Socialised Medicine ...... Arrrrgh

SteveNZ · Jan 2, 2015

dogs4thewin said:
Well, you cannot just make bad choices and expect that others will pay for those mistakes.

Please share then how you would handle the scenario of a person without medical insurance, who has an accident creating a compound fracture in the leg with the bones sticking out and bleeding to death..... I am not being smart I was in this position (in NZ though)....

I assume they would be taken to hospital by ambulance anyway. The lack of insurance or funds is discovered, then what....?
You have to treat them (from tax funds or some source) or not treat them.

How would you handle this 'bad choice'.
And you have to make that choice quickly if you do want to save the life...

dogs4thewin · Jan 2, 2015

SteveNZ said:
Please share then how you would handle the scenario of a person without medical insurance, who has an accident creating a compound fracture in the leg with the bones sticking out and bleeding to death..... I am not being smart I was in this position (in NZ though)....

I assume they would be taken to hospital by ambulance anyway. The lack of insurance or funds is discovered, then what....?
You have to treat them (from tax funds or some source) or not treat them.

How would you handle this 'bad choice'.
And you have to make that choice quickly if you do want to save the life...

I should have been clearer on "bad choice" that meaning poor lifestyle choices which lead to health problems. An accident a true accident would not fit in that catogory.

Avid · Jan 2, 2015

SteveNZ said:
Please share then how you would handle the scenario of a person without medical insurance, who has an accident creating a compound fracture in the leg with the bones sticking out and bleeding to death..... I am not being smart I was in this position (in NZ though)....

I assume they would be taken to hospital by ambulance anyway. The lack of insurance or funds is discovered, then what....?
You have to treat them (from tax funds or some source) or not treat them.

How would you handle this 'bad choice'.
And you have to make that choice quickly if you do want to save the life...

Not made a response to the other question, but this is easy. Presently, there are laws, rules or what have you, that such a person is treated, and LATER the issue of paying is addressed. The hospital often is forced to absorb the cost having provided services that will not be paid.

Hospitals are EXPENSIVE specifically because we already do this. You may have heard lies about the critically ill or injured being turned away, and the inhumanity of the idea. Usually does not, or NEVER HAPPENS. The problem comes when EVERYONE floods the hospital ER, simply because of a runny-nose, or headache.

I suggested people here go the the ER in the middle of the day, or some OFF time, and see who is in there. It is an education.

thesopranopiano · Jan 2, 2015

dogs4thewin said:
I should have been clearer on "bad choice" that meaning poor lifestyle choices which lead to health problems. An accident a true accident would not fit in that catogory.

How would you determine who's medical needs are the result of, "bad choices," and something they truly had no control over?

dogs4thewin · Jan 2, 2015

thesopranopiano said:
How would you determine who's medical needs are the result of, "bad choices," and something they truly had no control over?

Well, bad choices could make your odds worse.

only a sojourner · Jan 2, 2015

I am frankly appalled at the lack of concern many American Christians have toward the needy. They seem far more concerned about helping the unborn then those already born.

I am opposed to abortion but believe in a consistent pro-life ethic.

SteveNZ · Jan 2, 2015

Avid said:
Not made a response to the other question, but this is easy. Presently, there are laws, rules or what have you, that such a person is treated, and LATER the issue of paying is addressed. The hospital often is forced to absorb the cost having provided services that will not be paid......

Thanks for that.

I never realised that ER (here in NZ A&E) is used like that. We have funded medical centres for all basic medical and 'Accident and Emergency' for that urgent task. The A&E can send you out to a medical centre (nearby) if they realise it is not an urgent issue. All are funded......

Hmmm ..... I do understand what you shared. What is your solution though.

1- To stick with the status quo ....... but it means you choose to put up with and fund the problems as they exist ...... or
2- Do you have a methodology to fund both the ER use as a basic medical centre, plus fund emergency treatment without the hospital carrying the cost.

A2SG · Jan 2, 2015

dogs4thewin said:
Well, you cannot just make bad choices and expect that others will pay for those mistakes.

