American Healthcare crisis as seen from a doctor's perspective

[Teeninvestor]

Part of the reason the US has lower taxes is because of its rampant borrowing, but there are parts of the US system which is effective(despite its denigracy into state capitalism).

In the US, it is VERY difficult to raise taxes. In Canada where I live, taxes get risen by politicians without a thought. AND THE PEOPLE DON'T COMPLAIN. McGuinty, for example, tacked on a $600 health premium for no reason besides his incompetence.

Canadian healthcare is very expensive and wasteful, despite what you would believe. In ontario, half the provincial budget is used on providing health care, and the cost rises every year, as well as taxes(such as the "health premium" I mentioned above).

Care is also delayed. One of my relatives is quite sickly and she regularly has to wait in hospitals for hours with severe pains(as in tylenol pills don't even work) and sometimes even bleeding without getting care. For HOURS.

Please don't give me the "we don't have enough doctors". In China, you can get care instantly despite having WAY LESS doctors per capita.(Of course, there are issues with the poor being unable to afford care). Many other countries that I know of have less waiting time than US OR CANADA.

I think this is primarily a problem of incentive. In Canada you get paid the same , so doctors have no incentive to treat patients. US is better, but the physicians cannot contact the patients directly- they must do it through insurance companies. That is the inefficient part.

 

[emzie]

Part of the reason the US has lower taxes is because of its rampant borrowing, but there are parts of the US system which is effective(despite its denigracy into state capitalism).

In the US, it is VERY difficult to raise taxes. In Canada where I live, taxes get risen by politicians without a thought. AND THE PEOPLE DON'T COMPLAIN. McGuinty, for example, tacked on a $600 health premium for no reason besides his incompetence.

Canadian healthcare is very expensive and wasteful, despite what you would believe. In ontario, half the provincial budget is used on providing health care, and the cost rises every year, as well as taxes(such as the "health premium" I mentioned above).

Care is also delayed. One of my relatives is quite sickly and she regularly has to wait in hospitals for hours with severe pains(as in tylenol pills don't even work) and sometimes even bleeding without getting care. For HOURS.

Please don't give me the "we don't have enough doctors". In China, you can get care instantly despite having WAY LESS doctors per capita.(Of course, there are issues with the poor being unable to afford care). Many other countries that I know of have less waiting time than US OR CANADA.

Again, I have no idea what hospitals you're going to, but I've never seen someone bleeding in the waiting room or writhing in pain for more than a few minutes before they goto the express line thing... at Ottawa General they call it urgent care or something like that.

As I said, I've received care in both the US and Canada, both insured and uninsured in the US. What we have going right now is what I'd take every time.

I think this is primarily a problem of incentive. In Canada you get paid the same , so doctors have no incentive to treat patients. US is better, but the physicians cannot contact the patients directly- they must do it through insurance companies. That is the inefficient part.

You do know that it's a publicly financed, privately run system right?

eg: your doctor, your clinic, your hospital only bill OHIP for services they actually do, not OHIP paying them a salary to do whatever.

 

[Teeninvestor]

Again, I have no idea what hospitals you're going to, but I've never seen someone bleeding in the waiting room or writhing in pain for more than a few minutes.

As I said, I've received care in both the US and Canada, both insured and uninsured in the US. What we have going right now is what I'd take every time.

I live in Ottawa.

 

[El_Machinae]

No, it would lower taxes.

Maybe, maybe in the long run. But that's assuming quite a bit. Total costs on health care would certainly be able to come down a great deal though

 

[emzie]

I live in Ottawa.

I know. Which was my point. I've never been to a hospital in this city that was anything like what you're describing.

 

[Neonanocyborgasm]

Nanocyborgasm, forgive me if you feel this is irrelevant, but in most cases you take the conservative side, correct?

Conservative on some issues, flaming liberal on others.

My issue with universal health insurance is twofold:
1. US is spending cash like crazy and will soon be in hyperinflation at this rate. Why make it worse???
2. Would it raise taxes???? I mean if you cut somewhere like the military or welfare to fund this program from current funds, I don't mind. But if you have to raise taxes, this would make the current depression even worse.

