Hillary's Universal Health Care Plan

[Sanslines]

Here is the latest on Hillarys' Universal Health Care Plan:

http://www.msnbc.msn.com/id/20819827/

What an idea! Create universal health care by creating and passing laws that force people to have health insurance. If tax credits are not sufficient and poor people still can not afford to pay out even more money for health care coverage, we can fine and jail them for breaking the new laws. Brilliant!

[walter05]

Sanslines;

Thank you for bringing this to our attention. The MSNBC source is helpful. However, I have found a couple of others that provide more detail.

http://www.hillaryclinton.com/feature/healthcareplan/summary.aspx provides a summary of the plan. It is from the official Hillary Clinton For President website.

http://www.hillaryclinton.com/feature/healthcareplan/am...ealthchoicesplan.pdf (http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf) provides a link to the entire plan.

I think the plan shows some promise. Currently, large companies such as GM and Ford are spending large sums on health insurance. Paying for health care is one reason these automakers have a hard time staying in business.

Hospitals must treat all emergency patients. Trauma Centers are in danger of closing because they treat so many without getting paid.

Since hospitals must treat indigents, they apportion out the costs and paying patients pay them. This puts additional burden on insurance companies. As a result premiums paid by employers and private individuals go up.

Clearly the current system is broken. At this time, military personnel and retirees, federal government workers, state government workers, local government workers, teachers, retirees on social security, and poor people on Medicaid get government paid medical care. It is therefore clear that the government is already in the business of providing healthcare.

I would prefer a system that has incentives and penalties for healthy habits to control costs. Those who smoke and/or weigh too much and/or exercise too little should be required to pay more than those who take care of themselves.

I am also concerned for how it will be paid for.

While I think this system as proposed has serious problems, I think it is a good start. We really need to do something. The current system is bad for business and bad for healthcare.

[KNude]

Any health care provider can tell you how hard it is to work with many different payees ( insurance companies) each with their own set of rules and regulations and billing requirements. Much money can be saved by a using a central payer system. Also, although I can no longer cite the source, the government actually manages the process, more effectively and with less overhead, therefore less cost than the private sector.

I realize Insurance companies, billing services, computerized billing clearing houses, advertising agencies, etc. would take a beating or go out of businees but we no longer keep many buggy whip makers in business either.

[usmc1]

Senator Clinton's plan is a good starting point for getting this extremely important policy issue front and center in the presidential races.

As with all such "plans" the devil will be in the details and much negotiation, concession giving and compromise will take place before any final "plan" is put forth or takes effect.

The honorable lady from New York has demonstrated tremendous courage by taking the initiative on this issue after the whipping the Republicans and their paymasters: Big Insurance, Pharmaceuticals, and the HMOs rendered her on the last go around.

We'll see, but this is certain, aside from Iraq, this is the issue of 2008. Voters may really be given a clear cut choice on this overriding issue.

Personally, so far, I'm underwhelmed with all their "plans". Anthing less than cradle to grave, universal health care, including dentistry, mental health, annual check ups, cancer screening, vision and long-term, in-place care will be a sell out to the right wing.

Who pays? The military industrial complex and the extremely wealthy will share their fair share burden along with the rest of us who pay taxes.

[MJ_KC]

The current system for paying for medical care is seriously broken and Clinton's plan is a very good starting point.

This issue has become too obvious a problem for Republicans to dismiss if they have a single clue.

[Naturist Mark]

I'd make a few changes to Hillary's plan.

* Medicare as a base program for everyone. Every citizens qualifies, no matter what.
* Alternative programs would be allowed, funded by a capitation fee from the government equivalent to Medicare, plus whatever additional premiums enlistees are willing to individually pay for.
* Under no circumstance may these private plans provide less coverage in ANY category than Medicare. If private insurers are going to continue to divert 30 percent of premiums to overhead, dividends, and outrageous CEO compensation, they will also have to be far more efficient than Medicare at providing health care services.
* No cherry picking clients. No rejecting coverage for pre-existing conditions.
* The same Premiums for the same coverage for all comers. Insurance is supposed to be the sharing of risk, not discrimination on the basis of risk.
* There should an exemption to anti-trust laws to allow insurers to share risk for catastrophic expenses.

Some may complain that I've set up a system that won't allow insurance companies to make money on health care.

Too bad.

They are making fist fulls of money now, while degrading the quality of health care delivered to the public. America has the worst health care in the industrialized world - the overall quality of our health care system puts us firmly in the third world. More than anyone else, this is the fault of our health insurance companies. As far as I'm concerned they no longer have a right to exist. I'd prefer a pure single payer system of private health providers with government run universal health insurance, but I'm willing to let the private insurers participate if they have to play by the same rules as Medicare.

-Mark

[Sanslines]

Originally posted by MJ_KC:
The current system for paying for medical care is seriously broken and Clinton's plan is a very good starting point.

This issue has become too obvious a problem for Republicans to dismiss if they have a single clue.

The current system is very much broken. Over twenty percent of our population has no health care coverage and this ongoing serious problem is only getting worse. One of the most serious problems with our present system of health coverage is that the uninsured have no protection from being charged the full fee for services rendered. Those with medicare, medicaid, or private health insurance are protected with fee caps.

One of the major reasons why so many in our nation do not have health care is because they can not afford the health insurance coverage payments. The gamble and hope that they do not become ill for if they do become ill, then the costs of that illness can easily bankrupt them.

I am not sure offering tax credits to the poor is a good way to help them, as the poor do not earn that much money and therefore either do not pay income tax or pay very little and thus such credits will not be of much help to them. Also, any additional costs or fees to the poor (ie copayments and deductable excesses), are a burden that they can not afford. Those who can afford insurance most likely will have insurance to prevent them from being wiped out due to a catastrophic illness. Those who can not afford any health insurance will only be able to afford it if there is a means to charge them either a very small copayment or they receive free health care coverage.

I agree with Obama in that mandating health insurance and offering only tax credits will unfairly burden the poor and they are the ones who need health care coverage the most.

[MJ_KC]

Originally posted by Naturist Mark:
Some may complain that I've set up a system that won't allow insurance companies to make money on health care.

Too bad.
Sounds like an equitable plan.

Can you imagine the amount of money that would get tossed around by lobbyists to see that this never happens?

[Sanslines]

Some may complain that I've set up a system that won't allow insurance companies to make money on health care.

I think that the major event that ruined health care was to change it from a basic necessity of life to a for profit business. Insurance companies, pharmaceutical companies, medical establishments are making enormous amounts of money and can charge whatever they wish to the uninsured. Only those with medicare, medicaid, and insurance are offered some protections as these organizations set limits as to what they can be charged for services.

[chickenman]

there is simple way to solve the problem of the poor and indigent if they can not pay make them work off there bills or for them to pay taxes since the poor don't pay taxes now they will have pay. If poor need service take all there pay and provide there needs since they cannot do it themselves. If they are illegal make them pay up front. If they don't have jobs make people pick up litter or garbage on the streets. If are drug addict that OD no treatment just let them die since they want it that way. If wish to poison you self your out of luck. Mandate the food those the government cover eat since if taxes pay for you health care you have eat only healthy food. If you smoke your out luck. If you sick do to your own vices we make your relatives pay.

