why are people against socialized medicine?

[blankcheck]

It's lengthy debates like this that help me understand the common trend of recent residency grads at my program:

1-find a job with a hospital affiliated clinic, or a hospital itself

2-build a small private fee-for service practice on the side

3-do whatever else you can on a salary basis to cover initial overhead

4-adjust your practice for whatever balance of insurance/no insurance that you are ethically comfortable with, officially leave the salaried position, and deal with fewer headaches.

So many of the doctors around my age (I'm 27) are incredibly disillusioned about healthcare that they are willing to go into major debt and run at a loss just to get to step 4 sooner.

Whoever said on page 1 or 2 that this situation comes down to personality had it pegged properly. You're not going to convince someone who hates government that we should have the government run something. You're not going to convince someone who hates private corporations that we should continue to have private insurance only.

This, I think, is such a bad stalemate that the only way to get anything done is to continue with revisions to the split system. So conservatives, suck it up; you'll pay taxes. Liberals, suck it up; there will always be a difference in level of care.

[blankcheck]

I posted this in a similar thread, and I think it applies here as well.

http://www.nytimes.com/2009/07/07/health/07essa.html

I'm sure not all doctors are as disillusioned as this one is, but I'm also sure they're not all as sincere in their motives for getting into medicine.

[LivingAlmostLarge]

Because the number one reason? EVERYONE thinks they are "healthy" and don't need health insurance which spreads around the risk to everyone.

That is until they need insurance and care and then suddenly they BEG the government or insurance for help.

Everyone says they aren't overweight or have any issues when 35% are obese. So where are all these people?

It's like why people don't want to pay taxes and complain. Then if there is a fire they are grateful for the fire department. Or borrowing books from the library.

People in the US keep thinking they are independent islands and don't need to help anyone else or will ever need a hand. Smaller government, less taxes, no health insurance by employers. Capitalism at it's finest.

Honestly? All we'll see is the rich can afford care, the poor will get care and the middle class will cease to exist.

[Seeker]

Originally Posted by LivingAlmostLarge

Because the number one reason? EVERYONE thinks they are "healthy" and don't need health insurance which spreads around the risk to everyone.

That is until they need insurance and care and then suddenly they BEG the government or insurance for help.

Everyone says they aren't overweight or have any issues when 35% are obese. So where are all these people?

It's like why people don't want to pay taxes and complain. Then if there is a fire they are grateful for the fire department. Or borrowing books from the library.

People in the US keep thinking they are independent islands and don't need to help anyone else or will ever need a hand. Smaller government, less taxes, no health insurance by employers. Capitalism at it's finest.

Honestly? All we'll see is the rich can afford care, the poor will get care and the middle class will cease to exist.

100% truth here.

When you're young healthly working and growing, you don't always need the vast majority of the needs that are happening to elder folks today. But you still depend on the things they've done and put into the whole in the past.

When age starts to get ahold of each individual person, we truely come to realize how fragile we are. If an accident or injury occurs, the damage done to a person of age takes a whole lot longer to heal, than a young person. Medical needs grow with time (and DS is also 100% correct -- America needs to become better at preventative care -- do you all know how long it takes to make an appointment for such a simple thing as a mamogram -- last time for me 7 months; and I have insurance).

The medical situation in this country is handled/controlled, if you will, by Insurance companies. If they not only deny coverage to individuals (whom are working and do have coverage), they also take from hospitals/doctors in the form of malpractice premiums. I honesty do not know if they play any part of the manufacturing process of drugs... but if they do, that would also explain the steadily rising costs of medicine.

Ultimately much needs to change.

I think what many countries are headed toward (US included) is a combination of medical formats. I think, there does indeed need to be some form of healthcare for all, and for those people not willing to wait and/or willing to pay more for "better" care, that there'd be an option there as well. Yes, the rich whom choose better care for themselves, may end up paying through taxes for everyone else.

Someone posted earlier -- why should we (the American tax payer) pay for an 80-year old person whom needs heart surgery or whatever? Why? Because it's the right thing to do. In all probabity that 80 year old contributed as much to society as anyone else. Why in a person's time of need, do we fail to help? What goes around, comes around. One day, we'll be in that other person's shoes; then I think we'll understand better.

None of us will live forever, stop being greedy folks.

[swanson719]

I'm not suggesting that the elderly don't deserve care. Rather, if you read my comment, with socialist health care the government will be forced to decide who gets treatment. Today, the younger you are, the higher priority you have when it comes to transplants and other life saving surgeries. This is dictated by hospitals and the groups that administer the transplants and surgeries.

Common sense would dictate the gov't would continue this system. So when an 80 yr old and a 20 yr old both need a life saving heart surgery, who is the gov't going to give the surgery to? The 20 yr old. And who are we going to blame when our grandparents die because they didn't get the care they need? The gov't, who we endorsed to administer this plan to begin with.

The gov't will perform a triage system based on finances as much as health care needs. Why should the gov't give care to the elderly or retirees? They are financially a drain on a socialist system afterall. They get social security, medicare, and don't pay taxes. For a gov't and nation that are going deeply in debt, these will be concerns. It's not to say that the elderly and retirees aren't deserving, but compare the glorification of Michael Jackson and his alleged crimes to the blatant disregard for our men and women dying to protect our country. Who is more deserving? Who have we been forced to watch incessant media coverage of for the last 2 weeks? It's nonsensical.

The point is, that while we may need to reform health care and find ways to make it cheaper, these things can be accomplished without giving carte blanche control of health care to government.

