And yet another argument for single payer.......

[EVT1]

www.reuters.com/article/2014/05/24/us-usa-politics-shinseki-republican-idUSBREA4M0RM20140524

    Reuters) - The Republican congressman overseeing a U.S. House panel investigation into delays in veterans' treatment demanded on Friday that Veteran Affairs Secretary Eric Shinseki allow patients to seek emergency private health care.

[truthbound]

Yes you are a liberal progressive. There is no argument.

[jkapp]

May 24, 2014 2:02:04 GMT -5 EVT1 said:

www.reuters.com/article/2014/05/24/us-usa-politics-shinseki-republican-idUSBREA4M0RM20140524

    Reuters) - The Republican congressman overseeing a U.S. House panel investigation into delays in veterans' treatment demanded on Friday that Veteran Affairs Secretary Eric Shinseki allow patients to seek emergency private health care.

Considering the VA is a social program, how is this issue a positive argument for another social program?

[EVT1]

Because the VA is 100% socialized- you should support ending that. Single payer is just that- one person writes the checks and you can go to any private provider you wish.

How do you think soldiers get treated in all of these other countries?  Think we are doing a better job?

[truthbound]

The VA is not a social program. And it has nothing to do with the insurance regular people get. Moving on.

[Shooby]

May 24, 2014 14:13:58 GMT -5 EVT1 said:

Because the VA is 100% socialized- you should support ending that. Single payer is just that- one person writes the checks and you can go to any private provider you wish.

How do you think soldiers get treated in all of these other countries?  Think we are doing a better job?

One person writes the check. Or that same person can choose Not to write the check , denying you care with absolutely no recourse. Funny how liberals think that shutting down everyone's options is a good thing.

[tallguy]

One person writes the check. Or that same person can choose Not to write the check , denying you care with absolutely no recourse. Funny how liberals think that shutting down everyone's options is a good thing.

And yet you prefer a system where that person's incentives and bonuses are at least in part conditioned on figuring out ways how to NOT write that check for you?  Seriously?  Funny how conservatives don't seem to think at all.

[Ava]

I think more and more people are starting to realize "we have the best healthcare in the world" is a shameful lie.
More and more citizens now see single payer as the real solution to our health care crisis.
I think pretty soon we'll join the rest of the industrialized nations. Let's face it; every other country is doing it that way, and they achieve better results than the U.S.
Even now, with the changes brought by the ACA, healthcare remains expensive and out of reach for way too many Americans.
We'll soon find a candidate (hopefully senator Warren from MA) who will run on single payer and that candidate will win, because people are tired of what we have. Not only that, the current system, even with the ACA, is unsustainable and will crash pretty soon.
The only folk I can see defending our current system (besides politicians, big pharma, and the for-profit insurance companies) are those lucky enough to carry excellent coverage through work, so they never had to face an unexpected huge bill coming from nowhere, or have their doctors choices, or their medicine or procedures severely limited by a crappy health insurance plan. But it's sad because they are just one downsizing or job loss away from having to deal with our insane, expensive, and cruel system. They just don't realize it.

[EVT1]

May 25, 2014 12:26:49 GMT -5 Shooby said:

May 24, 2014 14:13:58 GMT -5 EVT1 said:

Because the VA is 100% socialized- you should support ending that. Single payer is just that- one person writes the checks and you can go to any private provider you wish.

How do you think soldiers get treated in all of these other countries?  Think we are doing a better job?

One person writes the check. Or that same person can choose Not to write the check , denying you care with absolutely no recourse. Funny how liberals think that shutting down everyone's options is a good thing.

That's not true at all- in a good system all basic care and procedures would be covered based on whatever we decide we want our citizens to have.

You would be absolutely free to buy insurance for non-covered things or pay cash.  And I am sure there would be an appeals process as there is now in the system- that exists in both private insurance and public.

A government payer system has only one goal- to administer the system in an effective way.  Finding ways to deny care and make a larger profit isn't one of them.

The only 'option' being removed is the ability to add piles and piles of red tape and crap inherent dealing with multiple insurance companies, policies, procedures, etc. into the system- not to mention the added costs.

I didn't think fixing something that doesn't work was a 'liberal' thing.  Take one look around the world and it is painfully obvious we are doing it wrong.  Cancer doesn't give a shit about politics- so think about the fact that people die untreated and/or go bankrupt in this country while citizens in others get treatment and recover- and don't even have to dick around with numerous companies that are going to try and bill them into oblivion.

I am with the ava- the only people that love this system are either very wealthy or have gold-plated policies (and of course the medical-industrial complex).  And guess what- unless you are very wealthy you can lose it all too .  That gold-plated policy means shit when you get terminated from your job and can't afford the premium while you are laid up in the hospital- or even worse you get something that is going to last the rest of your life- people formerly known as 'un-insurable' before the ACA. 

