Health Care in the US

[Racerbvd]

Anyone notice that Sen. Kennedy chose to have his surgury in the USA, not good enough to keep his money here, but was to save his life

Everyone seems to bemoan how to pay for the health care, but no one seems to discuss how to reduce the COST by charging less, for doctors to make a decent wage, but they all seem to be able to afford huge houses and expensive cars, as to why a hospital should charge $5 for ONE aspirin, etc etc.

You clearly don't don't what it cost, both financially and in time to become an doctor, do you??
Start out with just the cost of education

Annual tuition and fees at state medical schools in 2004-2005 averaged $14,607 for state residents and $33,036 for non-residents. At private schools, tuition and fees averaged $32,092 for residents and $33,666 for nonresidents These figures do not include housing or living expenses. But don't let these costs discourage you. A wide array of grants and loans are available to those who are determined to get a medical education.

Most medical students borrow at least a portion of the money they need to finance their education. In 2005, the median debt was more than $120,000.

Then the amount of time that it takes to become a doctor

It takes many years of education and training to become a physician: 4 years of undergraduate school, 4 years of medical school, and 3 to 8 years of internship and residency, depending on the specialty selected. A few medical schools offer a combined undergraduate and medical school programs that last 6 rather than the customary 8 years.

Premedical students must complete undergraduate work in physics, biology, mathematics, English, and inorganic and organic chemistry. Students also take courses in the humanities and the social sciences. Some students volunteer at local hospitals or clinics to gain practical experience in the health professions.

The minimum educational requirement for entry into a medical school is 3 years of college; most applicants, however, have at least a bachelor�s degree, and many have advanced degrees. There are 146 medical schools in the United States�126 teach allopathic medicine and award a Doctor of Medicine (M.D.) degree; 20 teach osteopathic medicine and award the Doctor of Osteopathic Medicine (D.O.) degree. Acceptance to medical school is highly competitive. Applicants must submit transcripts, scores from the Medical College Admission Test, and letters of recommendation. Schools also consider applicants� character, personality, leadership qualities, and participation in extracurricular activities. Most schools require an interview with members of the admissions committee.

Then, after all that, there is the cost of running a practice.
Not just the cost of the office, either leased or owned, but the staff, equipment, training, insurance, ect.

Medical Practices

Technology Startups & Established Companies

Homecare, Staffing Agencies

Device and Pharma companies

Healthcare service companies

MT, Laboratory, Billing, Other Service Cos.

And the hours a doctor puts in to his or her practice a week.
Add in the non pays like illegals & such, since they can't turn them away, then there is the emotional cost, how would you like to be the one telling a family their son, father, mother, ect, had a terminal illness, trying to save a baby who had been in an car accident??? Not being able to save someone's leg?? You don't think that takes a big toll on someone??

Doctors, like other professions also have to be licensed, and do continuing education. Do you have any idea what they pay for Mal-Practice insurance?? One reason a pill cost $5 is all the ones & other services that go unpaid for.

Yea, those evil doctors earn to much money, have homes too large for what they do


Funny, I don't hear anyone complain that it cost $12 to see a movie, $30 with pop corn an a coke, tickets for Pro Foot ball games over $100, and cost another $50 for beer & dogs. Over $100 for a good concert, and again, $$$$ for food & drinks. But no one is crying about what actors, pro athletes or singers earn.

On insurance, most people CHOOSE not to have it, when in reality they chose cable TV & the Internet, cigarettes, & beer over their health.

[Tobra]

I can tell you right now how to solve the "healthcare crisis."

Everybody who is not on the sick, lame and lazy list, must get up off of their ass. You could control a large part of the population to some degree, the ones you are paying somehow, must not be obese. A tax on your percent body fat, maybe.

Tobacco, most likely out, but people sure are addicted to them, worse than smack or meth to quit, or so I am told, perhaps a tax on them, more so than already I mean, think punitive for that, and distilled spirits, make whatever dope people want legal and tax the schiznit out of it.

Use the dough that is not siphoned off from the tap to the LOCK BOX and use it to pay for it all, healthcare, roads, defense

QED

[jyl]

The US has the most expensive health care system in the world. Total spending was $2 trillion spent in 2006, $7,026 per person. Our health care costs are growing fast - that $2 trillion was $714MM in 1990.

We spend far more on health care that any other country. Roughly 2X to 3X the per person spending of other developed countries, e.g. Western Europe, Japan, Australia, etc.

