Healthcare Education and Q&A Thread

[saden1]

Originally Posted by Slingin Sammy 33

You have gone over the cliff my friend.

Why? We already have government hospitals for vets, why not for citizens? I haven't gone over the cliff though I'm sure there are plenty of folks here who would be more than happy to push me over and watch me fall with glee.

[Schneed10]

Originally Posted by dmek25

schneed, what happens at your hospital right now, if and uninsured person comes in that desperately needs help?

When you say "desperately needs help", I assume you mean emergency care. Like if they're shot, or having a heart attack.

We treat them. We have to by law. It is illegal to turn a patient away from an emergency care setting.

If they're uninsured, we try to collect from them directly. We usually fail because people can't pay. We lose nearly $75 million each year on these patients.

[Schneed10]

Originally Posted by saden1

My sentiments also applies to urban hospitals. I understand the problem fully, we have this bastardized hybrid system where hospitals are "basically government hospitals" when they aught to be "fully taxpayer funded government hospitals."


Let me ask you this, are there any type of savings having universal healthcare would yield? I know the AHA was all for saving taxpayers 155 billion no too long ago if 95% of Americans were coverage.

That is definitely an extreme view, out of touch with reality, and doomed to failure. Trust me, we can run our hospital a lot more efficiently than the government can.

We answer to the University, who will have our ass if we lose more money than they expect us to lose. They're willing to fund us to a certain extent, and if we lose more than we told them, they'll send us packing in a heartbeat. Our CEO and COO were pushed out the door last year, in fact. We just had a round of layoffs, too.

If the government runs us, then we ultimately get backed by the giant pit of money collected from the American taxpayer. Answering to the government would be a nice respite from the pressure we currently feel to meet targets. The University is up our ass because we are the only hospitals they have. Imagine a management team that has to manage every hospital in the country, or at least lots and lots of hospitals. Pretty easy to have your failures fly under their radar.

Sounds like Tenet, a large hospital operator. No wonder they had to close so many in the last few years.

[Slingin Sammy 33]

Originally Posted by saden1

Why? We already have government hospitals for vets, why not for citizens? I haven't gone over the cliff though I'm sure there are plenty of folks here who would be more than happy to push me over and watch me fall with glee.

And as someone who has been served by "government run hospitals", and provided IT products/services to a couple of the top "government run hospitals" in the nation, I can tell you if I'm sick or in an emergency situation I'm going to a private hospital every time. Take off the partisan blinders and ask any military member or vet how their health care experiences have been and you will see the fault in your statement.

The stark reality is, there are folks who don't have health insurance coverage. Their reasons are mostly financial. Most families spend/sacrifice a great deal to make sure they have coverage. There are programs to help the very poor (Medicaid). Those that don't/won't make the sacrifice to take care of their families or themselves should not burden the 95% of the U.S. who are doing what is needed to have health insurance. The Obama Care program solves nothing, but is simply a power grab, period.

I mentioned in the Obama Care thread about vouchers and their cost being significantly less that the current proposed program, you either missed it or chose to ignore that argument.

P.S. I'd reach out to pull you back, there's room for all in the conservative tent. A few books/documentaries on Reagan and a proper re-reading of Levin's stuff and you'll be fine.

[CRedskinsRule]

In the Obama Care thread a question came up, and I want to bring it here for clarification, keeping in mind this thread's original goal of information

Specifically, I asked for a model that was based not on a homogeneous population. It seemed clear to me that a diverse population would have more stresses on the healthcare system than a uniform nation like Japan or Norway.

In Saden's response he stated

Honest, I can't quite comprehend what difference diversity makes in the field of health care? Care to elaborate with something more than "it has, don't you think," specifically why you think it does. Also, France is very good example of a diverse country with a successful universal health care and relatively low poverty rate.

So, I am asking this question:

Does the diversity of a nation make a difference in the field of health care?

Thanks in advance.

[Schneed10]

Originally Posted by CRedskinsRule

In the Obama Care thread a question came up, and I want to bring it here for clarification, keeping in mind this thread's original goal of information

Specifically, I asked for a model that was based not on a homogeneous population. It seemed clear to me that a diverse population would have more stresses on the healthcare system than a uniform nation like Japan or Norway.

In Saden's response he stated


So, I am asking this question:

Does the diversity of a nation make a difference in the field of health care?

Thanks in advance.

I see what you're getting at, certain races and ethnicities deal with varying levels of incidences of different diseases. But all modern nations have to be ready to treat any illness, no matter how prevalent in their society. I don't think certain nations experience a lower level of cost than we do because of this, I think they experience it because their system is set up to encourage a lower level of utilization of healthcare services.

[CRedskinsRule]

Originally Posted by Schneed10

I see what you're getting at, certain races and ethnicities deal with varying levels of incidences of different diseases. But all modern nations have to be ready to treat any illness, no matter how prevalent in their society. I don't think certain nations experience a lower level of cost than we do because of this, I think they experience it because their system is set up to encourage a lower level of utilization of healthcare services.

Ok, I accept this. I was not necessarily thinking cost when I was asking the questions as much as the difficulties in setting up a national healthcare system, if that is the same thing then i will leave it at this.

[JoeRedskin]

Originally Posted by Schneed10

I see what you're getting at, certain races and ethnicities deal with varying levels of incidences of different diseases. But all modern nations have to be ready to treat any illness, no matter how prevalent in their society. I don't think certain nations experience a lower level of cost than we do because of this, I think they experience it because their system is set up to encourage a lower level of utilization of healthcare services.

Sorry, can you explain walk me through what you mean by the bolded statement?