The reason this needs to be addressed is because we are already paying exhorbitant sums of money for an inefficient healthcare system. It is inefficient because it directs spending on the elderly after a lifetime of untreated illness. For example, about 90% of all medical expenses in a lifetime are consumed in the last 6 months of life. Instead, it needs to be directed to the general population so that the citizenry of the nation do not become impoverished by their medical expenses, and so that we do not pay crazy high taxes to fund that. By making the system more efficient, we would actually pay less taxes. Also by making a healthier population, we allow people to remain productive for longer, allowing them to earn more income, and therefore be more prosperous.

 

[Teeninvestor]

Have you ever tried to get emergency care at night in the civic hospital??? It takes four hours. At least that's what I've heard from my friend, who had an attack of appenditicis. Afterwards, she had to go back because the doctors failed to do it correctly and she had to have 4 surgeries in 2 months. I also read on the news once that a person actually became a vegetable due to easily treatable strain of malaria which however was not treated because of waiting times & she didn't think it was so serious.

 

[civ_king]

My bro had a stick piercing both sides of his mouth and it took 4 HOURs!!!!! in ER for them to see him (this is US)
Malaria in Canada‽‽‽‽‽‽‽

 

[Teeninvestor]

My bro had a stick piercing both sides of his mouth and it took 4 HOURs!!!!! in ER for them to see him (this is US)
Malaria in Canada‽‽‽‽‽‽‽

Think it was after returning from some other country. Don't know. Read it in a local newspaper.

 

[emzie]

Have you ever tried to get emergency care at night in the civic hospital???

The one on Smyth (near Riverside)? Yes.

It takes four hours.

Or it takes 30 seconds if you walk in with chest pains / symptoms of a stroke / are in labour. It all depends on how the triage nurse rates you, when you got there, and how many other people are there.

I've spent 20 minutes in that waiting room with my wife when she was in severe pain. I've dropped my brother-in-law off there and he waited 12 hours... he wanted them to check his eyes because "they felt weird."

This is more or less the same experience you'll have in the US.

At least that's what I've heard from my friend, who had an attack of appenditicis.

What your heard...

... appendicitis is a medical emergency, yes. But walking into the ER with stomach pains can be many things. If your pain isn't doubling you over in agony, they're probably not going to rate you as high.

Afterwards, she had to go back because the doctors failed to do it correctly and she had to have 4 surgeries in 2 months.

A doctor, or doctors, screwing up isn't indicitive of a system in itself.

I also read on the news once that a person actually became a vegetable due to easily treatable strain of malaria which however was not treated because of waiting times & she didn't think it was so serious.

Um, there's no wait time that's going to kill someone with malaria. Her death, or her coma rather, was a result of her own stupidity.

 

[Ayatollah So]

Excellent OP. My wife works in the health care system as a psychologist, and reports basically the same experiences.

II.

A second and unseen problem is the tendency by the American medical establishment to allow sloppy medical care to continue without scrutiny. [...] This will continue so long as doctors realize that there is no oversight to their actions.

II.B. Hospitals and other facilities also have some sloppy or downright insane habits. Of course, a lot of this is simply the direct result of problem I, insurance and payment.

 

[Neonanocyborgasm]

Have you ever tried to get emergency care at night in the civic hospital??? It takes four hours. At least that's what I've heard from my friend, who had an attack of appenditicis. Afterwards, she had to go back because the doctors failed to do it correctly and she had to have 4 surgeries in 2 months. I also read on the news once that a person actually became a vegetable due to easily treatable strain of malaria which however was not treated because of waiting times & she didn't think it was so serious.

4 hours is nothing. I've known waiting times of 9 hours or more. Like it or not, it's in the name: emergency room. If you don't have an emergency, don't expect 5 star hotel treatment. You will be assigned priority based on your perceived level of illness by the triage nurse. High levels of priority include neurologic dysfunction, hemodynamic compromise, hemorrhage and severe injury. Low level priority might be an earache. The majority get the middle. That means that if you show up on a day when there are 5 high priority patients being seen, you will have to wait for them before you even see the doctor, and that's only if you make it on the middle priority. If you are low priority, you may not even be seen.

