Govenment in Medicine

[pirana 0]

The better insurance companies have been doing outcomes studies for ages, comparing effectiveness of varying treatment regimens. They have mountains of data. They have info that shows you are more likely to get certain treatments at certain providers. They also can show you have significantly different chances of fatal outcome based on your choice of provider.

Not surprisingly, some medical professionals have fought hard to keep this information out of the public eye; but it is beginning to be put to use.

" . . . 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

[wmw999 2,149]

And there are the insurance providers who have medical care review folks, whose job it is to make sure that the insurance company doesn't pay for treatment that is too expensive. That's where you get your formulary (i.e. what drugs they'll pay for), as well as limitations on transplants and experimental treatment.

I'm not sure it's better having an insurance company than the government doing it, but maybe it is.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[riddler 0]

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Having a government agency run medical care is a baaaaaaaaaaaaaaaaaaad idea.

Given a choice between the government and insurance companies, I'll take the government. At least we would actually get some healthcare, instead of being denied because of a wart on our left toe, or something equally ludicrous.

Trapped on the surface of a sphere. XKCD

[chuckakers 370]

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Having a government agency run medical care is a baaaaaaaaaaaaaaaaaaad idea.

Given a choice between the government and insurance companies, I'll take the government. At least we would actually get some healthcare, instead of being denied because of a wart on our left toe, or something equally ludicrous.

I wouldn't bet on better care from the government. Socialized health care in other countries is a disaster. For example, in the UK, the government won't even allow patients with macular degeneration to get the drugs needed to treat it until they go blind in one eye. Seems they won't justify the money until a person is down to their last good eye.

The story is the same elsewhere. People with illnesses needing immediate attention are told they have to wait, because there are too many people in front of them.

Conversely, here in the U.S. an illegal alien can walk into any emergency room and be treated in short order FREE.

Let's try this. How about some input from folks that live in countries WITH socialized medicine. What's your system like???

Chuck Akers
D-10855
Houston, TX

[billvon 2,435]

>Conversely, here in the U.S. an illegal alien can walk into any emergency
>room and be treated in short order FREE.

As can anyone in the US. Which effectively is socialized medicine.

[Capt.Slog 0]

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I think this whole discussion stems from the thought that every patient should get the best possible care and treatment.

"Ineffective" != "best possible"

[MartinOlsson 0]

First you will have to define socialized medicine. Few countries forbid private alternatives, and many governments pay private companies to produce the health care the people are in need of. It's in many ways a competitive market just with the difference that the health care companies basically have one customer.

All these systems of course have glitches. The most obvious will be the service level since the incentive to give great customer service is somewhat weaker. On the other hand, the incentive to produce good medical results cheap is high.

In total I'm satisfied with the system that i live in. Especially as I'm a soon to be father in the place with the worlds lowest Infant mortality rate. But sure if time were the only factor important to me, maybe I would want it another way.

/Martin

[Andy9o8 0]

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here in the U.S. an illegal alien can walk into any emergency room and be treated in short order FREE.

Well, may be you're willing to fuck with an alien, but I'm not. For all you know, he could have a phaser that could take out half the building.

[mpohl 1]

I for one love the "f*cking post office": fast, efficient, a bargain by any means when compared to its competitors...and they deliver on Saturday!!!

Not sure what point you were trying to make, if any.

P.S.: Suffice it to say that, in my opinion, just like health care, water, telecom, and electricity...postal service does not belong in the for-profit realm.

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Having politicians run medicine is like having a porti-potty cleaning crew fix your plumbing.

The best medical care in the world is about to be as efficient as the f*cking post office.

[chuckakers 370]

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here in the U.S. an illegal alien can walk into any emergency room and be treated in short order FREE.

Well, may be you're willing to fuck with an alien, but I'm not. For all you know, he could have a phaser that could take out half the building.

I'm not even sure what you just said or why. Have another drink. Wait. I'll have one and re-read your post....hold on.........................................................................................................................................................
..................nope, didn't help.

