Suggestions for good healthcare system?

Discussion in 'Fibromyalgia Main Forum' started by shootingstar, Jun 17, 2006.

  1. shootingstar

    shootingstar New Member

    There have been several recent postings on peoples' frustration with health care in the U.S.

    So what are some suggestions for improving out healthcare situation?

    For those in other countries: what is and isn't working?
    [This Message was Edited on 06/18/2006]
  2. shootingstar

    shootingstar New Member

    I want both good doctors and access to medical care, including prescription medication, for everyone. Our ideas may need refining, that's OK. I like the idea of having a choice on where part of our taxes go -- would not have to be 50%, and part of the fixed portion could be a budgeted amount to healthcare with the optional portion filling in.

    Maybe others' thoughts will build on what is said here. I agree some sort of grass root push from lots of individuals is needed here. Even a letter to your congressmen saying you want solutions will help, but insight/unique solutions might give a sense of direction.

    There are overlapping considerations here from high malpractice premiums, people being forced into part time employment by employers who do not provide health benefits resulting in a huge sector of the population who are left uninsured, poorly employed and with little hope. Our companies need to be able to compete globally, to a much greater extent than in many years past -- employer based healthcare may no longer work. All ideas welcome. Thanks.
  3. 1975jet

    1975jet New Member

    I kinda agree with the comment about the government- don't get them involved anymore than you have to- it is a road to frustration!!!!!!
  4. shootingstar

    shootingstar New Member

    If you have money and/or are well insured and are fortunate enough to have a doctor who is not on patient overload in order to pay astonomical malpractice insurance premiums, you might think it is good. If you are among the 40% of the population who is uninsured you probably have tons of doubts. If you need to go to an emergency room you may be shuffled to another hospital because there are so many people who have no insurance, or money, they are using our emergency rooms for their primary care. Yes, some people are taking advantage of that, but many, many people are hurting.

    This system is, in effect, telling 40% of the people it doesn't care about them. If we want to undermine everything about this country keeping the status quo is a pretty good way to help realize that result.

    I don't know if socialized medicine is the best answer or not, but I would take it in a minute over what we have now. There may be something better, but what we have now is totally obscene. And it is really scary to think it may just have to get worse before it gets better.

    There are people who NEVER get MRI's in this country. Basic medical care is becoming the privilege of those with money and/or good insurance.

    There are people who work two and three jobs who are uninsured and can't afford private insurance. Once you've been significantly sick with anything private insurance is pretty much out of the question for anyone who is not wealthy.

    We now have a Medicare Part D prescription plan which has a clause built in so that the government may not negotiate the prices of prescription drugs with pharmeceutical companies. Other countries can negotiate with our pharmeceutical companies, but we can't.

    This system kicks people in the face and rubs their noses in the dirt every day.

    We hear there's a lot of research and development, but how many are now able to afford to avail themselves of the results? There is research and development in other countries too.

    I don't know what the answers are, but to me the problem is one the biggest our country faces today. We are telling people every day we don't care about them. We are robbing them of dignity. The resentment created by this situation has to be huge and that energy should be redirected in a positive way. We need to let our citizens know we care by taking some steps to remedy this situation for a big share of the middle class who are falling through the cracks -- not old, disabled, or poverty stricken enough to qualify for aid -- but working hard and getting nowhere and uninsured. They have no way out, no way to get help. It is wrong.
  5. ANNXYZ

    ANNXYZ New Member

    BOTH Lamotta and Shooting star are correct . Thus , we have no good solution.

    I lived in a military town once for a few years w/ military families from NATO countries - European.

    I did not know any who were satisfied w/ the care provided in their country . I heard many horror stories
    about lack of access to tests and physicians, and about
    doctors who were poor clinicians with no accountability .
    The stories were enough to scare me .

