Thanks again, Sandmason, right when we are facing the baby boomers' need to encourage more medical professionals to enter the geriatrics field, the incentive to do so is being removed. A good geriatrician saves a lot of pain and suffering by avoiding overmedication and inappropriate testing.

Here's another good article on geriatrics, EXCELLENT!
http://www.newyorker.com/repor...70430fa_fact_gawande

Geriatricians can't afford to stay in practice. There's no billing codes that pay anything.

Thanks for the article, SM. And the support.. it seems that if I voiced any disapproval of the proposal as it was written, I was thought to be against well baby care or something.


Opinionated wrote:

quote:

Isn't your mother on Medicare? Has that not been helpful to her? If it has been, why do you feel that your mother has been helped but other people would not be?

Mother has lost her wonderful doctor because of the way medicare is being currently run. As a geriatrics specialist, most of her patients were on medicare. She could not operate her office (and believe me, it was a no frills place), pay her bills, insurance, etc., on what medicare currently pays. She sold her private practice to the hospital conglomerate. The hospital now calls it a clinic and they send young PCPs to be there in rotation. You don't know who you will get if you need to go, and they do not know Mom. The closest geriatrics doc NOW is 20 miles further away and will not 'consult'. He will only see Mom IF she makes him her primary and he in not an associate of the hospital in this town (less than 5 miles from her home). The hospital where he 'visits' is 35 miles from her home. That's where he wants her to go for any of the tests he automatically orders for new patients.

Medicare as a primary insurance seems to be letting geriatric patients down at the moment, as I see it. I seriously doubt Mom is the only one finding her PCP unable to afford to care for her.

That was a good article, Sandmason.

I might add that I can guess which hospital it was. One of my daughters was taken there while on a trip to NYC when she became sick and they suspected meningitis. (Just the flu, thank heaven.) I can't fault the doctors' care she got, but she remarked to me that it was the filthiest place she'd ever been. She had to hold her bladder for a full day because she couldn't bring herself to touch anything in their nasty rest rooms, and the ER waiting and examining rooms weren't much better. She said that there was blood on the floors that hadn't been mopped up! Yuck, yuck, yuck.

quote:

Originally posted by Bobcat:
The problem is with a rush job that didn't allow careful reading and fine tuning before a deadline, AND a problem of confidence in a government that is happy to be in debt past whatever our grandchildren can pay because it isn't their money.

Absolutely Bobcat! Let's get it right and not try to pull another fast one on our grandkids.
I do have to suggest this incredible article that we came across while scavenging something to read on the airplane. My husband, the doctor, believes this is the best ever description of the mess we are in, the causes and possibly the solutions.
http://www.theatlantic.com/doc/200909/health-care
A MUST READ for anyone trying to get a grip on this mess.

Gypsy, I am very glad that your experience with your health care system worked out so well for you and Mike. I don't think anyone in the USA wants anyone else to be deprived of care. I sincerely wish for our government to work out a good plan, but as the saying goes, "Wish in one hand and poop in the other and see which hand gets full first".

The problem is with a rush job that didn't allow careful reading and fine tuning before a deadline, AND a problem of confidence in a government that is happy to be in debt past whatever our grandchildren can pay because it isn't their money.

I've bit my tongue long enough. Actually I have read the links and then some. I know our system isn't perfect. But I think with the American system we would have lost everything in the last few years(if not befoe) It costs $0 to go to the doc. I now only go every 3 months it was every month. It cost nothing when Mike had bipass surgery( nothing for the month they kept him in after his angiogram) Nothing for his carotoid surgery. Once he had been in the hospital here(acute care) he was considered extended care and it did cost(based on his income) When he went to rehab it cost $0. It costs nothing to go to the doc unless it is to fill a form or for an exam such as pilot. Here we do pay a few $ a month for medical(think we are one of the few provinces that do -even that is income based. I do have other coverage for things such as physio and prescriptions(pharmacare does cut in again based on income) I know our system isn't perfect but without it I don't think my parents would have owned their own home(even in the 50's there was only a $!.00 a day charge for hospital and none(that I know of for docs visits) I know when I was in the hospital for 3 months it only cost $90. When Mike had his open heart surgery, stroke etc. it cost $0. Sorry I don't understand why some people are so againt the system(I know some people here would like to change to a more American like system to me no way.)

As I understand it, the major insurers are in favor of some of the proposed regulations e.g. forbidding exclusions of preexisting conditions. They believe that this will put them all on a level playing field and allow them to be more competitive with each other.

I doubt it will do much to bring premiums down, though. That's a separate problem. But at least being part of an insurance pool will allow the individuals to get in on the contract rate for services.

Well, I can tell you for sure the stockholders and administrators of the for-profit health payment insurers are NOT us. They work against us politically and their duty to return the highest possible return to their investors makes them hostile to any customer who actually gets sick.

