Fuck you American healthcare system

[rhys 0]

You are still confusing sickness with accidents.

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"Visitors to New Zealand are not eligible for publicly funded health and disability services unless they are from Australia or the United Kingdom."

This is more to do what we call the sickness benifit, which is an income while you are ill and provides all the post treatment care that keeps the rehabilitation period shorter.

break your arm/smash your teeth out/fimur yourself.......any injury, you and any person on new Zealand soil is covered, no bills.

You pay an ACC levy when you rent your car, purchase fuel etc. no hospital bills.

Do you get it now, I'm kinda sick of talking about it because it is kinda only relevant as a comparison to the subject at hand,

Someone with a bee in their bonnet changed the title of the thread which seems pointless.

I've never had to pay for healthcare in my own counrty (or Australia). That is my comparison.

I feel bad you don't have it that way but obviously you like they way it is there.

I hope you agree to disagree, becaue this conversation seems pointless.

"When the power of love overcomes the love of power, then the world will see peace." - 'Jimi' Hendrix

[kbordson 8]

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I hope you agree to disagree, becaue this conversation seems pointless.

I ABSOLUTELY agree to disagree because even though you might live there, I don't think you understand or appropriately represent your countries system. Nor do I believe you understand the American system. Hell, I'm IN IT and don't assume to state that really understand it. And I honestly think that you are misrepresenting the situation with your friend in an attempt to vilify the American Healthcare system. But... these are all MY opinions.

I'm choosing to defend my country and my profession, just as you would if someone was attacking skydiving in New Zealand. Are there problems, yes. You would have to be illiterate to not have read that in this thread... but I DO NOT BELIEVE that socialized medicine is the answer.

[kallend 1,623]

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Ummm - this sounds like perfect example of the "physician as God" attitude.

Yeah... cuz I have a "God complex"

She comes to the hospital for care. Recieves recommendations. Refuses to follow those recommendations. But yet still has the ability to sue regardless of the outcome. And I have the attitude?!

Try again.

Why don't you just re-read what you wrote. You "ALLOW" her to do stuff. She goes against your "WISHES" (oh the travesty that a patient might disgree with a PHYSICIAN!).

I disagree with my physician over things but she doesn't get all prickly about it and come on like she's a minor deity.

...

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

[kbordson 8]

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Why don't you just re-read what you wrote. You "ALLOW" her to do stuff. She goes against your "WISHES" (oh the travesty that a patient might disgree with a PHYSICIAN!).

I disagree with my physician over things but she doesn't get all prickly about it and come on like she's a minor deity.

My "wishes" were not wanting a uterine ruupture and a dead baby, which is the risk that she was definately taking. She had had two (TWO) prior cesarean section deliveries. Most hospitals and physicians would not even allow her to attempt vaginal birth after two prior c-sections. It's not a "God complex" issue, it's a risk assessment issue. If the uterus ruptures, the baby could die. Her "wish" to have natural delivery was counter to my "wish" to have a safe and healthy delivery.

I allowed spontaneous labor UNTIL she stopped progressing. Then after FOUR hours of not making any progress and still contracting, testing that uterine scar every 3-4min with a new contraction, my "wish" is to stop gambling with the babies life.

I do take risks... but don't like it when people risk killing their babies on my shift.


edit to add: she was an eligible candidate and HAD she continued in an appropriate pattern, all would have been fine. But when she stopped dilating... and made NO change.... AND the baby didn't like the labor.... then I don't like the situation. And just as patients are able to decide what care they want, doctors should be allowed to say "this is what I recommend - if you don't like it, here are other physicians" BUT in this case.... NO-ONE would want to do what she was wanting due to the risks (and yes, I do understand that the risk is only 1:300... but that number goes up with protracted or arrest of labor... there was a REASON that she wasn't dilating)

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[likearock 1]

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Another point is PATIENT AUTONOMY.

Right now, I am waiting on labor and delivery and allowing a patient to do something that I, in my professional opinion, don't agree with. I have counselled her on her options. Told her what I think is most medically safe for her and her baby. She is CHOOSING to act opposite of my wishes.

Legal implications? HUGE! Either way. I do the procedure and something happens - "I didn't want it." I allow her to act against medical judgment - "I didn't know."

So... here is a perfect example of the ATTITUDE that is the problem. She is on medicaid (FREE healthcare to her) making demands that compormise the physicians future.

Ummm - this sounds like perfect example of the "physician as God" attitude.

You're picking at the wording of her post and completely ignoring the substance of it. It must be very difficult to give a patient life-saving advice and have that advice ignored. The fact that she is not god means she has to "allow" it.

