Health care mythology

Below is an excerpt from an article by Clifford Asness as it appeared in the July 26, 2009 Wall Street Journal.

Here’s a link to the entire article from stumblingontruth.
http://www.stumblingontruth.com/#

I particularly enjoyed the quote from Winston Churchill:
“Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened”.

From The Wall Street Journal:

[I]"Hedge-fund manager Clifford Asness, writing at Stumblingontruth.com:

Myth #1 Health Care Costs Are Soaring:

No, they are not. The amount we spend on health care has indeed risen, in absolute terms, after inflation, and as a percentage of our incomes and GDP. That does not mean costs are soaring.

You cannot judge the “cost” of something by simply what you spend. You must also judge what you get. I’m reasonably certain the cost of 1950s level health care has dropped in real terms over the last 60 years (and you can probably have a barber from the year 1500 bleed you for almost nothing nowadays). Of course, with 1950s health care, lots of things will kill you that 2009 health care would prevent. Also, your quality of life, in many instances, would be far worse, but you will have a little bit more change in your pocket as the price will be lower. Want to take the deal? In fact, nobody in the US really wants 1950s health care (or even 1990s health care). They just want to pay 1950 prices for 2009 health care. They want the latest pills, techniques, therapies, general genius discoveries, and highly skilled labor that would make today’s health care seem like science fiction a few years ago. But alas, successful science fiction is expensive. . . .

Health care today is a combination of stuff that has existed for a while and a set of entirely new things that look like (and really are) miracles from the lens of even a few years ago. We spend more on health care because it’s better. Say it with me again, slowly—this is a good thing, not a bad thing. . . .

In summary, if one more person cites soaring health care costs as an indictment of the free market, when it is in fact a staggering achievement of the free market, I’m going to rupture their appendix and send them to a queue in the U.K. to get it fixed. Last we’ll see of them."[/I]

Healthcare in the U.S. is already rationed. I was getting Spinal Injections for pain relief due to damage to my central nervous system from Lme disease. After6 months the Doctor and I agreed it was really helping (trigger point injections). Then the Insurance company stepped in and said they would only pay $120 of the $259 the Dcotor was charging, stating the norm across the country for that type of therapy (Aetna Insurance).

The Doctor said to me: "Qote, I don’t think the Spional Injections are really giving anything more than really short temporary relief so I want you to take “Lyrica”. This is opposite of what he said a week earlier, (I was seeing him on a different issue). When I got home is when I saw the insurance statement and the reasons they would not pay the Doctor the full amount.

Bottom line, Doctor not getting money he wants, stops therapy. Doctor is Head of Rheumatology at local hospital, so no one else to go to. We’re talking Connecticut here, on of the best medical systems in the country. Medicine is rationed by Doctors who will not give you want you need unless they get the bucks to pay for it.

Those injections took about 5 minutes to do, he was charging way off scale.

I spent 7 days at the local Hospital and my bill came to $13.00 dollars, so my insurance is good. This was done on a Doctor level and it happens to a lot of people I know.

Doctors ration medical care if they don’t get the money they want regardless what the norm for such service is.

Please do not infer that I want Socialized medicine, I am just reporting what happened to me. Everyone has the feeling that something has to be done about medical care,as I do, and like me, I don’t think anyone knows what to do.

[I]“The healthcare systems in the United States, Canada, and Great Britain provide interesting comparisons to one another, especially since the U.S. system is considered private and Canada and Great Britain each have national health systems that supply universal coverage. National health systems are theoretically designed to provide accessible, affordable care for all segments of the population, but critics of such systems often question the quality of that care. Conversely, critics of the U.S. system often point to the fact that affordable, high-quality healthcare is not equally available to all who need it.”[/I]

[I]"Amid all the hyperbole in the ongoing debate about the future of American health care, some of the most extreme public disagreements are over the experiences of our neighbors to the North, in Canada.

Many progressives say the Canadian system of universal care is an excellent role model for our own country. The the upfront costs of establishing such a system, they argue, would eventually be offset by the competitive advantages to American business.