 

[Cutlass]

A few months ago my sis had hip replacement surgery. A few days later she was running a fever, so the doc on the phone said go tot the emergency room. She went to the hospital she had the surgery at, and waited 9 hours to get told it was a minor infection.


Boy were we all impressed on how bad everyone else's health care system is

 

[MobBoss]

What about people that could afford health care insurance, but it simply isnt a priority for them? i.e. they want to simply spend their cash on something else instead of their health care insurance? Why should all the rest of us subsidize someone like that?

 

[Mountain-God]

It seems some people here are confusing Universal Health Insurance with Universal Health Care.

There is a difference.

I am with the faction that believes that insurance/coverage should be universal. If it needs to be handled by the government, then so be it. This does not mean the doctors and hospitals are run by the government. Also, if you want a private health plan, you should be free to obtain one.

Quible over semantics does not for difference make

 

[Mountain-God]

Part of the reason the US has lower taxes is because of its rampant borrowing, but there are parts of the US system which is effective(despite its denigracy into state capitalism).

...

I think this is primarily a problem of incentive. In Canada you get paid the same , so doctors have no incentive to treat patients. US is better, but the physicians cannot contact the patients directly- they must do it through insurance companies. That is the inefficient part.

I tend to think US taxes rather high - or, to be more accurate, the overall 'taxes' a person pays in the USA.

Consider income tax, sales tax, and a multitude of other 'taxes' and the USA actually ranks very high in the overall cost-to-the-citizen rate.

There's just so much corruption, and so many loopholes, it's nuts

 

[Cheezy the Wiz]

Again, this is false.

Less than 10% of Americans buy their own insurance plans; 60% receive it as part of employer benefits.

If the government provides it, then employers don't have to. This makes it easier on your beloved corporations.

What about people that could afford health care insurance, but it simply isnt a priority for them? i.e. they want to simply spend their cash on something else instead of their health care insurance? Why should all the rest of us subsidize someone like that?

They would be subsidizing it, too, since it would most likely be paid for by a progressive tax. Its like asking why should people who don't want to call the cops when someone breaks into their home pay the percentage of their tax that goes toward police funding, or the people who walk everywhere pay for the part of taxes that goes towards road or rail maintenance?

I don't see how universal health care is not a public good, any different from fire departments or police stations or roads.

 

[emzie]

What about people that could afford health care insurance, but it simply isnt a priority for them? i.e. they want to simply spend their cash on something else instead of their health care insurance? Why should all the rest of us subsidize someone like that?

Because they're paying into it as well. You need to stop see it as "My money is subsidizing their healthcare!" because in turn, their money is subsidizing yours.

 

[MobBoss]

Because they're paying into it as well. You need to stop see it as "My money is subsidizing their healthcare!" because in turn, their money is subsidizing yours.

Not if I am paying for my own health insurance their not.

To me, this is akin the mortgage bailouts to people who bought more house than they could afford. I didnt. I acted responsibly.

I would simply prefer to keep my own share of the 'universal healthcare tax' instead of paying it and use it for my own healthcare insurance that I choose. Is that so unreasonable?

 

[Yeekim]

I would simply prefer to keep my own share of the 'universal healthcare tax' instead of paying it and use it for my own healthcare insurance that I choose. Is that so unreasonable?

It is. Because the system of private healthcare insurance creates an extra layer of "middlemen" - these same insurance companies. As they are organizations that run for profit, it is obviously not most cost-effective solution for government, employers or the workforce.
Private insurance companies can be effective for other purposes - like insuring one's house against fire. Since only few houses actually catch fire, the company can make profit while the costs for his clients are not unreasonably high. Health insurance is different, because eventually (nearly) every insured person will need treatment. And the way to keep costs low, as correctly pointed out above, is monitoring and preemption, rather than treating out-of-hand cases at the last moment.