Looked at another way, we spend 15% of our GDP on health care, versus 8% to 11% in most other developed countries.

So our health should be 2X to 3X better that the health of people in Germany, UK, France, Australia, Japan, etc? But it isn't, not hardly.

Why do we spend so much more, for no better results?

- Our health care system is extremely complex, with all it layers of insurance and govt programs and claims/benefits and separate doctors and hospitals and labs and specialists etc etc. About 25% of our health care spending goes to administrative costs.

- We pay much higher prices for prescription medications. A pharma company with a new drug will look to get 2X the revenue from the US as from Europe, even though the population is similar. Because Europe pays less per dose.

- Over 40% of the population being uninsured means more expensive critical/urgent care in emergency rooms, rather than less expensive preventative care, out-patient care, and continuing care with needed medication.

This cannot continue. At this rate, health care will swallow up more and more of our GDP, and we still won't have health any better than other developed countries.

Yes, right now, those of us with good health insurance are very happy with our care. I can go to any doctor I like, get treated right away, pretty much any procedure regardless of cost. So, some of us don't much care that 40% of the country doesn't have good insurance (or any), or that the country can't afford these health care cost trends indefinitely. Keep the status quo, they say.

But that is a losing position. Over time, the number of us with good health insurance will get smaller, and smaller. More people will fall into the uninsured, or the underinsured, category. Eventually we will reach the tipping point - when a majority of the country is uninsured or underinsured, the voters will force through a change.

Personally, I'd like to see that change be a sort of hybrid system - a national health care system that covers everyone, and the option to buy private health insurance/care if you are wealthy enough to afford it.

Since snowman is wealthy, that should work for him :-)

[RPKESQ]

Originally Posted by on2wheels52

Not to drag back to the topic, but who here wants to have any of their medical problems treated in another country?
I am indeed fortunate not to have any conditions that need treatment but in the event any arise I would wish the best medical care available. Where should I go?
Jim

Try France. WHO has ranked it superior to the US over and over again. Many times it is rated best in the world. there is no wait for treatment. Many UK citizens who could partake of the UK's national heath service for free actually go to France and pay instead of wait for the free NHS.

France ranks above the US in all major measurements used in determining healthcare quality. Lower doctor to patient ratios, lower infant mortality, long lifespan, etc.

According to snowedman, these are all lies. According to the WHO and Doctors without Borders and every other healthcare ranking organization the US is not at the top. That is the real lie that has been sold to the American public, just like the need to invade Iraq.

Never listen to anyone who rants about how the US is the best in everything. That has never been true. I am proud to be an American and America has much to be proud of. We don't need to promote outright lies in order to hold our heads up. We can be plenty proud of the truth, without resorting to baldfaced lies of the worst sort.

Do the research, and stop believing in lies.

[Hugh R]

Ask someone like Moses what his malpractice insurance costs annually as an OB/GYN. Ask him about patients who he gets "assigned" when he has to do rounds in order to get priviledges at hospitals and the liability he takes on for the illegal women who never had prenatal care and she arrives in labor with the head showing. And if there is a problem with the delivery or the kid, the lawyer for the illegal says it must be Moses' fault.

Sorry Moses, just remember a post of yours like that.

I suppose that if I went to school/residency for 12-16 years post high school, I'd expect to make good or at least decent money. I imagine in today's market if you want to make really good money as an MD, you'd be a plastic surgeon, not an OB/GYN.

[Dottore]

Originally Posted by RPKESQ

Try France. WHO has ranked it superior to the US over and over again. Many times it is rated best in the world. there is no wait for treatment. Many UK citizens who could partake of the UK's national heath service for free actually go to France and pay instead of wait for the free NHS.

Never listen to anyone who rants about how the US is the best in everything. That has never been true. e worst sort.

Do the research, and stop believing in lies.

+1000

The guy who started this thread has nicely demonstrated his ignorance of the rest of the world. I can think of few countries in which I would rather fall seriously ill than the US.

[snowman]

Anyone who thinks France has better medical care then the US is definitely believing a LIE. It is the statistics that almost all countries, other than the US use. These countries make up statistics to suit their needs. They do this in various ways, eg an unborn dies. This becomes an abortion that dosen't count, or it may not count, just because it isn't a person yet, in that country. Why did one of the Beetles, with all the money in the world, who had a choice of both private and universal care in the UK, come to the US for care. Because we have the best.

People from all over the world come here for care. WHY? Because its the best.