By contrast, American conservatives see the Canadian approach as signifying the end of the freedom to choose your own doctor, the rationing of crucial treatments, and an enormous tax burden." [/I]

I would like someone to call 1000 people in Canada or Great Britain and
ask them if they would rather have there system or the one in the USA. I for am sure that 995 out of the thousand would say what the got no way would they want what we have.

[I]“The fact of the matter is that America’s health care system is like a free market in the same way that Madonna is like a virgin–i.e. in fiction only. If anything, the U.S. system has many more similarities than differences with France and Germany. The only big outlier among European nations is England, which, even in a post-communist world, has managed the impressive feat of hanging on to a socialized, single-payer model. This means that the U.K. government doesn’t just pays for medical services but actually owns and operates the hospitals that provide them. English doctors are government employees!”[/I]

http://www.forbes.com/2009/07/28/health-care-reform-obama-opinions-columnists-shikha-dalmia.html

I read all the links only to realize that no one knows what to do or understands the problem (I’m one of them). The Connecticut Supreme Court has ordered a review on all standards applying to the care and treatment of lyme disease as it was discovered that the head of the council was on the receiving money from major insurance carriers and was obviously in “their pocket”. The conclusion of there not being “chronic Lyme disease” and the unwillingness to use intravenous anti-biotics is now being re-examined. The Doctors don’t know what to do or if they will be reimbursed, so they hold back treatment. again, the Doctors being the person who in the end rations the care.

America is not Canada, Germany, or France, so the comparisons really do no good. Something needs to be done, no one knows what it is, and if you get really sick you may be in for a big surprise when it comes to your care.

I don’t consider this a Dems. vs. Repub issue as both parties have been so derelict in their duty that in fact they are both to blame.

One big step would be the standardization of all information and systems so the system becomes paperless. This is one of the biggest problems in medicine, the management of information. This leads to many drugs being prescribed to people who are taking other drugs which cause often fatal in not otherwise serious injury bringing up the cost of medical care.

An intelligent system could even suggests health issues if it was designed to evaluate the symptoms, history and other pertinent information. Instant access to information would save 1000’s of hours and people would need only show up with I.D, which could be a retinal scan, or fingerprint, or drivers license etc. and get the care they need.

Trends in diseases could be monitored instantly and areas of high cost could be defined and the accompanying issues dealt with.

Of course, this will never happen.

Describing and comparing American’s health woes to other countries does nothing nor offers answers. There is no other country in the world like the U.S.A… The answer has to be an American one.

The C.D.C. is an example of the quality of solutions that could be generated. There is no other system in the world that compares to the C.D.C. (Centers for Disease Control).

Well lets see, I have employer provided health care. I recently found out I have high blood pressure and I’d had kidney stones off and on for years. I also need dental work and don’t have insurance for that part.
I go to my family doctor for the first time in years to get the BP taken care of, she asks how the kidney stone are doing as well and I tell her I’m still trying to pass one. We get me started on BP medicine, then she refers me to a urologist to figure out the rocks. They do a CT scan and find out I have a 10mm in the left kidney and 7.5 in the right and want to do the ultra sound smashing thing.
The cost is estimated at 5k for the surgeon and 5k or more for the hospital.
In the mean time I got hurt at work and can’t work for a while till I heal up but get comp pay till I’m healed.
Now I start getting bills for 850 and up becuase our insurance has a 750 deductible, plus 20/80 to 10K and thats now considered GOOD insurance.
So far I owe like 1800 bucks for the care I’ve gotten so far and most Americans insurance has much higher deductible then mine does.
Now that’s not a lot of money but it is when your dead broke and making 2/3 of what you did before, and it would have been almost as bad at full pay from my job. Luckily all the health providers I’m dealing with are willing to accept much reduced payments till I slowly pay off my part of the bills and they have other programs as well.
Before I had insurance I would go into the emergency room if something serious happened and hope they would forgive or let me make payments.
This is why they need to reform health care, even with great insurance most people end up paying 20 percent or more of their medical bills themselves and most regular working folks can’t afford that.
My sister pays 180 a month for insurance that has a 5K deductible and many more restrictions on what they allow for treatment and what they cover. Thats more typical of the insurance the average American can afford or is provided and they keep upping premiums and the percentage you pay up to a certain limit:a Because of this they make huge profits and many are forced to go without.
I still don’t have a clue how I’m paying for the dentist either and they are a teaching school that charges 1/3 of what a regular dentist does. I used to have some money put away for things like this but now its all used up when all the other issues came about.:sad:

