Michaelmike5556

yes but i'm not the one trying to tell you what to do =-)

paddingtongreen

I don't recall telling you what to do, you "read" it in to make an excuse for a snide remark.

Tracym

I am too tired tonight to go back and read all the surveys, but I'll look at them again.

I remember it being said in some prior articles that it made a BIG difference how questions were asked. For example, people said "oh sure I'd pay more taxes" - but then many were only willing to pay $100. That's just an example of the discrepancies in what the polls seemed to indicate, and what people really felt.

I'm not personally complaining about medicare - but a lot of seniors sure do. Well, if you simply eliminate the co-pay, that's lovely - but the money has to come from somewhere - so.... more taxes then?

Personally, I think the 20% co-pay was probably fine years ago, before all the technological advances and cost increases.

I am about as certain as I can be that the medicare co-pay is 20%.

When I was referring to incompetant - I was referring to what I would expect from our government, not any other government.

To be honest, until I saw the experiences of Keith, and his family and friends, and at the same time discussed things on here I didn't have any big impression of "socialized" health care at all. Had heard some vague things about Canadians coming to the US because they couldn't get care in a timely fashion, but that was about it. I never even heard the name of the NHS. So my personal impressions were not formed from the media - they were from personal (secondhand) experiences and this board. And a bit of looking around the net.

Yes, most insurance has some co-pay. I think 20% is fairly high though. And I think many (but not all) have some maximum like that. Not sure what is most common.

Here I am not certain, but I think Medicare maxes out around $1 million also.

That will work, as long as you are eligible for SSI disability - you have to have worked 10 quarters or some such though. There is some waiting period - which is one of the reasons people are advised to have private disability insurance if possible.

RoadWarriorFromLP

Not necessarily. Your comment incorrectly presumes that the price of medical services is fixed, and that the amount that isn't paid by one party must be paid by another.

This is absolutely not true in the US. In practice, individual consumers pay full retail, insurers negotiate a substantial break, and the feds spend even less for the same exact services.

It's quite possible that if deductibles were eliminated that there may be little or no additional cost at all, because the party with the buying power -- the government -- would negotiate most or all of it away. The feds have leverage that the regular consumer does not.

In any case, the deductibles are not assessed on a percentage basis, but on a sliding scale depending upon the length of stay and the income of the patient. This summarizes the current schedule: http://www.medicareadvocacy.org/FAQ_...mary.htm#_ftn1

paddingtongreen

There is a problem here of generalizing where generalizing is illogical and produces answers that are a nonsense.

For the pre-Medicare people, there are variations on the PPOs and the HMOs and then there are hybrids and oddball policies. Premiums and benefits for these are all over the shop.

Medicare has three parts, A, B, C and D. B and D are optional. A is free, D is the newest part and that covers drugs. C is the "Advantage Plans". The cost of B, $96.4/month this year, is withheld from the Social Security pension, or can be paid if the person is not entitled to an SS pension. In addition there are PPOs and HMOs that are qualified as "Medicare Advantage" plans. These take over from, and are paid by, Medicare with additional premiums from the clients.

An alternative to the advantage plans are the Medi-Gap policies. These supplement Medicare and require premiums, but don't take over all the paperwork.

Here are some of the deductibles for straight Medicare:

2008 Part A (Hospital Deductible: Days 1-60) (Per Benefit Period)$1,024
2008 Part A (Hospital Co-pay: Days 61-90) (Per Benefit Period)$256
2008 Part A (Hospital Co-pay: Days 90+) (Per Benefit Period)$512
2008 Part A (Nursing Home Co-Pay: Day 1 – 20)$ 0
2008 Part A (Nursing Home Co-pay: Day 21 – 100)$128
2008 Part B Deductible$135


You can checkout Medicare here

fatbrit

You're still rabbiting on about co-pays and increased taxes If it were half the price (which it should be if we got rid of the insurance companies since everyone else manages to provide an equal or better service for this amount or less), then you needn't worry about folks paying extra in taxes or co-pays. The savings will be quite enough to cover the lot.

Giantaxe

The US pays about 5% of GDP for healthcare administration. It's an astoundingly inefficient system.

RoadWarriorFromLP

Here's the problem in a nutshell (thanks to Nationmaster):

We spend more per capita on health care than anyone else in the world...
http://www.nationmaster.com/graph/he...tional-dollars

So what do we get for all of that extra cash?

-We don't get more acute care -- we rank 19th for the number of beds per capita, with the first place Germans having three times more than we do, even though we spend twice as much:
http://www.nationmaster.com/graph/he...cute-care-beds

-We don't get more hospital beds, either -- by that measure, we ranked 83rd, behind Samoa, Andorra, our own territory of Puerto Rico, and Congo:
http://www.nationmaster.com/graph/he...r-1-000-people

-We don't seem to have more support staff -- we rank 14th in the number of nurses per capita, with the first place Finns having almost twice the ratio:
http://www.nationmaster.com/graph/hea_nur-health-nurses

-We do see our doctors more often, though -- by that measure, we rank #2:
http://www.nationmaster.com/graph/he...n-with-doctors

-We don't seem to live any longer than anyone else -- we rank 44th, with a life expectancy within a year or so of most of our spendthrift peers, so all that extra cash isn't buying us time:
http://www.nationmaster.com/graph/he...tal-population

-That disparity becomes even more glaring when "healthy years" are measured -- by this measure, we rank 22nd:
http://www.nationmaster.com/graph/he...-healthy-years

So all in all, I'm not sure what benefit we get from all of these extra expenditures. We're not living longer or healthier lives, and we're certainly not saving any money, so what is it that we are trying to protect here?

