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Art Read
08-11-2009, 05:42 AM
Unintended consequences? You really should watch this video before saying it could never happen in America... Whoops!

http://www.youtube.com/watch?v=g6ojBgTyA7I (Oregon Health Policy Commission? Would that be like a "government panel"?)

__________________________________________________ _________

Oregon health plan covers assisted suicide, not drugs, for cancer patient

Eugene, Ore., Jun 6, 2008 / 01:09 am (CNA).- An Oregon woman suffering from lung cancer was notified by the state-run Oregon Health Plan that their policy would not cover her life-extending cancer drug, telling her the health plan would cover doctor-assisted suicide instead.

Barbara Wagener discovered her lung cancer had recurred last month, the Register-Guard said. Her oncologist prescribed a drug called Tarceva, which could slow the cancer growth and extend her life.

The Oregon Health Plan notified Wagner that it would not cover the drug, but it would cover palliative care, which it said included assisted suicide.

“Treatment of advanced cancer that is meant to prolong life, or change the course of this disease, is not a covered benefit of the Oregon Health Plan,” said the letter Wagner received from LIPA, the Eugene company that administers the Oregon Health Plan in Lane County.

“I think it’s messed up,” Wagner said. She said she was particularly upset because the letter said doctor-assisted suicide would be covered.

“To say to someone, we’ll pay for you to die, but not pay for you to live, it’s cruel,” she said. “I get angry. Who do they think they are?”

A doctor appealed to Genentech, the company that markets Tarceva in the U.S., to cover Wagner’s medication. On Monday Wagner was told the company would cover the drug treatment for a year, after which she could re-apply for the drug.

“I am just so thrilled,” Wagner said. “I am so relieved and so happy.”

According to the Register-Guard, Oregon oncologists say they have seen a change in state health policy, saying their Oregon Health Plan patients with advanced cancer are no longer covered for chemotherapy if it is considered comfort care.

“It doesn’t adhere to the standards of care set out in the oncology community,” said Dr. John Caton, an oncologist at Willamette Valley Cancer Center. He said many studies have found that chemotherapy in a palliative setting decreases pain and time spent in the hospital and increases quality of life.

Officials of LIPA and the state Health Services Commission, which sets policy for the Oregon Health Plan, say they have not changed their coverage of recurrent cancer patients, but have only clarified the rules.

seanz
08-11-2009, 06:17 AM
Yep, once they make it legal, next thing you know they'll make it compulsory.
:rolleyes:


Would she have got the drugs under a insurance scheme that didn't have euthanasia?

Not an exciting enough question?


Been to any townhall meetings recently?
:p

Art Read
08-11-2009, 06:20 AM
"Would she have got the drugs under a insurance scheme that didn't have euthanasia?"

Actually, the "greedy, evil, capitalistic" drug company GAVE her the drugs... But that's a pretty good question. Why is it that nobody seems to be advocating reasonable standard of care guidelines that ANY provider must adhere to instead of the abortion of a plan they are currently proposing? I think we all can agree on consumer protections against pre-existing conditions, non-portability and recision. Throw in tort reform and improved income based subsidies and I think we'd have a plan!

seanz
08-11-2009, 06:26 AM
I know......I read that bit.

Good for them. Good publicity too.

Hurrah for drug companies.


Would she have got the drugs under a insurance scheme that didn't have euthanasia?

I knew that question wasn't exciting and edgy enough......maybe if I shouted?

:)

LeeG
08-11-2009, 06:31 AM
my moms last chemo therapy treatment occured two weeks before she died. No doubt all these anecdotes can be reduced to political talking points. Why, I think it's time to feel something, quick, another anecdote.

elf
08-11-2009, 07:16 AM
What's wrong with assisted suicide?

Art Read
08-11-2009, 07:30 AM
"What's wrong with assisted suicide?"

________________________________

In my opinion, nothing. If that's what the patient wants. She didn't. Big difference.

Art Read
08-11-2009, 08:05 AM
I don't disagree, Norman. Pity the "Oregon Public Health Care Commission" has no such self interested incentive towards compassion, morality or even good public relations!