1800 bucks is 1800 bucks. That is a lot of money. If someone doesn’t think so then that is probably a person who needs to have their taxes raised.

The 20% deductions are killing a lot of people and forcing people to loose their homes. Doctors should take what the insurance companies pay and lower their standard of living in line with the rest of the country. My suggestion is to do everything thru the emergency room. On most insurance policies, they pay 100% visits. I was on Doxycyclin for 3 months due to lyme disease and went into full C-Diff (Colitis Deficil). I lost all the goood bacteria in my intestines and a bad bactyeria took over. It nearly killed me. I was taking Pro-biotics but to no avail. By going through the emergency room, the final bill for the 7 day stay at the hospital was $13.00 dollars. If I had gone through the front door with a Doctors note I would have had to pay 20% of a $30K bill. So much for Private Capitalist set the price insurance.

Something must be done. Everyone must let go of the labels like socialized or whatever and the system must be fixed. We have to stop giving billions to companies that throw money away and fix the populace. And, by the way, Dentists are paid way too much for what they do, they are one of the most overpriced of the health care providers and should be knocked down a few notches.

I hear the argument:“If you knock down the pay then it won’t attract the people to the profession”. Well how about getting people into the profession who want to do it because they want to do that kind of work. If not let them become auto industry workers, or carpenters, or machinists, or electricians.

We are becoming a “service oriented society”. It’s true, we are in service to the Orient. China won the war, they beat us at our own game. We gave them the country. We can still get it back but we will end up looking like a has been country soon if we don’t get tough and start making stuff here and selling it here and buying it here. Bio-diesel is one thing that comes to mind. If we don’t fix out production, don’t worry about health care, no one will have it or be able to pay for it. Service oriented society, the biggest bag of sh*t sold, period.

Well I have used the emergency room twice so far. Most of the time lately I just go without but all my health issues suddenly ganged up on me and they aren’t going to Zap a kidney stone from the emergency room unless your writhing on the floor and your kidney or bladder is bocked.
I just wanted to point out that even having insurance most folks are stuck with a hefty bill they never see coming then they wonder what all that money they paid out really did for them. The doctors even kept saying but you have insurance when they first started making plans for treatment and then I had to explain the same thing I just stated about a deductible then 20/80. After that the Urologist did his best to keep cost down becuase he said he didn’t want to bankrupt me and everyone let me know my options and who to talk to to see how much I would be responsible for, and how much the insurance covered, in fact everyone in the billings offices liked the fact that I was being proactive and getting cost estimates and how to pay plans before I made the commitment to have the procedures done.
If they stopped bickering and made a good public option available maybe less people would be stuck with bills they never saw coming then figuring out how to pay rent and the doctor.

My psychiatrist told me once that in medical care, sometimes you have to give the Doctors what they want. Don’t you know how to writhe in pain? You’d be surprised how Doctors react to pain. They fear a lawsuit if the pain is “Intractable”, that is the word my Neurosurgeon told me to use when I needed care. If you play the game, there’s a good chance you win. Doctors are playing "Cover Your Ass’, they will treat you if they know that on paper it looks warranted. This is a dollar and political game. You have to play to win.

For the record, I have a 3.5 titanium plate in my neck. Four interbody cages fusing 2 vertebrae in my lumbar spine and 5 inoperable herniated disc. I am not telling you to be dishonest, just how to work the system that has been set up.