[Sanslines]

Mark,

This may be of interest to you. It is an article about how Americans are finding low cost and affordable dental care by traveling to Mexico. It appears to be all about costs.

http://www.dentistasdemexico.com/indexfiles/newsstory.html

[nudenwv]

sure hope she knows what she is talking about!! http://oakhurstonline.com/icon/rolleyes2.gif

[nudebushwalker]

The health system over there is stuffed - that seems to be the one thing everyone agrees on...

It is stuffed because of the healthcare funds, pharmaceutical companies, and hospital operators - the costs they get away with over there are exorbitant - that's why it is always highly suggested that visitors to the USA are well insured..

It is those invested interests that seem to lead the fight against a national health system.
The USA is the only 'western' country that doesn't have a nationalised healthcare system.
Canada, Australia, Britain, Russia and Cuba have 'universal' health cover systems in place (even though there has been some 'dismantling' of the Australian and Canadian systems, they are still far superior to anything in the US..).
The fact that health cover hasn't bankrupted any of these countries puts the lie to the propaganda being spread around by those vested interests in the USA.

The USA is the only 'western' country where medical/health costs are a leading cause of bankruptcies, (as reported in another thread..).

[usmc1]

Somehow, not necessarily in this thread, there exists the notion that Medicare is somehow a charitable free ride for those who are on it---mostly older Americans.

It is not. To have "full" medical and hospital coverage the cost is about $260 per month per person. A retired couple would be paying around $520 in premiums. There are many gaps in the coverage so recipients are prudent to buy supplemental or "gap" coverage with premiums, depending on age, geography and various different plans, ranging from $100 to $180 or more. Our retired couple are now paying $720 per month for health care--before drugs.

Plan D drug coverage, again depending on your plan, can run from $20 to $100, with about $275 in deductible, a near $3,000 doughnut hole where coverage stops but premiums continue until you reach around $6,000 - $7,000 in total drug costs before coverage resumes. There is a 25% co-pay for the drugs up until the doughnut hole at which time the couple must begin paying full-price.

So, our retirees, who, let us say worked at Enron or any of the thousands of other companies who have bailed on their pensions plans, have valueless 401ks, and no retiree health benefits might be drawing $2500 (and that is a very, very high estimate) from Social Security each month.

Of that, nearly $1,000 gets zapped for health care protection which does not provide: Dental, Vision, Preventative, Cancer Screening, Orthotics, Long-term, in-place care, or Mental Health.

So, our retired couple are "getting by" on $1500 a month and living at the precarious edge of disaster. Let's hope they don't still have a mortgage, and their autos, appliances, and so forth are in good working order. Otherwise, catastrophe awaits them.

Folks, that is the scenario that our current Older Americans face, and which the so-called "boomers" have to look forward to. And, in truth, you can slice any demography you wish: suburban families, young singles, single parents, and you will find them facing similar impossible choices and situations.

Health Care reform which includes affordable, quality, universal, cradle-to-grave coverage which includes all the things now left out has to be the very basic demand of the electorate this cycle, or the opportunity will probably be gone for a very, very long time.

Bush was beaten back on his attempt to hand Social Security over to Wall Street, he has enough energy left and will make an attempt before he leaves office to privatize Medicare and Medicaid by turning them over to Insurance Companies and HMOs. Humana has already started their marketing campaigns to try to divert Medicare recipients into their deplorable and disastrous Medicare-Advantage plan.

Senator Clinton's putting the issue front and center in the presidential race gives We The People the opportunity to hear and see all the plans and to debate and learn more before we decide which plan we want.

But, don't let anyone shivvy you into thinking the money is not there. It's there--we're already paying for it, except with enormous gaps in protection for way too many good, decent people---that cost merely needs to shifted, in part, from the pockets of our older citizens and hard working families to from the over flowing coffers of the wealthy, corporations and military-industrial complex.

[Nu]

We have universal health care in Canada.
It works well, except for the long waits in some instances to see GP's, specialists, and to have operations.

I waited quite some time to have a specialist look at my hernia. In the end, my GP and specialist got me in on an emergency basis and my hernia was fixed.

[Boreas]

I am always amazed at discussions about universal healthcare. In Canada, we are talking about private vs. public healthcare and it is a lively discussion some days. We have seen some corporatization of healthcare and that is a bad sign. I have worked in the healthcare system as an allied health professional for about 20 years. It is alarming that we are going to the corporate model. That is the model where the almighty dollar seems more important than good health.

Having said that, I do believe we have to continue to make universal healthcare a priority. No one should have to decide whether they can afford chemotherapy. No one should have to go bankrupt because of unforeseen health emergencies. It boggles my mind when I hear that people in the most powerful country in the world have to make that decision.

Canada's system, like many others, is in need of some tweaking. Some of this need is probably due to poor political decisions in the past. For example, in order to cut health costs in the 90's they cut staff, especially nurses. Now we are wondering why there is a shortage of nurses. Duh. http://oakhurstonline.com/icon/bonk.gif I will be getting a minor procedure to remove a ganglion from my wrist next week. I don't have to worry about money with that. Last year I had a CT scan and x-rays. Those tests happened quickly and I was given the results very quickly. Our system does step up when it needs to.

We have to move beyond the discussion of private vs public and make healthcare a priority. I am somewhat skeptical given the involvement of big business in policy making decisions. Perhaps if we all speak out and make our opinions known, we can affect change.

[Naturist Mark]

Somehow, not necessarily in this thread, there exists the notion that Medicare is somehow a charitable free ride for those who are on it---mostly older Americans.
Nope. Medicare is EXPENSIVE. It covers precisely those who are the most expensive to cover. There are large (but means tested) fees for Medicare, but even those don't cover the cost - most is borne by the Medicare taxes every wage earner (but not capitals gains receiver) pays.

But ... Medicare is the most efficient provider of health care services in America. Less than 3% of Medicare funds go to administrative overhead - over 97% goes to pay for actual health care.

When Medicare covers everyone, the per person cost will drop precipitously, because the sharing of risk will include not only those with the greatest risk.

Let's put this in perspective. The most expensive health care system in the world, after ours, is France's. It is also the best in the world. They spend $2900 a year per person. We spend $6200 per year, nearly half of those are direct tax dollars (over 60% (http://clothesfreeforums.com/eve/forums/a/tpc/f/6500016152/m/2870009134?r=2300080734#2300080734) when we include indirect tax dollars) - That means that we already pay more tex dollars per person for health care in the United States than the next most expensive health care system in the world does. Even if we are 20% LESS EFFICIENT THAN THE FRENCH we should be able to provide the best health care in the world to every single citizen without raising taxes by a single cent or requiring patients to spend a single penny on their own.

-Mark

[MJ_KC]

A massive expenditure area under the current system is the high number of computer programs that have to be written in order to process billing between all of the medical providers and the many insurance companies. You have programmers, managers and executives who add to the cost of simply getting paid.

