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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lazarus_Long who wrote (94)	1/14/2005 11:32:37 AM
From: Wharf Rat	Read Replies (3) \| Respond to of 42652

Take 3; damn cat just erased my message. Thanks for the invite. Had to think about what I wanted to say; pretty complex subject. We have a model for national healthcare; it's called the VA. Yes, it has problems, but it was also the purest form of medicine I ever practiced. There is no emphasis on money. I've been at places where I've felt like was able to cheat the hospital by giving out free kleenex. At the VA, you got what you needed, whether care or DME. Since many of the big ones are associated with medical schools, sometimes the quality of care is even pretty good. OTH, there are lots of problems, not the least of which is the bureaucracy.( However, I think the bureaucracy/ bed at my little 75 bed place is pretty close to the VA's. Why does a small hospital need a 4 person marketing department? Another is the system itself; it literally takes acts of Congress to change things. I mean, it took an act of Congress sometime in the eighties to recognize respiratory therapy was a profession, and not something called a medical machine tech. Pay can be a big problem,too, at least in high priced regions like the Bay Area. Lots of things need to be looked at. What's the cost of the entire bureaucracy, (hospital, insurance, and gvt ) built up just to handle the paperwork generated by the bureaucracy.HMO clerks telling docs what they can or can't do. Cost of keeping somebody alive for the last year of their life, at no gain in quality of life. (We need to change attitudes about death; there is a time to let go. We can only push a failing bod so far, and lots of times it is just for the family. I am so glad my father died at home.) Too many tests; a doc at Stanfurd used to say, "If you aren't going to act on the results, don't do the test." Unfortunately, that is forgotten. The ER has become the primary care physician; how much does that add to the cost of care? Rat