Saden asserts we can learn something from these systems in revamping the US healthcare system. In your opinion, is that a reasonable assertion?

[JoeRedskin]

Also, I am curious. What would the costs involved be in simply expanding Medicaid to cover these 45 Million. In your opinion, would it be more or less than the costs anticipated by Obama's legislation.

[Schneed10]

Originally Posted by JoeRedskin

Sorry, can you explain walk me through what you mean by the bolded statement?

This post may help. Essentially the influx of covered patients causes a logjam with wait times, and eventually a lot of people decide going to the doctor isn't worth it (unless it's a serious issue). The longer the wait time for appointments, the more you have people deciding that going to the doctor isn't worth it.

http://www.thewarpath.net/parking-lo...tml#post566223

Originally Posted by JoeRedskin

Saden asserts we can learn something from these systems in revamping the US healthcare system. In your opinion, is that a reasonable assertion?

Yes there are things they do which would be intelligent moves for us to adopt:

1) Other nations don't allow malpractice awards like the US does. Consequently their physicians don't have to pay $50,000 - $100,000 a year in malpractice premiums like ours do, so their lower physician salaries afford them a nice standard of living.

2) I think one source of major excess expense in the US is our overabundance of the best technology. When you have a government-run healthcare system, the government decides how to allocate expensive technologies in hospitals all throughout the country. They decide how many Gamma Knife machines the country needs, and where to put them. However, American hospitals are in business competing with one another, so they tend to go after the latest technology to remain competitive and attract physicians to direct their patients there. This results in a technology "arms race", and lots of technologies get underutilized. Then of course, naturally hospitals put pressure on physicians to make more use of the equipment, and you end up with expensive procedures and treatments in lieu of tried & true methods that may be much cheaper.

If the government could find a way to allocate the technology and equipment without oversaturating, but without jamming appointment times out for weeks and weeks, then I think we'd be in great shape.

[JoeRedskin]

Excellent points. Thank you.

[Schneed10]

Also, it should be noted that the geography of the United States lends itself to an expensive healthcare system. We're spread out across a lot of square miles.

Conversely, Europe and Japan are tightly packed. When tightly packed, you gain economies of scale by having fewer access points to care. It makes for fewer locations to staff up. However when spread out geographically like the US, you can't just have a number of hospitals in Chicago and then a number of hospitals in St. Louis, you need a number of centers in between to accomodate emergency care.

While building costs wouldn't vary between countries (you'd simply scale the size of the building to the population density in the area), you still have to staff each facility adequately to handle patient needs. The more facilities you have to staff, the more costly it gets.

[Schneed10]

Originally Posted by JoeRedskin

Also, I am curious. What would the costs involved be in simply expanding Medicaid to cover these 45 Million. In your opinion, would it be more or less than the costs anticipated by Obama's legislation.

It's really tough to say without knowing what the reimbursement to hospitals would be under the government plan. My instinct says covering all 45 million under Medicaid would be cheaper.

However to cover the 45 million you'd have to raise the limit on the income level that qualifies people for Medicaid. In doing so, you'd end up covering a lot more than 45 million people, which would get exceedingly expensive.

But in a vacuum, if you covered the 45 million under Medicaid, I think it would be cheaper for the government. However, as discussed in previous posts in this thread, Medicaid reimbursement to hospitals blows, and commercial insurance companies are asked to pay rates to hospitals high enough to cover the losses on Medicaid patients. Adding Medicaid patients (without boosting Medicaid reimbursement rates) would mean an even greater burden would be placed on commercial insurance companies.

Those of us who are insured through the Blue Crosses of the world would pay even higher premiums to make up for even more horrendous Medicaid reimbursement. So while the federal government saves money by covering the 45 million through Medicaid, the ultimate cost on the citizenship is the same.

That's the thing, no matter how you configure the reimbursement and coverage part of the equation, healthcare costs what it costs. You're just debating over who pays for it, and how much. The only way we can make the system better is by actually attacking the cost of delivering care.

[JoeRedskin]

Originally Posted by Schneed10

It's really tough to say without knowing what the reimbursement to hospitals would be under the government plan. My instinct says covering all 45 million under Medicaid would be cheaper.

However to cover the 45 million you'd have to raise the limit on the income level that qualifies people for Medicaid. In doing so, you'd end up covering a lot more than 45 million people, which would get exceedingly expensive.

But in a vacuum, if you covered the 45 million under Medicaid, I think it would be cheaper for the government. However, as discussed in previous posts in this thread, Medicaid reimbursement to hospitals blows, and commercial insurance companies are asked to pay rates to hospitals high enough to cover the losses on Medicaid patients. Adding Medicaid patients (without boosting Medicaid reimbursement rates) would mean an even greater burden would be placed on commercial insurance companies.

Those of us who are insured through the Blue Crosses of the world would pay even higher premiums to make up for even more horrendous Medicaid reimbursement. So while the federal government saves money by covering the 45 million through Medicaid, the ultimate cost on the citizenship is the same.

That's the thing, no matter how you configure the reimbursement and coverage part of the equation, healthcare costs what it costs. You're just debating over who pays for it, and how much. The only way we can make the system better is by actually attacking the cost of delivering care.

First, and again, thanks for the info. As, to the bolded part, I wholeheartedly agree.

[budw38]

Originally Posted by saden1

Why? We already have government hospitals for vets, why not for citizens? I haven't gone over the cliff though I'm sure there are plenty of folks here who would be more than happy to push me over and watch me fall with glee.

Nobody wants to push you off a cliff , you are to entertaining ,,,, oh and too smart . Some might enjoy a " boxing match " between you and Joe , but not falling off a cliff .