[justme]

I don't know of any single payer system out there that only pays for "basic" care and then people buy private insurance for the rest. Probably because there's no way to define "basic" that doesn't cause outrage. I don't think anyone would label cancer treatments as "basic" but it would defeat the purpose of your single payer not to have that covered.

From what I know, those countries that allow private insurance (there are some that do not) it mostly gives you access to doctors that don't want to be part of the single payer system and there you can get better/quick access/choice.

I'd be interested in seeing what countries provide "basic" care where the citizens then pay for anything above "basic" and how they determined "basic".

[Deleted]

Actually the U.S. does have "the best healthcare money can buy"... unfortunately too many people in the U.S. don't have enough money TO buy it.

[EVT1]

May 25, 2014 18:33:15 GMT -5 justme said:

I don't know of any single payer system out there that only pays for "basic" care and then people buy private insurance for the rest. Probably because there's no way to define "basic" that doesn't cause outrage. I don't think anyone would label cancer treatments as "basic" but it would defeat the purpose of your single payer not to have that covered.

From what I know, those countries that allow private insurance (there are some that do not) it mostly gives you access to doctors that don't want to be part of the single payer system and there you can get better/quick access/choice.

I'd be interested in seeing what countries provide "basic" care where the citizens then pay for anything above "basic" and how they determined "basic".

I need to clarify that- what I mean by basic care is the normal care and treatments for conditions that have been proven effective.   That would obviously include cancer, heart disease, etc. 

The uncovered care would be experimental/unproven treatments, elective procedures, etc.  And even with proven treatments- if a million dollar procedure is available with a marginally better recovery time, but a 500,000 treatment will cure you just the same- then basic care gets the economy version.  Same goes for new drugs that are not much more effective than tried and true drugs that have generics.

That is what would have to be decided based on a cost/benefit analysis.  Everyone can't have around the clock heroic measures by a team of doctors like some of the ultra-rich people think they deserve.  They can pay for that- but no way should an American citizen be left to die because they can't afford treatment that will save their lives, and neither should they lose their house and possessions over it.  It is immoral to continue that type of system.

[justme]

May 25, 2014 22:10:33 GMT -5 EVT1 said:

May 25, 2014 18:33:15 GMT -5 justme said:

I don't know of any single payer system out there that only pays for "basic" care and then people buy private insurance for the rest. Probably because there's no way to define "basic" that doesn't cause outrage. I don't think anyone would label cancer treatments as "basic" but it would defeat the purpose of your single payer not to have that covered.

From what I know, those countries that allow private insurance (there are some that do not) it mostly gives you access to doctors that don't want to be part of the single payer system and there you can get better/quick access/choice.

I'd be interested in seeing what countries provide "basic" care where the citizens then pay for anything above "basic" and how they determined "basic".

I need to clarify that- what I mean by basic care is the normal care and treatments for conditions that have been proven effective.   That would obviously include cancer, heart disease, etc. 

The uncovered care would be experimental/unproven treatments, elective procedures, etc.  And even with proven treatments- if a million dollar procedure is available with a marginally better recovery time, but a 500,000 treatment will cure you just the same- then basic care gets the economy version.  Same goes for new drugs that are not much more effective than tried and true drugs that have generics.

That is what would have to be decided based on a cost/benefit analysis.  Everyone can't have around the clock heroic measures by a team of doctors like some of the ultra-rich people think they deserve.  They can pay for that- but no way should an American citizen be left to die because they can't afford treatment that will save their lives, and neither should they lose their house and possessions over it.  It is immoral to continue that type of system.

The biggest problem is with what I've bolded. I'm a proud owner of two cheaper medications (Imitrex and naproxen) instead of a newer med that combines the two (honestly have forgotten the name of it) because the two work just as well and are cheaper for me than the new one. Though, I am one that can 97% of the time swallow easily with a migraine so 2 pills is no problem, those like my mother that can't one pill would be almost necessary. Which is almost an argument against making the "newer" meds more expensive. She doesn't have the option of doing two because she'd be throwing up everywhere.

My problem is who decides it's experimental and at what point does it become proven? The FDA has a long ass approval process for proven meds/treatments and even then it doesn't take it off the experimental list. There was a case I read a while back where a new cancer drug was doing well in trial, but a patient who wasn't healthy enough for the trial was denied the treatment after the approved ones failed. Would she be SOL without paying for private insurance? When its the government red tape that kept her from it? Or, in a less experimental sense, what about TENS units. A lot of doctors/insurance/etc classify it as unproven/experiment even against a lot of evidence to the contrary. My pain doctor gave me an RX for it to just try it out with my insurance before buying it on my own but told me a lot of places deny it as experimental. Mine approved it, but my Dr had a tons of patients who had to pay out of pocket yet it relieved their pain. Yet other countries don't - in Canada you can get a new TENS like unit for migraines without an RX. In the states? You need an RX and even then it's so new insurance doesn't cover it. Yet there's enough evidence for others to release it.

