Health Care - What Should Happen?

Off Topic Politics and World Issues
1

I am a first-year medical student, so this a very pertinent topic for me and my fellow classmates. The vast majority of them are Obama supporters and are in favor of a more socialized/government-involved set-up to current healthcare.

I know I butchered the soc/gov-inv. part but I don’t know how else to describe Obama’s plans. He wants to take tax cuts from the rich (meaning they pay less of the vast majority of taxes) and use it to pay for insurance for the poorest (which, I believe, is a socialist principle).

On the other hand, he says those who like their current plans do not have to change (I’m not sure how valid this claim will be once the added citizens will be added to the pot). I don’t see how adding millions of patients to the system will not change things. Especially since the number of doctors is not changing in any significant way, which is something nobody is talking about.

From a logical standpoint, it seems that one’s primary care will not change as long as your family physician is not taking on tons of new patients. However, for those patients that become very sick and are within striking distance of a teaching hospital, I do not see how your care will remain the same. Since this teaching hospital is most likely located within a city full of newly qualified patients with increased access, why will your quality of care not change?

I am not so much challenging why these new patients should have coverage, but how we think patient care would not be compromised by such a plan?

The bottom line is, for those who have adequate care, how do you see your quality of care increasing under Obama?

2

In my mind healthcare is already socialized. Socialized in the sense that society pays for those who don’t pay for themselves. The hospitals treat people without insurance. To remain profitable hospitals have to raise their cost per services to people who will pay and insurance providers. Insurance providers raise our premiums.

3

I don’t see it improving, largely because universal health care (UHC) doesn’t address some of the largest causes of health care problems that ultimately exhaust our resources. Unfortunately, we would see a similar effect of “moral hazard” that we saw when government decided to play its role in housing.

When you don’t absorb your own risk of irresponsible behavior, you tend to do more of it - that is human nature. Here we have a largely private health insurance arrangement now, and our health is atrocious. That would get worse under UHC, because the behaviors leading to the health problems wouldn’t get any better - they’d likely get worse.

As mentioned in the Michael Moore thread, UHC amounts to a taxpayer bailout of bad health choices.

That is not to say that people don’t need help - I argue from a position of recognizing limited resources, that every dollar and hour spent on a guy who can’t stop eating french fries or won’t hit the treadmill is a dollar and an hour taken away from someone who legitimately needs care due to an unforeseen calamity.

I also believe in public health insurance for the poor - and would prefer it at the state level. But, UHC is a bad idea, because policy can’t simply be based on “good intentions”, it must be based on a measure of “unintended consequences”, and I don’t see UHC improving the public measure of our health.

4

Lots of docs want out and are telling their kids to avoid medicine (saw a survey a couple of days ago).

Wait until your doc is paid $30,000 a year to start, and maxes out at about $60,000 after 30 years, you know, kind of like…public school teachers.

Won’t medicine be a shining star then!!!

5

[quote]engerland66 wrote:
I am a first-year medical student, so this a very pertinent topic for me and my fellow classmates. The vast majority of them are Obama supporters and are in favor of a more socialized/government-involved set-up to current healthcare.

I know I butchered the soc/gov-inv. part but I don’t know how else to describe Obama’s plans. He wants to take tax cuts from the rich (meaning they pay less of the vast majority of taxes) and use it to pay for insurance for the poorest (which, I believe, is a socialist principle).

On the other hand, he says those who like their current plans do not have to change (I’m not sure how valid this claim will be once the added citizens will be added to the pot). I don’t see how adding millions of patients to the system will not change things. Especially since the number of doctors is not changing in any significant way, which is something nobody is talking about.

From a logical standpoint, it seems that one’s primary care will not change as long as your family physician is not taking on tons of new patients. However, for those patients that become very sick and are within striking distance of a teaching hospital, I do not see how your care will remain the same. Since this teaching hospital is most likely located within a city full of newly qualified patients with increased access, why will your quality of care not change?

I am not so much challenging why these new patients should have coverage, but how we think patient care would not be compromised by such a plan?

The bottom line is, for those who have adequate care, how do you see your quality of care increasing under Obama?[/quote]

I don’t.

6

Health Care - What Should Happen…

People should stop getting ill!

7

[quote]vroom wrote:
Health Care - What Should Happen…

People should stop getting ill![/quote]

That would take care of most of it.

If we socialize the consequences of bad individual decisions it won´t happen though.

That is what you meant, right?

8

I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.

9

[quote]vroom wrote:
I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.[/quote]

you know what most people die of, right?

Coronary heart diseases, strokes, diabetes related stuff, and so on.

