Healthcare in America, Canada's way
- Thread starter Spytheweb
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- Sep 27, 2005
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In each one of those stats you have to think about in the UK and Canada you're talking about everybody, 100% coverage. Think about this way, in UK and Canada everybody's in line for care, in the US you have faster wait times because you taken 45,000,000 people out of the line. For non-emergency wait time for the US is 7%, but for 45,000,000 Americans the wait time is forever, in other words, you will die before you get any care because you're not covered.
You bring up a very good point. It's amazing how you can make statistics sway a certain way.
We have to factor in the fact that those countries have EVERYONE insured. I would, anyone should, expect the wait time to be longer.
45million people not factored into the equation is a big difference.
Watch the 9 minute video I posted and tell me you think 45 million do not get coverage.
This video speaks some truth. Talking about the "uninsured" while painting an overblown picture of citizens dying in the streets for lack of coverage is just ridiculous. Seriously. Nobody gets turned away. Nobody gets refused urgent follow-up care for their primary problem. When somebody can get sued for providing too hot coffee? Fuhgeddaboutit.
Now is that to say this nation should not seriously discuss a single-payer model? No. It has its merits. It has several disadvantages as well, but a serious discussion is deserved.
My own ED has seen a 20% bump in visits since 2000.......we're already up 20% over last year at this time (rough and unusually long influenza season).......and the knee jerk, layman reaction is to say its the self-pay, non-pay, entitlement crowd. That is not true. The self-pay percentage is around 15%, which is the same percentage of "uninsured" in the country.
Some of the "uninsured" do actually pay the bill we send them. In 2006, the ED collected around $3.5 MILLION in payments from non-insured patients. Without breaking down all stats, I would bet that around 10% of that actually came from undocumented citizens. You would be very surprised how much I actually favor our share of "illegals." Granted, up here in the Great White North, the problems consistently discussed in reference to "illegals" are not as prevalent. My gestalt is that they are here to work, they are family-oriented, fiercely loyal, and above all, maintain self-respect and pride to the point that they are actually willing to accept responsibility for their actions or for whatever life happens to throw at them. I never see a Mexican "drug-seeker." I never see a Mexican that didn't have several visitors or some social support. And, they pay their bills if not already on the rolls. Please remember I also worked in Chicago. Immigration is not the problem.
My point is to illustrate once again one of the two major reasons why I don't think we've really thought the single-payer issue through...........its our culture that could lead this to financial ruin. I just can't repeat this enough times.
Now is that to say this nation should not seriously discuss a single-payer model? No. It has its merits. It has several disadvantages as well, but a serious discussion is deserved.
My own ED has seen a 20% bump in visits since 2000.......we're already up 20% over last year at this time (rough and unusually long influenza season).......and the knee jerk, layman reaction is to say its the self-pay, non-pay, entitlement crowd. That is not true. The self-pay percentage is around 15%, which is the same percentage of "uninsured" in the country.
Some of the "uninsured" do actually pay the bill we send them. In 2006, the ED collected around $3.5 MILLION in payments from non-insured patients. Without breaking down all stats, I would bet that around 10% of that actually came from undocumented citizens. You would be very surprised how much I actually favor our share of "illegals." Granted, up here in the Great White North, the problems consistently discussed in reference to "illegals" are not as prevalent. My gestalt is that they are here to work, they are family-oriented, fiercely loyal, and above all, maintain self-respect and pride to the point that they are actually willing to accept responsibility for their actions or for whatever life happens to throw at them. I never see a Mexican "drug-seeker." I never see a Mexican that didn't have several visitors or some social support. And, they pay their bills if not already on the rolls. Please remember I also worked in Chicago. Immigration is not the problem.
My point is to illustrate once again one of the two major reasons why I don't think we've really thought the single-payer issue through...........its our culture that could lead this to financial ruin. I just can't repeat this enough times.
I was referring to this video, btw. That first Asian girl was great. I won't spend the money b/c I dont need insurance. I don't pay taxes on my income, btw. I did get the care I needed when I got into a bike accident, but I didn't pay the bill. Obviously, she was chosen to make the point of the video, but its not an uncommon story.
To say that nobody gets turned away is absolutely crazy. I've spoken with 2 friends who's parents are both doctors. They've told me stories about how the only times their dad's talk about how it's sad seeing people come in that aren't insured.