Not in every case, no. I mean, if you, of your own free will, decide to watch Adam Sandler's Jack and Jill movie, no one give you your money or your time back for that.

But in some ways, such as with the criminal justice system as well as health care, it does work that way. Health insurance, for example, cannot function without healthy people paying premiums so that sick people can get medical treatment.

I oppose long sentences for non-violent inmates. Other than that, the violent ones are there to protect society.

Although, I will say that even MOST "violent" have longer sentences than needed.

And we all pay for prisons because of someone else's bad decision...in this case, to commit a crime.

Again, that's how societies work.

-- A2SG, but the criminal justice thing was just an example to illustrate the point, best to not get off track here....

A2SG · Jan 2, 2015

dogs4thewin said:
I should have been clearer on "bad choice" that meaning poor lifestyle choices which lead to health problems. An accident a true accident would not fit in that catogory.

Here's the thing, doctors can't take the time to check these things first, before they decide to administer care. If someone has diabetes, for example, the doctor can't check to see if the patient got it because of "poor lifestyle choices" or heredity before they decide whether or not to treat the patient.

-- A2SG, look at it this way: do EMTs check to make sure a person who was hit by a car looked both ways first before crossing the road before treating the injury?

Should they?

KarateCowboy · Jan 3, 2015

The next time you go to the DMV or the Post Office, ask yourself on the way out: Do I want them managing my health care?

A2SG · Jan 3, 2015

KarateCowboy said:
The next time you go to the DMV or the Post Office, ask yourself on the way out: Do I want them managing my health care?

Why would they be?

If you're talking about a single payer system, your health care would still be managed by a Doctor. The bills would be paid by the government, that's all.

If you're worried about government interference in health care, then would you support a Constitutional amendment that specifically states all medical decisions, including which medical procedures you'd be able to have, be kept strictly between doctor and patient, with no government interference whatsoever?

-- A2SG, it sounds like a good thing, but I've yet to hear a single conservative or republican agree to it.....can't imagine why.....

SteveNZ · Jan 3, 2015

KarateCowboy said:
The next time you go to the DMV or the Post Office, ask yourself on the way out: Do I want them managing my health care?

I can see that the management of such a health system also needs to be sorted.

We have regional elected health boards. Voted at the time of county elections.And the various powers to each party (including objecting to service) well identified. The equivalent I suppose of a health service constitution. The central government only manages the funding. But yes central government does set the budget that is a big political item.

only a sojourner · Jan 3, 2015

Even if a person has made poor lifestyle choices they should not be penalized by not receiving adequate health care. One scenario I offer is diabetes which is related to poor lifestyle choices but also has a genetic factor. Diabetic medication is costly and people who can't afford it have typically had low paying jobs without health insurance. Not taking the medication can eventually lead to serious medical conditions, for example amputation and blindness. After the person becomes seriously disabled they can get on SSD and then they will receive medical coverage. I can't get away from the idea that many American Christians are greedy and self-centered.

Joykins · Jan 3, 2015

SteveNZ said:
I thought it was compulsory. So pretty universal.

There is a tax penalty for not buying qualifying insurance plan, as long as you have a certain income and you can find a plan that qualifies as "affordable" (usually up to about 9% of your income in premiums). Note that there is no requirement to buy a plan if you can't find an affordable one, nor is there a requirement for an affordable plan to be provided to you.

I don't know if I'd call that compulsory, exactly.

Joykins · Jan 3, 2015

Standing_Ultraviolet said:
A fairer comparison, of course, would be to Germany or Switzerland, which have systems that are more realistic for the U.S. to eventually take on. They're not perfect, obviously, because no system is perfect, but they work very well with shorter wait times than the U.S. or Canada and less political craziness (generally speaking) than the system in the U.K. But you never hear a comparison to them, because it's more convenient to talk about a person having to wait six months to get a hip replacement than it is to discuss a system whose minor annoyances would be familiar to pretty much anyone in the U.S. and whose benefits would be much greater.

