Perhaps because of our history. We are a republic, formed rather differently than most other countries.Quote:
Originally Posted by loosechickens
Should we be just like all the other "democracies"?
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Perhaps because of our history. We are a republic, formed rather differently than most other countries.Quote:
Originally Posted by loosechickens
Should we be just like all the other "democracies"?
Because in the US the primary purpose of healthcare isn't healthcare - it's to make money.Quote:
Originally Posted by loosechickens
"Because in the US the primary purpose of healthcare isn't healthcare - it's to make money. " How true!
Good article in the New England Journal of Medicine talking about just ONE ASPECT (administration) of differing healthcare costs between US and Canada:
Results:
Concusion:Quote:
In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.
Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)
Because of all the different, convoluted private (and public) insurers in this country, doctors and hospitals have to employ huge staffs just to sort it all out. That's just one aspect--we're not even talking about the price of drugs, malpractice insurance, and professional service fees.Quote:
The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.
When I lived in California, I had a great doctor. He and his partner gave up their complex practice, because they were tired of having to be office managers and deal with mountains of paperwork. They closed up shop, and opened up a walk-in, no-appointments, cash-only, no-insurance-taken clinic, because they simply wanted to practice medicine.Quote:
Originally Posted by catherine
To see them, you showed up, handed $50 to the one staff person in the place, then waited, anywhere from 0->60 mins, then you saw the doctor, and he'd spend as much time as necessary to deal with your situation. If it was something complicated that involved having to go the the hospital, then you had to re-enter the world of paperwork.
Where I live now, the not-for-profit clinic I use has: 1 doctor, one nurse-practitioner, 1 nurse, a tech, and about 5 office staff people who seem to handle billing/insurance all day long. The paperwork staff to my eye seems to outnumber the medical staff at any moment in time, and they used to have *more* staff before they became a non-profit operation. And this doctor will see and treat anyone who walks in, regardless of ability to pay. He's not in it for the money, he just wants to practice medicine.
bae, you are right. I'm sorry if i sometimes rub the wrong way. I just get so tired of the same old arguments. And to be honest, you sometimes have a way of twisting people's meanings to mean something else.Quote:
Originally Posted by bae
You know I believe in people getting paid for their work, and I'm guessing you haven't lived your entire life secluded on your island, so you've seen successful not for profit business. You know everyone makes a good living and they work. Not socialist, or some evil, subversive creep of communism, or whatever.
This world, and even this country is full of successful, purposeful enterprise that isn't for profit. Profit really isn't the end all to beat all. Just a stroll through these forums here will show you that. There really are bigger things out there than profit.
Now I'm not at all opposed to profit. I am an American through and through and think capitalism is a wonderful thing, where appropriate. And there is plenty for investors to make loads of money in. There just shouldn't be a profit in playing god.
Peggy - again you persist. I asked a very simple question above - "which specific 'profit' is the problem?"
I did not invoke any of the demons you are railing against. You are arguing with someone else, apparently.
bae, I believe I answered you. Just because you don't accept my answer doesn't mean I didn't answer.
No profit: police, fire department, military, direct medical care (doesn't include scalpel producers, rubber tubing manufactures, etc.. Does include hospitals, access, clinics, immunizations, etc..) our government, and probably a few smaller ones I can't think of right now. And it's not just the life and death aspect, although that is certainly important, but it is also the corruption aspect that is ALWAYS present when these are profit enterprises.
In the "profit", "not for profit" sense, I don't see anything wrong with a company making a profit providing a product or service, but in the case of "for profit" health care entitites, it's as though they are NOT in the business of providing health care, but primarily in the business of producing profit for stockholders, often at the expense of the people they are supposed to be serving by providing health insurance or health care.
When it becomes more profitable for you to deny care, and that is how you produce profits, then the whole basic idea of your business being "providing health care or insurance" has been compromised. You're not in the business of providing health care or insurance, and in fact, providing those things to your customers actually cuts into your profit, so the incentive is NOT to produce better care, but to provide as little as you can get away with.
The incentives are mixed up. And rather than blame a profit making entity for trying to make a profit the best way they can, we should be asking ourselves how could the best quality and amount of care be provided, not depending on a system that actually has another objective in mind. The objective being maximizing profit for stockholders rather than maximizing care for the policyholders. No point blaming the companies, it's the system that is skewed.
To me, it's almost exactly like blaming Bain Capital for maximizing profits to their stockholders even if it meant lots of folks losing jobs or companies being caused to go bankrupt. Bain Capital was NOT in the business of creating jobs, or in business to grow businesses so that more workers could be employed. They were (and are) in the business of going into a business, assessing how best to make the most possible money for their stockholders and executives, and sometimes that meant creating jobs, but the creation of jobs was a byproduct, not the purpose, and sometimes it meant bankrupting a business because more profit could be made for Bain Capital by doing so.
If the business of creating jobs was what they were doing, then creating jobs flew right in the face of their prime objective, which was to make money for themselves. The only problem with that is if we were under the impression, somehow, that what they were in business to do was to create jobs.
If we recognize that making a profit for stockholders is the business of many healthcare companies, then it is almost wrong to blame them for providing poor access to care. If they ran their businesses to provide the best kind of health care, it wouldn't make as much profit. Providing the health care is almost a byproduct, rather than their purpose, and often providing that care runs directly counter to what is in their own best interest, which is to deny as much care as they can, cherry pick who they are willing to insure, trying not to pick anyone likely to need expensive care. That is their business model, and expecting them not to do that is like expecting Bain Capital to be mostly concerned with whether jobs are created, or whether people are laid off......putting their attention onto THOSE things would be counter to what their actual purpose of being in business IS.
are we to blame a tiger for not being a lamb? If we want good, quality health care to be provided to our citizens, whether by private companies or a public option, we've got to have a system where such companies or systems are rewarded for doing the best possible job of providing that health care.
I don't blame the companies. Heck, we've made some very nice profits and dividends in some health insurance companies. They are doing what they are designed to do, make profits for their investors. They are not really in the business of providing health care, let alone providing the very BEST health care they can. We need a new system with different incentives.
Otherwise, we are just blaming health care companies for doing what they are actually designed to do, just as we blame Bain Capital for costing people jobs, when they are just doing what they are designed to do, which is to make profits for stockholders, not to create jobs. (I never thought I'd be in the position of defending Bain Capital OR health care companies, but it is a very similar situation, and blaming them for being good at what they are actually designed to do is not right).
What might BE right would be figuring out a way to have a health care system where providing the best quality care would be incentivized to the company, so THAT would be the best way for them to profit, rather than what we have now, which is them denying as much care as they possibly can to increase profits.
LC, once again you say it better than everyone else! Very well put!