Chuck Akers
D-10855
Houston, TX

[Amazon 7]

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here in the U.S. an illegal alien can walk into any emergency room and be treated in short order FREE.

Well, may be you're willing to fuck with an alien, but I'm not. For all you know, he could have a phaser that could take out half the building.

I'm not even sure what you just said or why. Have another drink. Wait. I'll have one and re-read your post....hold on.........................................................................................................................................................
..................nope, didn't help.

DUDE... suck on some helium... and lighten up a little...

[billvon 2,435]

>I'm not even sure what you just said or why. Have another drink. Wait.
>I'll have one and re-read your post....hold on . . .nope, didn't help.

"May I ask how you dealt with this post?"
"You may ask. . . . that's a little joke."
"Humor - it is a difficult concept."
"We learn by doing."

[chuckakers 370]

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I for one love the "f*cking post office": fast, efficient, a bargain by any means when compared to its competitors...and they deliver on Saturday!!!

Not sure what point you were trying to make, if any.

P.S.: Suffice it to say that, in my opinion, just like health care, water, telecom, and electricity...postal service does not belong in the for-profit realm.

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Having politicians run medicine is like having a porti-potty cleaning crew fix your plumbing.

The best medical care in the world is about to be as efficient as the f*cking post office.

The USPS may provide good service - in fact, my local 77377 does a good job - but the value you see is a perception, not reality. The USPS loses money and your federal government extracts money from me and the rest of the taxpayers to make it up.

Those tax dollars aren't just making up losses, either. They are also subsidizing all non-taxpayers who use the USPS, since prices are artificially low. That's backdoor welfare and it's wrong.

The point I was making is that as a business, the USPS sucks. It can not sustain itself. And speaking of service, I don't feel very well served when I have to sift through pounds of advertising fliers to find the mail I actually need. Your low prices are also subsidized by the USPS allowing - hell, encouraging & marketing - bulk mail advertising. And whether we like it or not, most of those (dare I say) billions of pounds of paper - those millions of earth-saving trees - will end up in a dump, where a bulldozer burning fossil fuel will have to stack it up in piles to rot and pollute. That's not really serving anyone, especially the greenies that should be picketing naked over it.

OK, rant complete, mostly. Now back on subject.

I understand your position on thinking the government - or some (presumable government controlled) entity in the not-for-profit realm - should handle certain basic citizen needs. My question is where do you believe that ends? What industry could not eventually be called a basic need? Everyone needs a furnace. Everyone needs groceries. What all do you believe should be provided on a not-for-profit basis?

Chuck Akers
D-10855
Houston, TX

[billvon 2,435]

>The USPS loses money and your federal government extracts
>money from me and the rest of the taxpayers to make it up.

=============
Postal Service Turns a Profit in 2008
Tuesday February 12, 2008
Despite a downturn in mail volume, the perennially cash-strapped U.S. Postal Service managed to post a net profit of $672 million on gross revenue of $20.4 billion during the first quarter of 2008.

The USPS' total revenue of $20.4 billion represented a 3.5 percent increase over the same period last year. Postal officials attributed the increase to last May's postage increase. Total mail volume during the quarter declined 3 percent; with First-Class Mail being particularly affected, declining by 3.9 percent.
==============

>The point I was making is that as a business, the USPS sucks. It can
>not sustain itself.

Apparently it's doing about as well as any other business did in 2008.

[chuckakers 370]

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>I'm not even sure what you just said or why. Have another drink. Wait.
>I'll have one and re-read your post....hold on . . .nope, didn't help.

"May I ask how you dealt with this post?"
"You may ask. . . . that's a little joke."
"Humor - it is a difficult concept."
"We learn by doing."

I'm tossed between "??????????" and "zzzzzzzzzz".

Chuck Akers
D-10855
Houston, TX

[billvon 2,435]

>I'm tossed between "??????????" and "zzzzzzzzzz".