You know what people do that aren't insured? THEY GOTO THE DAMN ER for EVERYTHING. The ER can't turn you down, but the regular doctor visit or what not, yep, turned down.
The problem with alot of people is they goto the doctor for way too much damn shit.
You know what people do that aren't insured? THEY GOTO THE DAMN ER for EVERYTHING. The ER can't turn you down, but the regular doctor visit or what not, yep, turned down.
The problem with alot of people is they goto the doctor for way too much damn shit.
Careful there, TP. Last time I said something along these lines I was accused of calling for certain posters to be banned.:nono:
Dirty little secret..........EVERYONE, not just the the "uninsured" go to the ER...... for convenience. I posted the numbers above. Good for me, bad for driving up the cost on all customers.
You can't talk about people getting "turned away" without context. Establishing with a family doc for general check-ups? Getting in to see a neurosurgeon to determine if the back surgery they want so badly is even indicated? New OB for pre-natal care?
With regards to the follow-up, if its necessary to complete the care for what brought you to the ED,..... i.e. to the gen. surgeon to talk about your stone-filled gallbladder, to the ob-gyn for a miscarriage in progress that can be safely discharged, to the ortho for a broken wrist, to the optho to grind off a rust ring after I pull metal off of the cornea, to peds for a not-quite-sick-enough-to-admit kid w/ a fever for a re-exam, to GI for re-exam for blood coming out your bottom if you're well enough to be safely discharged.......EMTALA is frustratingly gray, but trust me when I say that the consultant will not turn this problem away from their office if referred from the ED for follow-up. Especially, in my experience, if the potential for turning the patient away with an "ignorance" argument is pre-empted by a phone call thats documented in the medical record. The potential for liability under EMTALA is too high to chance a violation, and the statute is vague enough here to prevent screwing around. Any lawyer with half a brain could tag the on-call consultant the patient is referred to pretty easily. That means gov't fine plus potential civil suit.
Establishing with a new doc is a different animal. Not my business, but they have margins, there's not enough primary care docs to begin with, and there are so many hours in a day:shrug: Can't speak for them, but I do know how much of their work I do for them any given day.
Frontline just had a nice program on healthcare. Seemed to point to the Taiwan system as a successful adoption of the best of Japanese, German, English systems. Have a smart card system which goes to one central monitoring government center which pays the provider. no hassle. each person has a card. if there medical provider visits start getting out of hand, Uncle Cho (Sam) pays them a visit to see why. Slammed US system. Totally rejected it when studying possibilites based upon the insurance companies profit motivation.
Taiwanese system cuts administrative costs to 2%. American for profit insurance companies appear to be major culprit. Funny Wayne didn't hear the evil, corrupt, malpractice trial lawyers to blame for all the costs you've been railing about for years. Seems like your employers are the main culprits as to why the American healthcare system sucks.
Looks like all the profits you have been sliming out of the system for years as well as all of the bs administrative costs keeping people on hold, going through gatekeepers, ad nauseum runs the costs up to where the US systems doesn't work for the consumers. Like I've been saying for years, it ain't the lawyers, its the insurance companies.
Eddie
Taiwanese system cuts administrative costs to 2%. American for profit insurance companies appear to be major culprit. Funny Wayne didn't hear the evil, corrupt, malpractice trial lawyers to blame for all the costs you've been railing about for years. Seems like your employers are the main culprits as to why the American healthcare system sucks.
Looks like all the profits you have been sliming out of the system for years as well as all of the bs administrative costs keeping people on hold, going through gatekeepers, ad nauseum runs the costs up to where the US systems doesn't work for the consumers. Like I've been saying for years, it ain't the lawyers, its the insurance companies.
Eddie
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Ed,
You know we could have another rhubarb over who's fault the rising costs get pinned on, but life's too short:SIB I'll just stand by my previous posts ...... (bad metaphor alert!!).........we've all got a little blood on our hands here.
