Most of us aren't facing up to the real problem of health care.

[pnwmom]

The high costs of the high tech medicine that we'd all like to make universally available and affordable. The high tech medicine that is helping to extend most of our lives, and keeping those of us with chronic conditions in more active lives.

We laughed at Sharon Angle when she talked about paying for doctors visits with chickens. But I think a lot of people feel the way she does; they just don't express it the same way.

We're way beyond the days when doctors made visits with their black bags, set broken bones, and dispensed mostly pain relievers. More and more, medicine is about mammograms, colonoscopies, sonograms, MRI's, radiation treatments, etc. All of this requires expensive equipment with expensive upkeep and training. And doctors, who have had far more lengthy and intensive training than in our grandparents' and older generations, expect and deserve good compensation for their effort. And staffing hospitals with an adequate number of qualified R.N.'s is expensive. And even preventative medicine -- all those mammograms and colonoscopies -- can be costly. But some of us still expect health care to be the same fraction of income that it was back in the horse-and-buggy days.

So the question of rationing has to come to the forefront, eventually. If not based on ability to pay -- which clearly isn't fair -- how do we decide who gets what? How do we decide enough is enough? For example, the majority of a person's lifetime medical costs are often spent in the last few months of life. But, for most people, we don't know ahead of time which will be the last illness, so we don't know ahead of time which costs might be not be worth it. I have a relative who had cancer surgery at the age of 86, and had chemo for a different cancer. Ten years later, she's still living independently. To those who love her, the many thousands spent on her by Medicare was well worth it. But if, as a society, we were rationing, would we spend that much to extend the life of an 86 year old with two kinds of cancer?

What about a baby born 10 weeks prematurely? What about a person who'd been in a coma for weeks? Should those decisions be made only by families -- or , with universal health care, does society have an economic interest in getting involved in those decisions?

How would we choose? What would we choose? Who would decide? I think too many of us think that Medicare for all would solve all our problems. It won't. It will just open up a new, very uncomfortable set of problems. Problems almost too painful to think about.

[Jim__]

1. It will open up a new set of problems.

And, federally paid medical care will not pay for everything everyone needs. But, neither does the current system pay for everything everyone needs. But, federally paid medical care will at least set a minimum care level that we can all receive. There should be provision for privately paid for extended care; and we should all work to extend the care that the government pays for.

[Warpy]

7. You mean it will pay for needs, not wants

It won't extend life indefinitely, it won't cure the incurable diseases, it won't save all infants born under half a kilogram of body weight, and it won't keep us looking like Barbie & Ken into our 80s.

What it will do is provide basic care for all of us, plus the type of high tech care that has proven to be beneficial. It won't do things like liver transplants for active alcoholics and it likely won't keep dying elderly people hooked up to machines for 3 months in an ICU because guilt stricken family members want "everything" done.

Saying we should just throw up our hands and give up because it won't give us all the medical care enjoyed by only the top 5% of wealth holders in this country and their tame government is just plain silly. This is a rich country. It can afford to care for all of us without bankrupting people on the bottom who have the bad luck to get sick.

There is going to be some rationing and people are going to be very unhappy with it. However, death comes to us all and it can't be put off forever. When medicine becomes futile, it needs to be exchanged for comfort.

[pnwmom]

10. You make it all sound so simple, Warpy. n/t

[Warpy]

12. Finding the right balance will be very complicated

but I know how and what needs to be done because it's my field.

[pnwmom]

22. The problem is that we will be dealing with real, live, human people,

like my beloved elderly relative -- and not old cars to be tossed out on a reasonable schedule.

[Ron Green]

2. First of all, Single Payer means people won't have to avoid a doctor visit when the symptom first

appears just because they don't have insurance.

Secondly, ending subsidies for Big Corn, Big Soy and Big Oil will be a start toward healthier living for everyone.

Thirdly, a realistic discussion about death as the natural end of life, as well as abandoning the idea of eternal youth, will make more end-of-life decisions sensible.

Of course high-tech medicine and machines have a place, but as long as decisions are financial that should be medical (and spiritual), the inevitable lines will not be reasonably drawn.

[truedelphi]

8. You are nailing it on several fronts. Additionally, when the government has to

Fork over the money for a person's cancer care, maybe the government agencies will no longer offer their approval for such cancer sources as the benzene in shampoo and hair mouse, and the benzene and formaldehyde in air fresheners.

Is it any coincidence that in Europe, when the government does pay when someone is sick, the agencies have much tighter control over the products offered to consumers?

[mike_c]

3. personally, I think that's a non-issue....

Or at least not the main issue. I know it won't go away, but it's only an impediment to receiving good, affordable health care because our social priorities are badly skewed. Paying for health care is largely the province of individuals in this country, while easing burdens on business and industry, and maintaining an expansionist foreign policy are considered the proper role of government. Yes, high tech health care and preventive medicine are more expensive than the care provided by country doctors a century ago, but we DO have the means to pay those costs. We currently struggle to pay them as individuals, and even pay outrageously expensive value added costs to middlemen such as the insurance industry. More to the point however, we simultaneously pay many times those costs to the Pentagon and the military industrial complex for "defense" that is a sham code-word for military expansionism and corporate imperialism. Shifting just a fraction of this country's military budget to health care would easily provide plenty of money to fund universal health care for all Americans with few cost restrictions. As Dennis Kucinich has said, we're ALREADY paying for the best health care in the world, we're just (mostly) not getting it.