[kallend 1,623]

I'm sure you're an excellent and caring physician. You clearly missed the point of my post. The ATTITUDE reflected in your post (to paraphrase: "How dare she go against MY WISHES (stamps foot)") makes you sound more like the Wicked Witch of the West.

...

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

[Lindsey 0]

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I'm sure you're an excellent and caring physician. You clearly missed the point of my post. The ATTITUDE reflected in your post (to paraphrase: "How dare she go against MY WISHES (stamps foot)") makes you sound more like the Wicked Witch of the West.

That's really not the attitude I thought was reflected in her post. Maybe it has something to do with the attitude one brings as they read the post. I "allowed" a patient to walk out of the ER a month ago with a hemorrhagic stroke. I felt that she understood the risks as we discussed what was happening. My choices (as the person who could potentially be held liable) were to 1) ALLOW her to leave or 2) place her under a 72-hour hold. Either way, when a patient's wishes are contrary to a physician's, and there is a large morbidity or mortality risk associated with their decision, the physician HAS to act one way or another, either to allow or not allow the patient to act autonomously. It's not a God complex, but just one of the responsibilities that goes along with the job.

linz

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

[kbordson 8]

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I'm sure you're an excellent and caring physician. You clearly missed the point of my post. The ATTITUDE reflected in your post (to paraphrase: "How dare she go against MY WISHES (stamps foot)") makes you sound more like the Wicked Witch of the West.

Well... Elphaba was commonly misunderstood.

My "wishes" were based on knowledge of medical risks and of the current American College of Obstetrics and Gynecology (ACOG) guidelines... and the knowledge that she does have the choice.... but then if something bad happened also had the choice to sue me (and even appropriate education and signing a consent can fall by the way side if I "allow" her to step outside of the ACOG guidlelines. . . her lawyer can still sue and likely even WIN! "But Dr. Bordson, don't the guidelines state. . . ." and "yes, but she WANTED TO" doesn't cut it as an excuse.)

My "wish" is just to help people and NOT lose everything for patients "poor" decisions.

[kallend 1,623]

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I'm sure you're an excellent and caring physician. You clearly missed the point of my post. The ATTITUDE reflected in your post (to paraphrase: "How dare she go against MY WISHES (stamps foot)") makes you sound more like the Wicked Witch of the West.

Well... Elphaba was commonly misunderstood.

.

Yes, it isn't easy being green.

The real problem is that the legal climate has forced physicians and surgeons into such a defensive posture. It doesn't have anything to do with who is paying.

...

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

[kbordson 8]

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I'm sure you're an excellent and caring physician. You clearly missed the point of my post. The ATTITUDE reflected in your post (to paraphrase: "How dare she go against MY WISHES (stamps foot)") makes you sound more like the Wicked Witch of the West.

Well... Elphaba was commonly misunderstood.

.

Yes, it isn't easy being green.

The real problem is that the legal climate has forced physicians and surgeons into such a defensive posture. It doesn't have anything to do with who is paying.

That probably is a BIG part of the problem. One of the benefits with the New Zealand system is the limitations on litigation . . . but that would not fly here. And I don't know exactly how to think about that.

On one hand - there are some doctors out there that aren't doing things appropriately and people do end up getting hurt. They deserve to be held accountable for their actions. But there's a difference between true malpractice (responding to a call under the influence of alcohol) vs. medicine/practice that might have been done different by an "expert witness."

I think that the "American Dream" has become too guided by MONEY as a marker for success and one quick way to get that is to sue someone (even my own family has fallen to that mindset). Medicine (especially obstetrics) is notorious for it's malpractice risks. We are basically told "You will be sued." and that it's just a matter of practicing long enough. And that kinda scares the be-gebbers out of me.

[lawrocket 3]

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Why don't you just re-read what you wrote. You "ALLOW" her to do stuff. She goes against your "WISHES" (oh the travesty that a patient might disgree with a PHYSICIAN!).

Actually, that's EXACTLY what a physician does. Explain the possibilities, make recommendations, and let the patient decide.

"AMA" in notes mean "against medical advice." A "God Complex" doctor would not "allow" a person to do anything else other than what he or she recommends.

I face the same situation frequently. I advise clients of extreme perils fo doing one thing or another. But I do what they want me to do.

But professor, another thing to be understood is in the engineering side of things. There are some things that people want to try that you know will simply not work well. If somebody comes to you and says, "I want to have a roof made of straw" you would say, "It will collapse in winter due to snow loads" and discuss other options. "Nope. It must be straw."