Malpractice does happen, people do make errors. But malpractice suits are way out of hand, and force defensive medicine, which raises costs. Hospitals and companies aren't going to absorb these costs - they are passed onto the consumer. Insurance, settlements, all of the overhead to protect against lawsuits gets passed on the same as in business. Americans in general have too many frivolous lawsuits. Coffee is hot. Snickers bars do have nuts in them. If their is no immediate, lasting personal harm, then why file a suit? These things raise costs, and not much more. The woman who lost her hands and feet and went legally blind from the wrong diagnosis, that's a need for a malpractice suit, but she filed suit for $100 Million. That's a rather large sum of money even if she had died. I understand suing for enough money to get the best prosthetics available and having enough to cover care for the rest of her life, and then some, but that can be done for less than half of the amount filed.

So if we want to lower health care costs that are related to greed, let's go about reforming malpractice laws and stop the frivolous lawsuits in general.

[Seeker]

Swanson, I'm not sugesting that any elderly person be placed ahead of any younger person for a "transplant" that clearly has a better chance of being successful for a longer term in a youthful adaptive body than an elderly one.

But I am suggesting that when a Doctor decides that a pacemaker could help an elderly person lead a normal effective life for even a few more years, and that the patient wants this surgery, that no Insurance comapny should be allowed to intrude and come to the conculsion (and find a way/reason/excuse) to not cover this surgery.

I don't honesty believe that the government will micromanage Doctors to this degree. I believe that a medical system that allows patient/doctors to interact and come to the mutual decision of what is in the best interest of both parties, IS THE BEST way. Obviously what we have now, does not work.

Media and what they cover is another private business that has abused the rights of individuals; all in the name of letting people know, whether or not they want to.

Malpractice is a problem -- one of the reasons doctors do order so many tests is to cover themselves. Judging what is wrong with a person is not an easy task. We're all human. Juries that make outrageous awards do not realize that they too pay.... because yes, costs pay forward too.

I don't know that national health care will be better than private; but I do know that private is not working. The costs are high, but do you think Insurance companies will lower those costs? Only one way of that happening.... and that is for them to have competition from another form of healthcare. Monopolies are not a good thing... and right now, the Insurance Companies have the upper hand.

Every single dollar is tied to the world. It cannot leave the world. All we are is who we are. No more nor any less. In the end, money will not matter. Perceived "waste" will not matter. Only that we each do the best we can.

[disneysteve]

Originally Posted by Seeker

I am suggesting that when a Doctor decides that a pacemaker could help an elderly person lead a normal effective life for even a few more years, and that the patient wants this surgery, that no Insurance comapny should be allowed to intrude and come to the conculsion (and find a way/reason/excuse) to not cover this surgery.

This happens at all ages, not just the elderly, and not just with private insurance. I recently had a Medicaid patient with back problems. His Pain Management specialist ordered a particular item for him. Both his Orthopedist and his Physical Therapist agreed that it would benefit him. Medicaid denied the request. The doctor appealed and was still denied. So even though this patient has government insurance and had 3 healthcare providers in agreement that the item was needed, he couldn't get it.

[disneysteve]

Originally Posted by Seeker

(and DS is also 100% correct -- America needs to become better at preventative care -- do you all know how long it takes to make an appointment for such a simple thing as a mamogram -- last time for me 7 months; and I have insurance).

That's ridiculous. Where do you live? Around here, it might take a week to get an appointment for a mammogram, maybe 2 weeks tops.

[nmboone]

Working at a pharmacy, I deal with all types of insurance. Medicaid is one of them. I'm not sure how the medicaid system with prescriptions work in other states but usually children's medicaid scripts are always free. Adults usually pay from .50 to 3.00 for a rx. I think this fee is ridiculously low. I'm not against medicaid at all for the record, but I think that some of the people (definitely not all) could pay a little more. It could help offset the medicaid system for sure. Maybe $1.00 or .50 for a child's rx (depending on income of course) and maybe a $1 increase in an adult's rx. I know most of the people could afford it.

[disneysteve]

Originally Posted by nmboone

Working at a pharmacy, I deal with all types of insurance. Medicaid is one of them. I'm not sure how the medicaid system with prescriptions work in other states but usually children's medicaid scripts are always free. Adults usually pay from .50 to 3.00 for a rx. I think this fee is ridiculously low. I'm not against medicaid at all for the record, but I think that some of the people (definitely not all) could pay a little more. It could help offset the medicaid system for sure. Maybe $1.00 or .50 for a child's rx (depending on income of course) and maybe a $1 increase in an adult's rx. I know most of the people could afford it.

I've often thought the same thing. I guess the problem is identifying who could and couldn't afford it. They could base it on income. If they did that, I do think they should put a cap on out of pocket costs since I have some patients who take 6 or 8 or more different meds each month and even a small copay would add up at that point, especially if there are multiple family members filling prescriptions.

[nmboone]

Yeah it would be a challenge, but if it could be done it would help the system recoup more costs. There could be cutoffs though like the one you mentioned. I'm certainly not suggesting making the poor poorer.

[swanson719]

As far as prescriptions are concerned, it would seem that a simple solution such as a flat annual rate for people with a large number of prescriptions would do. Say $500 a year for someone with 10 or more prescriptions filled monthly at a certain income level, and $250 for someone at a different level. They have sliding scales like this all through the private sector - it's not so unreasonable to apply it to medicine.

Furthermore, we need a review of who has final authority in a determining who receives health care. I.e. - If 3 or more doctors determine that a patient needs certain care, then it should be covered by the insurance, regardless of their personal underwriters determination. Why should insurance cover defensive medicine, but not the treatment? That makes no sense. I'm not suggesting that we provide care for everyone, rather that those with insurance shouldn't be denied care after the doctors determine it is needed.