No matter; I have confidence that you will continue to respond to even those posts that go entirely over your head.

[Capt.Slog 0]

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>The USPS loses money and your federal government extracts
>money from me and the rest of the taxpayers to make it up.

=============
Postal Service Turns a Profit in 2008
Tuesday February 12, 2008
Despite a downturn in mail volume, the perennially cash-strapped U.S. Postal Service managed to post a net profit of $672 million on gross revenue of $20.4 billion during the first quarter of 2008.

The USPS' total revenue of $20.4 billion represented a 3.5 percent increase over the same period last year. Postal officials attributed the increase to last May's postage increase. Total mail volume during the quarter declined 3 percent; with First-Class Mail being particularly affected, declining by 3.9 percent.
==============

>The point I was making is that as a business, the USPS sucks. It can
>not sustain itself.

Apparently it's doing about as well as any other business did in 2008.

The USPS has averaged over $1Billion/yr in profits over the past 10 years.

Don't tell the righties, though; facts contrary to their belief system might make their heads explode.

[mnealtx 0]

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Just be clear on that you choose freedom over health. It's an opinion that is OK to have but don't try to make this an issue about the public getting worse health care.

/Martin

That's exactly what the issue is, unless you're going to claim that government rationing of care is somehow better than a pay as you go system.

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

[Botellines 0]

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You might want to look at that study closer. What drugs did they look at (specifically - antibiotics? hormones? anticoagulation? psychiatry?), what were the outcomes (knowing what they used as a bench mark for the "no real advantage" is important) , what was the cost savings? (truly... not just "millions of Euros.")

I honestly cannot answer your questions for medicine is not my field, besides it was quite a while ago. However the savings were worth mentioning as the government pay for 90% of the cost of the treatment and the user pays only 10%. With a population of almost 50 million, savings of several millions euros is not an understimation.

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There are only TWO medicines that I would not write generic for - those are Coumadin and Synthroid. I generally don't write for coumadin because it's contraindicated in pregnancy (I use heparin in those cases).

The reason that I prefer trade in those cases is that generic allows a broader variance of the actual dosage administered. Most of the time that variance isn't truly that big of a deal, but if I'm worried about hypothyroidism in pregnancy or blood clots in high risk patients post surgery... the cost of the trade FAR outweighs the issues of complications.

Not all drugs has been replaced with a generic, only some. The medical properties has weighted much more (if not all) in the decision than the cost-efficiency.
What they advertised was that there was absolutely no diference between the generic and the branded drug.

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BUT the bottom line is ... is it truly for the govenment to tell you "ahhhh... it's ok if you get a pulmonary embolus... we saved so much with warfarin." (like a Geico commercial)

(oh. and ... some neurologist write for trade on their anti-epileptics because serum levels are important with that too)

Of course not, but it is okay with me if they save some money that is unnecesarily spent and instead of buying a new jet for the stockholders of a pharmacy company they build another hospital or give a payrise to the doctors.

[chuckakers 370]

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>I'm tossed between "??????????" and "zzzzzzzzzz".

No matter; I have confidence that you will continue to respond to even those posts that go entirely over your head.

OK, I decided. "zzzzzzzzzzz"

Over my head. I get it. You a funny man.

Chuck Akers
D-10855
Houston, TX

[MartinOlsson 0]

You don't seem to have a clue of how these systems might work. It's fully possible, and common, to "pay as you go". The only difference is that it's not the patient that is paying the bill. If public health is what is important, publicly financed health care provides more care for the money. Without a doubt and by a landslide.

/Martin

[mnealtx 0]

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You don't seem to have a clue of how these systems might work. It's fully possible, and common, to "pay as you go". The only difference is that it's not the patient that is paying the bill. If public health is what is important, publicly financed health care provides more care for the money. Without a doubt and by a landslide.

