I see... so when a person does not have medical coverage, cannot afford it, they should be provided preventive care, but then they're crap out of luck should an actual medical issue need to be addressed? Preventive care only goes so far. Granted, it would be nice, but it only goes so far. Also, there is no logical means to penalize people for not taking care of themselves. What do you want to do, impose fines, deny services?
In addition to Hellstromm's questions, what happens to those who get serious health problems that can't be prevented?
These are valid questions, unfortunately, I am running out of time to answer in detail.
The short answer is this. Preventive cares are often much cheaper, this, however, only lessen the probability in some cases of preventing some disease, such as cold/flu with flu shot. polio and other vaccine still may not provide 100% protection.
Eating healthier, exercise more may not be practical nor feasible for some people. We have limited resources and there are problems everywhere I look.
USA provide some of the best care, but at the highest cost in the world. Do we have to go that far? Probably not if you are looking at pure efficiency.
I've worked in various industries and I have family member or friends who work in various industries concerning this problem. Instead of answer questions in detail, I'll pose some questions for you to ponder.
1. Doctors are frustrated with insurance companies, I know some doctors who charge patients 40% of what they typically charge for CASH customers. The reason being, they can get the cash, eventhough they take a huge hit up front, they end up better off in the end. They don't have to navigate a maze of insurance reimbursement code and pray they get what they deserve. It's pretty bad, trust me on that. Doctors drop insurance carriers because they are fed up with the problems.
2. Insurance companies pay their executives well, low ball health care providers, they seem like the villain, but is that really true? Insurance companies also have to deal with insurance fraud as doctors and patients figure out ways around it and the vicious cycle continues (reclassify some condition in order to get insurance company to pay). I think insurance company rightly deserve some of the harshest criticism but they also have legitimate problems that needs to be addressed.
3. Doctors order tests as a way to avoid malpractice lawsuit, states cap medical malpractice reward (California caps at about 250,000 I believe). But the problem is, there are some doctors, although few in number, are causing a lot of patient grief. Should we be lenient on those doctors or strictly enforce the penalty so they can never practice again? What's preventing those doctors who move to another state and cause more problems for patients in those states?
4. pharmaceutical companies who take government money, does medical research, then charge the public an arm and a leg for those prescription, are they double dipping? If they use entirely their fund for research and development cost of those medication, I have less issues with that, however, that's not the case as I pointed out earlier. What can we do about this? I also know people work in the pharmaceutical and they complain about the difficulty of smaller start ups, who are often the driving force behind new medicine, are often forced to either sell the patent of their medication to bigger pharmaceuticals as they cannot afford the clinical trial cost and/or the marketing cost. Is it the right thing to do to skip clinical trials? If not, what can we do to lower the clinical trial cost and still gain FDA approval?
5. USA spend a lot of money on medical research and other countries often benefit from it. Should USA force lower profit margin on patent holder for medical related technology, potentially driving some of the innovation to other countries in order to lower the medical cost in USA?
6. Why are at least some specialists flee Canada and move to USA?
7. government health plan = higher taxes. It's a given. Please don't give me examples where countries with low taxes still provide universal healthcare as a working example. One example I was given, Taiwan, is facing its own crisis as its universal healthcare is constantly broke, running a big deficit, forcing the government to raise fees and still scramble to find new revenue sources, including threats to sell of land and other assets of municipalities who fail to chip in their share of the medical cost.
There are many other questions I can ask in these areas plus more. I think USA's current system is broke, there are too many middle man between the doctor and patient. providing free preventive care is a compromise of sorts, where I think the least cost to the public can do the greatest good, eliminate some middle man and keep our fingers crossed that the bureaucracy will not grow inefficient over time.
It makes sense for government to provide public goods. When situations arise where there is "tragedy of the commons" or "tragedy of anti-commons", government should step in to remedy the situation. However, I just don't have enough faith to believe government will be able to run very efficiently.
I used to be a 100% free market supporter back in college, when I was studying economics. After I started to work, my view gradually changed, when I realized while preaching the merit of free market is great in theory, the reality is very different. Congress pass legislation to distort the market, one of the best "investment" a corporation can make is spend money on political contribution and/or lobbying to get favorable laws passed. I became more cynical and no longer a 100% believer in free market since what I observed in reality is different from the theories I learned from those economics textbook.
