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Thread: A perfect example of what is wrong with the Healthcare Private Market

  1. #11
    Senior Member Zigzagman's Avatar
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    The more money they have, the more options they have and anyone in this country has the right to shop around for their care. Just like where to buy jeans or a car or any service you can think of. Even people who are destitute DO have options.
    Capitalism at it's best!!

    Peace

  2. #12
    Senior Member bae's Avatar
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    Quote Originally Posted by Gregg View Post
    But even with that in mind, the uninsured DO have options. The more money they have, the more options they have and anyone in this country has the right to shop around for their care.
    This is not strictly speaking true, because as I mentioned previously, the market isn't really functioning anymore to deliver services to end-user customers directly.

    My resources for my recent adventures dealing with the health care industry were essentially unlimited. And yet, the products I wanted simply weren't available easily to an individual consumer, no matter what the price, unless one wanted to get really really silly and buy your own medical center.

    What I see is a market failure.

    I can pick up a phone and have a Gulfstream at the runway by my house in an hour, to take me just about anywhere, but try and find a specialist who can see you *right now* - it's tricky at any price, unless you know you have an issue considerably ahead of time, and can have minions line up ducks for you.

  3. #13
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    Quote Originally Posted by Gregg View Post
    My SIL is an emergency room RN. I don't know the exact percentage of patients that come to her uninsured, but she assures me it is a LARGE majority. I also do not know the laws and policies of other states, but in my home state if you walk into an emergency room you WILL be treated for whatever ails you. The uninsured around here don't get preventative testing, but they sure as he!! get care. Most of them don't pay for it. Not a penny. We all know who does pay for it. Please do not try to make it sound like care is not available to someone who needs it and to a whole lot of people who really don't. If you, the proverbial all of us "you" (not picking on you winterberry), don't think that is true I strongly suggest you head down to an emergency room near you and spend a little time observing what is going on.
    Gregg, I am a nurse, too, and I know that anyone can get treatment. The fact that we pay for it anyway is a good reason to make it official. If poor people did get preventative care it would save all of us a lot of money.

    A little over a year ago my brother, who is schizophrenic, almost died. His aorta dissected. He was flown by helicopter to the hospital where they did surgery on him that lasted over five hours. Post op he had every conceivable complication -- stroke, infection, bleed. He had to have a second surgery. He had a tracheostomy and a feeding tube. And he was not a cooperative patient. He kept pulling his tubes out. He really didn't know what was going on. He spent seven weeks in the hospital, three of them in ICU. For six weeks he had "one to one" care because he couldn't be left alone. His discharge planning was a nightmare for the social workers. No one wanted him. Finally he was accepted at a new rehab facility that needed patients. After a few weeks at rehab during which time he mostly slept because he was so heavily sedated, they sent him home. The social worker at the rehab was unable to find a doctor who was willing to be his primary care physician. After about fifty phone calls I found someone who would take him, but not right away. We have encountered one obstacle after another all along the way with trying to get his medications reordered and get him the care he needed when he was having drainage from his surgical wound. So, yes, he got care. Yes, the taxpayers paid for it -- I wish I knew how much, maybe a million? And yes, there could be a better way. Although the front end emergency care was there, the followup care wasn't. Which is why so many poor people just go to the ER for whatever ails them. They can't get the care anywhere else.
    Last edited by winterberry; 2-4-11 at 12:24am.

  4. #14
    Senior Member Gina's Avatar
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    Originally Posted by Gregg
    But even with that in mind, the uninsured DO have options. The more money they have, the more options they have and anyone in this country has the right to shop around for their care.
    This assumes it is not an acute emergency situation requiring immediate attention. Then, even if you can afford general care, you are a sitting duck as to cost.

  5. #15
    Senior Member freein05's Avatar
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    Aetna the big health insurance company announced yesterday it's 2010 profits had increased by 30% and it is now paying a very good dividend. I wonder if that has something to do with the increase in health care costs. I don't think health insurance companies provide medical care.