/Martin

I seem to have a better "clue" than you, since I have experienced both. I'd rather have the system where I can get the care that I need, *WHEN* I need it, thanks.

http://freestudents.blogspot.com/2007/01/illusion-of-socialized-health-care.html

http://www.theadvocates.org/freeman/8903lemi.html

http://www.jewishpolicycenter.org/article/226

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

[pirana 0]

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And there are the insurance providers who have medical care review folks, whose job it is to make sure that the insurance company doesn't pay for treatment that is too expensive. That's where you get your formulary (i.e. what drugs they'll pay for), as well as limitations on transplants and experimental treatment.

I'm not sure it's better having an insurance company than the government doing it, but maybe it is.

Wendy W.

All treatment is too expensive. Cost of care is beyond ridiculous. The root cause is not the 10 or 12% admin of insurance companies. Eliminate them, and their admin and you save one year's rate increase; assuming you can find someone to administer the plan for free. Then what do you do the next year, and the year after that? Cost of care is outrageous and continues to climb, outpacing inflation every year, most years by about 4 to 5 times.

People need to look at the bill from their provider. Ask if it is really worth it. If the answer is yes, then quit griping about insurance rates. Those rates are a direct reflection of cost of care, and would be much higher without things like drug formularies, medical review, exclusions for experimental, cosmetic, etc.

Demonstrating the public lack of awareness of cost of care is a bill moving thru the MN legislature right now that decrees comprehensive, no out-of-pocket coverage for every MN resident. That is no copay, no deductible, no coinsurance; full coverage for all care. It also stipulates a sliding premium based on ability to pay.

It of course does not address who will make up the difference for those that can not pay the approximately $800 to $1000 per month per person such a plan would cost.

BTW, brought to you by the same folks that want to legislate premium caps (fixed dollar amounts) that are way below actual cost of care. We've got legislators and regulators who need to go back and retake 4th grade arithmetic.

" . . . 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

[pirana 0]

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P.S.: Suffice it to say that, in my opinion, just like health care, water, telecom, and electricity...postal service does not belong in the for-profit realm.

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Having politicians run medicine is like having a porti-potty cleaning crew fix your plumbing.

Absolutely agree (on the health care part). Health care (providing it and financing it) should all be in the not-for-profit realm. Organizations adminstered by trustees with a goal of positive impact on public health and no interference from needing to satisfy stockholders.

It is a very good solution because there is still pressure to be effective and answer to a bottom line (need to be solvent and maintain claims reserves while ensuring good outcomes) but there is no pressure to not pay for needed care. In fact, with proper auditing in place, there is every incentive to get it right.

" . . . 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

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[mnealtx 0]

Crazy, isn't it?

"There's a shortage of doctors - we're going to solve the problem by limiting what they can charge."

Yeah, *THAT* is going to encourage more kids to spend the hundreds of thousands in schooling and insurance to become doctors instead of lawyers or engineers or some other career field that *isn't* price-capped.

"Drugs are too expensive - we're going to solve the problem by limiting what they can charge."

So, what are the drug companies supposed to use for capital to develop new drugs and do the required testing and evaluations?

http://www.america.gov/st/econ-english/2008/April/20080429230904myleen0.5233981.html

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(The following article is taken from the U.S. Department of State publication, Focus on Intellectual Property Rights.)

The Cost of Developing a New Drug
By Neal Masia

Many of us know a family member or friend who has benefited from a new medicine: Advances in treating cancer, HIV/AIDS, cardiovascular disease, and a broad host of other afflictions have been nearly continuous in recent decades, thanks to – in many instances – new drug discoveries. Economists estimate that almost half of the increase in life expectancy achieved over the past 15 years in the industrialized world can be attributed to new drugs. In the United States alone, the economic gains from medical innovation are estimated at more than $500 billion per year.

Finding new cures is an extremely expensive and risky proposition, however. Estimates about the cost of developing a new drug vary widely, from a low of $800 million to nearly $2 billion per drug. Even the high end of those estimates may soon be considered a bargain. Recently, Pfizer announced that it is investing $800 million just for a set of Phase III trials for a single drug.

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