I was in the hospital a few months back for kidney stones because the hospital did a test and said on of my kidneys was completely block. The doctor left me there with pain med. for three day saying give it time I might pass them. Then after I did pass a few very small ones he did not even take time to look at them he said well I will take you into the operating and have a look to make sure. I then in no pain and I told the hospital I was going home. HE JUST WANTED TO LOOK SO HE COULD GET MORE MONEY. After medicare and my companies ins. paid I still had a bill of 1000 dollars and for hat laying a hospital in pain waiting for the doctor it get free time to take me to the operating room.
What even worse is my wife has worked in doctors offices for year and will tell you the poor do not pay and they write off what the rich in town insurance does not pay. The only one that pay are the middleclass.

I tell you what, I DO know how to writhe in pain trust me, I’ve done it a few times when a rock was moving. If you walk into a ER and they ask your issue just say kidney stones and they’ll whisk you right in.
They did that for me a few times, especially when I was kinda moving like a snake and green.
And Samlar if they wanted to know how your kidneys were as far as rocks all they need to do is get a CT scan and they’ll have a perfect 3d view of every big rock in them. Thats why I ended up doing the smashing, the urologist showed me the perfect images of BIG rocks in both kidneys and my probability of passing them myself was nil. The kidney with the bigger stone was also swelled up 1/3 bigger then my other one and the blood work said my kidney function was starting to be impaired so he and I figured I NEEDED to have the work done or eventually in the very least I’d have permanent kidney damage. I told him I’d had large to small stones for over 20 years and since the first large ones they had all been small so I just took meds and passed them, I had no idea that I had 2 more that big inside me and had been having pain off and on for 2 years figuring it was another stubborn smallish one or 3. I wouldn’t have done any of that without the proof he showed me, I can take a lot of pain and would have just toughed it out like before till they passed.
You can probably make payment arrangements or even apply for financial aid through the hospital if they are good to work with. I think a lot of them rather then say you have to pay it all now would set something up before writing it all off, which they probably eventually will do, after ruining your credit rating.
Unfortunately a CT scan is around 12 to 1500 bucks as well but in some cases it’s really needed to see whats going on.

While I have no argument with attempting to “better” the current health care system, I’m not sure how or why anyone would think a government run health care system would be superior or cheaper.

The government can’t do anything cheaper. However it can attempt to contain cost by the only method available to it, which is to severely ration health care to its citizenry.
True, this will level the playing field and you will no longer complain that you can “ill afford” the care, you simply will not receive the care you have come to expect in the U.S.

Look at Medicare…enormously expensive, enormously wasteful, enormously inefficient and essentially bankrupt… Federally run.

Want more?..how about Medicaid (the state run variety of health care) ?..ditto here.
The states are so underfunded, (both Federal and State funds) and so over-spent, that in some states…Maine for one…they are paying $0.11 on the dollar and in arrears by more than a decade. Ever wonder why physicians’ practices limit the number of new medicaid patients admitted to their practice each month? They lose money, plain and simple. No matter how altruistic and noble the goal, you can’t operate [I]“any”[/I] business when your expenditures exceed your revenue.

How about Social Security?..another horribly and incompetently run Federal program…and dare I say…all but bankrupt.

And let’s not forget The Veterans Administration?
Any vets care to speak up about how wonderfully our brave men and women are taken care of in this system?
This is truly an outrage. Any wartime vet should have quality, health care for the rest of his or her life…period.
Put 'em in the private sector, take care of them and pay for it for God’s sake.

And some of the brainstorming to contain costs…oh please.

Let’s cap the physician’s fees…yeah, that’ll work well.
Let’s see…4 years undergrad and 4 years medical school.
That’s 8 years of runaway debt without gainful employment.

Anyone care to speculate what a 1st year resident makes at Maine Medical Center?
$10 an hour.
Even family practice now requires a 3 year residency…specialties are 4-5 years anyway. This represents anywhere from 11-13 or 14 years following high school. Again, essentially no or minimal income and enormous debt.
And really, really great hours with plenty of fun time for your youthful years.