That's the choice we have. It's not take care of ourselves or let the government do it. Few of us can pay for catastrophic health costs on our own, out of pocket. Certainly not those of us in the middle-class. So it's let the government handle insurance payments on a non-profit basis or let the corporations handle it with only their bottom line viewed as important.

And the insurance companies DO let people die or suffer who are deemed non-cost effective. There are pages of Congressional testimony from whistle-blowers, not to mention volumes of anecdotal evidence from clients like my family which prove that's so.

The fact that every other advanced nation on the planet has already effectively handled this problem on a non-profit basis through their government is a powerful indicator that we could, too.

Looks like the industry lobbyists are winning this one, though. They've taken what started as an effort to reign them in and turned it into an opportunity to make even more money from the sick and injured. And, cruelly, they did it by fooling the very people who would benefit most from public health insurance to fight against their own best interests. That's what happens when The People don't stand up for themselves.

quote:

In America, the government IS us.

Yes, if things are as they should be, that would be true.

A bailout for the U.S. health-care industry
(From The Ottawa Citizen)
http://www.ottawacitizen.com/o...y/1926021/story.html

(This is exactly what I feared when the for-profit insurers started liking what few scraps were left of the attempted reform. Once again, it looks like huge dollars wielded by private industry and a lack of will from The People have left us at the mercy of corporations who only want our wallets.)

"[...] What's left is a proposal that will force the uninsured to buy private insurance with subsidies for low-income earners and only limited constraints on industry price gouging and care denials that characterize the collapsing insurance-based system.

In sum, it looks like another massive corporate bailout, following the earlier version for the banks, this time for an equally unpopular insurance industry, which will fuel even more public cynicism of the reform process and political system.

To residents of all other industrialized countries, terrors over a government role in promoting and protecting the health and safety of its citizenry, and the reluctance of political leaders to effectively respond to these attacks must be especially confounding. Among major nations, only in the U.S. is health care not a fundamental right, but bartered for profit by a maze of health-care corporations. The result is that the U.S. continues to fall far behind other industrial nations in a variety of measurements, from access to care to equality in treatment, and even in the much discussed issue of waiting times for medical care."

quote:

People who have confidence that the government can and will do a better job of taking care of us than we can do for ourselves

Um, no, that's not it. It's people who believe we can take care of ourselves better than huge, corporate, for-profit insurers whose primary responsibility is not to the ill but to their stockholders. In America, the government IS us.

Isn't your mother on Medicare? Has that not been helpful to her? If it has been, why do you feel that your mother has been helped but other people would not be?

I believe what this all boils down to is:

People who have confidence that the government can and will do a better job of taking care of us than we can do for ourselves

And, those who don't.

I fall into the latter catagory. I feel that if we the people would force them to do their jobs as they are defined by the constitution instead of letting them run hog wild like children with a free pass at the carnival, we might make some progress. Nothing is going to be better until the voters start examining the resumes of the candidates instead of being dazzeled by the most expensive dog and pony show during elections.

I think we are all agreed that health care is over priced, insurance is a greedy sucking whirlpool, ,,,OOPs, that is how I would describe congress as well.

...only they decide to take the "bribes" offered by PACs, only they decide on the loopholes to allow for personal gain, only they decide to spend our grandchildren's money (our money was spent long ago as was our childrens money, in truth, working on our great grans now). I am very leery of policy that would combine the two.

So tell me they are already combined!! yep, thats so. Tell me why!,,, Voters elect selfserving representatives...And reelect them over and over again.

Sorry, I want the greedy rotten AHs out of my middle class pocket. When we reestablish who the "boss" is (we the people), and only then, can I have confidence to let the government get even more in my pocket.

This is why I was against having THAT overwhelming and possibly unconstitutional health care policy rushed ahead at this time.

Well meaning but wrongly written and rushed legislation is a disaster.

This message has been edited. Last edited by: Bobcat,

I knew we were in trouble when doctor's offices had to start adding an employee whose sole job was cajoling the private insurance companies to pay their bills and when that person had to have a four-year-degree in order to do that.

Our dentist has added quite a bit of expensive camera equipment with the main purpose of being able to force the insurance company into a corner so that they must admit care is needed. Mere x-rays were constantly denied.

http://www.factcheck.org/2009/...urance-not-everyone/

This is the article about the potential effect on private insurance. I do know that my daughter's plan will not qualify because it doesn't offer benefits for preventive exams, etc. But, for that matter, neither does medicare. We got the bill just this week for several hundred dollars worth of labs that medicare won't cover.

Ugh. Also spent a part of the afternoon at the nursing home because she had aspirated some of her lunch. They brought in the x-ray machine, etc. but by the time they did all that, she had evidently coughed up whatever it was she aspirated. Always something ...