[LamontCranston]

Mark informs us, But ... Medicare is the most efficient provider of health care services in America. Less than 3% of Medicare funds go to administrative overhead - over 97% goes to pay for actual health care.
And MJ chimes in, A massive expenditure area under the current system is the high number of computer programs that have to be written in order to process billing between all of the medical providers and the many insurance companies. You have programmers, managers and executives who add to the cost of simply getting paid. MJ - This "massive expenditure" fits within the 3% overhead Mark quotes. Maybe massive in dollars but not as a percentge of the total.

[usmc1]

Medicare, V.A. & Medicaid (to an extent) all provide models, and foundations for universal care. Senator Clinton, when First Lady, put forth a proposal which would have used these plans as foundation and infrastructure for universal care.

We know what the Drug, Insurance and HMOs had their paid help in congress do to that.

In '08, without significant "noise" from the public, election of a Democrat to the White House and an increase of Democratic majority in both houses of congress what we will get is sops or some sort of look good plan with a few incremental improvements and changes: "It's the best we can do right now".

The wild card is Bush's and the Republican minority's plans to privatize Medicare. Already, in many states, Humana is bombing the public with commercials, direct mail and other schemes touting its abysmally bad Advantage plans.

They're attempting to preempt our choice before the electoral process takes place.

[Sanslines]

The medical and pharmaceutical industrial complex has infinite and virtually bottomless resources to fight any and all changes. Bipartisan committees have already been formed to drive down the cost of prescription drugs but have been soundly defeated over and over again. It is amazing how vociferous the drug company lobbyists will hound committee members day and night and harrass them until they give in. Drug, insurance, and medical companies are in this to make money and even Congress does not seem to have the power to force any change. Any threat to drug, insurance, and medical companies are automatically responded to with a full scale attack and war.

[oldbob]

In this editorial, John Stosell of ABC News (http://www.creators.com/opinion/john-stossel.html) tries to make a case that socialized medicine can't work. He cites examples of problems with the Canadian system as the reasons why socialized medicine can't work. This is, of course, an entirely fallacious line of reasoning since he merely points out problems but does not provide any reasons why those problems can't be solved. I also find it telling that he hasn't discussed France's health care system. Is it because France's system works too well?

I'd like to hear what the Canadian who participate in this forum think of Stossel's piece.

Bob

[Sanslines]

The only criticism that I have heard concerning a national health system (whether that system be in Canada or the UK) are the very long waiting lists and lines for certain operations and procedures.

[Boreas]

The Stossel piece has some accuracies, but like stats, they are skewed. He makes it sound like you will ALWAYS have to wait in line. It also makes it sound like part of the reason there are line ups is due to inappropriate use of services, ie an MRI for a stress headache. That would not happen in this part of the country as far as I can tell.

I have an opinion on why there are shortages and line ups. It is not because everyone is using the service inappropriately. It is largely because of inappropriate cuts to services and such. In the 90's we had some budget constraints. They cut nursing staff dramatically and reduced the number of spots in medical school and nursing school. They did not factor in that boomers were aging, or that the people who were hospitalized would be sicker. Technology meant that fewer people had to be hospitalized, so those who were, were sick. Skeleton nursing staffs meant that the nurses were overworked and burned out doing more with less. Fewer nurses were replacing them. Now we have a crisis. I believe it is largely due to forces trying to get private healthcare in Canada. If you break the public system, people will want private, would be the reasoning. I think a lot of this crisis is manufactured.

I started working in the health system in 1985. I have worked in Newfoundland, Ontario and British Columbia. Things have changed a lot since 1985. We are expected to do more with less, and the almighty dollar is more important than ever now. I think that is a reflection of what has been happening outside of healthcare. Walmart is now a force, creating a demand for low paying jobs and deprofessionalization. The so called "Free- Market" is revered. Neo-liberalism (Canada) and neo-conservatism (US) are forces that waft through our world. Sadly, things have gotten worse for the weaker members of our societies and people in need of healthcare.

I do not think universal healthcare has to die. I think we can keep it alive, it may mean doing some things differently. Just don't throw the baby out with the bathwater.

Oh, and dental care is not part of universal healthcare in Canada.

Thus endeth my sermon.....or rant. http://oakhurstonline.com/icon/confused.gif

[earthpassenger(Kevin)]

They talk about waiting times in countries with government funded health care like Canada and the U.K. But the discussion is more complicated here in the U.S. by the number of people--as much as a sixth of the population, even more in some places, who don't have insurance to begin with or who find out of pocket costs prohibitively expensive.

But I've read some articles that indicate pilot programs in Canada have reduced waiting times for surgery just as complaints about waits in the U.S. are becoming more frequent such as this one, not by a supporter of single payer insurance, but by the Chief Medical Officer of Aetna, Troy Brennan, at Aetna's Investor Conference in March of this year:

"The U.S. Healthcare system is not timely..people are waiting an average of about 70 days to try to see a provider. And in Many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable."

Article "Waiting Times For Care? Try Looking at The U.S.-Nurses, Doctors Say It's Time to Debunk the Myths"
http://www.medicalnewstoday.com/articles/76295.php

Peace
Kevin

[usmc1]

Health care is an essential human right.

When we gather ourselves together to establish governments and pay taxes to that government to provide for our common defense, health, education and welfare; it becomes very difficult for anyone to attack universal, tax-funded health care with anything other than distorted and exaggerated anecdotes, emotional and politically charged appeals, and outright lies, prevarications, and canards.

One wonders if at anytime during the segment that Stoessel's piece aired there were commercials for E.D. drugs, sleep aid drugs, diabetic drugs, blood pressure drugs and all the other various drugs advertised on TV---or if Humana aired one of their Advantage promos targeting gullible Medicare recipients.

The dog most often licks the hand that feeds it!

[walter05]

Economics 101 starts with "supply and demand". When the supply is greater compared to demand, price goes down. When supply is scarce compared to demand, price goes up.

As Americans continue to smoke too much, chew too much tobacco, eat too much, eat too many of the wrong foods, and exercise too little the demand goes up.

The statistics from Harvard are dramatic. Over 70% of the deaths in the U.S. are due to avoidable causes. In many cases Diabetes, cholesterol, heart problems, and many cancers are either caused by or aggravated by behavior.

If we include a set of incentives for people to take care of themselves, we can reduce the costs. Once we have reduced the costs, it will be much easier to figure out how to pay for the lower cost.

[MoonShadow]

Another angle here!

Yes, people can do preventative behaviors to ward off some illnesses and diseases but good gracious! Let people live the way they choose. I don't buy the rubbish that if we do this or that, don't do this or that we will live very long and health lives. Our genetics define significantly what we will get. Not always but a high probability.

I believe in a healthy lifestyle but one's financial means comes into big play. To eat as "they" say we should is expensive! Many simply cannot afford the 5 to 6 daily portions of fruits and veggies. It's too expensive. People with limited food budgets eat high carb diets which is a trigger for diabetes and cholesterol as a high carb diet usually has high fat in it.

Walter, what type of incentives do you think we should have out there?