    On the other hand, I think health care is almost UNAFFORDABLE HERE for middle class people. Our system
    is seriously flawed and seems to be heading toward a genuine crisis.
  6. ANNXYZ

    ANNXYZ New Member

    is to devise a program that discounts or helps those with no insurance benefits . And how could it be funded ?
    How about using US tax dollars INSIDE THE US for the domestic nightmares that seem to be overlooked presently ( add the cost of soaring gasoline and utilities
    to this list ) .

    I REALLY question how we are going to continue w/ record deficits . I also worry that the vets coming home with missing limbs and eyes and ears will NOT receive adequate resources to rebuild their lives as disabled people.
  7. becc

    becc New Member

    My country, Australia, has universal health care. It’s not perfect but IMO it’s a lot better than what I know of the US system.

    We have two tiers - public and private health care.
    Everyone is covered by Medicare, regardless of income. It’s funded by taxes and allows anyone to access medical services when necessary.

    Nobody pays to go to a public hospital. This includes tests - blood, MRIs etc…)

    Private doctors can charge for their services but Medicare pays a large part of the cost - often enough for the doctor to “bulk bill” patients. This means they just take the amount Medicare pays and don’t charge the patient an excess. Our current government seems to be set on destroying Medicare and going more down the US path so more doctors now are charging a “gap” above the Medicare payment. In my experience, however, most bulk bill patients with chronic illness or disability.

    Prescription medications fall under the Pharmaceutical Benefit Scheme (PBS), also funded by taxpayers. Once approved by the PBS, nobody pays above about $27 (I think) for a script. The government pays the difference. People on disability pensions, unemployment benefits, aged pensions, low incomes (not only welfare payments) etc pay about $5 per script. Some medications are not covered by the PBS and cost more but I’ve never paid more than about $30 for a script. That said, however, there are some that are incredibly expensive - one particularly controversial exclusion from the PBS at the moment is a drug that treats some breast cancers.

    Then there’s the private system. Individuals (or families) can pay for private insurance. It’s expensive but IMO is worth having. It basically covers hospital stays in private hospitals and “extras” - optometrists, physios, dentists, some complementary therapies etc. Private hospitals are generally much nicer than public - more comfortable. I’ve had experience with both public and private hospitals and would choose private when possible.

    The main advantage of private over public is the lack of waiting time for ‘elective’ surgery. The waiting lists for elective surgery in the public system can be horrendous. Private patients can choose when they want to go into hospital. Elective surgery is a bit of a misnomer - some are very necessary but not considered an emergency. Life is miserable for some people waiting for elective surgery in the public system (without private insurance). If they are in a position to do so, they can pay to have the surgery in a private hospital. Very expensive but probably not more so than in the US.

    IMO, I’d rather have free health care for all with a waiting time for non-emergency surgery than no health care at all for the poor. I don’t think there’s any excuse for a government leaving the most vulnerable with the choice of remaining ill or going into massive debt. Of course, it remains to be seen what will happen to the Australian system in the next few years. The government is moving more and more towards a user pays system, not because universal health care is unaffordable - the budget is in surplus - but for ideological reasons. To put it bluntly, survival of the fittest and all that…


    [This Message was Edited on 06/19/2006]
  8. becc

    becc New Member

    Hi banya,

    I think there are some exclusions - I'm not really sure what they are but I know you're unlikely to be given private insurance if you apply after being diagnosed with cancer or other similar illnesses. I'm not aware of any restrictions on people with illnesses like CFS, FM etc.. My family always had private insurance so I just carried mine over when I was no longer covered under the family provisions. I don't remember being asked if I had any health problems when I joined individually. No insurance company can deny payment for an illness you acquire after joining, as far as I'm aware.

    Hope that helps!

