Fuck you American healthcare system

[Muenkel 0]

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How would that happen if thier parents came here properly/leagally? answer, it wouldnt. Point reamains, learn the language

Marc, You know I'm one of those evil RePUBICans and many times agree with what you have to say. I feel however, I should point out one thing to you. If you are going to make statements such as 'People in America should learn to speak English', you should lead by example. In other words, your grammar and spelling suck. I don't know if it is a case of massive typos or that you truly do not know how to write a proper English sentence.

Just looking out for you buddy.

_________________________________________
Chris

[Amazon 7]

BWAHAHAHAHAHAHAHAHA

[christelsabine 1]

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...
Marc, You know I'm one of those evil RePUBICans and many times agree with what you have to say. I feel however, I should point out one thing to you. If you are going to make statements such as 'People in America should learn to speak English', you should lead by example. In other words, your grammar and spelling suck. I don't know if it is a case of massive typos or that you truly do not know how to write a proper English sentence.
...

ROFL .......

dudeist skydiver # 3105

[shropshire 0]

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How would that happen if thier parents came here properly/leagally? answer, it wouldnt. Point reamains, learn the language

Marc, You know I'm one of those evil RePUBICans and many times agree with what you have to say. I feel however, I should point out one thing to you. If you are going to make statements such as 'People in America should learn to speak English', you should lead by example. In other words, your grammar and spelling suck. I don't know if it is a case of massive typos or that you truly do not know how to write a proper English sentence.

Just looking out for you buddy.

cHris, your A funi men.

(.)Y(.)
Chivalry is not dead; it only sleeps for want of work to do. - Jerome K Jerome

[kallend 1,621]

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How would that happen if thier parents came here properly/leagally? answer, it wouldnt. Point reamains, learn the language

Marc, You know I'm one of those evil RePUBICans and many times agree with what you have to say. I feel however, I should point out one thing to you. If you are going to make statements such as 'People in America should learn to speak English', you should lead by example. In other words, your grammar and spelling suck. I don't know if it is a case of massive typos or that you truly do not know how to write a proper English sentence.

Just looking out for you buddy.

cHris, your A funi men.

Sorry, you just can't hold a candle to the original

...

The only sure way to survive a canopy collision is not to have one.

[shropshire 0]

(.)Y(.)
Chivalry is not dead; it only sleeps for want of work to do. - Jerome K Jerome

[Muenkel 0]

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cHris, your A funi men.

No, I'm just trying to be an honest poster.

If I come across as funny, it may just be a brain hemorrhage.

_________________________________________
Chris

[shropshire 0]

(.)Y(.)
Chivalry is not dead; it only sleeps for want of work to do. - Jerome K Jerome

[kallend 1,621]

www.nytimes.com/2008/02/18/health/18cancer.html?ref=health

Interesting.

...

The only sure way to survive a canopy collision is not to have one.

[bodypilot90 0]

You mean this heath care system?

http://www.freemarketcure.com/brainsurgery.php

[mirage62 0]

Four and a half months for a MRI??? I live in a town of 15K and we have a MRI here, have used it several times and never waited a week to get in.

Surely this video clip is false, a fake.......

Oh thats right, MRI's aren't THAT important

Disclaimer: I am white, and I have health care.

Disclaimer II: Of course I PAY for the health care.

Kevin Keenan is my hero, a double FUP, he does so much with so little

[Royd 0]

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http://www.nytimes.com/...ncer.html?ref=health

Interesting.

Not only can they not afford private health insurance, they are getting colon cancer because they can't afford those fresh vegetables. So, they are having to settle for hamhocks, fatback and tripe for their diet.

Lucky for President

[bodypilot90 0]

when is the Gov't more efficient at doing anything?

[kbordson 8]

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www.nytimes.com/2008/02/18/health/18cancer.html?ref=health

Interesting.

very interesting article.

But my perspective on it.

A bit ago, I was on call over the weekend. One of my partners had received a consult for a female with "abdominal pain" (and since she's a she... they generally do get a gyn consult). My partner wants me to go see her (partially cuz I'm on call over the weekend). I agreed. I go in to talk to her - she has been having this pain for months. She had even been to Truman (one of the other local hospitals - county run) a few months ago, but didn't do the work up they had recommended. Her last pap was 8-10yrs ago - it was bad, but she didn't get the followup that was recommended. She smokes about 2packs/day (which is pertinent on many levels - 1 that she could afford a 2ppd habit but not afford health care. 2 smoking and cervical cancer... BAD COMBINATION.) Anyway, with just 15min of talking with her, I get a VERY SICK feeling in my gut that I'm going to have to tell her some VERY BAD news.