[walter05]

MoonShadow;

First of all, you are wrong about disease. Genetics plays a role. However, nutrition and exercise are very important.

Perhaps refundable tax credits to make up for the costs the system would not bear for people who have healthy weights.

If people are not taking proper care of themselves, then I think they should have higher premiums. This would help offset for the higher costs to provide them healthcare.

Taxes on tobacco already penalize people for this behavior.

All systems have some means for rationing healthcare. In the case of Canada, there can be significant delays for tests, etc. There are clinics in Buffalo that specialize in providing tests for Canadians willing to drive over and pay for them.

Instead of having an administrator decide that someone can't be saved or we can't afford to provide care, I would prefer to reduce the costs by lowering the demand.

P.S. I was with a customer from Canada yesterday. A key manager has a 16-year-old child with cancer. The cancer started as a skin cancer. From the time the daughter noticed the lump until the test there was a long delay. Now the cancer has metastasized. The insurance administrators originally said that treatment was not likely to help and refused treatment. The mother fought, and now treatment with a 20% chance of success is being tried.

My wife was diagnosed with cancer. Tests were concluded. Treatment was prompt. The surgeon and pathologist believe they got it all. Follow up chemotherapy and radiation were started promptly just in case. There is no sign of any cancer.

I can’t help but think if we were Canadian, my wife might be dieing instead just like the customer’s 16 year old daughter.

All systems must have a mechanism to pay for the service provided. In the case of healthcare, private and government providers approve expenditures. This is done to control costs.

At some point, we have to take responsibility to control costs. If we don’t the system will not get better whether it is government single payer or what the U.S. has now. If we can lower costs, then we can talk about how to pay for the best care all need rather than delaying life saving tests or denying treatment to people who need it.

[earthpassenger(Kevin)]

Originally posted by walter05:
MoonShadow;

First of all, you are wrong about disease. Genetics plays a role. However, nutrition and exercise are very important.

Perhaps refundable tax credits to make up for the costs the system would not bear for people who have healthy weights.

If people are not taking proper care of themselves, then I think they should have higher premiums. This would help offset for the higher costs to provide them healthcare.

Taxes on tobacco already penalize people for this behavior.

All systems have some means for rationing healthcare. In the case of Canada, there can be significant delays for tests, etc. There are clinics in Buffalo that specialize in providing tests for Canadians willing to drive over and pay for them.

Instead of having an administrator decide that someone can't be saved or we can't afford to provide care, I would prefer to reduce the costs by lowering the demand.

P.S. I was with a customer from Canada yesterday. A key manager has a 16-year-old child with cancer. The cancer started as a skin cancer. From the time the daughter noticed the lump until the test there was a long delay. Now the cancer has metastasized. The insurance administrators originally said that treatment was not likely to help and refused treatment. The mother fought, and now treatment with a 20% chance of success is being tried.

My wife was diagnosed with cancer. Tests were concluded. Treatment was prompt. The surgeon and pathologist believe they got it all. Follow up chemotherapy and radiation were started promptly just in case. There is no sign of any cancer.

I can’t help but think if we were Canadian, my wife might be dieing instead just like the customer’s 16 year old daughter.

All systems must have a mechanism to pay for the service provided. In the case of healthcare, private and government providers approve expenditures. This is done to control costs.

At some point, we have to take responsibility to control costs. If we don’t the system will not get better whether it is government single payer or what the U.S. has now. If we can lower costs, then we can talk about how to pay for the best care all need rather than delaying life saving tests or denying treatment to people who need it.

I've heard that pitch that people individually taking responsibility can lower costs but I'm confident that its wrong first of all because health care is not a pleasure item like say an evening out at the movie theater where sellers are aware of the fact that a customer can easily substitute a couple rented DVDs for that night at the movie. People don't choose when to get sick and in the vast number of cases they get medical care because they recognize that they have to not because they enjoy having their chest cut open for heart surgery or having their molars yanked out--this, first of all is where Health Policy economists point out that the basic analogy between the supply and demand for health care and the supply and demand for apples and oranges breaks down.
And how can someone not argue for more dramatic change than simply leaving the current financing system in place with maybe minor modifications of the tax structure with The U.S. spending twice as much per capita on health care than any other country and not getting better health care results--U.S. 37th among countries in the last survey by the World Health Organization, while France, for instance at number 1 spends about half as much per capita.(Among the criteria the WHO takes into consideration for its surveys is "healthy life expectancy"--the number of years a child born now can expect to live in good health--and children born in the 22 other industrialized countries are expected to live an average of 2.5 more years of healthy life than children born in the U. S. )
The Health care industry should be well aware of reduced demand when half of American patients respond to surveys, such as the 2005 Commonwealth Fund survey by saying they simply do without medical care because the cost will be too high (while people in countries which recognize health care as a human right understand the same medical care as an entitlement of living in a country where millions of people work hard and pay taxes to a government which should make sure that the essentials of modern life are within reach). www.commonwealthfund.org/publications/publications_show.htm?doc_id=313012 (http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=313012)
I think the demand-side pressure you refer to Walter has been here in America for quite some time and health care inflation has grown in spite of it.
The biggest difference between the Canadian system is not the waiting times which many people acknowledge, and the 2005 Commonwealth Fund survey of patients (perhaps the largest survey of its kind: of almost 7,000 patients in the U.S., and the other English speaking countries plus Germany) supports the observation many have made that waiting times are similar in the U.S. And Canada. The biggest difference is the much bigger amount of money that Americans spend not on health care but on administrative expenses.
Peace
Kevin

[Naturist Mark]

I can’t help but think if we were Canadian, my wife might be dieing instead just like the customer’s 16 year old daughter.

The Lancet (http://www.medscape.com/viewarticle/561737) has published that the United States has the highest cancer survival rate in the world. Which is wonderful - proving American medicine can indeed be the best when given a chance. But buried in the statistics is a big caveat - cancer survival in America is income dependent. A recent Meta-Study (http://www.openmedicine.ca/article/view/8/1) of Canadian/American comparative studies found that on the whole cancer outcomes were slightly better in Canada: <UL TYPE=SQUARE>In cancer, where a number of strong studies have used population-based registries, Canadian outcomes appear superior in head and neck cancer, and possibly for low-income patients with a variety of cancers; American women with breast cancer appear to have better survival rates than Canadian women. [/list]

-Mark

[Sanslines]

Another fact that should not be dismissed is that early screening, detection, and treatment of illness is very cost effective and will actually save money. The sad truth with our present health care system is that people without medical insurance and who can not afford to pay for health care generally wait until they are well advanced into their illness. Treatments at this stage are much more involved and expensive and the outcomes are much less successful.

[usmc1]

Walter, c'mon you're a stickler for unadorned fact and your apocryphal anecdote is not probative of anything other than the fact that you've met someone voicing a grievance.

If the story is entirely true, and I've got to suggest that I personally would have some questions that, it was a deplorable and sad thing that was done to that little girl. But, it certainly says nothing at all about whether your wife would have been treated worse or better under the Canadian system.

And, it certainly does nothing to prove that the Canadian system of health care delivery is better or worse than here in the U.S..