[Greyhound]

4. Ah yes, those barbarians in other parts of the world that have no access to these

advances, they just don't understand how badly they're doing.
:eyes:

ETA; :kick: & U

[pnwmom]

6. They're struggling with the costs of their systems, just as we are. n/t

[Greyhound]

14. They're "struggling", as you put it while paying less than half for superior care.

Nice try, but all the lipstick and lighting in the world can't hide the fact that this is still a pig.

BTW, one of the largest factors of the sane communities "struggle" is the obscene and completely unjustified costs of American medical equipment and the monopolies they hold.

[w8liftinglady]

5. true.It is an issue that needs addressing.

I guess I am a good example of how the current system works.
My health care costs were $250,000 since january.
Much of that is due to very intricate surgery and multiple,multiple x-rays,consults and medications.
there does come a point when you say-where do you draw the line?
right now,it's between the haves and have-nots.
Lucky for me...I had health insurance.
if I were a have-not,I wouldn't have been offered the brain surgery that saved my intellect.
Altering the cash flow from the wars in Iraq and Afghanistan will be a start-whenever that happens.
Involving those directly involved in patient care-like the docs that cared for me-in the decision-making and subsidizing their office costs will help.
I have no problem with the reimbursement that physicians receive-after their years in school.I believe we would see reduced medical costs because of early and preventative treatment-that would help the most.
Here-one in three patients seen in the ER has no insurance.
There is no follow-up.
patients are readmitted with more severe illness.the costs rise.

[pnwmom]

9. You, and others here, are right -- we can and should find savings

in eliminating unnecessary wars. But even countries like France, not involved in costly wars, are facing questions about health care costs.

So glad you were able to get the care you needed!

:hug:

[w8liftinglady]

11. I'm glad,too.But-I've been a nurse for 25 years...and have seen the other side.

I have had SO many patients who would have had better lives had they just had access to medical...and dental...care,the proper medications,and physical therapy.It kills me that we have the knowledge,and yet conditions like infections still kill and permanently injure...because the patient is reluctant to get medical care until it's too late.i have done cpr more times than I care to remember on people ...in their 20's..with something as simple as pneumonia,or a leg wound that was so severe it had to be amputated,or a heart condition that could have been saved with a simple valve replacement.It is inhumane.

[KT2000]

13. money - money - money

solves this problem. It is the "not talked about."
Your 86 yo relative had a payment source for the medical system. She will receive the best care.

My 93 yo neighbor was in the nursing home and was not responsive one morning. They sent her to the hospital despite a medical directive that stated otherwise. She received a CAT scan, x-rays and numerous blood tests. She was sent home when she woke up. She had been given Vicodin as a sleeping pill which caused her nonresponsiveness. She had medicare and private insurance.
A young man without insurance developed MRSA infection and the hospital treated him - removed the dead tissue and gave him antibiotics. They had a procedure to close the wound but since he did not have insurance they sent him home with antibiotic wipes to clean the open wound instead. Of course it reinfected and he had to go to thed hospital again.

Decisions will always be made according to money no matter what health system we have - unless it is single payer. Where I live the retired and elderly receive the best care. Many of the younger people, such as the self-employed have to rely on the charity clinic for a nurse's care or the emergency room.

America's medical system has morphed into superior care for the elderly - postponing or prolonging death because that is where the financial incentive is.

[madrchsod]

15. according to the people at medicare....

high tech medicine is cost effective.

i had a torn rotator cuff. years ago it would have been x-rayed which was`t as good as the mri. i had the latest -photon image. this allowed the doctor to use three holes in my arm to repair my tear.

like it or not, high tech is far cheaper in the long run.

[pnwmom]

23. How can today's high tech medicine be "far cheaper" than yesterday's

black doctor's bag and a saw?

[Vinca]

16. For starters, we need to take the obscene profit out of health care.

It seems pretty apparent that some consumers (fka patients) are tested too much, medicated too much and subjected to procedures that will make little difference in their outcomes. Why? The provider gets to keep a hefty chunk of change per item. The more that can be billed, the more money they make. Think mucous control device (Kleenex) for $12.00 and those little strips you pee on that cost 50 cents and get billed $20.00. If grandma's on her death bed and they can string her along for a couple of weeks, that's big bucks in the company till.

[FooshIt]

17. I'll solve this problem and fix the economy in one swoop

The richer you are, the less you get. That way the rich will die off soon, and the poor can get the treatments they need.

[Duer 157099]

18. Start by getting rid of the need for student loans

Do like they do in Germany, free education for anyone who wants it and can do it.

Begin there. Then remove the profit motive from health care.

Solutions are easy if only we remove GREED from the equation.

[Hannah Bell]

19. it would eliminate 7% of costs & put us costs on par with europe. i'll worry about the other stuff

later, particularly as health care is already rationed by price.

[obxhead]

20. The insurance industry is the number one problem with the costs

of healthcare. They are guaranteed a profit, while not actually providing actual health care in any way shape or form.

I also found an interesting PDF of the average operational costs of hospitals in 2004.

http://www.solucient.com/articles/07_MTM_Solucient.pdf

Salary is a significant part of their costs.

[derby378]

21. That wasn't Sharron Angle...

That was Sue Lowden, Angle's GOP primary opponent, talking about chickens for healthcare.

http://www.youtube.com/watch?v=qZezfjWox5s

[pnwmom]

24. You're right. Thanks for the correction. n/t