I do the exam. . . confirms my suspicion but the official biopsy results won't be read over the weekend. But I organize to have gynecology oncology and radiation oncology come and see her. I start social service consult. I work just as hard for her (in fact even harder, as I took 2 hours on Sat morning to bring in pictures and help her understand what this cancer means) as I do for ANY patient.

But yet her husband chews me out for being cold and uncaring "because she doesn't have money"?! And it's "MY FAULT" that she's in this situation.

She contracted HPV. She smoked and accelerated the process. She knew years ago that she had the bad pap smear. She knew months ago that something REALLY wrong was going on but didn't follow up. She knew, but she chose not to tell him (per her husband) nor to address the problem herself.

Now.... what CAUSED her to make that choice? THAT IS THE ISSUE. Not the blaming the healthcare system for her cancer. This was an unfortunate cancer that should have NEVER gotten to this stage in the U.S. But at what point would intervention had helped her?

-Was it a cost issue? I don't think entirely so. She knew that she had access to Truman. She just didn't like waiting there. And she was just prioritizing other issues of her life above her health.


-Was it a "knowledge" issue? Not completely. She knew something was wrong... but denial sometimes is a poor coping mechanism.

Additionally, there are commercials and posters all around about HPV and cervical cancer screening. Women know that they should get screening (especially if she had had a bad one.) More public information wouldn't have changed this.

Was it a "trust" issue? Probably a factor, but she didn't trust her husband with this information (but he seemed to be one to focus on blame, so that might account for why she wouldn't tell him). And she didn't even really "tell" me about the information. I had to directly ask in the history portion of my assessment. I'm sure that had I not asked, she would NEVER have told me freely that it had been a decade since her last pap. . . and that it was bad. Patients lie. . . because of lack of trust. But why should you trust your dr? As one myself, there are things that I would NEVER tell a doctor. Why? cuz I wouldn't want it used against me. Insurance companies review charts - billing has to approve procedures and they want to know why to spend this money. Government audits to oversee that appropriate care is given, which is sad that it has to be, but it is..... But because of these lots of people have access to your health record. I don't trust the system; how is she any different from me for not fully trusting? The records need to be between the patient and the doctor. But they're not.



- The other point to consider is the MINDSET of the people. Like I was saying in a post above. . . some cultures (Native Americans being an EXCELLENT example) don't view "preventative" health a priority. You go to the doctor when you are sick and dying. Not to ensure that you are well and good. That is considered a waste of time and money by many.

We need to convey to the people a sense that THEY are responsible for THEIR HEALTH. The government can subsidize and provide . . . but until the people choose to take the responsibility to make those appointments and wait for the visits (yes, you do tend to wait longer in the county hospitals. . . but suck it up and wait), we will continue to see studies like those you referenced.

Why? Because there is likely some population bias. The people with insurance value and prioritize their health. The devote time AND/OR money to routine screening. Those that present with advanced stage cancers haven't placed their health that high on the list. Do they deserve to? Hell yes. But other issues get in the way (financial: 3-4 children that she had to provide for, paying rent, life in general. Time: getting a sitter while she getting her annual exam, taking time off of her low income job, travel to and from the clinic issues) But.... those with the true desire to ensure their health make it to the doctors (trust me, I see medicaid patients. . . some arrange swapping babysitting with a friend so that one comes at this time while she's watching the children and then the other comes the next time. Not that my clinic doesn't allow children, but they do have to be chaperoned and do you really want your 3 children in the room with you while getting a pap?!)

- but did you also notice

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The study by researchers with the American Cancer Society also found that blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured and underinsured. The study’s authors speculated that the disparity might be caused by a lack of health literacy and an inadequate supply of providers in minority communities.

THIS population is at higher risk just based on population alone. Not just whether they had insurance or not. They speculate health literacy, supply. I would include: genetics, coping mechanisms, stress (see here) personal beliefs of healthcare.

Maybe earlier in school we need to focus on HEALTH. True health (not just that silly class that everyone blows off in 9th grade): back to basics - healthy diet, weight restriction, recommended health maintenance.

I don't know what the REAL answer is but I believe that we need to change the mindset.

[kbordson 8]

Sorry that last post was so wordy:

Take 2

Interesting article:

But I don't think that having the government throw money at this problem with fix it.

(nor do I trust the government to be in charge of my health)




edit to add: and THANK YOU to all that are actually discussing this topic reasonably. I think this really IS and important topic (one that people actually die due to) and thinking about ways to correct it is important..... if we can get a "right" answer.

[lawrocket 3]

I will go back, doctor, to a point that I have reiterated time and again:

There are three factors involved in the provision of health care: 1) cost; 2) quality; and 3) availability. These factors form a tripartite relationship and there is an irreconcilable tensions between them.