I'm certain that there are horror stories aplenty in every healthcare system in the world where someone died, or was maimed, or whatever, due to the carelessness, indifference or bureaucratic delays of someone who was supposed to help.

I think it is very early in the process to look toward the Canadian model as the model for our plan. But, I wouldn't want that process derailed as it was in the past by senseless and apocryphal horror stories about how bad "socialized medicine" is in Canada.

[Journeyman]

Originally posted by usmc1:
I think it is very early in the process to look toward the Canadian model as the model for our plan. But, I wouldn't want that process derailed as it was in the past by senseless and apocryphal horror stories about how bad "socialized medicine" is in Canada.

Thank you, usmc1. I'm surprised at some of the comments here from Americans about the Canadian system, when those same people are not experiencing our health care system firsthand.

In the smaller Canadian towns and cities, at least here on the east coast, the medical care is excellent. My 88 year old Father did not have to wait long for an MRI test recently; and two years ago he had heart surgery almost immediately after those typical early symptoms. I have had prompt medical care as well; even some non-crucial surgery only had a two week wait.

There are horror stories undoubtedly, but the success stories far outweigh those. No one can be denied health care here, and that is a blessing.

[oldbob]

Still_Boreas

Thanks for your reply. What you wrote indicates that whatever problems the Canadian healthcare system has can be fixed.

USMC

You're right, anecdotes such as Walter related, even if true, do not prove that universal healthcare can't be made to work well.

Anecdotes are generally a waste of time. If you want to convince me that universal healthcare can't work, then show me what is inherent in a government provided universal healthcare system that makes it impossible for such a system to function well. Too many people look at the problems and say it won't work instead of looking for solutions.

Bob

[Boreas]

Journeyman, I have had the same experience here in northern BC. We have an adequate amount of doctors here. I am sure we could still use a couple more. If you moved here tomorrow though, you would be able to find a family doctor. You would also be able to get an appointment in a reasonable amount of time. All three of our local medical clinics have walk-in clinics that are quite good. The last time I went to the walk-in, I only waited half an hour or so. I do not think that is unreasonable.

oldbob, you are quite right. Our system is quite fixable if the powers that be are willing to focus on the right things. I would imagine the same could be said about US healthcare.

It absolutely amazes me when I hear or read anecdotal "evidence" of the horrible healthcare problems in Canada. I am especially amazed that it usually comes from south of our border where so many people cannot get adequate healthcare because they cannot afford insurance. That is absolutely scandalous in such a rich and powerful country.

[LamontCranston]

Ah but Bob that's not how it works.
If you want to convince me that universal healthcare can't work, then show me what is inherent in a government provided universal healthcare system that makes it impossible for such a system to function well. Too many people look at the problems and say it won't work instead of looking for solutions. Show us that it will work and if persuaded we will finance it.

Too many people think big government will do a better job. Maybe they'll just shift the problem and not solve it.

I think insurance company executive are snakes but how many people will say Medicare, Social Security or the Veterans Administration are well run systems.

And to answer your question, there is no accountability for government to make it work. Look at Social Security... they spend that money on all manner of things.

The United States hits it's debt ceiling on October 1st... at $9 trillion dollars. The line of credit is used up.

[Naturist Mark]

Show us that it will work and if persuaded we will finance it.

France

Less than half the cost per person we are already paying - less than we already pay in tax dollars - and a better result.

By his word I now I expect Mike to be at the front of the parade demanding a French style universal health system.

-Mark

[nudebushwalker]

Looking at the rubbish that Walter05 has written over the past few weeks (across several different threads..) I can only come to one simple conclusion :
Walter is nothing more than a lying piece of s**t, who has more interest in running other countries and systems down, rather then offering anything positive wherever he goes in these forums...
http://oakhurstonline.com/icon/tongue.gif

[Sanslines]

I think insurance company executive are snakes but how many people will say Medicare, Social Security or the Veterans Administration are well run systems.

Medicare, by it's sheer size, has been able to successfully place dollar limit caps on medical services and procedures. The industry has mostly accepted those caps. Medicare is not a perfect system, but it is an absolute necessity for the elderly and does have some very positive aspects to it.

This issue is not only about those who have insurance versus those who do. Many people who do have insurance and have been paying premiums for years would be shocked to know that their insurance company can and in many cases does place dollar limits on what they will pay out for an individual. With a serious illness such as cancer, stroke, or heart attack, it is very easy to exceed those limits and once exceeded it is the responsibility of the sick person to pay the excesses. In so many cases like this, the only answer is for that sick person to declare bankruptcy.

There is also another issue that is being debated and this issue concerns closing all VA Medical Centers and then covering all veterans through medicare. I do not think that this will ever happen, as there are so many war specific injuries that require specialized treatments that the average civilian family doctor is not equiped to handle.

[usmc1]

There is an important element of health care that almost never comes up in these discussions: The patient.

We as consumers of health care do have responsibilities. For me, they include:

1. Staying aware of what's available and asking questions and even pinning down my doc. I guess you'd call it being an informed consumer.

2. Eating properly and healthily. No more than three fist sized servings per meal. At least five servings of FRESH vegetables and fruits per day. Eschewing added salt and sugar. Keeping myself hydrated. And, no processed foods and rare forays into junk or comfort foods. And, yes, getting my carbs from whole grains, nuts and never, ever eating white bread.

3. Exercise. Walking with the dogs at least one mile each day, stairs instead of elevators, and light weights to keep toned. Fencing to retain my balance and reflexes and to release aggression.

4. Peace of mind, staying centered and grounded in the moment, reflecting and meditating, acknowledging I'm not in control and accepting that things don't always work out for the best, and, I have no right to think that they will.

5. Staying engaged and involved with young and old, serious and frivolous, and getting at least 8 to 9 hours of good restorative sleep each night.

6. Don't smoke and do not use alcohol in excess.

7. Rarely, eat red meat. About three times a year though, I go insane and head to What-a-Burger and get some fries, a "double the malt" chocolate malt, and cheeseburger loaded with mayo, mustard, ketchup, onions, tomato, lettuce and pickles and pretend I have the arteries and constitution of a sixteen year old.

8. Cancer is the death of choice in my father's family, so I stay tuned to the genetic issues and talk with my doc about screenings and early detection and lifestyle issues related to what is probably/potentially a genetic predisposition.

All this is to say, that we do have responsibilities for own health, and should stay informed so we can be smart consumers and know when and what to do if our provider is missing the mark, and keep ourselves at peak health to ward off disease, ailments and infirmities and have the strength to recuperate should we be afflicted by something.

I think that as we go along, we'll see more and more, from government, from service agencies, and health and geriatric providers of some form of the message of what I've written above as an integral component of any and all future health care plans.

[MoonShadow]

[QUOTE]Originally posted by walter05:
MoonShadow;

First of all, you are wrong about disease. Genetics plays a role. However, nutrition and exercise are very important.

Thank you very much, Walter, for that response.

Sorry, but genetics does play a huge role. And yes, nutrition, exercise also play a big role. Knowing what our family history is/was is an excellent guide for us as to what we need to focus on and take preventive measures. However, I still advocate not to "shove" into people's faces all the time what they should do and should not do. Educate, inform, give guidelines. Each is responsible for their own health.