(You also might want to do a little research into drug company "means based" prescription assistance. It's quite common and quite generous. I should know. I'm a beneficiary of Eli Lilly's program: http://www.lillycares.com/index.jsp )

Dan McCosh
08-11-2009, 08:24 AM
I don't understand why anyone would think that these kinds of decisions aren't made every day by someone--a private health insurer, a hospital staff, a doctor, etc. A government policy would simply add to the list, but many people will have to face the decision in some form.

Art Read
08-11-2009, 08:27 AM
"...should an insuror have been required to keep him alive, at the cost of hundreds of thousands of dollars per year, when there was simply no hope or possibility that he could have ever recovered?"

__________________________________________________ _____________________

Absolutely not. But that's hardly the case here is it? Did you listen to what her doctor said? They based their decision on 15 year old data! Her DOCTOR believed the treatment was worthwhile and reasonable, she wanted it and yet the "committee" denied her appeal twice.

We can argue about whether or not she "deserved" it, or whether she represented the most "efficient" allocation of limited resources all day. The bottom line however is that this was unquestionably a case of government "health care rationing". I'm not comfortable letting that particular camel nose under the tent!

“Treatment of advanced cancer that is meant to prolong life, or change the course of this disease, is not a covered benefit of the Oregon Health Plan...” That an organization in charge of managing a government run healthcare system could write that sentence TERRIFIES me...

Tom Montgomery
08-11-2009, 08:32 AM
Aren't you glad the public health plan will merely be an option? You'll also have a variety of private plans from which to choose.

htom
08-11-2009, 08:35 AM
Beancounters over-ruling doctor's decisions. Just out of curiosity, are any of the committee members licensed to practice medicine in Oregon, and are any of them enrolled in the program they supervise?

Art Read
08-11-2009, 08:38 AM
"Aren't you glad the public health plan will merely be an option? You'll also have a variety of private plans from which to choose."

__________________________________________________ _______

For how long? The government can and will mandate what services will be provided, restrict free nationwide competition, and do nothing about tort reform while remaining immune from the consequences itself. You may believe in the government's ability to carry through on that promise, but I remain skeptical.

Keith Wilson
08-11-2009, 08:38 AM
Beancounters over-ruling doctor's decisions. Yep, point granted; they screwed up. But bean-counters overruling doctors' decisions is by no at all exclusive to government heath insurance; it's precisely what we have all the time right now. Shall we now post ten thousand stories of those who died, were crippled, went bankrupt, or lived with terrible pain because of their private insurance company, or because they had no insurance at all?

Again - and I don't know how many times I'll have to say this, but I'll keep at it until people understand - look at the experience of every other wealthy country. They are NOT killing people off when the care gets too expensive. Yes, they may not always pay for last-ditch treatments at the end of life that offer little chance of success; the curious fact that US insurance companies generally will pay for these, while being spectacularly cheap under more normal circumstances, is one of the reasons US health care is so expensive. Under a more rational system, payment for such procedures would have to be restricted; we simply can't afford them.

Tom Montgomery
08-11-2009, 08:43 AM
Beancounters over-ruling doctor's decisions.

Which my private insurer (Humana) does routinely. I chuckle every time a Republican pol says: "I don't want a government bureaucrat standing between a doctor and his patient." They have no problem with a corporate bureaucrat doing the very same thing.

Republicans appear to take the American public as fools. When I see the town hall disrupters in action I begin to think they may be right.

Flying Orca
08-11-2009, 08:48 AM
IMNSHO, it's better when care decisions are left between doctor and patient... like in Canada. :D

Art Read
08-11-2009, 08:54 AM
"I chuckle every time a Republican pol says: "I don't want a government beurocrat standing between a doctor and his patient." They have mo problem with a corporate beurocrat doing the same."

_____________________________________________

Yes, but I can READ a private health insurers policy BEFORE I sign on the dotted line. If I choose to pay less for a plan that is less inclusive than others, at least I know that going in. Can ANYBODY honestly say just exactly what or who will be covered under the "public plan"?