Everybody wants high quality, low-cost health care on demand. That's a problem. You CAN'T get high quality, low cost health care on demand.

You can get high quality, low-cost healthcare, but it will be rationed. Therefore, it will not be available on demand.

You can get high quality health care on demand - but it is expensive.

Or you can get low cost healthcare on demand - and it'll be shitty.

Anybody who says that it can be done on a governmental basis is full of shit. You cannot provide cheap Ferraris to everyone in a country on demand. It doesn't work like that.

My wife is hotter than your wife.

[billvon 2,380]

>You cannot provide cheap Ferraris to everyone in a country on demand. It
>doesn't work like that.

No. But you can provide cheap scooters to everyone and sell Ferraris to people who can afford them.

[lawrocket 3]

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>You cannot provide cheap Ferraris to everyone in a country on demand. It
>doesn't work like that.

No. But you can provide cheap scooters to everyone and sell Ferraris to people who can afford them.

But that, argue many, is unfair, bill. We can't do that. Some people might have Ferraris while others have scooters.

Actually - it's much the same as what we have today.

My wife is hotter than your wife.

[billvon 2,380]

>Actually - it's much the same as what we have today.

Yep. But unfortunately, the way we do it today results in the hardest-working hospitals and clinics going out of business. We should try to fix that,

[kbordson 8]

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>Actually - it's much the same as what we have today.

Yep. But unfortunately, the way we do it today results in the hardest-working hospitals and clinics going out of business. We should try to fix that,

I don't know that a government funded system is going to do that. Medicaid/Medicare has done more to limit reimbursement. And with less physician autonomy. I am CONSTANTLY trying to help patients work AROUND the system to get them the care they deserve.

[lawrocket 3]

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>Actually - it's much the same as what we have today.

Yep. But unfortunately, the way we do it today results in the hardest-working hospitals and clinics going out of business. We should try to fix that,

Indeed! And here's an example of how socialized healthcare will work. In California, there is a large budget deficit. So, one of the things under the budget is that doctors who treat low-income patients under Medi-Cal will see a 10% drop in reimbursement rates.

Socialized medicine at work! Let's not close loopholes relating to yachts. Let's just not pay doctors as much for treating poor patients.

My wife is hotter than your wife.

[billvon 2,380]

>So, one of the things under the budget is that doctors who treat
>low-income patients under Medi-Cal will see a 10% drop in reimbursement
>rates.

Right. And the alternative is that in a poor economy people go to the ER and simply don't pay, in which case hospitals see a 100% drop in payment rates.

Neither case is ideal.

[kbordson 8]

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>So, one of the things under the budget is that doctors who treat
>low-income patients under Medi-Cal will see a 10% drop in reimbursement
>rates.

Right. And the alternative is that in a poor economy people go to the ER and simply don't pay, in which case hospitals see a 100% drop in payment rates.

Neither case is ideal.

Not exactly.

County hospitals and Training hospitals/clinics generally take medicare/medicaid but they get other sources of income from grants and government funding. Additionally the low overhead with cheap labor from residents.

But people don't like going there because "I deserve better" or "I don't like waiting" or "I need to see 'real doctors'" (totally ignoring the fact that residents ARE "real doctors" just in specific training programs under supervision of attending physicians.

But.... they can't see everyone. That's why some community dr's step up to see a portion of that population. However, with the cuts in rates that are below what you can run a clinic on.... that's where the problem is. The American Medical Association has been addressing this concern for quite a while now.

AMA Addresses Medicare reimbursement

[Lindsey 0]

That's why a lot of physicians in Arkansas won't take Medicaid....but some do. We have a kind of neat program in Arkansas that provides insurance for children from families whose incomes are above poverty level, but for whom paying for insurance is just not do-able....ArKidsFirst. Our state being so poor, I'd bet that there's almost as many kids with this insurance as without. It's a Medicaid program. Physicians are really good about taking ArKidsFirst while they're not as good about taking Medicaid. In my mind it has to do with how they see kids vs. adults who don't have resources. It's kind of interesting though. At least I think so.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[kbordson 8]

And it looks like the ever touted dual system (equal healthcare for all, but some are more equal than others) isn't working either.

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LONDON — Created 60 years ago as a cornerstone of the British welfare state, the National Health Service is devoted to the principle of free medical care for everyone. But recently it has been wrestling with a problem its founders never anticipated: how to handle patients with complex illnesses who want to pay for parts of their treatment while receiving the rest free from the health service.

Although the government is reluctant to discuss the issue, hopscotching back and forth between private and public care has long been standard here for those who can afford it. But a few recent cases have exposed fundamental contradictions between policy and practice in the system, and tested its founding philosophy to its very limits.

Source