[walter05]

USMC1;

Your criticism is fair. I generally prefer to avoid anecdotal information that can’t be verified. I certainly would not rely on it for making a decision.

Your post at September 21, 2007 08:20 AM September 21, 2007 05:20 AM is excellent. How would you provide incentives for that?

Nudebushwalter;

I may be incorrect at time, but I am not lying.

I agree with most on here that we will put in some changes in the U.S. However, I would like to end up with the best system we can. In order to do that we need to look at what others have done well and poorly so we can learn from them.

Journeyman and Moonshadow;

You both make good points. The customer I was with was from Toronto. The area in an arch from Fort Erie through Hamilton and the Greater Toronto Area is heavily populated, as you know. There may be some specific issues with resource availability in those areas.

It is also possible that someone made an error and missed something on an earlier test. Errors happen everywhere.

When you have a close family member have a brush with cancer, it is as much an emotional experience as anything else. Soon after, when you encounter others going through it, there are all kinds of thoughts.

I was reacting more emotionally. I have since had some more time.

Moonshadow:

If I am asked to pay for medical treatments, then it affects me. If someone is careless and drives up my costs, that is unfair to me.

How would you encourage people to take better care of them selves to keep costs down? Perhaps you have a better idea how to do it and I would like reading it.

USMC1, Sanslines, and others:

There is no question that I am fortunate to have very good health insurance. Despite that, between my Legionnaire’s Disease and my wife’s cancer, we still have thousands of dollars in bills that we are responsible for and paying over time.

I would like to see a better system. I just don’t want to lose what is good about our current system in the process.

I think blaming various bogeymen has hampered the debate in the U.S. Drug companies, insurance companies, doctors, lawyers, etc. are blamed. All are factors. However, personal responsibility is also an important factor and I think the lack of it might be the biggest problem in the U.S.

All systems that pay for services or products have to control costs. All do this through various mechanisms. Instead of some sort of rationing or scarcity of needed resources, I think we could control costs by cutting demand. We can do this best when we take care to be as healthy as we can be. The hope is that the lesser demand would keep costs down.

Sanslines comments about the scale of Medicare and how this helps to keep costs down are good. If we control demand and there is such a national plan, the combination might provide the best services to the most people for a cost that we can afford.

[usmc1]

USMC1;

Your criticism is fair. I generally prefer to avoid anecdotal information that can’t be verified. I certainly would not rely on it for making a decision.

Your post at September 21, 2007 08:20 AM September 21, 2007 05:20 AM is excellent. How would you provide incentives for that?



Well Walter, you'd think a longer, healthier more active life would be sufficient incentive, wouldn't you?

Someone pointed out the education challenge related to healthy living. It needs to start early in our lives, and it needs to be continuous and inter-disciplinary from Pre-k through 12. It really needs to be a national agenda on the level of Kennedy's encouragement of healthy activities.

The problems and challenges are very clear--school boards are politicized and you can recognize the outcry from the Weatherford, Texas ISD if there were a national educational mandate about the reduction of red meat (beef) in the diet and eating salads and fruits.

I think the answer is, as it always is in our system, do the debating, negotiating, compromising and establish some solid guidelines and withhold federal dollars from schools, or districts who would refuse to teach to those guidelines.

But, the issue is essentially educational and empowering individuals to take responsibility for their own health---but education alone will not suffice. For example we know that smoking is disastrous to our health, driving without seatbelts is deadly, and motorcycle riding without helmets is even deadlier. Yet, there are significant numbers of dumbbells who persist in these practices--even though they know the danger.

[MJ_KC]

Just because someone receives information about how to live a healthier life does not mean that they will do it. With that said, there is no possibility if the info is never presented to them.

[Naturist Mark]

I just heard a very good comment on the radio today - America doesn't have a "Health Care System", it has a "Sick Care System" - because most people, even (especially) under managed care (insurance, HMO's etc) are discouraged or even flat out prohibited from getting care when problems are minor and easily treated.

It is well known how Emergency Room care is the safety net for all uninsured patients - and the most expensive way possible to provide "universal" care, but it is not as well appreciated how even those with health coverage are excluded and discouraged from seeking routine and preventative care.

I remember when HMO's had their start, they were going to be a medical revolution because they were going to take people's premiums and give them such aggressive preventative care that it would end up being far far less expensive than traditional medical practice. And the Insurance companies (back then it was mostly the non-profit Blues) were going to jump on the bandwagon and do the same. The free market was going to make American Health Care not only the best in the world, but the least expensive.

Nice Dream.

Soon the HMO's found it was far more profitable to deny care and raise premiums. Just like everyone else - plus Congress had conveniently passed a law that exempted them from lawsuits for this practice.

Again, I must recommend that people watch "Sicko", it is NOT about the huge problem of people without insurance, rather it is about how bad the health care is for those of us who DO have insurance.

-Mark

[Sanslines]

Whatever happened to the President's Council on Physical Fitness. This was a government program that encouraged health and physical fitness in the K-12 years. For some reason, this program seems to have faded away and was replaced with half hearted efforts that obviously are not working to control and / or eliminate overweight and obesity conditions for children. Proper diet and exercise education must start with children for this is where good habits can be formed and can last a lifetime.

[MJ_KC]

Whatever happened to the President's Council on Physical Fitness.
It still exists, but maybe there is less participation by schools. I don't really know what the level of participation really is.

http://www.fitness.gov/

[MJ_KC]

Again, I must recommend that people watch "Sicko", it is NOT about the huge problem of people without insurance, rather it is about how bad the health care is for those of us who DO have insurance.
I needed a referral to an osteoporosis specialist and it will be about 2.5 months from the the time I made the request until I see the doctor. This is even after having a confirmed problem from a bone density scan.

Our medical system is getting worse with each passing year, and it is my opinion that we are far from ready to deal with all of the baby boomers getting old enough to have a lot of chronic problems.

[Min]

Naturalist Mark makes a lot of sense, and I can only simplify that further by urging universal health care for all citizens and other legal aliens. Illegal aliens limited to free emergency services, unless they pay their own costs.

[Tampanude]

I only want the same coverage and healthcare premium that my elected Senator and State Rep. has.

OH! and a nice free private jet ride would be wicked cool too!

[Boreas]

Wow, what a discussion. Healthcare is a right, not a privilege. It is for all citizens, not for the elite, or those lucky enough to have insurance. I can't even imagine using the concept of supply and demand to warrant health services. Of course, planners need to provide services that reflect the needs of the community they serve, but supply and demand in economics 101 terms? No way.

As a Canadian, I find it incomprehensible that people have to decline things like chemotherapy because they cannot afford it.

I have reverted to my Boreas nick and see that I have gone back to a junior member. Perhaps you will see me as Still_Boreas again soon! :)

[usmc1]

The only criticism that I have heard concerning a national health system (whether that system be in Canada or the UK) are the very long waiting lists and lines for certain operations and procedures.