Most people die prematurely and have large medical bills because they treat themselves like shit.

That is not ideology, these are facts.

10

[quote]orion wrote:
vroom wrote:
I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.

you know what most people die of, right?

Coronary heart diseases, strokes, diabetes related stuff, and so on.

Most people die prematurely and have large medical bills because they treat themselves like shit.

That is not ideology, these are facts.

[/quote]

These facts are indisputable. But what do we do? In England, doctors are getting paid bonuses if they can increase the health of their patients. The NHS web site (The NHS website - NHS) offers help to improve health and prevent disease. So, one approach is to have a health system that is organized around prevention and cost containment.

If you give bonus pay for improving the health of patients, a rational heath care provider is incented to improve the health of patients. If you pay providers for services, a rational provider will maximize the services they render (consistent with the constraints of the insurance provider).

11

[quote]Journeyman wrote:
orion wrote:
vroom wrote:
I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.

you know what most people die of, right?

Coronary heart diseases, strokes, diabetes related stuff, and so on.

Most people die prematurely and have large medical bills because they treat themselves like shit.

That is not ideology, these are facts.

These facts are indisputable. But what do we do? In England, doctors are getting paid bonuses if they can increase the health of their patients. The NHS web site (The NHS website - NHS) offers help to improve health and prevent disease. So, one approach is to have a health system that is organized around prevention and cost containment.

If you give bonus pay for improving the health of patients, a rational heath care provider is incented to improve the health of patients. If you pay providers for services, a rational provider will maximize the services they render (consistent with the constraints of the insurance provider).[/quote]

Well said. Preventative care is almost completely non-existent in this country and it’s costing us horribly. People ignore their illnesses until they are acute and then go to the emergency room (where hospitals are obligated to treat them). Then when the individuals are unable to pay these hospital fees (which are often exponentially higher than if they had gone in before the issue was acute) the hospitals must cover the costs, which means rising prices for the rest of us. Essentially, as another poster said, we’re already socializing medicine…the only issue is we’re doing it in the worst possible and most expensive way (or damn near to it).

Preventative care must become a part of our culture IMO.

12

[quote]Journeyman wrote:
orion wrote:
vroom wrote:
I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.

you know what most people die of, right?

Coronary heart diseases, strokes, diabetes related stuff, and so on.

Most people die prematurely and have large medical bills because they treat themselves like shit.

That is not ideology, these are facts.

These facts are indisputable. But what do we do? In England, doctors are getting paid bonuses if they can increase the health of their patients. The NHS web site (The NHS website - NHS) offers help to improve health and prevent disease. So, one approach is to have a health system that is organized around prevention and cost containment.

If you give bonus pay for improving the health of patients, a rational heath care provider is incented to improve the health of patients. If you pay providers for services, a rational provider will maximize the services they render (consistent with the constraints of the insurance provider).[/quote]

The point that you are missing is that a socialized system is a politicized system that follows its own ratio, which is fundamentally different from the one you are proposing.

An efficient socialized health care system is simply bad politics, you maximize your political potential by coddling the masses.

13

[quote]Gambit_Lost wrote:
Journeyman wrote:
orion wrote:
vroom wrote:
I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.

you know what most people die of, right?

Coronary heart diseases, strokes, diabetes related stuff, and so on.

Most people die prematurely and have large medical bills because they treat themselves like shit.

That is not ideology, these are facts.

These facts are indisputable. But what do we do? In England, doctors are getting paid bonuses if they can increase the health of their patients. The NHS web site (The NHS website - NHS) offers help to improve health and prevent disease. So, one approach is to have a health system that is organized around prevention and cost containment.

If you give bonus pay for improving the health of patients, a rational heath care provider is incented to improve the health of patients. If you pay providers for services, a rational provider will maximize the services they render (consistent with the constraints of the insurance provider).

Well said. Preventative care is almost completely non-existent in this country and it’s costing us horribly. People ignore their illnesses until they are acute and then go to the emergency room (where hospitals are obligated to treat them). Then when the individuals are unable to pay these hospital fees (which are often exponentially higher than if they had gone in before the issue was acute) the hospitals must cover the costs, which means rising prices for the rest of us. Essentially, as another poster said, we’re already socializing medicine…the only issue is we’re doing it in the worst possible and most expensive way (or damn near to it).

Preventative care must become a part of our culture IMO. [/quote]

It is important to define preventative care, though. Mammograms for every women over 45 or colonoscopies for every person over 50 would certainly be preventative, but they’d also be incredibly expensive.

Preventative care, in terms of diet and exercise, are cheap and very effective. Preventative care in terms of expensive screening tests is not the answer, despite what politicians say.

