NeonVomit wrote:Socialised healthcare works as well as it does in Europe. It's not perfect, but if you're unable to afford private healthcare, you don't feel as if it's the end of the world if something goes wrong.
I don't know how well a similar system would work in the US, given that we're talking about a population of 300+ million, as opposed to around 20 million which is the average population of an EU country. Maybe if it was done at a state level?
We already have elements of socialized medicine here in the States;
- Medicaid, for people that cannot afford regular
insurance.
- Medicare, kicks in when you turn 65 years of age.
Also, socialized medicine has also been done at the state level, there is Georgia Medicaid, Georgia Kids, as well as a really stinking bureaucratic nightmare called TennCare, which nearly bankrupted the state.
TennCare kicked out an older neighbor of mine (in her sixties and retired, but not quite sixty-five) as she was deemed as too high of a risk. She nearly lost her leg due to circulatory problems, but there was one doctor- an angel as far as I am concerned, that would not give up on her, and accepted payment based on her family's ability to pay, and then he wrote off the rest.
When the neighbors called TennCare to get an explanation, they had to navigate menus to press 1 for English (which they never answered), press 2 for Spanish, press 3 for Urdu, press 4 for Vietnamese, press 5 for Somalian, and press 6 for Arabic- these are real menu options folks, and for people that are not even citizens of the United States- but they got priority over Rhonda's case. Period.
I can speak with at least some authority on this topic because I was self-employed for several years, I built computer networks and installed/supported billing systems for physicians and medium sized medical groups as a core business offering.
TennCare was too stupid to even process their own claims, so they outsourced payment processing (at least for behavioral health) to an equally incompetent group- United Healthcare. Claims are constantly rejected, and even when processed with an approval number, getting them to pay the doctors for services rendered is an even bigger nightmare. United was trying to start a trend that psychiatric care wasn't "real" medicine, but had no problem paying smaller fees to quacks like chiropractors!
I worked on a Y2K remediation team at CIGNA, and one of the bigger projects was patching several hundred workstations in the IT department's programming group with some rather complex deployment scripts. PROCLAIM was the internal claims management and processing system, and as I was patching systems there, I noticed hundreds and hundreds of work orders taped to the walls of worker's spaces in these giant cube farms.
What did these work orders consist of? Well, most companies spend big bucks on their IT infrastructures to make their businesses more efficient, to cut costs, and to provide higher levels of service to their customers. This was the complete opposite- a typical work order here was for a programmer to write code that would, for example:
"If a range of claims runs from 10,000-12,001 AND
meets procedure codes 122.2, 125.1, 121.0, and
120.0, AND were submitted from the dates of 5/1/99
through 5/30/99 (two digit years, heh heh), THEN
DELAY the claims for 90 days, (run them through
the system) and DENY the claims for various
"Denied due to timely filing", "Denied due to pre
existing conditions", etc. and so on. "
And there were HUNDREDS and HUNDREDS of work orders
like this. These programmers were literally being paid to not make the system more efficient, but it is a concept that I call institutionalized bureaucracy, and on an industrial scale, with the full weight of an incredibly large array of IBM mainframes, minis, and PC Servers with enough computing power to run a small country!
When I was a kid and got sick, we went to the doctor's office, and typically paid $25-$35 per visit. The waiting room was always packed with sick kids and cranky parents. The doctors rarely, if ever, even accepted insurance then, yet they still lived in the most exclusive neighborhoods, and drove rather expensive cars. They didn't turn people away, and would work with families in need on payment arrangements.
That was before the insurance and pharmacetical companies moved in and screwed everything up. This was before the lawyers started getting rich chasing ambulances and putting the screws to insurance companies, and in the days before your mom's friendly neighborhood OB-GYN started having to pay upwards of $250k per year per partner per practice in malpractice insurance premiums.
This was before doctors had to deal with people that don't want to work, are too stupid to learn the electronic billing systems despite hours of training, and never make collection calls, or follow-up on rejected claims.
But they certainly know how to play on MySpace and Facebook all day long, pay their bills on-line, and download untold amounts of viruses and spyware into the practice's network while being rude and capricious to patients on the phone, pocketing the co-pays when the doctor is not looking, and setting up fake bank accounts in the doctor's name- forging his signature on checks- depositing the checks into the shell account, and ripping his practice off for thousands and thousands of dollars- all of this WHILE being rude and capricious to the patients, many of whom are longtime patrons on the practice in question!
