Wednesday, June 24, 2009

What US government run healthcare looks like

A man attacked by a rottweiler was rolled into the ER and they called the orthopedic surgeon (a good friend and customer of mine) to work on him. The surgeon spent 6 hours on surgery- and saved this man's arm and leg which could have easily been amputated.

The surgeon submitted his claim to medicare, and it came back denied- because the surgery was too complex to bill. If the surgeon had amputated the man's arm and leg he would have gotten paid.

We don't need to look to other nations or come up with theory as to how government run health care would look like, (not that Gibbs nor the president can name a single payer system that they'd want to emulate) just look to medicare and Medicaid- that IS US government run health care.

I know some are going to put some wonderful stories about how medicare and Medicaid are perfect and delightful and the best thing that ever happened to you- well maybe not you but your cousin's best friend's dad...swell. But if we're already in a system where some people get great health care and others don't, why spend trillions of taxpayer dollars recreating another unfair and unsuccessful system with the same problems, except the problems are owned and created by the government, instead of the free market? A system that will restrict a greater majority of the population's choices and reduce the quality of healthcare for all?

The current system leaves some with out healthcare and carrying a debt of huge bills, the new system will incentivize physicians to amputate your arms and legs rather than save them? Why waste our money?


Emmy said...

Let me just say I am terrified of what Obama is going to do to health care. Good luck to all of us

Steve said...

There are already TONS of restrictions on healthcare when you have PRIVATE insurance. Ever have to deal with an HMO?!?!? If you skip a step in 1-10, you either get no coverage or have to start all over again.

I'm not worried about this at all b/c again, this is only for people that CHOOSE to not have private insurance. It's not meant to replace the insurance we (ie working people with benefits) currently have.

As for the country that this will work like is most likely Germany. Germany has Universal, which isn't what ours will be, at least not initially, and also private, if you choose to pay extra. So when you go to the doctor's, you tell them which plan you are on. A small percentage, at least less than half, have private, but they tend to get the quicker and better coverage, since the doctors know they will get their money sooner. But one benefit of the universal there is they do a MUCH more thorough testing and prevention patient markup then here. They'll spend a whole hour with you when you go in for an appt instead of the 5-10 you are lucky to get now (even though you are there at least the whole hour being shuffled around).

Does all this cost more money that is ultimately paid for by the taxpayers; yes, probably. But if it means everyone gets healthcare and better preventitive care, then my response is "so what?". There are lots of things governments, at ALL levels, spend money on that I feel are way less important than healthcare. Besides, if you don't have your health, what good is a multi-billion dollar missle defense system that may or may not work, for instance?!?!?

Cameron said...

In addition to Medicare being the best example of how government run health care would not be good, it's also important to note that Medicare services only a portion of the population yet is running out of money. There will have to be either large tax increases or large reduction in benefits just to keep that limited program going. It'll take ginormous amounts of money to expand it as is being discussed.

davers said...

The free market is poorly regulated and run by big pharma. The answer though is not to throw the baby out with the bath water and succumb to socialist policies. The republican plan would work ... which is why Obama's plan is looking more like it everyday.

Truth is though, the problem with health in America comes down to diet. To date you can still become an MD without knowing a single worthwhile thing about nutrition. It's all about treating the illness and symptoms and not the patient.

The thing is, making it state run won't change any of that. It will still be all about treating symptoms, and big pharma owns a big part of congress.

Alice said...

I don't particularly care if the health care system is run by our government, or privately, what I care about is that medical decisions not being made based on how much money they can pay their stockholders.

Make health insurance companies not-for-profit and there suddenly is a lot more money to go around.

Salt H2O said...


I wish it were that simple, but IHC is a 'nonprofit' and it's administrative staff makes ridiculous money, it binds the doctors as to what they can and can't do and it runs physicians and practices it doesn't like out of town.

adamf said...

Just wanted to say, davers, this is one of the first times I really liked your comment, for the most part. :) As a therapist, I agree, we are treating the symptoms or the problems too much, and not doing much in the way of prevention, and could save us all money.