Brav

I'll say this one thing. My uncle is a physician and when he sees patients that are only in need of an aspirin or ibuprofen, he advises them to go to the store and just buy an entire bottle. Why? Because for one dose it costs approx. $60! Why in the hell does/could/should it possibly cost that much? For something that costs about 2 cents to make?:curse:

pejpm1

I'm sorry but thats a total cop out. It has nothing to do with the 'culture' of the two countries. Why does England being an older country have any bearing whatsoever on wanting to provide universal healthcare? I believe it comes down to selfishness. Believe me, I've heard plenty of people in the UK that think that if they go private, they should have a tax rebate and not have to fund the NHS....so the same kind of views exist in the UK as well. As I've said before, I go private, but it's my duty to pay towards the NHS as well.


I think the truth of the matter is "most people DO think that everyone should have access to decent health care. They just dont want to pay for it"

Dan725

Because the root of all evil, the medical billing companies, make up this BS to justify their jobs, which to my mind is just about the most wasteful industry ever created. If healthcare here wasn't such a self made, ridiculously complicated and completely off the cuff system designed to make fat cats rich, there would be no need (or at least, a massively reduced need) for these shitty middlemen.

Xebedee

My OH and I are 25 yrs from retirement and are tackling it in simple terms of "save as much as is possible right now, for then" any more planning seems a waste of energy, as who knows what the systems might look like in 2033 (Peter Cushing chasing Daleks thru London by then) BUT: as for right here, right now would you say that the US offers something better to the oap who needs to go into a nursing home as opposed to in the UK? The bupa costs are grim and the NHS appears strapped in many instances for facilities. I wouldn't like to imagine what state run nursing homes in the US are like.

If that doesn't put a nail in the insurance-based argument's coffin, then try the next logical question which might be:
Why do you feel it to be your duty?

pejpm1

Because many other people are not as fortunate as I am, and I realise that I am not alone....we inhabit this world with others who also require looking after. The idea that if someone is too poor to afford healthcare, it's a case of 'tough luck' is totally abhorrent.

Tracym

You're right, the hospitilizatoin co-pays are entirely different (part A). Unfortunately, the above link isn't working for me just now - but I believe part B (outpatient treatment) has a 20% deductible. And lots and lots of tests and treatment are outpatient.

As far as Medicare negotiating prices lower to eliminate co-pays (well actually it would be dictating, not negotiating) many doctors are already refusing to take new Medicare patients, and are considering dropping the ones the have, because of the already *inadequate* reinbursements from Medicare.

So I wonder just what will happen if the govt creates such low reimbursements that the doctors aren't interested. The first article is very interesting in general.

http://www.heartland.org/Article.cfm?artId=11799

"Why Doctors are Leaving Medicare"

"A recent study by the American Medical Association (AMA) found nearly half (48 percent) of all U.S. physicians would have limited their Medicare practices if the 4.4 percent fee reduction had been implemented. Fearing a death blow to Medicare, Congress responded to the doctors’ pain and cancelled the scheduled fee reduction. Instead of the intended 4.4 percent cut, a 1.6 percent increase in Medicare physician payments becomes available"

"While Medicare may have dodged a potential crisis, many doctors are still refusing to accept new Medicare patients. Some are dropping out of the Medicare program completely because of other issues.

Two of the most troubling reasons are stepped-up threats of prosecution of doctors and growing government red tape, according to the Association of American Physicians and Surgeons (AAPS) In July 1999, AAPS released the results of a survey that revealed, “Medicare regulations and a recent increased government crack down on so-called ‘fraudulent’ billings are actually responsible for severely restricting patients’ access to medical care."

“Money is not the issue--it’s the government in the examining room. More doctors would rather treat uninsured patients, possibly for free, than risk being prosecuted as a ‘Medicare cheat.’”"

http://www.njbiz.com/weekly_article....239&aID2=72993

"... Medicare reimbursements are falling behind the rising cost of running a doctor’s office in New Jersey..."

"... spine surgeons and some other specialists have already stopped taking Medicare users, mostly because they can’t afford to see “low-margin patients.”

"General practitioners and internists may soon follow suit if a new reimbursement formula isn’t implemented..."


Hard to be a senior in Colorado - from a colorado state website:

http://www.dora.state.co.us/INSURANCE/pr/042402.pdf

"The 2002 survey results indicate that 191 doctors out of 527 surveyed are taking new Medicare patients. This is a decrease of 8 percent over the November 2001 survey."

I can't find the other article just now, but it said some of those in Colorado were considering dropping the ones they had.

Rete

It is my thought that they, like myself who would welcome national healthcare, are afraid that it won't work, at least for the first 5 to 10 years. I also feel that many are afraid that the same thing will happen which is happening in Canada, doctors and nurses will leave for areas where practices are more lucrative.

My friend in Massachusettes rented out a room in her home to doctors who come from other countries to intern at hospitals in the US so that they can be accredited. One example that horrified both of us is that the wife of one doctor was also a doctor, a pediatrician, while the husband was an internist. They had a two year old son. The son did not speak at the age of two. He only grunted or screamed and pointed at what he wanted. We immediately thought this child cannot hear and asked them if they have had their hearing checked. Of course, communication was hard as they both spoke limited English (they were East Indian). They got indignant and said "We doctors. We take good care of son". It was only when my friend's granddaughter who was 3 months younger than their son came to visit and she was talking non-stop, that they conceded there might be a problem. Yes, the child was diagnosed as being hearing impaired.

Speaking only for myself is the fear that the doctor's will not have a good grasp of the English language; the quality of our care will decrease; we will have waiting lists for medical tests, surgeries as they have in the UK and Canada. However, even with those fears, we do need national healthcare for all Americans regardless of their present health status or income level.