Health Care Policy

[frankj]

Gern: McCain presented an alternative health care plan during the campaign. I read a side-by-side comparison of his and BHO's and his was better. BHO criticized it by mischaracterizing it with the sound bite: "He wants to tax your health care," and he got away with it, in my opinion, because too few people took the time to inform themselves on the issues and the popular press, certainly didn't pick up the slack.

 

 

[TheScout]

What would we ever do if the federal government does not come up with plans for our life?

 

We need them to tell us what to do!

[GernBlansten]

I think the closest thing we might have to a free market health care analogy would be the current US veterinary system. Its a pay as you go system. If you don't have the cash, your pet doesn't get care. Only the richest can afford care above the normal preventative procedures and routine visits. Not to mention the millions of pets who never see a vet, ever. A majority of pets are simply euthanized when costs exceed the family budget. Of course we can justify that saying that the patients quality of life wouldn't be worth the expense or trauma of treatment.

 

Imagine telling grandma, sorry, that chemo is pretty expensive and you know, you aren't going to be feeling that great after it anyways. Besides, you've had a good life and reached your expected life span.

 

[vol_scouter]

Gern wrote:

 

"Imagine telling grandma, sorry, that chemo is pretty expensive and you know, you aren't going to be feeling that great after it anyways. Besides, you've had a good life and reached your expected life span."

 

What do you think happens in socialized countries right now? Here in the US hemodialysis cannot be started under certain conditions one of which is age (though there is no age that it is stopped just because you are that age). Socialism brings rationing to everybody but the wealthy. People wait for procedures and surgeries in Canada for years that are done next week here. If you wish rationing, keep supporting socialism for the health care system and you WILL have it. That is part of the reason that I am leaving. BTW, almost ever physician who has practiced a number of years that I know is considering or has considered leaving the field - a sad comment.

[TheScout]

Someone has to pay for it.

 

I have no problem helping out those in need. I am even not opposed to government doing some.

 

It must be done at the local level though. The bigger a government program gets the more wasteful and bureaucratic it will be though. Not to mention the fact that the Constitution doen't authorize the federal government to do anything in this regard.

 

I don't like seeing my money shipped to other states to fix problems. It might as well go to other countries. Just people I don't know that are far away.

[GernBlansten]

Rationing occurs in every system. Insurance companies ration care by excluding pre-existing conditions and denial of benefits for other various reasons, like procedures they deem experimental. Often, when presented a case where two methods of treatment are available, they will authorize the cheaper one, even when challenged by the physician to allow the alternative.

 

In a free market system, the rationing is naturally taken care of by the thickness of your wallet.

 

State by state systems would be OK, if you never planned on traveling outside your state. Say Colorado had socialized medicine so I didn't need health insurance, and New Mexico had a free market system. Get hurt at Philmont, and you better bring a bag of cash.

[TheScout]

I am sure such a system can be worked out. Europeans can travel through the Union and enjoy care wherever they are.

 

In your example you would think Colorado would look out for its traveling citizens and have a system to cover its citizens in other states. If Colorado does not come up with a system its people would be at risk. That would only be the fault of the people of Colorado who elected those who made a faulty system.

 

Plus by their Constitutions, most states are authorized to do such things as they have far less restraints than the federal government. But that is if you care about following the Constitution. . .

[GernBlansten]

All European countries all have socialized medicine, so of course they can travel without risk.

[TheScout]

But foreign citizens did not used to be covered by the host nation health system. Now the EU has developed a health card to allow citizens to get treatment in whatever country they are in.

 

Even if a state did not have socialized medicine for example, Colorado could have a system to pay for any treatment needed by its citizens in New Mexico. Plus it would be constitutional.

[vol_scouter]

I cared for a patient from Canada traveling in my area who had a small stroke. He had a prior stroke due to carotid artery disease that resulted in a carotid endarterectomy (CEA) on one side. My work-up revealed that the opposite side was now critically stenotic (narrowed) causing his stroke and he needed a CEA on that side. He would be at high risk of another stroke. The vascular surgeon would perform the surgery in a few weeks after the stroke had some time to heal (otherwise he may have bled into the prior stroke area when placed on anticoagulants for the surgery). The Canadian insurance pay. The family was absolutely astonished because in Canada it required a 2 year wait despite being at high risk for another stroke. That is not good medical care for a routine surgery.

 

I had a patient who came here just prior to WWII who later developed breast cancer. One day she related to me the concern for her sister who was still in Great Britain. She described a lesion on her breast that she said looked like an orange peel. Her sister had told the primary care physician that her sister had a history of breast cancer. The appearance of the sister's breast is called peau d'orange and is considered pathognomonic for breast cancer - which means when you see this sign you an make a diagnosis of breast cancer. It is a classic finding. The patient did not have a mammogram ordered and the lesion was watched for some time. Then a 'knot' appeared on her calf that was biopsied revealing breast cancer (shocking finding right). She was then told that she was too far advanced to have chemo (probably a correct call) and sent home to die with pain meds.

 

Daschle has sited the British system, NICE, as the system that we should emulate. Physicians are punished if their patient population costs the system too much (as are many HMOs here). The physician in GB, in my opinion, was controlling costs by waiting for the disease to become too far advanced too treat. Narcotics are cheap. Mammograms and the findings that they lead to are expensive.

 

Those who want socialized medicine think that they will get the current system only a little better for no cost to them. The reality is that they will get a far worse system that will cost society much more though it could be partially hidden by taxes.

 

Socialism has never worked and will never work because it is contrary to human nature. I know that the best medical system in the history of the world will soon be a footnote in history for a socialist ideal. It is truly sad that we have so rapidly deteriorated to this state - caused by the same government that says trust me, I will fix it. The government will fix it the same way as it caused the banking collapse.

 

I know that this seems all doom and gloom but that is the way that most physicians medicine going.

 

 

[frankj]

Vol_scouter: Thank you, very much.

[GernBlansten]

Yep, lots of horror stories out there.

From both sides. No system is perfect.

[TheScout]

Good stories vol-scouter.

 

Gern, all systems have faults that is true.

 

Lets err on the side of liberty and the free market.

[GernBlansten]

As long as you have a plan to deal with all the sick kids and dead old folks.

[TheScout]

Well first there is individual responsibility.

 

Then there are famalies to assist.

 

Then there are churches, benevolent health care providers, and other charities to help.

 

Then there are local governments that can help their citizens.

 

Then there are state governments that can aid the people of their states.

 

If all this fails I don't see why a giant nationwide bureaucratic system would do any better. Nor would I want it to. I do not want to see resources from my state pushed to others to help people far away I do not even know and little in common with.