I love the tacit assumption in these discussions that no one would EVER have to wait months for surgery in the US, although people actually routinely wait months for certain elective surgeries in the US. I waited 6 weeks to have a gall bladder out, even. And I have had to wait up to 3 months to get in to see specialists, too.

SteveNZ · Jan 3, 2015

Joykins said:
I love the tacit assumption in these discussions that no one would EVER have to wait months for surgery in the US, although people actually routinely wait months for certain elective surgeries in the US. I waited 6 weeks to have a gall bladder out, even. And I have had to wait up to 3 months to get in to see specialists, too.

With our (NZ) system you then moan to the health board and they have a system of examining these. Normally another team of specialists reviewing the case.

That I think is part of the requirement for a good system. Continual reviews (not enquiries for blame) as required, with the equivalent of independent patient advocates available.

Yes we do have waiting lists and yes when the economy is poor they get longer. But you are always at least kept track of and if necessary handled earlier.

Joykins · Jan 3, 2015

There is not ever a wait list for Labor & Delivery, thank goodness

Panzerkamfwagen · Jan 3, 2015

A2SG said:
Why would they be?

You're right. Someone worse would be in charge...Congress.

If you're talking about a single payer system, your health care would still be managed by a Doctor. The bills would be paid by the government, that's all.

Because government-run health care would never not have money, right?

:doh:

If you're worried about government interference in health care, then would you support a Constitutional amendment that specifically states all medical decisions, including which medical procedures you'd be able to have, be kept strictly between doctor and patient, with no government interference whatsoever?

-- A2SG, it sounds like a good thing, but I've yet to hear a single conservative or republican agree to it.....can't imagine why.....

For medical treatments that I pay for, or are privately paid for, that would be a good thing.

If it's somehow socialized, and the government runs things, then, that's not necessarily a good law because Congress really wouldn't have any oversight about how it's run, and government money disappearing in black holes is not a good thing.

Can you think of anything that could possibly go wrong with essentially handing a doctor a blank check? If you have a single payer system, and all of the treatment information is restricted to between the doctor and the patient you have absolutely no way to hold a doctor accountable for fraud, or, at least it makes the investigation far more difficult.

Standing_Ultraviolet · Jan 3, 2015

Joykins said:
I love the tacit assumption in these discussions that no one would EVER have to wait months for surgery in the US, although people actually routinely wait months for certain elective surgeries in the US. I waited 6 weeks to have a gall bladder out, even. And I have had to wait up to 3 months to get in to see specialists, too.

It can be a problem in any healthcare system. It's one of the very, very few instances where the healthcare system in the U.S. generally does better (for those to whom it's accessible) than some universal systems, though, so it's something that some opponents of universal healthcare latch onto.

SteveNZ · Jan 3, 2015

Panzerkampfwagen said:
.......... If it's somehow socialized, and the government runs things, then, that's not necessarily a good law because Congress really wouldn't have any oversight about how it's run, and government money disappearing in black holes is not a good thing.

............ If you have a single payer system, and all of the treatment information is restricted to between the doctor and the patient you have absolutely no way to hold a doctor accountable for fraud, or, at least it makes the investigation far more difficult.

Of course that whole description stinks. Why would anyone even want a system like that? No such system you describes exist anywhere (that I know of) so why try to make one.

I agree that the US is too large and with a governing system that would make the whole thing difficult.

So develop a system that will work.

I like the model where........
-Federal government funds, via taxes (therefore compulsory), a basic health insurance system. And that there is a 'Health Constitution' for a better word that identifies all patient advocacy methods, review methods and even ways to handle medical fraud within the system.

- The providers are independent health insurance companies that meet the basic minimum criteria, follow the 'Health Constitution' and who receive fnds. Some will already exist within states others may be required.

-Those folk who do not wish to be part of the federal scheme may choose to follow the current health insurance methodology. These folk can apply to not pay the federal tax on health as they have an alternative.

The main point is that no one can either opt out of funding nor fail to receive health care.

Socialised Medicine ...... Arrrrgh

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