What would you do? Would you get all snooty and God-like and figure, "This person is an idiot." Would you go through pains to explain to the person the risks? Would you simply decide not to take that person on?

In the event that you think it is a silly comparison, trust me - the sheer stupidity of some people is astounding. Lawyers, doctors and police see the craziness of people more than probably anyone else.

My wife is hotter than your wife.

[rhys 0]

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but I DO NOT BELIEVE that socialized medicine is the answer.

Is capitalist medicine better than socialised medicine IYO?

"When the power of love overcomes the love of power, then the world will see peace." - 'Jimi' Hendrix

[rhys 0]

It is sad that you don't understand your health system and you are a physician.

I don't know ours inside out but I know enough to Not have to worry about how I am going to pay for health insurance because I don't NEED it, or hospital bills because there aren't any.

Quite a load of anyones shoulders.

What is the average monthy charge for heath insurance for the average American citizen?

"When the power of love overcomes the love of power, then the world will see peace." - 'Jimi' Hendrix

[akarunway 1]

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It is sad that you don't understand your health system and you are a physician.

I don't know ours inside out but I know enough to Not have to worry about how I am going to pay for health insurance because I don't NEED it, or hospital bills because there aren't any.

Quite a load of anyones shoulders.

What is the average monthy charge for heath insurance for the average American citizen?

I don't know about average but around $600 a month comes out of my pay and in the 6 yrs I've had it I've never used it. Then I was out of work for a couple months and went to see a doctor and guess what. SORRY. Your insurance expired. Let's see. 6 times 12 equals, 72, times 600 equals like 43K I think. Fuck me.

I hold it true, whate'er befall;
I feel it, when I sorrow most;
'Tis better to have loved and lost
Than never to have loved at all.

[Royd 0]

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don't know about average but around $600 a month comes out of my pay and in the 6 yrs I've had it I've never used it. Then I was out of work for a couple months and went to see a doctor and guess what. SORRY. Your insurance expired. Let's see. 6 times 12 equals, 72, times 600 equals like 43K I think. Fuck me.

You'd have been better off putting that money in a savings acccount or in the stock market.

[kbordson 8]

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but I DO NOT BELIEVE that socialized medicine is the answer.

Is capitalist medicine better than socialised medicine IYO?

Yes. I've seen socialized medicine while I was in the military. It sucks worse. The people expect ridiculous services (a CT scan for bumping his head with the video recorder because "I'm not paying for it") and they want it NOW. You can't get that in a rationed system. As you should know. Your government decides who is "appropriate" for care, not the doctors. And I have quoted prior references to that effect. If you are "too sick," the government stops your dialysis. Or in England, it prevents you from getting certain types of chemotherapy (another reference that I have already posted) Or limits on the MRI's to diagnose.

You refer to our system as "capitalist" but that is an inaccurate statement. Our healthcare has private insurance AND medicaid/medicare for those UNABLE. A two tiered system.... Kinda like most "socialized" medicine. Granted our system is reversed. It assumes that a RESPONSIBLE ADULT will make choices that look out for his/her future - have a job, have life/health/disability insurance, save to a 401k or other savings for retirement. PLAN for YOUR future. Don't expect everybody else to take care of you for your lack of forethought. But if you do have situations where you CAN'T work, or where bills become extreme, then the government DOES step in with support (medicare/medicaid). More might fall through the cracks here if they aren't really "poor" just aren't planning.

And I'm glad that you think you're so smart that you understand your system. But I still don't think you truly do. You understand that you don't have to pay... thats all you need/want to know.

[kbordson 8]

You and I seem to have different beliefs not just on healthcare but on life in general.

I believe that I have the RESPONSIBILITY to plan for my future. I decide whether I retire nicely or live impoverished.

To that end, I worked HARD in school. I obtained scholarships (my family didn't have the money for college). I postponed medical school until I could afford it. I had goals that I aimed for and achieved.

In contrast, my older sister CHOSE to be a carnie (work at the carnivals) for about 10-15 years.... she CHOSE to live the gypsy lifestyle..... she CHOSE to do drugs.... she CHOSE to not plan for her future. It's not that she COULDN'T hold a "reasonable" job (she is as smart as I am, National Honor Society and all that).... she just didn't WANT to. She got pregnant and was on medicaid. The government stepped in and helped her. But then Mr. and Mrs. John Doe were paying for HER DECISIONS to not plan ahead. Now... I'm not going to fault her for making decisions to live the life that SHE WANTED. We each get that choice. But, BE AN ADULT and accept responsibility for those decisions.

It's the whiny mantra of "IT'S NOT FAIR" and "MY LIFE IS SO ROUGH. THE GOVERNMENT NEEDS TO HELP ME." that really pisses me off.