14

[quote]Headhunter wrote:
Lots of docs want out and are telling their kids to avoid medicine (saw a survey a couple of days ago).

Wait until your doc is paid $30,000 a year to start, and maxes out at about $60,000 after 30 years, you know, kind of like…public school teachers.

Won’t medicine be a shining star then!!![/quote]

The idea of becoming one step closer to a government employee bothers me a lot.

15

Preventative care shouldn’t cost us anything. Nor should care after the fact. Instead, preventative care and regular care should cost the individual. That’s cool if you want to shoot heroin, eat pizza and drink cola everyday, and smoke a pack a cigs before getting your 4 of sleep for the night. We’re just not going to pay for it.

Between subsidizing someone else’s healthcare and not, I bet not doing so results in a society much more aware of what the hell they’re doing to their bodies.

16

[quote]Sloth wrote:
Preventative care shouldn’t cost us anything. Nor should care after the fact. Instead, preventative care and regular care should cost the individual. That’s cool if you want to shoot heroin, eat pizza and drink cola everyday, and smoke a pack a cigs before getting your 4 of sleep for the night. We’re just not going to pay for it.

Between subsidizing someone else’s healthcare and not, I bet not doing so results in a society much more aware of what the hell they’re doing to their bodies.[/quote]

I don’t think history is on your side on this, Sloth. Public healthcare wont change it, either. To pay or not, that’s more of an ideological question.

17

[quote]engerland66 wrote:
Gambit_Lost wrote:
Journeyman wrote:
orion wrote:
vroom wrote:
I wasn’t planning to argue ideologies orion, I thought I’d just jump right to the heart of the matter. If we would all just stop choosing to age and die, we’d be much better off as a society… except for the overcrowding.

you know what most people die of, right?

Coronary heart diseases, strokes, diabetes related stuff, and so on.

Most people die prematurely and have large medical bills because they treat themselves like shit.

That is not ideology, these are facts.

These facts are indisputable. But what do we do? In England, doctors are getting paid bonuses if they can increase the health of their patients. The NHS web site (The NHS website - NHS) offers help to improve health and prevent disease. So, one approach is to have a health system that is organized around prevention and cost containment.

If you give bonus pay for improving the health of patients, a rational heath care provider is incented to improve the health of patients. If you pay providers for services, a rational provider will maximize the services they render (consistent with the constraints of the insurance provider).

Well said. Preventative care is almost completely non-existent in this country and it’s costing us horribly. People ignore their illnesses until they are acute and then go to the emergency room (where hospitals are obligated to treat them). Then when the individuals are unable to pay these hospital fees (which are often exponentially higher than if they had gone in before the issue was acute) the hospitals must cover the costs, which means rising prices for the rest of us. Essentially, as another poster said, we’re already socializing medicine…the only issue is we’re doing it in the worst possible and most expensive way (or damn near to it).

Preventative care must become a part of our culture IMO.

It is important to define preventative care, though. Mammograms for every women over 45 or colonoscopies for every person over 50 would certainly be preventative, but they’d also be incredibly expensive.

Preventative care, in terms of diet and exercise, are cheap and very effective. Preventative care in terms of expensive screening tests is not the answer, despite what politicians say.
[/quote]

Good point. The devil is always in the details, right? As you say, the govt could take “preventative care” and turn it into a number of incredibly expensive things. Bottom line though is that the current system is broken. It’s making our society sicker and our economy poorer.

18

[quote]kaaleppi wrote:

I don’t think history is on your side on this, Sloth. Public healthcare wont change it, either. To pay or not, that’s more of an ideological question.[/quote]

Oh, someone should pay. The individual. Well, and whatever freely given charity is available.

19

Prevention. It has to begin there.

Liberals tax the crap out of things they don’t agree with. They should tax more on tobacco, and packaged foods with high glycemic indexes, high salt content foods, high cholesterol, trans fat, excessive calories per serving at fast food places, etc. Tax you if your kids don’t take all the school vaccinations.

Those taxes go into a federal fund for treating this. (I know they’d screw it up like social security)

Also mandate more real physical fitness in public schools. Allow public access to school tracks.

And deport every illegal alien (especially the sick ones) back to their country of origin.

Work to get more Americans prepared to accept death. I know it’s morbid, but we spend the majority of our health care money in the last 60 days of everyone’s life on pointless interventions.

That’s where I’d start.

20

If people that are paying for their insurance are happy with it, they can keep it, but the gov’t paid health care is there, courtesy of…?
I either have to pay twice, once by premium and once by bloated taxes, or just accept government health care? Lose/lose scenario.