Taylor Swift

[TulipsAndSunscreen]

I agree ST. Also, there are financial implications to just doing away with health insurance companies. They employ a lot of people...I mean, I hate them as much as the next person but it is a factor here.

Also, the govt getting involved is scary to me. My FIL was told at a recent appointment, "Medicaid makes/encourages me to prescribe [inappropriate medication for my FIL] for my diabetes patients" (they are thinking of switching to Medicaid). SERIOUSLY. This is quality control by our govt...

At a recent Pedi appointment, the poor nurse came to ask me what I want to "work on" from a list of "healthy child initiatives" that insurance companies (led by Medicaid) are making them do to be a certified medical home. So now in addition to doing a physical well baby check and answering my questions in a 10 minute appt, my poor MD has to "counsel" me on weaning from sippy cups and not letting them drink soda...thanks US govt, I really needed those reminders!

[gem]

I hear what y'all are saying about our societal expectations regarding healthcare and the infrastructure in place, but I don't think continuing the system of health care as we know it is an option. It's too expensive. I don't know what the right next step is, but I can't fault the government for trying to implement measures to control costs and improve outcomes. Maybe they're going about it wrong, but to me that means we need more smart people working on solutions, not that we just accept the status quo.

[rufflesanddots]

I suppose it would look different than other places, and very difficult to implement, though I'm not sure I agree that those are reasons not to pursue it.

As to the insurance company argument, I would imagine the government would need more people to process claims even under a universal healthcare option? That may not account for all employees, but it could be a solution for some number of them.

T&S, I can see where that "counseling" is annoying to both you and the MD, but (and this is admittedly coming from someone who doesn't have kids and is very early in training still), it doesn't seem inconvenient enough to prevent something like universal healthcare from existing.

To those of you that are against universal healthcare, would you agree to further expansion of Medicaid in your states? NC did not expand Medicaid after ACA passed, so over a million people are caught in between having too many resources to qualify for Medicaid and not being able to afford insurance through the exchanges. What do we do with those people

Full disclosure, my BIL once accused me of being a socialist and I was like, "And?" I've seen state run programs work really, really well, so I think that further government involvement in healthcare does not necessarily spell disaster.

[TulipsAndSunscreen]

NC should expand Medicare. Full stop. I live here. We need it.

I just think it's a slippery slope to have the govt telling providers what to do. But I agree that the current situation is both unethical and unsustainable. There is no good model for how the US needs to transform but reforms are definitely needed. I have a feeling we are headed to a two tier system - everyone covered marginally and those who can pay for more will get more. Still seems horrible but that's my prediction.

[rufflesanddots]

NC should expand Medicare. Full stop. I live here. We need it.

I just think it's a slippery slope to have the govt telling providers what to do. But I agree that the current situation is both unethical and unsustainable. There is no good model for how the US needs to transform but reforms are definitely needed. I have a feeling we are headed to a two tier system - everyone covered marginally and those who can pay for more will get more. Still seems horrible but that's my prediction.

I could see that happening. I feel like a version of that exists now. People with more money generally have better insurance, as well as "cash only" providers that may have smaller patient loads and be able to provide more individualized care.

It is a mess, I agree with that. And hey NC.

Sent from my SCH-I535 using Tapatalk

[ides]

I don't know enough to argue one way or another in terms of single payer or the current corrupt system however I do think insurance co's need to be non profit. They are profiting at everyone's expense. It's messed up.

[Vanquisher]

Insurance companies also dictate what physicians can and can't do, and I would argue MORE than Medicare/Medicaid. They all have formularies and hoops that have to be jumped through in order to get the required treatment for patients. Honestly, in my experience Medicare had fewer of these hoops than any insurance company we worked with. This dictation of care on what physicians can and can't do, tests they can order, medications, therapies, etc. is happening NOW at higher rates in private insurance companies than in Medicare.

[ides]

1+

[SoonerTexan]

everyone covered marginally and those who can pay for more will get more. Still seems horrible but that's my prediction.

I don't think most view it as horrible in countries where it exists now, but I think it wouldn't go over well here. It's not like private hospitals and care don't exist in countries with universal health care. Remember Kate Middleton and the Lindo Wing? Now THAT will cause an uproar here.

[Sheherezade]

My point is I cannot fathom how you can retrofit something like that in to a system that is already so entrenched. No matter what, it isn't going to look like it does elsewhere because we aren't starting from the same place.

I think this is why we ended up with the ACA. It's an attempt to make insurance for all out of a private market - and uses tax money to supplement insurance costs for the population not poor enough for Medicaid, but too poor to pay today's insurance rates. It includes a lot of levers/pulleys to work on stabilizing or reducing health care costs and insurance costs. It's an extremely complicated act but you'd imaging anything that's going to act on a circular interdependent system as large as our healthcare/insurance/medical training costs/employers paying benefits craziness would be.

I agree it has a lot of problems, but any attempt to build something new would. I wish we'd have some collaboration at fixing the problems with new ideas instead of all the grandstanding and repeal bs for the last 6 years.


Angie

[medpedspouse]

Lol, my Canadian friends and German friends do not care for their health coverage. Yes, all is covered but it is not the care that they would like. Some of my Canadian friends have come to the US for care for various health issues they felt were either misdiagnosed or they could not get the desired care in what they perceived was a timely fashion. I remember going to BC for vacay after DH's med school graduation and getting an earful from all the guests at the B&B that week. They all had negative stories about the Canadian system that I thought was so great.

In theory, I agree with healthcare coverage for all BUT a lot must change. Care is often determined by clinic/hospital admins and insurance companies. Care as it stands is so screwed up now - the VA is embarrassing, our friends in the military complain about the lack of care, and medicare has unrealistic reimbursement rates. When DH was in PP medicare would not even reimburse the cost of some meds - never mind the cost associated to have staff on hand for the infusion, the equipment, etc. The clinic was losing money so they had to stop and began referring patients to the hospital owned infusion clinic. I also agree with the fact that care will not look the same and that our expectations need to be lowered. For example, these patients complained of being treated like cattle. They had to find parking at a large med center, infusions were no longer in an individual (private) room and they felt like they did not get the "care" they used to get at the clinic.

Yes, I believe we need some sort of universal care so that people do not head to the ER for things that could have been preventable. The litigious tendencies also needs to change. One thing that both my German and UK friends noted is the lack of "covering your ass" consults and tests.

[corn poffi]

I think it depends on who you talk to...my Canadian friends rave about their coverage. Like constantly.

[SoonerTexan]

I think it depends on who you talk to...my Canadian friends rave about their coverage. Like constantly.

I wonder if thoughts on it change as you get older and have to use it more? I think it certainly does in the US!

[corn poffi]

Some of the people I was referring to are friends of my parents (my 68-year-old dad spends a lot of time up there and you know how old people like to talk about their health/doctor experiences!).

Given, my dad has had good insurance experiences (he has great insurance as a former public school counselor). He's also had a million health problems since he retired, so it's not like he goes to Canada to bitch about our system. It often turns into a discussion. Proud Canadians they are.

[rainbabies]

Before med school, my dh was a billing/coder. He's fluent in French. He was always asked to interpret (as best he could He's fluent in European French, not Canadian) for the French Canadians when they came down to VT by the MEGA bus loads to get the cancer treatment socialized medicine was not proficient in.
No thanks on the socialized medicine.