    Bec
  9. rachel432

    rachel432 New Member

    not only is the system in bad shape from a patient's view, but it is even worse from the side of hospital staff. i work as a nurse for an agency so i go to different hospitals in the area depending on who needs help that day. each hospital is frequntly running on the bare minimum of staff that they can have as far as nurses and nurse's aids, and they don't want to take patients up to the floors that are only going to be observation for a few hours after surgery, they try to push them out the door instead. the reason for this is that the hospitals only can bill an insurance company or medicare if a patient is there at midnight. so if you came onto the floor at 11am and left at 9pm the hospital can't charge like it's a hospital stay. so some nursing managers now don't count those patient into there count for staffing, so the floors are then always short staffed but they have to do it that way to stay within their budget. it's very messed up.
    rachel
  10. shootingstar

    shootingstar New Member

    It sounds like part of Australia's system is working well -- at least no one is left out completely. I guess I'd prefer everyone getting the same quality care -- a tiered system with the additional insurance covering less, basic medicare type insurance covering more and operating more efficiently.

    Wakemeup mentioned that medical care here in the 70's seemed better than now and wondered why that had changed. I think there were problems even then, but not as obvious to middle America. There were uninsured then too, just not as many. Greed on many fronts was not as obvious. Malpractice was not the huge issue it is now -- I've wondered if caps should be set on various types of injuries, possibly medical care paid over a lifetime rather than as a lump sum with a cap on pain and suffering. I'm sure corporate greed has crept into the pharmeceutical industry just as it has in others -- overpaid CEO's etc. And businesses are hiring part time to avoid the system, leaving many in poor work circumstances and uninsured, and the system underfunded.

    We're paying for our health care system one way or another. Hospitals are robbing Peter to pay Paul. Many negotiate with insurance companies to pay them a lesser fee for services they provide to the uninsured for more. The conscientious uninsured borderline poor people who pay these inflated bills are being penalized in comparison to the rest of society. Many with money/good insurance do not want to give up anything at all so that people with less can have even the most basic health care. Some, not all by any means, seem to think it is the working poor's fault that they are disadvantaged, that somehow there is something wrong with those people that they have problems.

    We are paying for the system we have, but in the wrong way, and everyone is suffering. I'm not in favor of putting the whole burden of funding medical on property owners in the form of increased property taxes. Many people have saved their whole life trying to plan for a secure future by owning their own home. Young people are struggling to get into their first home. I think a portion could come from property tax, but the major portion probably has to come from income taxes, some alternate source or combination of many sources.

    Another contributing factor may have been the fact that workers' salaries have not, in general, kept pace with inflation. Therefore the gap between those who have and do not have may be wider, more people may have fallen out of the system and any pre-existing problems in the system may have consequently become more obvious.

    I hope Australia works toward improving its existing system. I'm sure it has its problems, but the U.S. alternative is deteriorating -- not the way to go as it currently exists.

    Ouch -- I agree with much of what you said. A lot of opposition to that approach, and I understand that to some extent, but too many people are just plain left out in the cold now.
    [This Message was Edited on 06/20/2006]
    [This Message was Edited on 06/20/2006]
  11. becc

    becc New Member

    Hi shootingstar,

    Yes, I agree. I'd prefer a more equal system, too. While the universal health care model certainly seems fairer than the US system, the fact remains that it's the poorer sections of society that are on the waiting lists, not the more privileged. I think all countries would find vastly different health care systems if their politicians were forced to access the services available to the poor rather than the rich.
    There's nothing available under the private system in Australia that isn't under the public system (as far as I'm aware). The services you receive will be basically the same - private hospitals are just more comfortable and patients can essentially choose when they have surgery.

    Dentists, however, are a different matter. I can see my insurance company's own dentist within a few days for a pre-booked appointment. I'm not sure how dental emergencies work with private insurance as I've never (touch wood) had to find out. Patients without private insurance, however, can wait *years* for an appointment. It's absolutely unacceptable.