I had to wait three weeks to get into a private practice for a nuclear stress test with MRI, because I was feeling a bit dicky. Must have been the Jalepeno "poppers"---I wore out their treadmill.

A woman out here on the ranch was told that her symptoms could indicate cancer, she had to wait a month for the tests, then had to wait for two weeks for the results--six weeks of unnecessary terror and anxiety.

I developed a floater a few years ago, since has gone away, but after spending two hours, with an appointment, in the waiting room, I informed the office manager that they would, "be getting a bill for my time at either the SAG/Aftra rate or the $150 per hour consultant's fee that I charge. Take your pick!"

"Huh, what's that?"

"You're about to find out"

Short version is, I refused to pay the co-pay and told them to apply it to what they owed me for my wait. I don't know what they did, but I never paid it!:)

Lost records, long waits, rude, indifferent, snippy office people, screwed up billing and insurance coordination, interminable delays in getting appointments and results of tests are not merely a part of some foreign country government administered plans. We got plenty of that guff right here in the U.S. of A.

[usmc1]

Wow, what a discussion. Healthcare is a right, not a privilege. It is for all citizens, not for the elite, or those lucky enough to have insurance. I can't even imagine using the concept of supply and demand to warrant health services. Of course, planners need to provide services that reflect the needs of the community they serve, but supply and demand in economics 101 terms? No way.

As a Canadian, I find it incomprehensible that people have to decline things like chemotherapy because they cannot afford it.

I have reverted to my Boreas nick and see that I have gone back to a junior member. Perhaps you will see me as Still_Boreas again soon! :)

You're absolutely right (er, maybe left) in your statement that healthcare is a right, not a privilege.

For something to be a human right it must: Be universal (apply to everyone in the world), Be equal (one group does not have an entitlement to more or better than another), Be natural (Come from nature, not religious, altruistic or charitable philosophy or thinking).

Quality, affordable, universal, cradle-to-grave healthcare meets those standards; and is an essential human right.

By the way, your kitty avatar looks a lot like our gentle giant, Jasper-Rascal!

[Sanslines]

[QUOTE=Boreas;169763]..........
As a Canadian, I find it incomprehensible that people have to decline things like chemotherapy because they cannot afford it. .........QUOTE]

There is no doubt that the USA Health Care system needs some serious changes. I personally know people who have declined certain procedures due to high cost. However, this is not always a death sentence. I have advised some people to travel overseas to where the costs of serious and involved procedures (such as hearth bypass surgery) are so much cheaper. Those who have serious illness and are desperate to live may consider doing exactly that. Others may chose not to do this and some will prefer to stay in the USA and struggle with no health care or to even die. Part of the problem is that people in the USA are too ignorant of other foreign peoples and cultures. They want to accept what they are told and that is that the USA has the best health care in the world and all other country's health care systems are inferior to the USA system. This is false but try to convince some people of this. The fact is that there are countries such as India with very competent physicians who charge so much less and have even developed specific programs to meet sick patients at the airport and handle all aspects of their care including travel from the airport to lodging, travel to and from the medical facility, and accomodations for the patients relatives.

I personally have found dentists in Mexico to be of the same quality as those in the USA. There are obviously some good ones as well as some bad ones in both countries and so it is up to the patient to do the research and find their own good solution. I have also heard all of the horror stories in San Diego about Tijuana dentists but most of this information is intentionally misleading propoganda that has been put out by our own health care establishments. Sadly, most people will not put in time or effort to look beyond what they are told and find a proper solution for their own health care.

In the end, it is always up to the patient to take charge and care of their own health.

[walter05]

USMC1;

You said, “The problems and challenges are very clear--school boards are politicized and you can recognize the outcry from the Weatherford, Texas ISD if there were a national educational mandate about the reduction of red meat (beef) in the diet and eating salads and fruits.”

Dr. Walter Willett points out the USDA food pyramid is fundamentally flawed. Agricultural business interests have been able to have adjustments made for economic reasons. Therefore, unless the right resources get to the schools, they will not teach the correct information.

Education is nice, but it may not suffice. Six years ago, the federal budget of the U.S. was running sizable surpluses. Now we have been running huge deficits. We have more limitations on resources than we had because Congress and our president have spent what they did not have and charged it to the future.

Given the financial limitations, if we don’t have some strong cost controls, I am afraid we will not be able to pay for universal healthcare. We have to do something. Rather than have administrators tell be people what they can and can’t have and when, I would rather a reduction in demand be used to control the cost. Once again, do you have any idea on incentives that would help?

Still_Boreas;

Even if healthcare is a right in Canada, there have been debates from time to time about cost containment in Canada also. Are you open to some incentives for people to take better care of themselves? If so, do you have any suggestions?

Mark;

HMOs can be a disaster. I would not be a member of one. You are right on how bad this has been.

Sanslines;

You make some cogent points. Healthcare in a lot of other places is much better than we are told. 1/3 of all prescriptions in the U.S. are filled with Israeli made pharmaceuticals. Radiologists reading X-Rays for U.S. hospitals are often in Israel, India, and other countries.

[Sanslines]

.........

1/3 of all prescriptions in the U.S. are filled with Israeli made pharmaceuticals. Radiologists reading X-Rays for U.S. hospitals are often in Israel, India, and other countries.


Yes, Many pharmaceuticals are made overseas. I would be curious to know how much is paid to those overseas pharmaceuticals and how much of a markup that our own pharmaceutical companies place on those overseas pharmaceuticals.

[Boreas]

You're absolutely right (er, maybe left) in your statement that healthcare is a right, not a privilege.

For something to be a human right it must: Be universal (apply to everyone in the world), Be equal (one group does not have an entitlement to more or better than another), Be natural (Come from nature, not religious, altruistic or charitable philosophy or thinking).

Quality, affordable, universal, cradle-to-grave healthcare meets those standards; and is an essential human right. (yeah, I am pretty left leaning at times)

By the way, your kitty avatar looks a lot like our gentle giant, Jasper-Rascal!

I agree with you and could not have said it better myself!

The said kitty in my avatar is a fifteen pound silver bengal with attitude! He is full of steam and like a lot of men, has a macho exterior that covers a mushy interior. He is far more needy than his "sister" Artemis. Oh, and his name is Apollo.

[Boreas]

Even if healthcare is a right in Canada, there have been debates from time to time about cost containment in Canada also. Are you open to some incentives for people to take better care of themselves? If so, do you have any suggestions?

I am totally open to initiatives that help people take better care of themselves. Our local hospital apparently is doing some things towards this end. The cardiac care centre has exercise equipment and gets heart patients on to exercise routines. I am not sure if peopl at risk for heart attacks could use the program or not. This centre has been opened up for mental health clients to use, since aerobic exercise is shown to be a good natural anti-depressant.

My only concern about incentives is that they do not become means to punish those who do not or cannot look after themselves properly. It does take awhile to change things after all.