Unfortunately it seems there will be problems with healthcare either way.

Steve said...

Davers - Good comment. But to really solve the health problems in this country you mention, we need to ban half the food our grocery stores sell, really allow the FDA and USDA do their jobs (seriously, the meat in this country WILL kill us all sooner or later, but even I can't stop eating it), and move more towards a total supplement type diet like on Star Trek (seriously!). But to do that would be "socialist"(TM), so people will get mad that the govt is telling them what to do; just like smoking, drinking, and, oh yeah, drugs.

Mike said...

I think Kory hit the nail right on the head.

davers said...

I see what you're saying Steve, but the FDA and USDA needs a short leash and considerable oversight themselves (as is the case with most gov't entities).

For proof consider Canada where last year they already tried to pass a bill (Bill C-51) to restrict vitamin access. Talk about being restrictive. This is what happens when gov't entities are so heavily funded that the oversight becomes too overwhelming and costly, and things unwatched always go awry.

I will admit this though ... health care is one of the few industries where the capital objectives are often at odds with public objective and common decency. That's why all developed countries but the US has adopted a universal care system, and why it's the only socialist-like program I'm willing to partially consider (although not embrace).

A universal care system must have adequate provisions for free market dynamics and innovation - and I not confident Obama's plan has enough of that. It's the free market that has made the US the primary source of innovation in that industry all along ... by allowing people to fund new hopeful therapies. I'm certain Obama's plan will have a significantly detrimental effect on that.

davers said...


"this is one of the first times I really liked your comment, at least partially"

I apologize ... I'll have to throw in some more of my ultra-right-wing beliefs in the future so I don't put you in such an uncomfortable position of agreeing with me.

Seriously though ... I feel strongly about this issue on the corruption and professionally-promoted ignorance in medicine and medical societies. That said, I think those in the profession are some of the best people in the world.

Jo's Outlet said...

Kory's complaints are exactly my worries as well.
I want doctors to have incentive to do the best job possible on my body - whether they're deciding on the best treatment for cancer, whether to amputate or save my limb, what medication will be most effective for a mental illness, etc. I want doctors who've taken their own initiative to be educated in medical school and beyond who care about people's health to be incentivized to be the best doctors they can be, so that people will CHOOSE to be treated by them.
I don't want a doctor to choose treatment for me based on what is simplest to bill or easiest to perform. The freedom we have in this country to become educated, to learn, and to invent, has given rise to technology for a reason - and professionals can use their own judgment in determining the best options for healthcare and find better treatments based on further research.
In a free market, individuals and businesses are incentivized by earning money - which creates more technology, which benefits everybody. It doesn't mean that all goods and services are top-notch. We all know that some insurance companies and doctors' offices are worth crap. However, we can CHOOSE to go elsewhere and use different services.

adamf said...

so I don't put you in such an uncomfortable position of agreeing with me

davers-thanks for keeping my feelings in mind. :) The dissonance I first experienced was almost too great, but then I remembered how hard I'm trying to be moderate, and how easy it is to get sucked back in by the tentacles of my former democratic self. Not that there's anything wrong with that. ;)

Steve said...

Jo - I'd much rather go to a doctor that is there b/c s/he wants to help people, no matter the money or paperwork incentives, than the one that wants to make money. That is the problem now with the industry!?!

A solid healthcare system doesn't have to be monetarily incentivized to work, look at Cuba! They have one of the BEST healthcare systems and educated doctors in the world. People from all over the world go there for treatment.

Davers - I hear you about the vitamin laws, but don't forget that OUR government under a Republican Congress AND President in the early 2000's tried to do the same thing and only failed b/c of petitions and rabble rousing by retailers, something I participated in. Truth be told, a lot of vitamins and supplements ARE rubbish (literally), but the laws would have restricted everything sold OTC, and would have made it almost impossible to get any sort of vitamin without a prescription.