    A big part of the problem with the Australian system at the moment is the current political make-up of the country. The states are *all* governed by the Labor Party while the Liberal Party (conservative) is in power federally. This has resulted in the federal government blaming the states for all the problems with the health system and the states blaming the federal government. Meanwhile, nothing's changing. The blame actually falls on both tiers of government but neither will admit it. Ultimately, the federal Liberal Party gets its way which seems more and more to be limiting the scope of Medicare, unfortunately.
  12. shootingstar

    shootingstar New Member

    Lots of political conflicts here too. Dental is totally separate here too -- might be covered under some individual state's medicaid for the very poor programs -- not sure. Some, not all, private insurance plans offer it as an option.

    Right now there is a big funding problem with growing numbers of businesses opting out of the system in order to survive and/or remain competitive. It's left a scramble of everyone trying to get someone else to pay, and many left with few or no options for care. There has to be something better.

    Thanks for your input.
  13. shootingstar

    shootingstar New Member

    I agree major changes could be really chaotic, but do you have any thoughts on some initial steps which might be taken which would begin to provide help for those who are uninsured and have slipped through the system? I'm thinking in lines of keeping our existing system but improving on it, but wouldn't even know where to begin.

    There are so many now who have no insurance through their employment and can't afford the insurance premiums on their own, ever growing numbers. We can't ignore this because the problem will only get bigger.
  14. kiyoka

    kiyoka New Member

    Last semester I took a nursing class called Global Healthcare. We research lots of countries trying to understand what others are dealing with. It talked a lot about the US health care system, and how horrid it is. Leaving out some many people.I had to write up an propel from four different countries, but found none of the coutries really have a good system. But when I wrote my report, I wanted everyone to be covered the same. Whos life should we save. I dont think the immiate Government shouldn't be controling it. They should pass it on to someone that cares and lives to help people. If you look at a lot of health care systems in other countries they are mostly or all paid by the tax payer. We are paying taxes for it, but it's not for everyone. I wouldn't mind paying 10% of my pay to go towards a new health care system. I think we should keep the we want the best eqpiment, doctors. I think we should have more schoools for doctors and nursing. I know that no one wants to teach people because the pay is soo small. I think we should pay teachers more. I know that lots of schoool deniel soo many people each semester. YOu go to a doctors office...and there are so many people, long waiting times. I think it would decrease the waiting time if there were more doctors and nurses, and techs, and rad.
  15. thirkmom

    thirkmom New Member

    If you live in an area that has a lot of illegal immigrants it's easy to see where some cuts could be made if the government enforced them. Many illegals cross the border in border states to have their children. First of all the bill is paid by the American taxpayer and secondly their children become automatic American citizens. In our state the immigrants treat the Emergency Room like a clinic because the visit is paid for the taxpayer. My sister-in-law has been an ER nurse for 25+ years and she is always complaining about them coming in for pregnancy tests, colds, and other non-emergent situations. It costs me a $75.00 co-pay to be seen in the ER then everything else is extra. This bogs down the wait time in the ER and causes medical staff shortages because these patients have to be seen.

    The problems we have are like fingers on a hand. You take care of one and you still have 9 more to deal with. My heart goes out to all those needing medical care but first we need to take care of our own. After that we need to find a way to care for others. LuAnn
  16. GwenGlo

    GwenGlo New Member

    This is a good system here but there are negatives.

    Don't forget that with this system the GOVERNMENT determines how much money each hospital receives and each one must meet their budgets.

    When budgets can't be met then there will be no new equipment, beds will be closed, staff laid off and numerous other measures are taken.

    The result is often outdated equipment (eg. Xray machines, limited number of MRI machines), people on stretchers in ERs for days waiting to be admitted, inadequate staffing and all the woes associated with that.

    There is also the matter of waits for surgery as operating rooms are not available for surgeons due to staff shortages.

    All drugs need approval by the government. Some of the newest cancer drugs only become available years after they have been in use in the USA.

    In my city there are 35,000 people without a primary care physician which is almost 10% of the population.

    The 'paperwork' that needs to happen in doctor's offices is huge and I know of several doctors who have quit because of that.

    These are just a very few of the shortfalls of this system.

    But, while it is not perfect, it is free and one shouldn't complain.

    Gwen