A Health Care Expert Speaks Up

"As many times as those Senators pass that officer every day in the hallway, I'll bet it has never occurred to them that they are in the presence of a first-class health care expert."

To paraphrase Barney the Gay Dinosaur, exactly what planet do they reside?

doesn't it also beg the question as to why those first-class health care experts don't demand reform with the same intensity as those who shout against it?

Can it be that hard to get 70,000 + people to protest in the Capital demanding reform? Well, yes it can be because the people who feel most passionately about it would rather gripe about what might not be done rather than support the good things that can be done. But I suppose it's way easier to scream betrayal than anything else.

"The officer said he is mystified by all the talk he hears about how covering the uninsured would be too expensive for the government to take on. "Don't they know?" the officer said, gesturing to the Senators who were scurrying in and out of the elevator. "It's getting paid for. We are all paying for this. We are paying with our tax dollars."

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Actually not our tax dollars, but increases to our premiums would better describe how the "indigent" get healthcare for nothing, today. That hospitals simply charge those of us with insurance more, and the insurance companies pass that on as higher insurance premium costs.
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Perhaps this Officer also doesn't know that the real cause of rising healthcare costs for premiums is due to the fact that legislation permits near monopolies with insurance on a State by State basis. That with over 1300 different insurance companies in the US, in California for example, a small business would give their employees health insurance coverage, but out of the 1300 or so insurance companies the small business owner can only choose from 3, 4, maybe 6 of those insurance companies "approved" to do business in that State.
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Perhaps that Officer also doesn't realize the huge sums paid out to trial Lawyers for frivilous law suits, and how that also raises the cost of each and every premium, and thereby makes it too costly for that indigent person he just picked up and carted off to the hospital to afford.
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Perhaps that Officer also doesn't realize that there is so much fraud and claims submitted which are bilking billions out of Medicare and Medicaid that has kept legislatures from relaxing the restrictions to who can qualify for either of these already existing Government backed/run healthcare insurance programs.
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Perhaps if this Officer / EMT knew to tell this individual enroute to the hospital, that if they asked to speak with a social worker in the hospital, they could fill out the forms necessary to get them at minimum, Medicaid coverage, if they are indeed indigent and not just paying for healthcare insurance for such times when they need to get Emergency care.
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Perhaps this Officer also knows that the system is indeed broken, and needs fixed, but not at the total expense of hard working tax payers of the US.

Karen some of these Senators want the bills written in legislative language that they cannot read themselves so they can post if for the public to read.

off topic I know, but why does Mark Halperin think Palin's private paid for speech to a bunch of bankers in Hong Kong is more newsworthy than the pretty decent speech Obama gave to the UN GA today?

The officer said he is mystified by all the talk he hears about how covering the uninsured would be too expensive for the government to take on. "Don't they know?" the officer said, gesturing to the Senators who were scurrying in and out of the elevator. "It's getting paid for. We are all paying for this. We are paying with our tax dollars."
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This is your idea of an expert?
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I mean, you aren't this stupid -- I know that YOU know that tax dollars do not fully compensate hospitals for the costs of providing care to people without insurance --- that much of those costs are covered by higher insurance premiums -- and SKY HIGH costs for the uninsured OR UNDERINSURED who do have some income/assets.
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Indeed, when someone says "I can't afford to be taken to the hospital", it may usually means that they do have income/assets that the hospital can attach.
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In other words, you are promoting as an expert someone who presents an extremely limited, and INACCURATE, view of the situation. And my question is WHY ARE YOU MISREPRESENTING THE SITUATION?

President Obama needs to meet with T.R. Reid!

"No Country for Sick Men" * By T.R. Reid * Newsweek * 9/12/09
-- To judge the content of a nation's character, look no further than its health-care system.

http://www.newsweek.com/id/215290

Reid's book "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care" was just published by Penguin Press. He was the Correspondent for Two PBS Frontline documentaries based on the book.

~~

Daily Kos * Book Review by mcjoan * 9/20/09 * http://mcjoan.dailykos.com
“The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care” by T.R. Reid

“On September 11, 2001, some three thousand Americans were killed by terrorists; our country has spent hundreds of billions of dollars to make sure it doesn't happen again. But that same year, and every year since then, some twenty thousand Americans died because they couldn't get health care. That doesn't happen in any other developed country. Hundreds of thousands of Americans go bankrupt every year because of medical bills. That doesn't happen in any other developed country, either.”

Since T.R. Reid wrote those words in the prologue to his new book, the picture has gotten even bleaker, with a new study from the Harvard Medical School putting the number of lives lost at 45,000 a year--one every 12 minutes--from lack of insurance. Which makes this critical book from Mr. Reid all the more important for activists, concerned citizens, healthcare providers, and most critically, policy-makers.

In his book, Reid embarks on what he calls “a quest for two cures,” one for a bum shoulder that has bothered him for years, causing pain and curtailing some activities, and a second for a fatally flawed American health system. Using his shoulder as a means of entree into the healthcare systems of some of the worlds other industrialized nations, Reid gives in-depth (and totally accessible) descriptions of those systems. We see how it'd done in the French, Canadian, German, Japanese, and British systems, along with descriptions of the recently implemented Swedish and Taiwanese systems. You don't necessarily realize it while you're reading, but you're taking Comparative Health Economics 101. With a really fun professor.