There is NO other country in the world that has less than one day wait time for the best care in the world, for Anyone who walks or is carried thru the door.

[Dottore]

Originally Posted by snowman

Anyone who thinks France has better medical care then the US is definitely believing a LIE.

Laughable!

You need to get out more. When were you last in a hospital in Europe?

Just curious.

[snowman]

Really!!! I think you are smoking to much of something illegal.

Just talk to the French and English patients that come here for care that they cannot get there.

[artplumber]

You guys who think France is so great, fine. Go there. The WHO stats are a bunch of baloney. (I got healthcare in Europe and am in the industry in the US). The data are carefully engineered to eliminate the true benefits. Yeah, England had as good mortality data as the US during the NHS days, but you couldn't get a kidney after 55 (IIRC) or get started on dialysis after 70 (IIRC). A lot of this data also does not take into account the general health of the population. US BMI's were way higher than the continent. That is changing, and I bet that the real costs in Europe will soon start to mimic the US.

Some of this has to do with attitudes of the patients/families. In the US, often "pull out all the stops" is the attitude, where other cultures accept the inevitable.

We could always be like India/Hong Kong where if you can't pay, you don't get it. I have a friend who told me of families who watched their loved ones expire because they could not afford the treatment for easily treated diseases. But our country forces physicians and hospitals to work for free (once a patient is in the ambulance/ER they must be treated), and those patients are often the ones most likely to sue (afterall the hosp/doc are rich and can afford to give everyone $5 million, right?).

As to whether the cost of medicine is linear, as simplistically suggested elsewhere, it's not. 2x cost does not yield 2x benefit, especially when politics plays a role in reimbursement decisions. Most major mortality benefits for new classes of therapeutic agents for the major mortality diagnoses (coronary artery disease, stroke, cancers) are not giving huge benefits even though benefits are present. How does politics play a role? Screening for cancer is a great example. Routine colonoscopy is very expensive for population screening, and doesn't have a great yield. Yet, because it was promoted by someone with access to the public through widely dispersed medium (Katie Couric), suddenly it is a reimbursed procedure. Likewise, Oprah facilitated the emergence of coronary artery CT for screening. I can't wait until some exec getting routine CT's every year or two develops a leukemia and then wants to sue the scanner company (or Oprah) for radiation exposure induced cancer.

Then there is the whole defensive medicine aspect of doing tests to prove that certain things aren't going on in case providers are sued later on....

[john70t]

I'd suggest:
1) The AMA and the educational systems aggressively start marketing the need for doctors, especially general practictioners, to fill the numerical needs of our growing society. Demand is way ahead of supply.

2) The AMA streamline their physician reviews, allow changing of physicians within all medical systems(HMO's), have emergency complaint departments available, and pull licences aggresively for aggreigeous cases. No more murdering quacks bouncing from state to state two steps ahead of the law.

3) Set limits on pain-and-suffering cases

4) Allow and make publically available in easy-to-read format doctor/office rates, patient complaints, and physician reviews so the customer isn't stuck with an emergency "contract-by-adhesion"- not knowing what they are in for.
Except in the case of superglue accidents of course.

5) Reign in the corrupt pharma-kickbacks to control drug costs. Most basic drugs(except anitbiotics) have been around for a long time and work just fine. Simese-twin patenting and rebadging them under different names should go out the door.

I like the idea of a dual system as well.
I recently had a (lucky) chop saw accident that required 4 stitches with a tetnus, and required a quick 20 minutes of stitching by a nurse. The cost? $1,100!!! There were no alternatives available except the emergency room.

[Gogar]

If I need to pick a side in a debate about the French health care system, I think I'll go with the Frenchman who lives in France and uses the system personally, not snowman. Sorry.

The only foreigners coming to America for health care are Canadians who can afford it, and don't want to wait.

Americans who don't want to deal with it are going to India; I watched 60 minutes this one time . . . .

[MFAFF]

I'll start by say... 'Not this sh#t again'....

There have been numerous threads on this before...so at the risk of repeating myself... the real difference lies not in the quality of the medical treatments but in the access to that treatment.

The US is the world leader in that regard, access to health care is far easier and for that priviledge you pay handsomely for it..so is it a surprise? In parallel to that the actual 'hotery' services whilst in 'in patient' care is of a higher standard and offers a greater scope of benefits. Again the cost associated with it via the private health insurance premiums is a direct cuase of this higher standard.

