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Politics : Foreign Affairs Discussion Group -- Ignore unavailable to you. Want to Upgrade?

To: geode00 who wrote (192334)	7/20/2006 5:01:25 PM
From: Constant Reader	Read Replies (3) \| Respond to of 281500

Teachers and schools get nailed if children fail tests, why don't parents? Parents outnumber teachers at the voting booth. If the AMA or the government would police doctors and get rid of those who have lousy skills (including horrific bedside manners) then malpractice (which increases medical costs by 1-2%) wouldn't be an issue. I believe that all state governments have a medical board. They could do a better job at overseeing doctor performance, I agree, but malpractice will always be an issue. Although some doctors like to think so, doctors aren't God and they aren't perfect. Mistakes will always be made. The idea is to find the ones who are incompetent and get rid of them. I seriously question the need to withdraw someone's license because he or she has a lousy bedside manner. Don't like the doctor? Find another. The same holds true for most nationalized plans. As it is, it isn't anywhere near as much an issue as pharmaceutical gouging. As I am alive thanks to what most people think of as "pharmaceutical gouging," but I know was a series of multi-billion dollar investments in incredibly risky projects (most of which failed) that led to development (in a remarkably short time) of a few revolutionary drugs, I'm all for it, as it is commonly defined. Of course, I could have lived in Canada and been very, very dead before they got around to authorizing use of those same drugs because they didn't want to pay for them despite the fact they worked. So much for valuing human life over a budget. Medicare contracts out care to private doctors. Perhaps you misunderstood me. Medicare basically contracts out everything. Most (if not all) claims and payments are handled by private contractors, not government employees. And yes, they pay the private (and public) doctors. So is the problem insurance companies? I think they're a very big part of both high costs AND the denial of healthcare. Ah, I see now. You want your cake and eat it, too! ;-) Most Americans are now covered by HMO's. Whether you (or anyone else) wants to believe it or not, HMO's operate in a fashion remarkably similar to nationalized healthcare the world over. The primary physician is the gatekeeper. To see a specialist you need a referral. To get a referral you need to meet certain criteria. (According to most common criteria, I would not have been allowed to see a cardiologist before my first heart procedure because my symptoms were unusual.) To get an MRI or CAT scan or whatever, you get on a list. If you do some digging, you will probably find that most countries have prioritized waiting lists, based on severity of condition, for such procedures while we do not have much of a waiting list at all (unless through an HMO). This is, BTW one of the primary reasons so many Canadians cross the border to get treatment - a 2 month or longer wait for one of those scans could literally mean the difference between life or death. Much has been written about this over the years. If you believe that nationalized plans the world over do not prioritize care authorization, and delay or deny it with some degree of frequency, you are sorely mistaken. This gets back to satisfaction. Because of our culture, Americans have high expectations, resent gatekeepers, and don't accept "No" very easily. In countries with long histories of nationalized care, the expectation is lower because people are accustomed to gatekeepers. As for traditional insurance (deductible w/ co-pays), the numbers of Americans covered by it is quite small - when offerings of HMO's & PPO's were mandated in the late 1970's, the healthy young fled to lower premiums, causing costs for those left in traditional plans to skyrocket. It didn't take long for it to be next to impossible to get anyone who wasn't already sick into an indemnity plan, so HMO's & PPO's walked off with most of the business (there's a litle more freedom in a PPO, but not much). Most traditional insurance companies lost their shirts offering health insurance and began getting out of the business beginning in the late 1980's. The only big one left that I can think of is Aetna. Kaiser is the largest HMO in the country, and the best-run. They are non-profit. Most of the others converted to profit-making enterprises in the early to mid-90's. Thus, if you want a view of what a nationalized system would look like in the United States, look at Kaiser but also look at HealthNet or PacifiCare. And pray real hard for the first, (if you believe in God, otherwise think positive thoughts). If you want to see how a government prioritizes healthcare treatments while budgeting, look at Oregon's plan. Would everyone be covered by nationalized healthcare here? Sure. Would it be better than what most people have now? I doubt it. Would infant mortality go down? Maybe, maybe not - a lot of that problem is related to lifestyle choices that will not change. BTW, Why are you mentioning property & casualty insurers? On the whole, property & casualty insurance has nothing to do with health insurance. Very few P&C companies offer health insurance and those are probably an insignificant percentage of the total.