I just did a search for health insurance if I had to buy my own. These are quotes specific for me and my current location: Blue Cross/Blue Shield - $158/mos with a $1000 annual deductible. Humana - $131/mos. with a $2500 deductible. Aetana - $98/mos with a $5000 deductible. Those costs are not unreasonable. But, you have to research and submit... Instead of just wanting big brother to take care of you.

I do NOT WANT government control. Not cuz I'm "greedy" or "seppo," rather because I want to be RESPONSIBLE for MY LIFE. (and I expect others to step up to that level of responsibility as well)

[skydyvr 0]

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I don't know ours inside out . . .

Yes, you've made that abundantly clear over the course of this and other threads. Good thing kbordson has stepped up to help you understand your own system a little better.

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. . . but I know enough to Not have to worry about how I am going to pay for health insurance because I don't NEED it, or hospital bills because there aren't any.

Uh, you pay for health care and hospital bills in your tax bill. It's your choice not to "worry" about how much you're paying.

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Quite a load of anyones shoulders.

Again, it's your choice not to "worry" about how much you're paying. But you're paying.

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What is the average monthy charge for heath insurance for the average American citizen?

What is the percentage of your tax that goes toward providing "free" healthcare to all your citizens?

. . =(_8^(1)

[mnealtx 0]

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The people expect ridiculous services (a CT scan for bumping his head with the video recorder because "I'm not paying for it") and they want it NOW.

Hey, everyone wants Kobe beef...as long as someone ELSE is picking up the tab.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[freethefly 6]

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I just did a search for health insurance if I had to buy my own. These are quotes specific for me and my current location: Blue Cross/Blue Shield - $158/mos with a $1000 annual deductible. Humana - $131/mos. with a $2500 deductible. Aetana - $98/mos with a $5000 deductible. Those costs are not unreasonable. But, you have to research and submit... Instead of just wanting big brother to take care of you.

For a good number of people those cost are out of reach. I am uninsurable. There is no insurance company that would take me so, I am forced to use Mo.Healthnet. I have to pay $571.00 to use it and then pay more than $2000.00 afterwards. With these kind of cost, I can only see a doctor once a year if even that. On the 21st of this month, I am going back to the V.A. to lower my cost and hopefully get the healthcare my illness demands. Do i care if the taxpayers are going to pay for part of my healthcare? i do not as I am one of those who pay into the system. I see it as the same as paying insurance premiums as it is the same.
Those who have never been in a position where their life has been turned upside down can never understand how it can happen. I had a plan for my future. I bought stock, I had a very well paying mutual fund that would had made me a millionaire at age 65, I had a job that payed more than $50,000.00 a year in the early 90's. I fully understand how it can all dissappear in a heartbeat. Something, quite a few on this board cannot understand or even fathom. I do blame myself for what happened but, I also understand that there is nothing I can do to change what has happened. I also know that anyone can end up in the position that I am in. If you skydive, one mistake can change your plans. One car accident can change your plans. One slip in the tub can change your plans. You should realize that you are only one slip away from your plan being changed. You can buy all of the insurance you want but, once you are bedridden or your care is more than your insurance whishes to pay for, you are out the door. I am very glad that I have the system to fall back on. Although, it pays very little, it is something which is better than nothing.
On another note, I have been accepted for vocational rehab which will pay for a degree in graphics design technology, if I decide to go that route (I already do graphics in CS2 Illustrator and have been trying to keep my t-shirt business afloat) or, I may even decide to further my skills in weld testing technology. I know that some certian people on this board will fume at the idea of me using tax dollars to further my education but, guess what? They're my tax dollars also and this is a chance to get off of SSDI and back to making great money and paying the tax that can help another better his/her life. Is that not what it is all about? Helping each other out when the need arise? I much rather my taxes pay for someones education and healthcare than for it to go to building bombs and destroying life.

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young

[pirana 0]

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don't know about average but around $600 a month comes out of my pay and in the 6 yrs I've had it I've never used it. Then I was out of work for a couple months and went to see a doctor and guess what. SORRY. Your insurance expired. Let's see. 6 times 12 equals, 72, times 600 equals like 43K I think. Fuck me.

You'd have been better off putting that money in a savings acccount or in the stock market.

Which is exactly how an HSA (Health Savings Account) works. Where available, they are far outselling traditional plans. You purchase a plan with a high deductible and low premium. In addition, you contribute regularly to the HSA from your pay -- pre-tax.

Preventive care covered at 100% to encourage check-ups, immunizations, and the like; plus a low copay for generic medications.