This was before organized crime groups started getting involved in Medicaid and Medicare scams, and screwing the government out of billions of dollars per year, with bureaucrats too stupid to put two and two together and getting paid six figures to be essentially worthless paperweights taking up space at a desk in offices decorated like the Taj Mahal!
This was before the hospitals started gouging the insurance companies, before countries that have SOCIALIZED medicine TOLD the drug companies what they would be ALLOWED to charge- and guess who makes up the difference?
If you said US consumers, then move to the front of the class.
So in a nutshell, at the present time, you basically have a choice between a crooked MBA (
who by the way is more worried about his bonus than your health) denying your claims, -or a crooked government bureaucrat that could care even less about your health (
especially if you are an American to begin with, and God help you if you're white) that just can't wait to outsource your insurance processing to the crooked MBA at the lowest bidding insurance company that is going to get yet another bonus if he's able to land the next contract with the crooked bureaucrat (
who he will undoubtedly grease/bribe in the process- in order to secure the contract)
Personally, I would prefer a single layer of bureaucracy with the insurance companies- as reviling as they are, they are still a slightly lesser evil than the government being the customer, which gives you two customers separating the patient from the doctor (first the government then the insurance company), but that's just my opinion.
Obama can't even fix the post office, which is a fairly simple service- he can't fix Detroit- everyone took their cash for clunker goodies and went and bought Toyotas and Hondas, his $1+ trillion stimulus plan has only made the economy worse, and now The Chimp-in-Chief would have people believe that he can somehow magically fix a system that is so utterly vast and complex, he can't even begin to comprehend the business processes behind it- let alone try to "fix" them.
I'd love to speak with him during a town hall meeting- one on one, with no teleprompter and with no wire in his ear for answers by his handlers, and within ten miniutes, he would be exposed as someone that really has no clue what he's talking about when it comes to health care reform.
Tort reform- jerking the ambulance chasing trial lawyers in line, would go a long, long, way towards reducing the single biggest expense (and liability) that most doctors and hospitals have. Good luck with that- the demos are in the American Bar Association's pocket, and that will never ever happen.
Deport ALL of the illegals that are flooding our emergency rooms- if they can't pay $100 for a visit (but won't pay their taxes, and still get welfare and food stamps) to the local doctor's office when the kid gets sick, then tough shit- go home to your country with socialized medicine and its grand ideals. If a 25 year old bartender can afford insurance, but would rather buy an ounce of pot a week and drink up the rest, then it's really not my problem. Hate your career- then get another job doing something else that has better insurance. Drop the attitude, because I don't owe you or some welfare queen with eight kids jack shit.
Widespread EMR implementation- and tax write-offs for successful (not aborted) implementations would also help, but there are no standards for data interchange and exchange, and those would also need to be worked out.
Repealing the stupid and expensive HIPPA regulations would also help- all it did was provide a boom to the medical tech sector, and of course, lined the pockets of senators and congressmen that helped to pass that nefarious legislation.
This is far too complex for one post, but hopefully these "Cliff's Notes" will give everyone at least a glimpse into a system that is complex beyond the imagination of most- and always remember the old adage- "If you want somehthing done right, do it yourself; if you want it screwed up beyond all recognition, then leave it to Congress." - just take a look at our stupid, patchworked tax code- all 30,000+ regulations, rules, and loopholes- do you think that it is fair and equitable?
No one understands it, just like Congress and Obama are among the most spectacularly stupid people in existence. It's not about equity, it's not about health- it's about control- and I can see right through their little charade.
If they want a civil war, then so be it- and it's starting to look like that gray panthers/retirees (ex-AARP members that burned their cards at the Town Hall meetings) will be the ones that fired the second shot heard 'round the world.
) he will most likely still have to pay 2 or 3 thousand out of his/her own pocket. And, dont forget that deductable!!!! 
I do not understand these goddamn grumps who are raising so much fucking Hell against this program. 
They must be independently wealthy, in the entertainment industry, have a secure government job, be by profession a goddamn lawyer, doctor, or some shit like that. What the hell are these self righteous Christian people doing who are hollering about socialism for? WTF is that about? When these people complaining about socialism get really sick and then lose everything they have to some hospital, or blueblooded doctor(to pay his med school loans)then, maybe these pricks will beg for something to keep them off the street after the doctors have stripped them naked! Literally. 
After all, some states are going in the hole financially as we speak, and then, the richer states who could and would do this program will expect a population increase as people move there to get the benefits.