he fell within 10 minutes. It took awhile cuz he had soiled himself and he wasn't the skinniest fellow in the world.

I messed my knee up and they didn't use an MRI, they used an X-ray and could tell based off of that what had happened. Next thing I know I was in a surgeon's office being consulted and scheduled surgery for a week later. He gave me a list of options with the plus and negative sides and we made a decision. Went with just getting the loose cartilage fragments out as opposed to a graft or knee replacement.

We actually had two insurances, one from my dad who was in the service(which almost nobody accepts because the government doesn't like to pay) and a private insurance(because they actually do pay).

As to having to pay the NHS and a private person for seeing the private person, yes there is a flaw there.

It would be like having to pay the USPS(United States Postal Service) whenever we use FedEx or UPS.

Frazzled wrote:
bs. I know people who have had MRI's scheduled and done within a week. In fact ALL the MRI's / CT scans were done in a week.

When you have the right insurance plan, sure.

Unfortunately, that's not the case for everyone.

Before I had my current insurance plan, my average wait for an MRI, and I've had many of them, was 4-5 weeks.

Nice try though.

dogma wrote:

Frazzled wrote:
bs. I know people who have had MRI's scheduled and done within a week. In fact ALL the MRI's / CT scans were done in a week.

When you have the right insurance plan, sure.

Unfortunately, that's not the case for everyone.

Before I had my current insurance plan, my average wait for an MRI, and I've had many of them, was 4-5 weeks.

Nice try though.

Missed the Medicare part there hoss.

sebster wrote:
You've tried this argument before, that you wouldn't want to have two tiers of healthcare so you couldn't have a public/private hybrid, and it's just ridiculous. The split is not in the quality of actual care, but in the waiting time for non-emergency care, and in how pleasant your stay in hospital is (shared or private room, for instance). Meanwhile you have a system where people who don't have insurance are denied non-emergency care entirely...

Never mind that he's also argued, frequently in the next breath, that medicaid should be done away with entirely.


Automatically Appended Next Post:

Frazzled wrote:
Missed the Medicare part there hoss.

Did medicare suddenly become something other than state funded health insurance?

With my current insurance I get all the pills and champagne I want. Plus I also get a gold gurney studded with diamonds and IV's filled with liquid caviar.

Now, are you telling me that people without insurance DON'T get that kind of treatment?

dogma wrote:

Frazzled wrote:
Missed the Medicare part there hoss.

Did medicare suddenly become something other than state funded health insurance?

Thats what everything is. Your point is nonsensical.

Frazzled wrote:
Thats what everything is. Your point is nonsensical.

No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.

I'm differentiating between types of insurance, not insurance and no insurance.

This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.

Honestly, it isn't that difficult to understand.


Automatically Appended Next Post:

halonachos wrote:With my current insurance I get all the pills and champagne I want. Plus I also get a gold gurney studded with diamonds and IV's filled with liquid caviar.

Now, are you telling me that people without insurance DON'T get that kind of treatment?

No.

Admittedly, I did not explicitly state that I've had insurance since I was born, but that is the stance I'm arguing from. One which indicates that all insurance is not equivalent.

dogma wrote:

Frazzled wrote:
Thats what everything is. Your point is nonsensical.

No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.

I'm differentiating between types of insurance, not insurance and no insurance.

This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.

Honestly, it isn't that difficult to understand.

What insurance is worse than Medicare?

Frazzled wrote:

dogma wrote:

Frazzled wrote:
Thats what everything is. Your point is nonsensical.

No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.

I'm differentiating between types of insurance, not insurance and no insurance.

This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.

Honestly, it isn't that difficult to understand.

What insurance is worse than Medicare?

http://en.wikipedia.org/wiki/Comparison_of_the_health_care_systems_in_Canada_and_the_United_States

Wikipedia - the almighty source of all knowledge wrote:In the U.S., patients on Medicaid, the low-income government programs, can wait three months or more to see specialists. Because Medicaid payments are low, some have claimed that some doctors do not want to see Medicaid patients. For example, in Benton Harbor, Michigan, specialists agreed to spend one afternoon every week or two at a Medicaid clinic, which meant that Medicaid patients had to make appointments not at the doctor's office, but at the clinic, where appointments had to be booked months in advance.[55] A 2009 study found that on average the wait in the United States to see a medical specialist is 20.5 days.

And as I said before not everyone qualifys for medicare/medicaid and still cannot afford healthcare (This isnt even taking into account the practice of denying "Experimental Procedures" like liver transplants).