I'm not saying our system is perfect, but that the government sure isn't that great in deciding stuff.

[tallguy]

Or, in a less experimental sense, what about TENS units. A lot of doctors/insurance/etc classify it as unproven/experiment even against a lot of evidence to the contrary. My pain doctor gave me an RX for it to just try it out with my insurance before buying it on my own but told me a lot of places deny it as experimental. Mine approved it, but my Dr had a tons of patients who had to pay out of pocket yet it relieved their pain. Yet other countries don't - in Canada you can get a new TENS like unit for migraines without an RX. In the states? You need an RX and even then it's so new insurance doesn't cover it. Yet there's enough evidence for others to release it.

Not to pick nits, but isn't your post an equal argument against the current system?  Having the insurance companies decide whether something is or is not covered is no better than waiting for the FDA.  I would argue it is worse, since the insurance companies have an economic incentive to deny. 

[EVT1]

I would add private insurance is no better at deciding these things either- they are sure as hell not afraid of denying a treatment if they think they can get away with it.  It is in their best interests to do so and kind of their duty to maximize profits.  The ACA at least put some limits on the loss ratio- remains to be seen how that will affect the costs down the road.

At least a government insurance program would be accountable to voters instead of wall street.  Either way some group will have to decide what the limits are-and if it is left up to voters- as I think it should be- then we decide if we want to raise the bar to include more fringe treatments and increase the taxes used to pay for it.

I refuse to believe we could not implement a superior system- but I do believe we will not anytime soon.  That's the sad part- the ACA is really the best we could do with the politicians we have.  Says a whole lot about what kind of people we are- and it isn't very flattering.

[justme]

May 25, 2014 23:09:01 GMT -5 tallguy said:

Or, in a less experimental sense, what about TENS units. A lot of doctors/insurance/etc classify it as unproven/experiment even against a lot of evidence to the contrary. My pain doctor gave me an RX for it to just try it out with my insurance before buying it on my own but told me a lot of places deny it as experimental. Mine approved it, but my Dr had a tons of patients who had to pay out of pocket yet it relieved their pain. Yet other countries don't - in Canada you can get a new TENS like unit for migraines without an RX. In the states? You need an RX and even then it's so new insurance doesn't cover it. Yet there's enough evidence for others to release it.

Not to pick nits, but isn't your post an equal argument against the current system?  Having the insurance companies decide whether something is or is not covered is no better than waiting for the FDA.  I would argue it is worse, since the insurance companies have an economic incentive to deny. 

I never said the current system is perfect. But I'm also quite aware of several treatments I'm currently getting that I cannot in some universal healthcare countries due to my not responding to "normal" doses/treatments.

Though, I'm quite certain the government/FDA is to blame for the TENs and like machines debacles. If they didn't deem it experimental, insurance companies wouldn't have that out. Insurance companies can't deny a vicodin RX since it's proven. Well the TENS unit has made it so I've taken vicodin twice in the last year vs. at least twice a month before I got it. If my insurance didn't OK it, I'd still be popping pills - BUT if the FDA ok'd like they do for vicodin all insurance would cover it.

If the federal government is the only payer, there is an incentive for the government (FDA) to keep easier/older methods (in this case vicodin) the approved method and keep not necessarily better/cheaper methods (TENS) experimental.*

*Though I have to say my RX was $300 with insurance discounts for the machine while I bought a backup (arguably less potent, but still effective) for $50. But, every month it's around $40 for new electrodes if I use them all (haven't looked hard for a non-insurance option). Which I don't always. (A plus of TENs is it can have an effect of lowering spasms over time - vicodin/muscle relaxants do NOT have that effect) It's been a while since I filled an RX for vicodin, so I only know my portion was $10. So maybe vicodin is cheaper for insurance so even if TENS were non-experimental and insurance would rather have thousands dependent upon pills.

Personally? I think my life and the lives of A LOT of other people would be a lot better if TENS was not experimental so insurance would cover it instead of steering patients towards narcotics which can be quite addictive for some people.

[EVT1]

No argument from me- I think if something works and a doctor states that is what it is going to take- then OK- it should be covered.

Went through this a while back when it came to transplant rules and age.