Once you get beyond that the quality of the medical staff and the treatment they provide is broadly similar.. Snow, sorry to disappoint you but that comes from a few decades of dealing with UK, European and US trained and qualitied medical staff. Yes there are areas where treatemtns for specific ailments are far more avalaible/ succesful in the US as approaches and FDA approvals permit different drugs to be used at different times. Similarly there are proceedures in Europe where the skills are higher, by virtue of greater use than in the US.

No overall there is no doubt that for the 'median' person the total healthcare package in the US offers advantages, but factor in the cost and it becomes a different view. On a personal level I have found that friends of mine, same backgronud, colelge etc, similar family situations and careers are actually paying something like twice the healthcare costs per year person than I do here for the entire family (that's including a private healthcare package offered by my company)....

Is the service they reveive twice as good? Based on personal experience it would be hard pressed to imagine in which areas the healthcare we have recieved in the past decade could have been bettered by a factor of two... need to see a doctor, next day walk in clinic will do nicely...need a major operation... when do you want it, in three months on the NHS or three months privately..becasue that is when you will be medically ready for it..... pre and post natal intensive care.. right there, parents room as part of the unit, check....

The area where vast improvements were possible were in terms of the food offer... the quality of teh rooms for parents (Victorian standards were somewhat different to ours.. but the sheets were clean, the room cleaned every day..sure it was a lino floor not carpet and teh curtains were thin an let too much light in and htere was no a/c. To have all of these would have been nice but would have not improved the quality of the medical care.

From having lived in the Us for quite a few years I think that medically there is little difference.. but that in terms of access and 'hotel' services the US ofers far more.. however the cost associated with it must never be ignored...

You pays ya money, you takes you pick..

[Aurel]

I hear that healthcare for cavemen is great in the US. Too bad they can`t have access to it. Maybe GEICO could do something about it. Fortunately, and according to Snowman, most of cavemen live outside of the US. So, I think we are good: cavemen outside, good healthcare inside, USA rocks ! .

Aurel

[Tobra]

There are advantages to socialized medicine, cost containment is much easier, you just ration care, rather than reimbursement for care, which makes a bit more sense economically. I can think of many, many instances where millions of dollars, 1990's dollars, was spent in the last month of a person's life on healthcare. You could look up the stats on this, it is not uncommon.

Lot of grey areas in the end of life game. I suppose you could warehouse your elderly in buildings that are not climate controlled and pray for a heatwave to keep your budget in line, worked for the French a few summers ago. Saved on electric bill for air conditioning, and imagine how much they saved, just for medication, on all the people who died. Gotta be able to make tough choices.

If you think Canadians are the only ones coming to the US for healthcare I have a bridge I think you might be interested in purchasing. Try going to MD Anderson in Houston and see how many patients are from Mexico, Central and South America, paying cash.

[RPKESQ]

You will not have to wait for any treatment in France (other than a donor, same as in the US). To state such a blatent mistruth like snowedman is pushing, is just plain idiotic. France also does not "ration" healthcare out to a greater exent than the US. In France doctors still do housecalls, all prenatal and postnatal care is provided, maternity leave for both spouses and childcare when you return to work is provided. That is one reason France has a lower infant mortality rate than the US.

I am an American who splits the year between France and the US. If you do not have first hand experience with a different system, than you should know your "facts" *cough*opinions*cough* are just like assh*les, everybody has one, yours is nothing special.

Funny how the while world is wrong to snowedman except America. And of course America is perfect in every way.

Wonder where your 220mph trains are? How about your 80% electrical power from nuclear powerplants (for the last 40 years!)? First face transplant? Remember the Exocet? Yea, the US is always the best in everything! How infantile can you people be to agree with a koolaid drunk snowedman?

Wake up, there is an entire world to explore and to learn from, both good and bad.

[Tobra]

Frenchy, if you don't think healthcare is rationed in a socialist system, you are the one who does not understand the situation adequately.

There is free prenatal healthcare for everyone in this country, even those here illegally, they have but to take advantage of it. There is free healthcare for everyone else too, all one need do is go to ANY emergency room. You will be treated, independant of your ability to pay, and they will even work with you on the charges after the fact.

We don't have nuclear power generation in this country because of the left, if you get right down to it.

[RPKESQ]

Originally Posted by Tobra

Frenchy, if you don't think healthcare is rationed in a socialist system, you are the one who does not understand the situation adequately.