You learn that there are four basic models of national healthcare delivery at use in the industrialized world: The Bismarck model, named for Germany's Otto von Bismarck, a private system in which the government shapes the rules of the market, but insurers and providers are private actors. The Beveridge model, named for England's William Beveridge, is a socialized system--the government owns the hospitals and the medical professionals are all employed by the government. The National Health Insurance model, or single-payer, is sort of a hybrid of Bismarck and Beveridge in which the government is the insurer, but the doctors and hospitals are private. None of these systems is perfect, and all struggle with keeping costs under control. But none of them let people die for the simple reason that they can't pay.

Then there's the fourth model, the Out of Pocket model, which is what the U.S. as well as the whole rest of the world--primarily developing nations--has. You can get health services if you can afford to buy them. It's a model that no other developed nation has followed. Every other developed country has made the fundamental moral decision that healthcare is a basic right for its citizens, and each has achieved universal coverage. Reid doesn't really try to answer the basic question of what is lacking on the moral character of the U.S. to leave us out of the club, but that's not a deficiency in the book, nor was it his job. He's not an ethicist, but a reporter.

His reporting, thus, is geared toward describing how it can be done. To his credit, he keeps the discussion outside of the current battles and American political debate, and systematically advances that debate by debunking the most pernicious and pervasive American myths about healthcare systems overseas, myths that he also addressed in a Washington Post article --

MYTH 1 -- It's all socialized medicine out there.

Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans....

MYTH 2 -- Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer....

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.

MYTH 3 -- Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours....

MYTH 4 -- Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs....

MYTH 5 -- Health insurance has to be cruel.

Not really. American health insurance companies routinely reject applicants with a “preexisting condition” -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's “rescission department” digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business....

The final myth debunked in the book: “Those system are too foreign to work in the USA.” American exceptionalism often leads to this argument. We're different, we have to find our own path. The trouble is, all four models of healthcare delivery are alive and well within the U.S. today. The British model covers veterans, active-duty military personnel, and Native Americans. The Canadian model covers all of our seniors. People who have employer-provided insurance are just like those in Germany and Japan. As Reid says, “Of course the foreign models could work for Americans; they already do.”

There's another myth that underlies the entire debate, as well as Reid's book; the U.S. has the best healthcare in the world. We have got the makings of it; the best medical education, the most advanced technology, outstanding hospitals, and cutting-edge research. All of the components for achieving that goal are here, in our hands. But until the day when no American dies because of a lack of health insurance, we're nowhere near best in the world.

That's Reid's basic message. He's shown more than one path to getting there, including the most critical one: making that moral decision that healthcare is a right. Until our leaders make that decision, every single one of those deaths--one every 12 minutes--is on their hands. This book should be required reading for each and every one of those leaders.

Now you've done it - you implied that some of us is uncivil. How dare ye! Yarr.

KT:
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This is a very interesting post.

The magnitude of that cost-shifting is a matter of some dispute.
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Yet, your "expert" said that it was covered by tax dollar -- and you reported it as an undisputed fact, rather than "a matter of some dispute".
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More crucially, your "expert" was saying that people who "say they can't afford" to go to the hospital don't have to worry because its paid for. That is pig ignorant -- people who are uninsured or underinsured can still have jobs and assets that can be attached -- and can be sent into bankruptcy as a result of the costs of medical care.
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"I can't afford it" can mean "I will have to sell my house, empty my kids college fund, and cash in my IRAs in order to avoid bankruptcy". Your "expert" (and you) treated people in that position as unworthy of notice....

Get with it people.

Civility is the new bipartisan.

As a nurse married to an ED doc, we know that everyone pays through higher healthcare bills. There is but one logical and cost effective way to manage healthcare in our country, universal healthcare for all. Essentially Medicare for all with no pre-existing conditions (an insurance company made up word), no denial or care, medical malpractice or tort reform is the answer. Is it socialized medicine? I think our congressmen and women seem to like it and that is what they have. Why should we have less than they do? They work for us. The 30% off the top of your premiums that go to the excess in insurance companies overhead, bonuses, etc. could go to healthcare!! We could stop the outrageous expenditure on trade shows, perks, marketing on TV, etc. People in this country are fearful of loosing their jobs and coverage, going bankrupt to pay for their care and yes, dying because they don't have healthcare. HEALTHCARE IS A RIGHT NOT A PRIVILEGE. A message from the front lines.....

You may also be interested in this report "Catch Me if You Can: Hospitals, Cost Shifting, and the Game of Medicare Payment Policy" August 2004 Rick Mayes, Ph.D. Assistant Professor Faculty Research Fellow Department of Political Science Petris Center on Healthcare Markets University of Richmond School of Public Health Richmond, VA
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http://www.allacademic.com//meta/p_mla_apa_research_citation/0/6/0/4/0/pages60406/p60406-1.php
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This is perhaps the most comprehensive report on "cost shifting", and the history of Medicare payments.
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And, you are welcome.

The magnitude of that cost-shifting is a matter of some dispute.

Speaking of cost-shifting....Maybe consider that other countries' cost controls force global pharma/medical tech companies to reap their profits by jacking up prices in the US?