Re: Semi OT: THIS is what's wrong with US healthcre.

RichL wrote:
pTooner <geddings@xxxxxxxxxxxxx> wrote:
The Sicker Vicar wrote:
On Mar 12, 10:02 pm, Les Cargill <lcarg...@xxxxxxxxxx> wrote:
The Sicker Vicar wrote:
On Mar 11, 7:10 pm, Les Cargill <lcarg...@xxxxxxxxxx> wrote:
But government really is the problem.
No. No, it isn't. No matter how many times righties repeat it. If
government is the problem, then civilization is REALLY the problem,
and we should all go back to the savannah and hunt lemurs.
Well, in the larger context, *HUMANS* are the problem. But gummint
has fingerprints all over this 'un.

Post WWII, Truman froze
wages to curtail inflation. Companies
offered BCBS as a perk. Once BCBS became all but
universal, there was no longer any price feedback to health care
consumers. "Another xray? Sure!".
Except doctors rarely order X-rays that aren't necessary. Righties
just quibble and fuss over the definition of "necessary." Erring on
the side of caution is sound science, sound medicine and, in the
long run, sound accounting. But those who approach every problem
from the "how much can I make from this by the end of this
quarter?" angle disagree. And from that very myopic viewpoint,
they're right.
My quip was not intend to be a point of data, merely illustrative.

All I mean to show with that paragraph is that once you get
almost complete decoupling from the cost...

Health care has, in effect,
almost perfectly inelastic demand, so when you remove all
price feedback, the price zooms.
Which would be relevant if health care were eggs, or nails. But it
isn't. It's life or horrible, screaming, agonized death.
Nobody gets out alive, dude. Guy across the street where I live
told 'em "send me home" about a month ago. He lasted two weeks.

It's
different. Nobody thinks the right to eggs is universal. The great
majority of the wrold, including America, thinks the right to
health care IS universal. Why is it subject to market forces?
The problem is that it is neither fish nor fowl nor good red
herring. What you describe is "demand is highly inelastic" to a T.
But people have to expend resources, take risks and work
pretty damned hard to get the care to you.

And yes - a lot of the world does it quite differently.

This amounts to a subsidy, and any subsidized good gets more
expensive. WIC and cheese, for example. They sorta manage demand
for health care in Canada by queueing - it takes a very long
time to get into a doctor's office.
Proven false in study after study. The wait times quoted in
right-wing "studies" are for elective procedures. The waits for
these procedures in America is less than a day shorter. ER
response times are almost identical. No one waits for anything
that's urgent, and America has lines that are almost as long.
Right-wing boogeyman.
Frederic has told you what some of the "oops" cases for primary care
are. Canada has a good system, but denying that they're queuing care
to control costs is disingenuous. *That*'s why we pay for - the
immediacy of it.

--
Les Cargill
Is this what you're talking about?

"Summary: The system is very good since you don't have to pay
anything.
If your life is not in danger though, you will have to wait... and
wait... and wait..."

This sounds exactly like what happens in America. Completely
consistent with what I said--emergency care right away, and
everything else you wait. I walked a friend to the ER in Manhattan
with a dog bite recently. Waited three hours, and he was bleeding
profusely. Because he could hold a compress to it, he had to wait.
You've yet to show a disadvantage that doesn't have a match in
America. And thus, since it's a head-to-head comparison, no
disadvantage at all.

So we can have exactly the same quality of care, and no instances of
"pre-existing conditions," being told you're not covered, dropped
from coverage for one-day-late payments, etc.

He's wrong, though. He does pay for it, through taxes
From a previous post I know that you won't hear anything that doesn't
fit your pre-defined ideas but since other folks may be actually
reading this - my experiences are entirely different. BEcause of my
age I see much more of the medical world than younger folks. I can
tell you that there is a built in wait of 2 hrs at emergency room
facilities because people who don't have insurance go there instead
of to regular doctors. Most emergency rooms are at hospitals and
they are required to treat everyone regardless of insurance or other
ability to pay. They use the delay to try to discourage people who
don't really need to be there. Outside of that I have never
experienced a delay of an hour in my fairly long life. The very few
time I've been to emergency rooms there has been no wait at all, but
I've only been there when I was brought in an ambulance. I have
taken other family members on occasion and never experience a major
wait. I've never had to wait more than one month for any type of
specialty referral in my life. The normal wait is less than one
week. The only surgery I've ever had was eye surgery (cataract). I
checked around and found the best doctor in town for the surgery
(Richmond, VA) and made the appointment a couple of weeks later. Of
course that doesn't make for nearly as exciting reading as the
disasters that other folks seem to experience.

Gerry

There must be regional differences in emergency-room care.

The worst I ever had was when I was in my 20s and I had a kidney stone.
I didn't *know* it was a kidney stone. I writhed in pain for 3 hours in
the ER waiting room (PG County General, Maryland, for those familiar
with the area) while waiting to be seen and they finally took me when I
passed out and my then-GF started hollering at the person at the desk.
Then I waited (after waking up) *in* one of the ERs for an hour until
someone saw me.




I can speak to both your experience and to Gerry's. I've had numerous surgeries, most recently a TURP (resection of the prostate) and a rotator cuff repair. In both cases I selected the doctor I preferred and the surgery was scheduled as soon as was practical. Since the emergency leading to the TURP happened right at Christmas, even though my doctor was Jewish, there were several delays in getting me in. It still happened within two weeks of my admission to the EP.

My family and I have always been admitted promptly, although treatment has sometimes taken an hour or two, depending on the criticality of the condition. When I was completely obstructed due to benign prostate hypertropy, cateterization was almost immediate. When my father was admitted with severe disorientation (at age 84) and unprecendented dementia, he was admitted and MRI'd immediately. He was promptly diagnosed with a subdural hematoma. In other words, we were treated promptly and appropriately.

However, I live in a smaller town and I expect that in big cities, (Baltimore?) things may not move so quickly.

I, too, have had severe kidney stones, however, that was in the service, and nobody likes military medical folks. (that said, mine treated me pretty well).

-Raf

--
Misifus-
Rafael Seibert
Photos: http://www.flickr.com/photos/rafiii
home: http://www.rafandsioux.com
.

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