I agree about needing health CARE reform. I think that the whole system is too complicated and lends itself to people being unable to pay for things like office visits and simple labs. Back when a gold-plated policy had a fairly high deductible and only paid 80%, and when no doctor took insurance assignments (we had to file for reimbursement) everything cost much, much less. CarNow is able to provide basic services for half of what my PCP can. But they're cash up front.

TORP -- I did read an article recently (sorry, didn't keep link) that mentioned infant mortality and longevity may not be due to health care but lifestyle differences in different countries, so that is something to consider, as well. I'm sure lifestyle does play a part.

Bobcat -- re: quality of care.

Know what I've noticed? My cats get better health care than I do.

For one, there are fewer vet schools than medical schools, so competition is fierce to get into them. A vet friend mentioned to me that more than one person has gone into people medicine because their grades weren't good enough to get them into vet school.

For another... well, I don't know why the expenses are less at a vet, exactly. I know I've had cats with some pretty serious medical problems that required extensive tests, including various blood tests, endoscopies, and overnight stays. The bill was big, (say up to $3000) but nothing like what it would have been for a human being to have all those tests. I'd expect to add another zero to the total if we were talking about a person. Why?

Out vet calls every day to check on a sick cat's progress until the cat is well. Needless to say, our MD does not call us for daily follow ups. It's not a matter of time constraints, I don't think, because our vet's office covers a very large area and they are always very busy.

So beyond health insurance reform, I do believe we need health care reform, too. I used to think tort reform would be helpful but I was confronted with a recent story on how many people die in a hospital due to negligence, and now that doesn't seem like such a good idea. Talked with one gent whose wife died of negligence. He said there's a cap on pain-and-suffering recompense here in California which has mainly resulted in all the doctors who can't get malpractice insurance coming here. Not a good thing, so have no idea what solutions might be. Something has got to give, though, that's for sure.

Not sure how much her policy is. I could ask her. And depending on the policy, if one has a serious medical condition that they want coverage for, $416 a month doesn't sound like that much compared to what the actual cost of their care would be. I suspect, in fact, that your $5K/year number is on the low side.

Personally, I think that people who purchase private insurance should receive a tax deduction for it the same as businesses who contribute to employee benefits do.

Those infant mortality statistics are often debated and are affected by the higher rates of abortion in other countries and differences in how the countries count a "live birth." The cancer deaths number take into the account that we in the U.S. for unknown reasons have a higher incidence of cancer or perhaps more of them are diagnosed. Among those diagnosed, however, the five year survival rate is much superior here.

Medicare is costing more than any of us realize because it's not all coming from tax dollars directly into the program. Self-pay patients and those with private insurance are subsidizing their care via higher payments to the doctors and hospitals. We need to be careful about how much and how quickly we upset the balance of self/private pay and public pay because I think we'll find that it will eventually impact the care that our elders are able to receive.

I do have an article about the impact of the proposed plan on availability of private insurance, but I'd have to find it. I'll post later when I'm in the mood to look for it.

TORP, as I understand it, the bill as is does not affect -- in any way -- a person's ability to buy their own private insurance. Do you have a link to where it says that? And, btw, how much was that private policy? Because I'm hearing prices like $5000 per year, and much more if you have a pre-existing condition like diabetes. Nice if you've got the money but not an option for a very large percentage of our population. Can you imagine what would happen to our elders if they had to pay that kind of money instead of being covered by government health insurance?

As for statistics? I did not find that the UK had a higher mortality rate for cancer.
Cancer mortality per 100,000:
UK: 253.5
US: 321.9
France: 286.1
http://www.nationmaster.com/gr...th-death-from-cancer
(OECD Health Data 2004)

Infant Mortality Rate:
(Deaths Under Age 5 Per 1000 live births)
UK: 6.0
US: 7.8
France: 5.2
http://en.wikipedia.org/wiki/L...nfant_mortality_rate
CIA World Factbook

Average Life Span in U.S.: 77.9 years
"Despite the wide gaps, higher spending on health care does not necessarily prolong lives. In 2000, the United States spent more on health care than any other country in the world: an average of $ 4,500 per person. Switzerland was second highest, at $3,300 or 71% of the US. Nevertheless, average US life expectancy ranks 27th in the world, at 77 years. Many countries achieve higher life expectancy rates with significantly lower spending. [...] many countries outperform the US with approximately half the spending."
http://ucatlas.ucsc.edu/spend.php

I guess I'm very, very surprised to see such resistance to the very idea of government provided health insurance here, of all places, when every one of our elders is benefiting from government health insurance. I shudder to think where my mom would be if she did not have Medicare.

Let us not forget that the for-profit insurers DO NOT provide health care -- they provide payment for health care. If they choose to. If you're not denied for a pre-existing condition. If you're not denied for being too expensively ill. I still see no reason there needs to be a payment middleman making a profit on illness. I do not see how that benefits us, at all.

Insurance Industry Whistleblower Wendell Potter: ‘Americans Need To Be Alert’
http://speaker.house.gov/blog/?p=1916