Roland Hulme

Universal healthcare has pretty much bankrupted France and they're being forced to adopt a 'co-pay' scheme backed by private insurance.

Universal healthcare isn't financially viable with a population that's getting older and surviving more and more previously fatal illnesses.

I'm not saying private healthcare is the 'right' answer, but a viable effective solution lies only in between the two extremes.

Leslie

yes

snowbunny

You may have to ration by priority or money.

Secondly, the US is "fortunate" in that we don't have the same ageing issues (yet) -- thanks to legal and illegal immigration.

Bob

At the current wait, old people will die out because they can't afford care, then go universal health, problem sorted

Roland Hulme

If you start to ration healthcase, people who need it, but don't have access to it (because it's rationed) will have to go private.

You're exactly where you were to begin with. It's not universal unless it's... well, universal.

When you start talking about having to ration universal healthcare then you might as well throw up your hands and say: It doesn't work!

Tracym

I personally know someone who will die, and almost certainly didn't have to, precisely because of that rationing (wait list).

I will always be afraid of rationing.

Bob

and can be equally met with knowing people who died because they couldn't afford the cost of healthcare....it's a not so merry merry go round.

Tracym

True enough. But I would prefer not to replace one problem with another.

And (although I may be criticised for this), I am willing to give up some money to help others. i.e. I wouldn't mind more taxes. I am not willing to give up my life. As it stands, with decent insurance one doesn't have to worry much about not being treated. With rationing, you do.

And I think that, precisely, is the issue that has to be overcome before this country has true universal health care.

I'm not gonna go 'round again on how you can lose your insurance, etc. etc. There are problems. But for people who ARE in a good situation, they will not want to switch to a system with rationing. Human nature I think.

Tracym

You know, I just had another thought on the "Medicare for All" idea.

I believe that medicare reimburses doctors and hospitals at a FAR lower rate than private patients or private insurance pays. I don't have the data, when I have some time I can try to look, but I really do think I am correct.

I wonder what would happen economically (especially the private hospitals) if Medicare for All became a reality?

Easy enough to say, tough, let the greedy buggers take less. But if they go out of busines...

Bob

And there in lies the problem, as you say, as long as it is someone else with crap insurance they don't care, but if it were you who had inadequate cover...because I know I couldn't afford 20% of an expensive illness.

Bob

An easy solution might be to cap the litigation, thus the cost of insurance for the doctors, then they can afford to charge less...

Tracym

It's not so much not caring.

It's easy to say you care. But to put yourself at risk, when you don't feel so now, is not so easy. Just for the record, my insurance isn't that hot, I would be at financial risk, so I'm not saying I have it perfect, the heck with ya.

As far as capping litigation, well I dunno. There's a balance between not having ridiculous awards, and discouraging doctors from being careless and compensating people who are truly hurt.

Also, I think doctor's fees pale in comparison to hospital fees.

Your idea might make some significant progress though - didn't Texas do that?

David Richardson

[QUOTE=Tracym;5432761]It's not so much not caring.

As far as capping litigation, well I dunno. There's a balance between not having ridiculous awards, and discouraging doctors from being careless and compensating people who are truly hurt.

I heard or read a few years ago that the AMA (American Medical Association) could do more to police it's own members since roughly 5% of doctors account for around 50% of the medical malpractise cases. Apparently. it is rare for the AMA to act against repeat offenders unless they have been involved in Medicare fraud or similar. Just being inept or incompetent is not enough to get struck off........

snowbunny

Many moons ago, Oregon had a state system (and I don't know if this is still in place) where there was a fixed amount of money available to subsidise health care. And in reality, even with insurance, there is a fixed amount of money available past which the insurers would go bankrupt.

As such, the cost-benefit of care was considered heavily. For example, if a decision had to be made between a child receiving chemotherapy vs an 80-year-old, the child would be treated because the outcome would likely be better and the number of years the child could live if treated successfully would be far longer than the 80-year-old.

What is sobering is how we prolong the dying process -- something like 80% of all an individual's lifetime health care expenses are spent in the last two years of life. In many cases the quality of life is minimal and the individual is in pain and unable to lead a normal life, yet the treatment and the bills continue. We don't seem to be able to accept dying as inevitable even if the person is into their 80s.

Anyway, the Oregon state guidelines were somewhat revolutionary when they came out. I'd have to see what's changed since then, if anything.

Roland Hulme

I think this is true.

I interviewed a doctor on the radio once who paid something like £12,000 for malpractice insurance - and that was in the UK. It's about ten times that in America.

I'm all for policing bad doctors - but patients have to accept that there is some risk when you go under the knife.

Less malpractice insurance cost = cheaper doctors = cheaper insurance = more people able to afford it.