Technically it's multi-payer, but the concept is pretty much the same. It's just that there are mandatory private contributions. It's not like the U.S. where almost all of the non-Medicare costs of health care are private. The problem in the U.S., which Romneycare and the ACA addressed was the subsidizing of those that could afford insurance but decided that it was better to freeload, especially given the EMTALA which is basically an unfunded mandate. But it's an unfunded mandate that was made necessary in the first place by the screwed up health care system, so blaming Reagan for signing it into law isn't fair either.
No, it is not tiny. I leads to over-medication, over-examination, tons of unnecessary expense. I've been on the beat in med tech for over 25 years now. The topper, when I asked a doc why they bought Acuson ultrasound machines all the time: "Well, these are by far the most expensive and I agree with you that we don't need them. But then nobody in court can accuse us of not having done the best". One of many, many examples. Leftists stick their heads in the sand about it but that does not make it go away.
Complete nonsense. Sorry, but that's what it is.
Irrelevant. I personally met cardiologists who paid north of $100k in malpractice premiums. Guess who pays that in the end ...
It is totally clear to people in the medical field.
It made our system the most expensive in the world.
No. They have one method which has HMOs like we had them until about now but who cannot deny coverage because of pre-existing conditions. They also have the "Privatkasse" system which is unfettered by all this and can deny coverage. I have lived there and had the choice between the two.
... who, under Obamacare, will continue to freeload. I've met folks who are planning to do exactly that. What is better: Paying 1% (or in 2-3 years 2.5%) penalty, or >10% of your net income in sky-high premiums? Many people already have decided their answer and it's not what Dems thought it would be.
The issue is that even the defensive procedures don't have much of an effect on overall health care costs. The voices in your head that tell you that they do can be eliminated by turning off Faux News. This procedure is unfortunately not part of the ACA.
When hospitals, doctors, health care companies, and lawyers all agree that the tort system is having a negligible negative effect, if any, on overall expenses, you'd be better off believing them than listening to the right-wing talking heads from Faux News, or the Heritage Foundation, that make stuff up as they go along to suit their own agenda.
Here's where you can begin your education on this issue:
Small Cost Benefit for Tort Reform, More Primary Care
Tort reform has not reduced health care costs in Texas
Tort reform won't provide significant healthcare savings
$130 Million Verdicts Don?t Raise Medical Costs
It's true that there are expensive tests and defensive medicine and that drive up costs. Even in Texas they've continued because they were never really about preventing malpractice suits, they were always about increasing billable expenses.
No. Because the number of lawsuits where the reliability of such a machine would be an issue is nil.
Even if you were talking about something like a Gamma Knife versus a Cyber Knife since each has its pros and cons a plaintiff would have a hard time suing based on efficacy and reliability.
The bottom line is that the right wing has created this mythical issue of tort reform as an excuse to avoid doing anything real about health care. They really do understand that tort reform would have almost no effect on costs (it actually could drive them up) but their handlers tell them to use it as a talking point because nothing is better than bringing up an example of a large award by a jury and then bashing lawyers. They can wring their hands and proclaim that if only we had tort reform medical costs would plummet. It's not true.
What tort reform really means is that the average citizen can no longer use the justice system to determine a fair amount of damages. The amount of pain that the medical establishment is allowed to suffer at the hands of legitimate plaintiffs is limited.
In front of a jury, yes. If plaintiff's counsel makes a compelling case around the argument that defendant did not use the best of the best, having saved $50k on a machine can hit the fan as a million Dollar settlement.
Canada or the UK that it can fail the during serious illnesses. For settin g broken bones and stuff the single payer systems work well but when it com es to cancer mortality the picture is dark.
insurance farce.
a yearly stool test is "over-testing". It costs peanuts yet the health sys tem in Germany when I lived there did not do it.
test, is a cheap. and very good defense against colon cancer.
od"
eciated, and that there are questions about it's cost-effectiveness in mass
-screening.
mple:
do they? Neither does Germany. To me it is very clear why.
you want them to support. There are other ways of looking at them.
ying that US medicine is perceptibly better than Canadian or German. Once y ou've seen that, your brain stops processing.
his can only work through early screening (and polyp removal.