For small stuff, you can tap into your HSA for reimbursement or pay out of pocket. For big bills, the plan kicks in 100% after the deductible to keep you from ending up destitute because of a medical condition.

So basically, once you build your HSA up to the level of the deductible, you're fully covered. Plus the account earns interest. These programs usually come loaded with healthy lifestyles features and access to lots of information too. Free or very cheap stop smoking programs, medical management specialists for chronic diseases, nurse help lines so people don't run to the ER at every cough or fever, grading of clinics in general or by specialty, free health screenings, etc.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[lawrocket 3]

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but I DO NOT BELIEVE that socialized medicine is the answer.

Is capitalist medicine better than socialised medicine IYO?

Better at some things, worse at others.

My wife is hotter than your wife.

[lawrocket 3]

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It is sad that you don't understand your health system and you are a physician.

What is preferable? A doctor who doesn't understand the system but understands medicine?

Or a doctor who understands system but not the medicine?

I believe I know how the socialist would answer.

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know enough to Not have to worry about how I am going to pay for health insurance because I don't NEED it,

I know. The government takes it from you before you even see it. That means you can worry about having to pay for other things.

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Quite a load of anyones shoulders.

Off of SOME people's shoulders. As for me, I like the thought of knowing that I can go to the doctor, pay the doctor, get treated by the doctor and be gone.

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What is the average monthy charge for heath insurance for the average American citizen?

That's like asking "what is the average price of a car for the average American citizen?" Or, "what is the average cost for fuel for the average American citizen?"

My health insurance is cheaper per month that most people's because mine doesn't even kick in until I've spent $3,500.00 in a year. Guess how LOW my monthly insurance is? SIGNIFICANTLY lower than those with a no-deductible plan.

It's all about the deductible. If I get an HSA plan with a 1500/3000 deductible, I'll pay $836.00/month for it. No small sum.

If, however, I increase the deductible to a 3000/6000, it is now $575.00 per month. If I work up to a $3500/7000 plan (what I have now), it is now $200.00 per month!

Over the course of a year, there's $10,032 in premiums with a $1500 deductible, meaning for $11,532 they'll cover all of you (simplistically)

If I do a 3500/7000, then I'll have $2400 in premiums. Assuming I pay $3500in deductibles before they even cover a cent, I still make out ahead with a total of 5,900.00 per year!

So, the "average" price for insurance is a specious argument. It operates much like social healthcare. If you want fundamentally free visits, you'll pay A LOT. If, however, you decide to pay for things yourselves, you will save yourself $5k per year.

But people, for some reason, say they "can't afford insurance." I can understand those who say they can't afford $800 per month. Yeah, that's a righteous hit. But tmost can pretty easily do $200 per month. They just won't because, well, it actually takes some effort.

My wife is hotter than your wife.

[rhys 0]

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What is preferable? A doctor who doesn't understand the system but understands medicine?

Or a doctor who understands system but not the medicine?

I believe I know how the socialist would answer.

I believe they should know both! without such knowledge they should not be practicing and/or the system is too complex. Especially in the US system where yoou have rediculous over the top litigation claims to worry about. (well maybe not you personally, they are good for your profession)

Is that your prediction.

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I know. The government takes it from you before you even see it. That means you can worry about having to pay for other things.

Are you kidding, you guys pay far more, get less and all the money goes into the bank accounts and investments of large corporations rather than building and maintaining infrastucture and providing services that help provide a healthyountry/economy.

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Off of SOME people's shoulders. As for me, I like the thought of knowing that I can go to the doctor, pay the doctor, get treated by the doctor and be gone.

I have to go to the doctor today, I havn't made an appointment, I will have to wait about 45 minutes and then I will be gone. I don't have to bring my wallet, just a medicare card. (I am in Australia).

I havn't even paid a cent yet for medicare as the tax year has not finished. The system is different here, but it is still free to use, Tax pays for it.

What is the mean income tax % inthe USA?

All those tanks, guns and aeroplanes are not free? Where does that moeney come from. not to stray away from the subject but that seems rather socialised to me.

"When the power of love overcomes the love of power, then the world will see peace." - 'Jimi' Hendrix

[rhys 0]

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I believe that I have the RESPONSIBILITY to plan for my future. I decide whether I retire nicely or live impoverished.

Without getting personal and strayin away from the subjecy how about poor old Akarunaway?

Where has that $43K investment gone?

These HSA accounts seem better than insurance in some ways but If you can't afford what you need you are fucked.

Seems like a selfish system to me, that is my main problem with it.

"When the power of love overcomes the love of power, then the world will see peace." - 'Jimi' Hendrix