Didn't get to watch Frontline last nite, as I was on the front line. Wish I had recorded it. I would love a central info system. Not so much from the cost end, but from ease of accessing patient info.......ie meds, visit history and frequency, previous diagnostics.........I'm working with the IT folks in our system right now trying to develop a "smart card" for our visitors to ameliorate the bottlenecks at triage caused by repeating the same old questions every time. If they had basic demographics, current meds, & recent visit history (including testing) on an updateable card, we could just run it, generate a chart w/up-to-date info and a link to their in house med record-in-detail in a minute (literally) and just get today's complaint and vital signs and they're ready to go to a room and be seen. We could ram and jam if the 15-20 minute process (unless you are very ill) were eliminated.
I have it pretty tight for "our" patients, because after 8 yrs, I know them and can recall the pertnent info without starting from scratch, but 30% or so just go wherever they're closest to or wherever the line is shorter, and then I have to pull teeth out to get info (HIPAA and all that jazz), and it takes time, which most patients hate, of course, because they have no real concept of how long it really takes thanks to TV. We already keep lists of the "frequent fliers" to head off superfluous testing and to mark "seekers" ........ you would run into some big issues having non-providers mark patients like this before the visit due to EMTALA......insurance can gripe all they want; I still have to examine them and apprpriately work them up (D 'em up, as it were!), so good luck with that idea!
Have a day!
You know we could have another rhubarb over who's fault the rising costs get pinned on, but life's too short:SIB I'll just stand by my previous posts ...... (bad metaphor alert!!).........we've all got a little blood on our hands here.
Didn't get to watch Frontline last nite, as I was on the front line. Wish I had recorded it. I would love a central info system. Not so much from the cost end, but from ease of accessing patient info.......ie meds, visit history and frequency, previous diagnostics.........I'm working with the IT folks in our system right now trying to develop a "smart card" for our visitors to ameliorate the bottlenecks at triage caused by repeating the same old questions every time. If they had basic demographics, current meds, & recent visit history (including testing) on an updateable card, we could just run it, generate a chart w/up-to-date info and a link to their in house med record-in-detail in a minute (literally) and just get today's complaint and vital signs and they're ready to go to a room and be seen. We could ram and jam if the 15-20 minute process (unless you are very ill) were eliminated.
I have it pretty tight for "our" patients, because after 8 yrs, I know them and can recall the pertnent info without starting from scratch, but 30% or so just go wherever they're closest to or wherever the line is shorter, and then I have to pull teeth out to get info (HIPAA and all that jazz), and it takes time, which most patients hate, of course, because they have no real concept of how long it really takes thanks to TV. We already keep lists of the "frequent fliers" to head off superfluous testing and to mark "seekers" ........ you would run into some big issues having non-providers mark patients like this before the visit due to EMTALA......insurance can gripe all they want; I still have to examine them and apprpriately work them up (D 'em up, as it were!), so good luck with that idea!
Have a day!
Doc, won't everyone having EMRs help out? I think once all doc offices and hospitals are using EMRs we'll be able to link them all together. At least that's my understanding from the people I've talked with that are implementing the various systems.
The problem with institution of EMRs will be connecting the infrastructure horizontally. Its easy for a single health system to get their records minaturized (vertical integration), but how do you connect me to the hospital across town? I don't even know if its legal yet. I can get those records if the patient signs a permission form, but I have to do that each and every time I need those records. Plus, those records are not the property of the patient, but the hospital/corporation.
My questions are..........Do we have a central/national server (googleHealth:shrug: ) that we all access? Do patients give permission implicitly for access by their caretaker? How do we keep this secure for HIPAA (Health Insurance Portability & Accountability Act......simply put, patients rights to privacy of medical records) purposes? Who's going to pay for it? How much will it really cost? If we don't have single-payer model, do individual insurers get access to all the info? I don't know these answers...
The questions will keep coming. Believe me........I would love it. I'm used to all my other info being a mouse-click away. We have neither answered all the current questions, nor anticipated the future questions as yet.
My questions are..........Do we have a central/national server (googleHealth:shrug: ) that we all access? Do patients give permission implicitly for access by their caretaker? How do we keep this secure for HIPAA (Health Insurance Portability & Accountability Act......simply put, patients rights to privacy of medical records) purposes? Who's going to pay for it? How much will it really cost? If we don't have single-payer model, do individual insurers get access to all the info? I don't know these answers...
The questions will keep coming. Believe me........I would love it. I'm used to all my other info being a mouse-click away. We have neither answered all the current questions, nor anticipated the future questions as yet.