But either way we slice it there have to be limits- just a matter who is setting them.  I think that is a good argument for having secondary insurance.  That way if people want above and beyond the ordinary available care- they can still get it.  That way everyone is treated for their conditions at a minimum and we do not have a system that excludes people- but for some reason this always this ends up with the 'death panel' bullshit.  For some reason that label does not apply to private insurance companies when they set their limits- only government.

One problem not usually discussed is why the same procedure can vary in cost from 18K to 100K depending on the facility, why prices are a secret, etc.  The only way I can see fixing that is having a single payer and a negotiated price.

And speaking of price gouging- the medical device industry is real bad about this-I deal with repairing some medical equipment- and it is freaking nuts.  Have no problem taxing their ass- my company has to pay outrageous prices for run of the mill parts and hardware just because it is a medical device- that is apparently worth an 1000% markup.  Sort of like marine parts- same exact shit- but since it is in a boat....

[Shooby]

May 25, 2014 23:09:01 GMT -5 tallguy said:

Or, in a less experimental sense, what about TENS units. A lot of doctors/insurance/etc classify it as unproven/experiment even against a lot of evidence to the contrary. My pain doctor gave me an RX for it to just try it out with my insurance before buying it on my own but told me a lot of places deny it as experimental. Mine approved it, but my Dr had a tons of patients who had to pay out of pocket yet it relieved their pain. Yet other countries don't - in Canada you can get a new TENS like unit for migraines without an RX. In the states? You need an RX and even then it's so new insurance doesn't cover it. Yet there's enough evidence for others to release it.

Not to pick nits, but isn't your post an equal argument against the current system?  Having the insurance companies decide whether something is or is not covered is no better than waiting for the FDA.  I would argue it is worse, since the insurance companies have an economic incentive to deny. 

And the govt WON'T have an economic incentive to deny? Because we all know the govt is the magic money fairy who has unlimited funds to do anything and everything. Oh ok. LMAO!

[tallguy]

May 26, 2014 4:40:17 GMT -5 Shooby said:

May 25, 2014 23:09:01 GMT -5 tallguy said:

Not to pick nits, but isn't your post an equal argument against the current system?  Having the insurance companies decide whether something is or is not covered is no better than waiting for the FDA.  I would argue it is worse, since the insurance companies have an economic incentive to deny. 

And the govt WON'T have an economic incentive to deny? Because we all know the govt is the magic money fairy who has unlimited funds to do anything and everything. Oh ok. LMAO!

No.  The government MAY decide upfront on what is or is not covered (as EVT suggested) but once that is done it is covered for everyone.  Experimental treatments?  No.  Elective procedures? No.  Organ transplants for 93-year-olds with multiple issues?  No.   I have no problem with denying those, and that is not an exhaustive list.  But government would not have an economic incentive to deny on a case-by-case basis so that they can maximize their profits at the expense of the public.  That is silly, as are most of your arguments (on the rare occasions you attempt to actually make one.)   

[Shooby]

At least with the current system I have options. Sorry but I don't find Daddy govt to be all that benevolent. I would much rather have some control over my fate. You don't want govt in your bedroom but you want govt sticking its nose in your colonoscopy.

[Shooby]

Daddy govt can't even run the VA. So now they are allowing PRIVATE sector care because daddy can't get the job done

[Tennesseer]

May 26, 2014 8:59:58 GMT -5 Shooby said:

At least with the current system I have options. Sorry but I don't find Daddy govt to be all that benevolent. I would much rather have some control over my fate. You don't want govt in your bedroom but you want govt sticking its nose in your colonoscopy.

You are okay with the government up your uterus.  Why would you even care about the government up your colon?

[Ava]

May 26, 2014 8:59:58 GMT -5 Shooby said:

At least with the current system I have options. Sorry but I don't find Daddy govt to be all that benevolent. I would much rather have some control over my fate. You don't want govt in your bedroom but you want govt sticking its nose in your colonoscopy.

Shooby; the options you have now are limited to what your insurance company will cover. You don't really have much of a choice, but you don't realize it. Unless you can pay cash for everything. But considering that treating a major illness will cost more than a house, most people don't have that option.
A government program will decide in advance what procedure will be covered depending on a set of circumstances; age, for instance, or the general situation of the patient (whether they have other illnesses, etc.). After that is determined, you fall somewhere in the spectrum. If you have terminal cancer at age 80, you'll probably get palliative care.
If you want extras, then you buy private health insurance. That's the idea.
Everybody else is doing it with better results and they are spending less money than us.
The system we have now is unfair and corrupt. The main goal is not to save lives or cure people; it's to make profits. 
Are you ok with our health care being bought and sold in the market like a commodity? Really?
And how is it right that millions of citizens are denied routine, basic care because treating them is not profitable? All the other industrialized countries have single payer, and they are doing way better than us.