Yup, let’s cap the income at $70-75K
$300,00-450,000 in debt and no hope of even climbing out of debt until middle-age. Then you add in the shitty hours, endless red-tape and regulations, and filling out the mandated forms ad nauseum (oh, you get to do it electronically now…that’s so nice). You’ll get to see most patients in 15- minute blocks and actually spend 3 minutes interacting with the patient. This includes telling the patient your plan-of care, after you’ve [I]listened[/I] to them, assessed them, and run the differential diagnoses in your head.
The 15 minutes also includes the time it takes to dictate/type up your session and type out the prescription and sent it along electronically.
The patients, in particular, appreciate all the time given to them. Just ask 'em

Anyone want to comment on their last trip to the Emergency Room, etc., and how much quicker and more efficient the process is now than say 20 years ago?

Gee, I wonder where the line starts for this career with its Federally regulated salary.

You let this happen and you’ll get much [I]“more”[/I] than what you pay for…mediocre health care and it’ll be severely rationed health care to boot.

[QUOTE=samlar;2410284]I would like someone to call 1000 people in Canada or Great Britain and
ask them if they would rather have there system or the one in the USA. I for am sure that 995 out of the thousand would say what the got no way would they want what we have.[/QUOTE]

Well here is 1 out of 1000 that would prefer the Canadian system.

:cool::cool:

Well the problem is now that the insurance industry is so greedy and doctors fees are so high that most folks can’t afford any major medical crisis now so it makes no difference what anyone thinks about the Veterans health system or anything else. Even with insurance most folks get buried and all they want to do is rework a few things and tell us how horrible any other system is becuase they truly don’t want to loose all that money they’re making now, and many of the politicians are paid very well from the health industry so they aren’t going to want to change anything either.

Because you can walk out the door in the morning, without a care in the world, with the certainty that if you get hit by a drunken driver crossing the street, you won’t turn up to a hospital, and the doctor checks your back pocket before attempting to fix your up, or worse be shuffled from hospital to hospital because your health insurance company refuses to pay the $$$ to put you right again.

It’s funny that you mention that … everyone outside the USA doesn’t expect to get ANY health care in the USA. Health insurance cover for a 2 week holiday in the USA costs a small fortune.

The thing about efficiency, is that 100% utilization = inability to meet peak demand.
It’s too much to hope that a government can run any system efficiently as they are generally required to have capacity to cope with peak demand, but at the same time, so long as it’s there - fix the system. Why is it so inefficient? Is someone buying $100,000 toilet seats?

[QUOTE=maineman;2410448]No matter how altruistic and noble the goal, you can’t operate [I]“any”[/I] business when your expenditures exceed your revenue.
[/quote]
And this is where americans and the rest of the world differ on opinions.
Healthcare is NOT a business, it is a service. You cannot measure the benefits, of a public healthcare system, to society in monetary terms alone. It’s so very … Americana … to suggest healthcare should be run as a business.

[QUOTE=maineman;2410448]How about Social Security?..another horribly and incompetently run Federal program…and dare I say…all but bankrupt.
[/quote]
Another service. Have some empathy for your fellow man when they’re down & out. It (hopefully) reduces crime.
Perhaps a different attitude would be a work scheme … instead of paying people to be unemployed, have them do some gardening in council parks, cleanup highways, supervise parks, train them up as basic medical officers … all they have to do is walk the streets & make sure everyones OK, heck, they can be the the guy/girl with the lollypop, to help children/the elderly to cross the street.

Universal Healthcare system takes care of everyone. Give them a slightly higher unemployment benefit … or better still, find them something within their capabilites to do, so they don’t feel useless. Heck, make them teachers aides in schools - help trouble kids by making vets mentors to provide life guidance!

[QUOTE=maineman;2410448]Let’s cap the physician’s fees…yeah, that’ll work well.
Let’s see…4 years undergrad and 4 years medical school.
That’s 8 years of runaway debt without gainful employment.
[/quote] Subsidised Education, heck, Free education - with a contract for 4years work in less-desirable locations as a general physician. They still get a choice, but the government gets the benefit of a medical presence in remote locations, or otherwise. Failure to comply with the 4years indentured labour results in the education costs reinstated. Pay them fair rates.