There is free prenatal healthcare for everyone in this country, even those here illegally, they have but to take advantage of it. There is free healthcare for everyone else too, all one need do is go to ANY emergency room. You will be treated, independant of your ability to pay, and they will even work with you on the charges after the fact.

We don't have nuclear power generation in this country because of the left, if you get right down to it.

If you think healthcare is rationed in France, then you are the one that is sadly misinformed. You mentioned prenatal, but did not touch on the postnatal, childcare and long maternity leave everybody enjoys in France. No need to go to a emergancy room and wait (or die, like the recent event in LA). French doctors will still come to you.

And if you think your lack of nuclear power generation is totally the fault of the left in America, then you are still drinking the rightwings koolaid. Try doing some research as to how France achieved this. It had little to do with right or left polictical claptrap.

Maybe you need to get out more.

[jyl]

Tobra, what you're saying doesn't actually work. Its not a substitute for actual health care.

Yes, if your bones are broken or you have been shot or cut or you are severely ill, you can go to an emergency room and be treated.

But if you are a lower-income, working-class person without insurance, who tries to be financially responsible, then you can only do this once or twice. The emergency room charges will break you - like, a month's living expenses per visit. So the ER really only works for the uninsured person who is already impoverished and/or and don't care about bills or paying. Your prescription (just go to the ER for free care) is one way that working-class people end up going bankrupt.

But forget the financial aspect - does it make any sense for an uninsured person to have to go to an emergency room for medical care? Absolutely not.

First, emergency rooms are for emergency care. Try walking into your local ER and asking for your annual physical, for an OB/GYN exam, for preventative care, or for continuing care of a chronic illness. Just try it. Doesn't work. So people who depend on ERs don't get that kind of preventative and ongoing care. They get sicker and sicker, and when they show up at the ER they are much worse off than if they had normal healthcare.

Second, the emergency room is the worst place for our healthcare system to treat patients. It is very expensive to deliver care there, especially for people who can't pay. Why do you think so many urban ERs are being forced to close? The next time you are in, say, an auto accident, better hope the nearest ERs haven't gone bankrupt and they don't have to drive you for 40 minutes to one that is open.

Third, the emergency room is a bad place for patients to go, unless they actually have emergencies. Can you imagine taking your little child to a big-city ER. Sitting there for hours among gunshot cases, bloody accident victims, freaky drug overdoses, etc? You call that decent health care?

Fourth, the ER will give you emergency care. What happens after you are discharged, but need on-going medication, therapy, outpatient care, etc? ERs don't do that. No insurance to cover your prescription? You get to go without, until you get sick enough, then you end up back in the ER.

People who say "everyone in the US has free healthcare, just go to the ER" just aren't making any sense.

Originally Posted by Tobra

There is free prenatal healthcare for everyone in this country, even those here illegally, they have but to take advantage of it. There is free healthcare for everyone else too, all one need do is go to ANY emergency room. You will be treated, independant of your ability to pay, and they will even work with you on the charges after the fact.

[snowman]

Most women could go out in the woods to have their kid with no complications. Using pre natal, post natal health care is a common trick used by HMOs to show how good they are at simulating the forest.

Just read your own news papers, there is a victim every day, a victim that waited until they died for urgent health care in your countries. It just dosen't happen here at anywhere near the rate it does there. Here it is usually the patients own fault, not the health care system.

As to waiting times. If you have a bad knee or carpel tunnel you suffer, you have a hard time functioning, your life is downright miserable until the problem is fixed. I have had surgery for carpel tunnel, both hands, torn rotator cuffs (both of them), and a knee. Probably because I did Judo for over 35 years. Waiting time for each... 3 days for the carpel tunnel, 2 days for the knee, 2 weeks for the rotator cuffs. Waiting time for the initial appointment several hours to one day. I know thats good, but again we have the best care in the world here.

I have a condition called neuropathy. No treatments, no cures for it so far. (unless you consider being loaded up with tri cyclic antidepressants to the point of being a Zombie or otherwise zoned out with Neuronton) I have been to all the worlds leading Neurologists and volunteered for many studies. In the process I have met patients from all over the world. People that come to the US for the best, all paying cash. Every single country, including France.

We have a local hospital that treats many patients from the UK, even though they have private insurance there, they also treat every single nationality in the world. People who have money vote with their feet, they come to the US. People with a lot of money also seem to be the more intelligent people (makes sense, thats part of the reason they have a lot of money). Why reject "free" treatment, treatment you have already paid for in taxes, unless it is substandard?

Follow the money. Works for almost anything.