  6. #16
    Senior Member Crystal's Avatar
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    Quote Originally Posted by Gregg View Post
    Let me be clear that I'm (mostly) just playing devil's advocate. But even with that in mind, the uninsured DO have options. The more money they have, the more options they have and anyone in this country has the right to shop around for their care. Just like where to buy jeans or a car or any service you can think of. Even people who are destitute DO have options.

    My SIL is an emergency room RN. I don't know the exact percentage of patients that come to her uninsured, but she assures me it is a LARGE majority. I also do not know the laws and policies of other states, but in my home state if you walk into an emergency room you WILL be treated for whatever ails you. The uninsured around here don't get preventative testing, but they sure as he!! get care. Most of them don't pay for it. Not a penny. We all know who does pay for it. Please do not try to make it sound like care is not available to someone who needs it and to a whole lot of people who really don't. If you, the proverbial all of us "you" (not picking on you winterberry), don't think that is true I strongly suggest you head down to an emergency room near you and spend a little time observing what is going on.
    Depends on your area and the emergency room too. Big cities, impoverished areas -- they DO turn people away unless life threatening. And waits can be very long just to be seen. I waited with an uninsured relative for 2-1/2 days in a California emergency room a few years ago. Things have not improved since then.

  7. #17
    Helper Gregg's Avatar
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    So many good examples that all work to show the complexity of the issue. Winterberry, I think most of us would agree that there must be a better way. There is no logical argument, economic or humanitarian, against finding a way to provide preventative care &/or screening. My frustration shows through sometimes because some would make the US out as a county void of all compassion who provides no avenue for care when the truth is quite the opposite. Oh absolutely there are huge opportunities for improvement (as your brother's case clearly shows), but people are not left to die in the streets, either.

    Zigzagman, even in the halls of socialist Europe, where the healthcare systems are so often held up as a shining example of what is possible, those with the means have more options. Not the least of those is travel to the United States or somewhere else in search of specialists. I wasn't trying to defend or condemn that, just trying to state a simple truth.

    I think bae's point is well taken and shows it is arguable how much advantage can be gained by even well above average resources. I'm a huge believer in the free market, but would tend to agree that shows the market has failed here. Of course the real argument comes when we try to address WHY the market is failing. Is it greed or is it over-regulation? Not sure I have the energy to open that can of worms right now, but it's not hard to guess how the ducks would align if we did.

  8. #18
    Senior Member freein05's Avatar
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    To make the free market work in health care we need to start at the bottom. Medical schools can cost $200,000 or more there needs to be a method to not only reduce the cost but also the number of medical students graduating. We live in a small rural community. I believe my doctor had all or part of her medical school expenses paid by the government for spending at least 5 years in our community. She stayed here and we are lucky to have her. She is as good or better than any doctor I had in the big city. She knows her patents and cares about them. The other day I had an appointment and got there 1/2 hour early and decided to take a nape in my car. I feel asleep and 5 min after I was due for my appointment she came out and woke me up. Where else but in a small town would a doctor do that.

  9. #19
    Helper Gregg's Avatar
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    Quote Originally Posted by freein05 View Post
    To make the free market work in health care we need to start at the bottom. Medical schools can cost $200,000 or more there needs to be a method to not only reduce the cost but also the number of medical students graduating.
    In my way of thinking costs of care would go down if the number of med students graduating went UP. Also more reliance on PA's and RN's, especially in low population settings like you and I both live in, Free. As supply approaches demand prices tend to fall. I do agree that med school shouldn't have to be so prohibitively expensive. There isn't much doubt that the cost has kept countless of intelligent, compassionate people out of the profession. That's a shame. Everyone would love to have a doctor like yours.

  10. #20
    Senior Member bae's Avatar
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    Is the major cost the doctor's time? My doctor will see me, and even make house calls, for $50. If I pop into the clinic to see the nurse or PA for something quick, they often don't even bother to charge.

    From my experience, the major cost sure doesn't seem to be the labor-value of the doctor, but is elsewhere.

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