Those links didn't give the number of people who had had polyp removal in t erms of patients per 100,000 in the population as a whole. If it were less than 5 per 100,000, your explanation couldn't possible be valid (to set up an extreme hypothetical case)
erences in diet and age are equally plausible.
"Better" depends on what aspect of the diet one is looking at. All that is required is "different". And you've passed on the differences in age, which could be equally significant - cancer is essentially an end of life diseas e.
formatting link
talks about it as a multi-stage progression. You need some six successive h eritable cell changes to get to a malignant cell, and this shapes the age-d ependent incidence.
ertainly haven't substantiated your polyp-snipping explanation - which woul d require evidence that enough polyps had been removed to explain the diffe rence, and even that wouldn't demonstrate that there were other factors in play.
y contradicts clinical evidence.
You haven't provided all the evidence necessary to make your explanation co nvincing. It is merely plausible, and there are other plausible explanation s available for the difference in the colon cancer incidences in the US Can adian and German populations.
oes leap on an obvious explanation and ignores all the alternative explanat ions with all the confidence of the converted. Try to think like a scientis t for a bit, and see if you can find - and perhaps test - a few alternative hypotheses.
. That has worked well for at least a century. You are welcome to ignore th at, it won't make a difference.
Medicine has a long history of confusing correlation with causation and oth er intellectual errors. As for clinical studies, the Korean study that you thought validated the use of your expensive cardiac catheter with the built
-in ultrasound imager (a brilliant, if expensive, device) only used it on p atients who were healthy enough to tolerate the procedure but you still got excited about their better survival rates.
, and the subsequent histories of people who have had their polyps snipped.
6
html
from colon cancer was about 90% lower if people underwent both the initia l and follow-up procedures than if they underwent neither". There are many more studies and they corroborate this. You can go into denial about it but that won't changes these medical facts.
But how many people - per 100,000 in the population - get their polyps snip ped?
ming, you'd expect a substantially larger difference.
Which is why we need to know what proportion report in for their colonoscop y, and what proportion have polyps that get snipped.
Sorry to be obnoxious about this, but clinical trial don't always mean what their sponsors like to claim that they mean. Big pharma has sinned repeate dly in this area, and medicos with irrational convictions can be worse.
Frankly, I don't care whether you believe it or not. Medical doctors know better, even European ones.
formatting link
Fact is, polyps are routinely snipped over here because we perform preventative colon cancer screening. In countries that don't screen via colonoscopy it is, obviously, impossible to even detect which people have intestinal polyps and how many. Therefore, obviously, there cannot be large scale statistics about it in those countries.
certainly haven't substantiated your polyp-snipping explanation - which wo uld require evidence that enough polyps had been removed to explain the dif ference, and even that wouldn't demonstrate that there were other factors i n play.
rly contradicts clinical evidence.
It isn't. You are over-interpreting the clinical evidence.
better, even European ones.
e
tative colon cancer screening. In countries that don't screen via colonosco py it is, obviously, impossible to even detect which people have intestinal polyps and how many. Therefore, obviously, there cannot be large scale sta tistics about it in those countries.
Your claim is in two parts - first that enough polyps are clipped in the US to explain the lower rate of colon cancer there than in Germany and Canada , adn - second - that this is the only explanation of the difference in rat e.
Since you can't tell me what proportion of the US population has their poly ps snipped, you haven't got to first base on substantiating the first claim .
I'm happy to believe that polyp-snipping works - I've always believed this since I first heard the story. I'm a lot less confident about your claim th at there's enough of it done in the US to explain the difference in the rat e of colon cancer. As you say, it's not a popular procedure.
Here are the (large) percentages of people screened by state:
formatting link
As for polyp detection and removal:
formatting link
Quote "The New York City Health and Hospitals Corporation (HHC) today announced that HHC doctors performed more than 21,000 colonoscopies and removed pre-cancerous polyps in about 20 percent of the cases at the city public hospitals last year". They even found 338 hardcore dangerous ones during those.
20% is a lot. I believe one can safely assume that the remainder of the US population and also that in Canada isn't all that much different from New Yorkers. We eat too much bacon, they eat too much poutine, both pretty bad for the health.