Kamilli Vanilli said...

Seriously, Steve...Cuba? You've been drinking a little too much Michael Moore Kool-Aid. Cuba's healthcare system is not all that Sean Penn says it is.... :)

You say that this public plan won't eliminate private insurers...but that could change. You only have to look at what happened in Tennessee when they tried something similar. Employers stopped offering private insurance. Why would they want to offer it when their employees could get it from the gov't?

Seems to me, the doctors are the ones who are getting screwed with any of these plans. I think the majority of docs are good people who try to do the best for their patients--regardless of money, insurance, etc. But they are highly trained people who have people's lives in their hands every day. They deserve to be well compensated. And docs hate dealing with Medicare and Medicaid because they are a nightmare--and they get paid peanuts for the services they provide. Removes any incentive for physicians to be good at what they do. Dealing with a public plan would be the same.

ray said...

Sorry I'm late to the discussion but, if anyone's still reading, here goes...

davers, a true free market system (one in which the patient pays all healthcare costs) would encourage preventative/healthful behavior. Wouldn't you try to reduce your number of visits to doctor if you had to pay for it each time? The purpose of insurance would be for unavoidable, catastrophic events. I have never understood why health insurers don't determine their premiums based on healthful behavior like life insurers do.

A universal coverage system encourages just the opposite. Like an apartment complex where everyone splits the utilities. How many people would really turn their airconditioners up to 78 degrees?? If you had to pay out the nose because someone's cooling off at 65 anyway, well, you might as well chill too. And the bill goes up.

Steve, I absolutely want to go to a doctor who is in it for the money. He will be motivated to be competent and efficient or else I'm taking my $$ to someone who is. I am totally willing to pay more for better service and doctors that provide it are well deserving of it.

Daisy Paige said...

"I absolutely want to go to a doctor who is in it for the money. He will be motivated to be competent and efficient or else I'm taking my $$ to someone who is. I am totally willing to pay more for better service and doctors that provide it are well deserving of it."

Are you sure? I job-shadowed a dentist in Las Vegas who preferred to pull teeth instead of doing root canals and other work because he didn't like the $$ insurance companies agreed to pay for those services and he could move complete pulls in and out of the office at a much faster pace. More patients = more money, and he booked himself solid six days a week, 8am-6pm. If the patients had insurance, he ordered a complete x-ray, regardless of the last time they were done. Medicaid, bitewings only. No insurance, no x-rays. He would schedule patients to come back another time for services even if he had time right then, just so he could charge them for two office visits. All he wanted was money. I was so disgusted with the way he practiced that I didn't go back after lunch.

I would never want a physician of any emphasis to see me as a pot of gold and not a human being. If one of his patients wised up and never went back after receiving such treatment, he wouldn't care enough to change because there are plenty more money-makers for him to service next.

davers said...

Ray -

Yeah, this post is getting old nonetheless ...

First of all, I'm not for Universal healthcare. That said Daisy Paige is exactly right.

In your scenario of a "true free market system" insurance companies get into bed with big Pharma ... just like they've done in our case. That is why I said pure capitalism isn't always good ... and this is coming from me: an ultra-capitalistic pig (although a very nice one).

Healthcare is one case where oversight and significant involvement is required by the government to insure the best outcome for the public - and that his why almost every country (sans the US) is government run. I still don't think government run healthcare is the answer ... but it does need to be involved enough to root out the corruption that capitalism invites.

Our current system doesn't do that, nor does the system proposed by Obama, and Obama's plan has a lot of extra detrimental effects.

Alice said...

Kory- this is a late response. I somehow forgot I liked to read your blog until today (blame summer), I didn't know IHC is considered a non-profit. Obviously there needs to be caps on income (and the caps can be ridiculously high (just not as ridiculously high as salaries are currently) and there needs to be more consistency among "health care" insurance companies as to what is covered and what is not, with more power given to doctors to decide what is best for the patient, weighed with the cost to the group (which in a single-payer system would be all of us).