Unfortunately competence requires experience, and lots of it.

[QUOTE=maineman;2410448]Yup, let’s cap the income at $70-75K
$300,00-450,000 in debt and no hope of even climbing out of debt until middle-age. Then you add in the shitty hours, endless red-tape and regulations, and filling out the mandated forms ad nauseum (oh, you get to do it electronically now…that’s so nice). You’ll get to see most patients in 15- minute blocks and actually spend 3 minutes interacting with the patient. This includes telling the patient your plan-of care, after you’ve [I]listened[/I] to them, assessed them, and run the differential diagnoses in your head.
The 15 minutes also includes the time it takes to dictate/type up your session and type out the prescription and sent it along electronically.
The patients, in particular, appreciate all the time given to them. Just ask 'em

Anyone want to comment on their last trip to the Emergency Room, etc., and how much quicker and more efficient the process is now than say 20 years ago?

Gee, I wonder where the line starts for this career with its Federally regulated salary.

You let this happen and you’ll get much [I]“more”[/I] than what you pay for…mediocre health care and it’ll be severely rationed health care to boot.[/QUOTE] Capping the salaries is not a solution. Ever. Make the career choice easier - heck promote the unemployed to a data entry operator to transcribe discussions of symptoms and resolutions. Save the doctors to use their strengths. Might allow them to process patients a tad faster. I’ve been to visit doctors which take 2-3minutes for a simple diagnoses, and then the doctors spend another 5 minutes typing everything in, using the one finger fantastic.

Heck, what every system needs is creative solutions, not just complaints.
Have a positive attitude, and be a can-do person.
The current system doesn’t work. Make some changes, could it really be that much worse?

As much as everyone points to the British/Canadian health care systems 6-9 month waiting lines … these waiting lines are for non-urgent/elective surgery … emergencies &/or time critical procedures are processed quickly & efficiently - other services like physiotherapy are processed quickly & efficiently.

Doctors contribution to society is highly under-rated. More emphasis, and recognition, of doctors contribution to society, and less emphasis regarding $$$ needs to be made to make the positions more attractive.

I don’t want to see any health care reform bill out of Congress, the White House or any other government official unless it puts all of them under the same system they want to put the country under. These sleazy politicians have gone the extra mile and EXEMPTED themselves from the very system they are trying to force on the rest of the country. The very fact they refuse to do this tells me all I need to know about their so called reform plans. Then, once they share the system with us, show me they can run Medicare/Medicaid and the Social Security system properly and within budgets. At this point I will entertain their suggestions.

Also, they just might try reading the bills they pass and giving everyone else a chance to do the same. Especially the ones that spend $787 billion for so called stimulus, tax our entire energy industry and will put over 1/6th of the economy under government control. If the government wants that kind of trust from me they have to earn it. They have a long way to go before that happens.

For those that think Europe and Canada have better health care systems you should look at the survival rates for diseases such as cancer etc. before making a decision.

[QUOTE=samlar;2410418]HE JUST WANTED TO LOOK SO HE COULD GET MORE MONEY.[/QUOTE] Oh noes! A person in a captilalist world desperately greedy trying to put even more coins in his enormous vault of money! Who would have thought?

That’s not why we invented capitalism and democracy! Everyone should get a fair chance at being greedy!

[QUOTE=UTR;2413118]I don’t want to see any health care reform bill out of Congress, the White House or any other government official unless it puts them under the same system they want to put the country under. The very fact they refuse to do this tells me all I need to know about their so called reform plans.[/QUOTE]

The fact that healthcare is governed and run by corporate companies should already give some slight sense of unbalance.

[QUOTE=Mr. Belvedere;2413123]The fact that healthcare is governed and run by corporate companies should already give some slight sense of unbalance.[/QUOTE]

The fact that Congress and federal government employees are exempting themselves from any new government controlled system, and keeping their PRIVATE insurance in place, shows how to get the BEST CARE available, that is being insured by private corporations. Why do you think Congress is exempting themselves from the very plan they are trying to sell to the rest of the country? Think about it.