Re: Obama takes on health care critics

On Thu, 13 Aug 2009 11:09:02 -0700, Michelle C. wrote:

ray wrote:
On Wed, 12 Aug 2009 10:59:23 -0700, Michelle C. wrote:

ray wrote:


Most folks in the U.S. would admit there are problems with the health
care system. Most would probably also agree that it is not so bad
that the entire system has to be scrapped. I believe that some
changes could be made, far short of what the administration proposes,
that would certainly improve the system. IMHO - the biggest problem
here is that congress has not identified what the problem is - but
they're going to 'fix' it anyway.
Hi Ray,

What changes do you think need to be made to preserve the current
system and make it workable?

Best regards,
Michelle C., T2, no meds

I'm not sure - so far no one has been able to tell me exactly what the
problem is. It's virtually impossible to solve a problem until you know
what it is!

Imo, it's more than one problem, but here are the issues as I see it:

1.) A significant portion of the middle class cannot afford the health
insurance premiums.

2.) Insurance companies deny coverage to anyone with a chronic condition
(like diabetes) or won't cover a "pre-existing" condition. So the only
people who get coverage are those who are in a group through a job, or
those who are completely healthy.

3.) Our economy is seeing a huge drain because much of the money
allocated for "health care" is actually going for administration and
that administration includes entire depts of people whose primary job is
to find a way to deny claims. (California has a class action lawsuit
against Anthem Blue Cross Blue Shield for denying claims for no valid
reasons.)

4.) Our economy is seeing a huge drain because since a large percentage
of people don't have adequate health coverage and don't seek services at
an early point in their illness where the treatment would cost less,
they are waiting until their condition becomes an emergency.

5.) Much health coverage is tied to a job. If a person loses that job,
then even though they are probably covered under Cobra laws as far as
still being entitled to their former employer's group health insurance,
they can't afford it. A relative of mine was laid off. She was paying
$375/mo for both she and her husband when employed. Under Cobra, they
are paying over $1200/mo.

6.) Under our current fee-for-service plan, doctors/clinics/hospitals
get paid by the number of tests they do. Studies have shown that
whether intentionally or unintentionally, doctors who have a vested
interest order more tests than doctors who do not have a vested
interest.

7.) We don't know which treatments are most effective, and yet
insurance/Medicare pays for whatever the doctor orders. For example,
there are 4 basic treatments available for prostate cancer--1. watch and
wait (most older men will die of something else before the cancer gets
them) 2. surgical removal of the prostate, 3.) radiation implants, and
4.) a new radiation based treatment in which the machine is very high
tech, and huge (sorry, I remember the description but not the name). The
watch and wait method is cheapest, costing the doctors visits and blood
tests, and the new radiation based treatment starts at $100,000. But we
have no idea which treatment works the best. A researcher had a cursory
look at the available data, and no one treatment stood out as being
superior. Yet if the doctor orders the $100,000 treatment, (and if he's
associated with the facility that has it s/he will) then
insurance/Medicare pays.

8.) And yes, I agree with you about drug company advertising.

9.) Frivolous lawsuits.

That's a fairly good start at an outline - certainly not comprehensive,
but a good start. IMHO what you have listed is more than can be taken on
and adequately dealt with at one time.




If it's a matter of insuring everyone, that could easily have
been accomplished with the 'economic stimulus' money that has already
been wasted. In my particular case, I'm not terribly dissatisfied - I
have had some issues with the VA - for example they only allow 50 test
strips per three months because I'm "in control" - well, how do they
think I got in control? The VA still does not offer metformin ER,
either - I seem to do much better with ER - I've tried them both.

I'd like to see a little more emphasis on individual responsibility -
many of us are mature enough to manage most things ourselves - I,
personally, don't want the government to 'take care of' me - I'd rather
they get out of the way and let me take care of myself. It seems that
whenever the govenment is involved, things go over budget and behind
schedule - I can't think of any counter examples.

Ray in principle I agree with you. However, I think adherence to this
principle is driving our economy into the ground. I also think the
playing field is far from level. The middle class as a group is
traditionally hard-working and plays by the rules, yet where once they
were able to provide for their own healthcare expenses, this is no
longer true.

As for over budget, Medicare, has 3% administrative costs; where as
private insurers' administrative costs are averaging around 16%. In
this case, Medicare is less wasteful.

Unfortunately it's going bankrupt and many doctors refuse to take new
medicare patients - it's far from perfect. I was pretty amazed at what
all medicare paid for in my mother's last few years - I think that may be
part of the problem.


Best regards,
Michelle C., T2, no meds


No matter what is done,
folks should still have choices in the matter. No choice = less
freedom.

It might be good to limit drug company advertising - everything I've
seen indicates the drug companies spend more on advertising than they
do on R&D - and all they're basically doing is fighting for market
share - makes no sense to me.

.

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