Fact is, if you don't get screening these polyps cannot be detected in a timely manner because they are nearly all asymptomatic. Once symptoms set in it is usually too late.
the right-wing tea-partiers to portray it as a big problem. "
In essence you are corrrect, however the costs to INSURE against this tort law cost alot more. Malpractice insurance is not cheap. Note though, that t he insurance companies ARE indeed making money on malpractice insurance, ju st like everything else they insure.
I still find it funny how people bitch about the oil companies' profits whi ch run someting like 7 % and think a 20 % cap for the insurance companies i s great. They would suck a mile of dick to make that much. The key to these massive profits is volume. I want $313 million dollars. I have alot better chance of getting a buck apiece form everyone than to find someone who wil l just give it all to me in one lump sum. Actually today it might be easier to get ten bucks apiece from 3 million people.
The problem here is that such industries in a free country should be tightl y regulated by the government and treated like public utilities. Now the go vernment regulates the People and industry regulates the government.
Let me tell you all a secret. Every regulation, I mean EVERY regulation the government makes on business in this country is approved by business in th is country.
Let's take an example, ridiculous safety and pollution standards on automob iles. Think that was bad for the automakers ? Nope, it protects them from t he likes of Tucker. It prevents the import of certain vehicles. When it com es to pharmaceuticals, it justifies higher prices.
If you look hard enough, in (almost) every case, industry has no problem wi th most regulations. The only exceptions are ones that would blatantly viol ate public trust and that only applies if the public knows about it.
In Pennsylvania Dr. Alfonso Rodriguez filed a suit on court for clarificati o, interpretation or limitation of a rulke on disclosure. Docrtors are give n information on the poisonous liquids used for fracking. Under the ruiles they are not allowed to tell their patients what these chemicals are and th erefor are impeded from having intelligent discussions about their conditio ns, which are a DIRECT result of exposure to fracking liquids.
the case was thrown out of court summarily. Tis tells you soemthing doesn't it ? this stuff is causing people to go into renal failure. This is not fu cking joke anymore and sooner or later there will probably be a huge lawsui t. Again, using the defensive tactic of a class action lawsuit the companie s will not pay the full costs for which they are responsible.
In fact they won't pay anything. ALL costs in ANY business are paid either by the customer, or indirectly by the employees or stockholders.
I thought the lifetime cap was one of the features that had to change even with the grandfathered plans?
I'm not sure what the "burden on society" comment means. But the elimination of lifetime caps is for your benefit. In some cases the care required for an illness can exceed that cap at which point the insurance changes from paying 100% to paying 0%. Not a happy circumstance. :(
You don't say what time period the costs cover. Certainly it is not per year and it sounds too high for per month as well. What state are you in? Each state regulates their own insurance and the costs are different, no?
No, you don't "lose" the grandfathered plans. You plan is not grandfathered if it changes significantly since the ACA was passed in
2010. Many insurance companies have significantly changed their plans in the intervening time and so some plans will *not* be grandfathered. It has nothing to do with the ACA requirements.
Do you understand how insurance works? You sign up for coverage and everyone pays for all of the costs. That spreads the risk and costs across *all members* of a plan. If you want to belong to a plan that only has members who can't get pregnant, I expect your rates will be even higher because it will have a lot of *older* people which, as we all know, is the single biggest risk factor in health insurance... not the ability to conceive.
Quote "A grandfathered plan has to follow some of the same rules other plans do under the ACA. For example, the plans cannot impose lifetime limits on how much health care coverage people may receive, and they must offer dependent coverage for young adults until age 26 (although until 2014, a grandfathered group plan does not have to offer such coverage if a young adult is eligible for coverage elsewhere)".
They don't have to comply with all rules but they the do have to with many of them. We got that in writing for our plan. For example, that it now covers strange elective stuff such as sex change operations and this was after 2010. With the consequential cost increase, of course.
A lot of catastrophic plans were also banned by Obamacare. They were a perfect fit for people with financial discipline, who have saved enough to pay for setting broken bones and stuff out of pocket. So now they must buy a much more expensive Obamacare plan they don't need. Because Obamacare has built-in age discrimination and only lets young people buy catastrophic-only coverage. The government essentially assumed people are incompetent. Which is despicable.
ou certainly haven't substantiated your polyp-snipping explanation - which would require evidence that enough polyps had been removed to explain the difference, and even that wouldn't demonstrate that there weren't other fa ctors in play.
early contradicts clinical evidence.