I don't want my friends to quit being doctors, since I already know several cases that have quit being a doctor. It's a great waste, since they took up valuable medical school spot and/or residency, preventing someone else to be a doctor then quit being one as they grow disillusioned while in medical school (as they do their rounds in their 3rd & 4th year) or during residency. What's even worse is at least a few of them genuinely care about patients and were very frustrated when they watch their own patients suffer as necessary medical treatments were denied.
One example my friend told me, that caused him to become disillusioned at being a doctor, he is still a doctor a few years ago, because he took pay cuts in order to give his patients better care, but if possible, it should be up to the doctor + patients to determine how much something cost (which may not be realistic as you look at the US patent portfolio. Some countries, such as China, disallow patent of medical procedure (at least 2-3 years ago when I checked this) in order to keep medical cost down.
If you are a doctor, you know a procedure will help a patient, but it's patented, you have to get a license from the patent holder, even if you prefer to provide this procedure to your patient at little to no cost to your patient as it doesn't cost much time nor material on your part.
Here are some URL
http://appft1.uspto.gov/netacgi/nph...70".PGNR.&OS=DN/20030175670&RS=DN/20030175670
http://www.google.com/patents?q=medical+procedure&btnG=Search+Patents
USA needs some kind of government health plan, but this problem is very complicated as I spent at least 10 years looking at it from different angle, the best solution is really eliminate some of those middle man and instead of awarding patents indiscriminately, force compulsory license on some medical patents BUT keep track how often they are used and how valuable it is, then reward those patent holders annually from government fund to compensate for the low compulsory license as they can save lives. However, this only scratch the surface of one layer of problem, you still need to address the inherent conflict of interest between insurance company (or government), who wants to keep the cost low while the patients wants as much care as they can get which will cost the insurance (or government) more money.
Don't penalize doctors who act reasonable and refuse to order tests + diagnostics. Don't let bad doctors get away.
Like I said in my other post, I can write pages after pages on this, my reason for proposing only offer preventive care + annual checkups with necessary dianogstic tests + reward healthy life style + penalize bad life style is probably the best starting point for "government funded healthcare". We still need to tackle the other part of escalating medical cost, such as executive compensation, pharmaceutical marketing (is it really that necessary to run all those TV ads about some medicine, making patients asking doctors for those eventhough they may not need those medicine?), laws that force ER to take anyone without considering the burden on hospitals. (In California, the result is more and more hospitals shut down ER to escape this as they are losing money from ER operation, forcing to choose either close hospital due to ER or just shuts down ER. You can google some of those news, Los angeles hospitals were sued by district attorney for violating law because they took in homeless, treated them, then discharge them after a day, eventhough those patients cause those hospitals to lose quite abit of money.
http://articles.latimes.com/2009/apr/09/local/me-homeless-dumping9
http://www.usatoday.com/news/nation/2007-02-15-skid-row_x.htm
http://pqasb.pqarchiver.com/latimes...standing+problem+with+uninsured.&pqatl=google
http://pqasb.pqarchiver.com/latimes...ublic+facilities+turn+them+away.&pqatl=google
You can easily google up some of these yourself. There is no free lunch, money has to come from somewhere. It makes sense to provide universal care as it will eliminate "uninsured patient" "waste". However, how far should we go in providing this universal health care? Will it add another layer of middle man between doctor & patient? Not all middle man are bad, if government can negotiate bulk prescription medicine rate, that'll provide more benefit to both doctor + patients, but will government do that? look at the Bush administration, don't negotiate bulk rate with pharmaceutical companies? What the???? I know Obama is different, so whatever they do, they have to do mandatory negotiation with pharmaceutical company and enough safeguards needs to be put in place so money cannot bribe its way into the system and corrupts it, making the taxpayers pay in the end for those special interest groups.
It is my fear of those lobbyists, special interest groups, and the fact money talks that makes me unwilling to support blanket, cover everything universal health care right now. If you can show me there will be enough safeguards and we really do try to provide more efficiency and take out the middle man, I will be all for universal healthcare that covers everything. Until then, no, I only want a more limited version right now, reward people for leading a healthy lifestyle and without burden those of us who lead a healthier lifestyle to pay for other people's indulgence. However, do not penalize people with genetic disposition as they are born with it, just like their skin color.