Our health ministry has cut funding for things like chiropractic, physio (PT) and I think other allied professional services. I got a bad whiplash ten years ago and now have the joys of chronic neck issues. Chiropractic, physio and massage are far more cost effective for this type of thing than the mainstream medical system. These treatments allow me to keep my neck painfree and out of the doctor's office. It would be nice if chiro and the like were covered, even partly. If I had relied on drugs and such ten years ago, my neck would have been much worse, and now I'd likely be more dependent on the system. I know that in places like Oregon, naturapaths have hospital priveleges. They are far better able to teach people how to eat well, and encourage their bodies to heal. That would be a good addition to healthcare.

Another way to cut costs, is to have nurse practitioners do some of the work docs do. They come cheaper and can do much of the same stuff. I do not see why docs need to be gatekeepers to specialized services. As a social worker with mental health experience, I might be a far better person to get someone to a psychiatrist or mental health nurse, than a doctor for one thing. A physio might be better for recommending someone needs an orthopedic specialist.

Just tossing out ideas here. I strongly believe that the discussion has to be more that public vs. private (as is the case in Canada) and we need to be creative. Cutting staff as was done in the 90s just caused bigger and worse headaches. It is NOT about the almighty dollar. It is supposed to be about health. Costs are not just measured in dollars and cents, even though dollars and cents are an important factor. Money is not the only measurement, and in fact should be lower on the list in some cases.

[walter05]

I believe we are coming closer to a consensus.

I agree that Chiropractic, massage, etc. can be very helpful. Some of the best nutritionists are out of Toronto. A lot of the healthier products that I can find here in Savannah are made in Canada.

One time, when I was in Calgary, I had some pulled shoulder muscles and back muscles. I called for a massage therapist that came and worked wonders. I definitely think he was less expensive than doctors and drugs. Not only did he cost less, but also the side effect was feeling really good rather than anything else.

Many of the doctors’ offices in the U.S. are now using nurse practitioners in the office. However, they are charging the same fees to the insurance companies. The nurse practitioners often take more time with the patients and may give better care than rushed doctors.

If we can come up with a way to encourage people that is fine if it works.

I don’t want denial of access to services to be the way the national health plan controls costs.

When my wife was undergoing chemotherapy, she received treatment from an acupuncturist that had privileges at the hospital. They also integrated support with our nutritionist. The acupuncture and nutritional support helped her with the side effects of the chemotherapy so she could withstand the treatments and they could be more effective and on schedule.

P.S. I have an awesome nutritionist that has been a lot of help to me. Between him and the guidance from Harvard, my family has been doing great. If you want to PM me with more details, when I see him later this week, I will ask him questions for you and see if I can get some information that may help you.

[Boreas]

Walter I was thinking about this after I posted my last. I do agree we can reach consensus. I think what we need to do is have a meeting of left and right with real discussion. As a social worker, I have a perspective that has value. I can hopefully teach an economist a few things. I know that an economist has value and can teach me a few things too. We are too often caught in left vs right and that too often involves mudslinging....and that is not useful at all!

You are welcome to send me that information. I live a long way from Toronto now though. I am about a four days drive from there along the Alaska Highway. We have an excellent Naturopath here in town and other things like accupuncture and massage. I LOVE my massage therapist, though she is pregnant. :( I guess I am on her core list so will continue once she has had her delivery break.

[missouriboy]

Mark,

This may be of interest to you. It is an article about how Americans are finding low cost and affordable dental care by traveling to Mexico. It appears to be all about costs.

http://www.dentistasdemexico.com/indexfiles/newsstory.htmlI can attest to this from my own experience there last winter. My wife had even more service than me, but I can't recall any of her cost comparisons. For myself I had:

A 5-unit permanent bridge made for $900 - that's $180 per unit. The last one I got in America cost $400 per unit... and that was in 1997, TEN YEARS AGO. How much would that $400 be today? Perhaps someone with recent experience could inform us.

Two extractions at $30 each. When I related this to my barber, he said he had just had two extractions himself, and he shopped for the lowest price he could find: that was $195 each!

Cleaning, $20. I don't know how much that costs here, either.

My experience with the dentist was quite comparable with dental service here at home. In fact, he was schooled in California. But Mexico just does not yet have the exorbitant pricing structures that we have up here.

Why is that?

[missouriboy]

And BTW, those bridges we both got in Mexico were Made In USA! At a dental laboratory in McAllen TX, in fact.

[walter05]

First of all, it is great that we can disagree, read each others' positions, reconsider and realize we both have parts of the puzzle and them put them together. I think this is what the forums are for.

I agree with you that often people who have some important contributions to make on a topic have a hard time accepting that they don't have all of the answers.

The nutritionist will provide individualized recommendations.

I will PM you with some questions so I can provide them to him. I am meeting with him tomorrow.

Walter

[Sanslines]

..............Cleaning, $20. I don't know how much that costs here, either..........

My experience with the dentist was quite comparable with dental service here at home. In fact, he was schooled in California. But Mexico just does not yet have the exorbitant pricing structures that we have up here.

Why is that?


$20 to about $35 is about the average price charged for teeth cleaning in Tijuana. X-rays may or may not be additional depending upon the dentist. In San Diego, I saw a special for cleaning that was $34, but this was a special with no x-rays. (Most good cleanings in San Diego cost at least $50 to $80.) After I phoned, I was told that the earliest that they could see me was in about one month. Instead, I went across the border and had my teeth cleaned the next day for $28. Out of curiosity I asked about a root canal procedure with a porcelain crown. In Mexico, the cost was $250 and the crown comes from the USA lab. In the USA, the same procedure costs $1250. With such fantastic differences as this, is it any wonder why so many Americans are going to Mexico for dental procedures. BTW, one major reason for the price differences is due to medical malpractice insurance in the USA. Too many lawsuits in the USA force all of us to pay. If only we could find a way to limit litigation.

[usmc1]

...BTW, one major reason for the price differences is due to medical malpractice insurance in the USA. Too many lawsuits in the USA force all of us to pay. If only we could find a way to limit litigation.

This remark, no doubt written in good faith, is a repetition and perpetuation of a myth and canard circulated by the conservative right-wing in America. :eek:

The facts are:

"Adding together all the premiums of all the different kinds of liability insurance together results in a big number -- about $215 billion in 2003 -- but that number is hardly exploding, and the medical malpractice share -- $11 billion --- looks pretty small by comparison. It looks even smaller next to the $1.5 trillion plus we spent on health care that year. Something that amounts to less than 1 percent of health care costs simply cannot have the impact that the medical malpractice myth would have us believe."

Additionally, we should acknowledge that more people die of medical error each year in the U.S. than from automobile and workplace accidents combined. There are very legitimate reasons for malpractice suits.

Even putting all that aside, the truth is that not all medical specialties face high liability premiums and those premiums vary from area to area. And while there are some headline making exceptions, most successful malpractice lawsuits with awards are based on proven injury with significant loss, pain and suffering arising from malpractice.

The issue is far more complicated than what is presented here, but I do strongly assert that medical liability insurance premiums and lawsuits are not "major" causes of high health costs in the U.S.. Not even close.

I would suggest that one look elsewhere than medical liability insurance for the reasons behind the disparity in prices of dental procedures between San Diego and Tijuana. I'd start with property values, as in cost per square foot.