I'll talk to my cancer specialist acquaintance next time I see him. He's ou t of town a lot regulating breast cancer trials, but we do seem to catch up with him and his wife (who is a retired expert on cancer statistics) from time to time.
ion convincing. It is merely plausible, and there are other plausible expla nations available for the difference in the colon cancer incidences in the US Canadian and German populations.
now better, even European ones.
ease
ventative colon cancer screening. In countries that don't screen via colono scopy it is, obviously, impossible to even detect which people have intesti nal polyps and how many. Therefore, obviously, there cannot be large scale statistics about it in those countries.
e US to explain the lower rate of colon cancer there than in Germany and Ca nada, and - second - that this is the only explanation of the difference in rate.
polyps snipped, you haven't got to first base on substantiating the first c laim.
his since I first heard the story. I'm a lot less confident about your clai m that there's enough of it done in the US to explain the difference in the rate of colon cancer. As you say, it's not a popular procedure.
That's between 50% and 60% of the affected population screened - which is t o say that they have all had fecal occult blood tests (FOCT). In fact that' s the percentage of the people sampled who responded, but the New York data does suggests that the respondents aren't wildly different from the non-re spondents.
The same URL also demonstrates that there's appreciable difference in the r ates of colorectal cancer from state to state - more than between the US av erage and the German and Canadian average, and that this doesn't correlate with the percentage of the affected population screened.
formatting link
ounced that HHC doctors performed more than 21,000 colonoscopies and remove d pre-cancerous polyps in about 20 percent of the cases at the city public hospitals last year". They even found 338 hardcore dangerous ones during th ose.
S population and also that in Canada isn't all that much different from New Yorkers. We eat too much bacon, they eat too much poutine, both pretty bad for the health.
New York is a 40.9 to 43.6 per 100,000 - appreciably higher than Canada as a whole.
21,000 colonoscopies isn't a lot for a state with a population of 19.5 mill ion people. 20% of that is 4,000 sets of polyps snipped, about 40 per 100,0
00 (since only about half the population is FOCT screened) which is about t he same as the colorectal cancer rate. Only about 10% of these patients (33
8) had polyps that were actively cancerous, so the rest wouldn't have gotte n into the cancer statistics.
The underlying colorectal cancer rate for New York has to be even higher th an the 40.9 to 43.6 per 100,000 shown on the map, outstripping Canada and G ermany even further, and again suggesting that US colorectal cancer is diff erent breed of cat to the US/Canadian one - or rather a different range and distribution of of cancers to the range and distribution that the the Cana dians and Germans have to cope with.
timely manner because they are nearly all asymptomatic. Once symptoms set i n it is usually too late.
On this point you are preaching to the converted. Not converted enough to g o out and buy a FOCT test kit from my local chemist, but probably converted enough to talk to my GP about it next Monday during my regular every-six-m onths appointment.
And thanks very much for digging out the statistical information I was afte r. I've now got a much clearer picture of what the US does in this area, an d it's good. Your health system is still grossly over-priced for what it do es, and only does it for the fully insured 70%, but at least it seems to ge t colorectal cancer screening as close to right as is humanly practical.
I was looking for info like The incidence of colon cancer is 1,000 per 100,000 for unscreened people and 500 per 100,000 for those getting colonoscopy with polyp removal. But I didn't find it. I have seen stats where this screen will reduce your chance of getting X by 50%, That sounds good, but then find that reduces your incidence from 1 per 100,000 to 1/2 per 100,000. 50% but not a great risk to begin with. Got a letter from my insurance company urging me to get a colon cancer screening. The only test mentioned is FIT, Fecal Immunochemical Test. I'm 58yrs old, so a colonoscopy is in my near future, I'm sure many have had one by my age. Others never get one. Mikek
ElectronDepot website is not affiliated with any of the manufacturers or service providers discussed here.
All logos and trade names are the property of their respective owners.