We all know private insurance has an adversarial and sometimes abusive relationship with patients. Nature of the beast. Why don't we just come up with a reasonable "patient's bill of rights", improved means based subsidies and then just get the hell out of the way? Modern health care is expensive. You can't have cheap, fast and good, you gotta choose two out of three. When the public option inevitably becomes "government run",we'll only have one choice...

ljb5
08-11-2009, 08:54 AM
People get screwed by insurance companies all the time --- both government run and private.

If you didn't know this already, you're not equipped to have this discussion.

John Smith
08-11-2009, 08:58 AM
Yep, once they make it legal, next thing you know they'll make it compulsory.
:rolleyes:


Would she have got the drugs under a insurance scheme that didn't have euthanasia?

Not an exciting enough question?


Been to any townhall meetings recently?
:p
Hard to answer. Private insurers do deny treatment.

Doesn't read like Oregon made it mandatory, just optional.

My mom would have loved such a choice. About 4 months before she died, she truly saw no point in continuing. She would have very much liked to choose the time, place, and method of her death.

Tom Montgomery
08-11-2009, 09:02 AM
I believe the "public option" will set a standard of basic health insurance coverage that the private insurers will either have to match or else charge less.

On a side note: I thought it was hilarious during the presidential election campaign when John McCain declared he was all for U.S. seniors purchasing lower-cost medications through Canadian pharmacies! He wants Americans to benefit from Canada's single-payer system. But he wants no part of a public health insurance option here. Precious.

John Smith
08-11-2009, 09:04 AM
"Would she have got the drugs under a insurance scheme that didn't have euthanasia?"

Actually, the "greedy, evil, capitalistic" drug company GAVE her the drugs... But that's a pretty good question. Why is it that nobody seems to be advocating reasonable standard of care guidelines that ANY provider must adhere to instead of the abortion of a plan they are currently proposing? I think we all can agree on consumer protections against pre-existing conditions, non-portability and recision. Throw in tort reform and improved income based subsidies and I think we'd have a plan!
I think it was California that tried tort reform. An elderly gentleman had the wrong leg cut off by his doctor. Due to his age, his maximum award was so low it wasn't worth the time of any lawyer taking his case, so he got nothing.

When tort reform was a big item, Bob Novak liked the $250k limit, as that's a lot of money. I found an email to contact him, and I asked if he'd agree on $250k net to the victim, after the lawyer takes his fees, and any other costs are covered.

Never got an answer.

I'll ask you the same question.

Keith Wilson
08-11-2009, 09:06 AM
Legal assisted suicide as Oregon handles it is an excellent idea. Look here for information about the program. (http://egov.oregon.gov/DHS/ph/pas/faqs.shtml) It's not done often; last year there were 60 people who took advantage of it.

John Smith
08-11-2009, 09:08 AM
I don't disagree, Norman. Pity the "Oregon Public Health Care Commission" has no such self interested incentive towards compassion, morality or even good public relations!

(You also might want to do a little research into drug company "means based" prescription assistance. It's quite common and quite generous. I should know. I'm a beneficiary of Eli Lilly's program: http://www.lillycares.com/index.jsp )
Some years back, Oregon made a number of tough decisions, based on the finite quality of resources. Babies born with no brain, for example, would get none of the resources.

Their logic, agree with it or not, was that if they spent less on those cases they could have no impact on the results of, they'd have more available for the cases where good, positive results could be found.

If, on the other hand, they spent that money elsewhere, it wouldn't be there were it could have a positive impact.

John Smith
08-11-2009, 09:11 AM
"I chuckle every time a Republican pol says: "I don't want a government beurocrat standing between a doctor and his patient." They have mo problem with a corporate beurocrat doing the same."

_____________________________________________

Yes, but I can READ a private health insurers policy BEFORE I sign on the dotted line. If I choose to pay less for a plan that is less inclusive than others, at least I know that going in. Can ANYBODY honestly say just exactly what or who will be covered under the "public plan"?



We all know private insurance has an adversarial and sometimes abusive relationship with patients. Nature of the beast. Why don't we just come up with a reasonable "patient's bill of rights", improved means based subsidies and then just get the hell out of the way? Modern health care is expensive. You can't have cheap, fast and good, you gotta choose two out of three. When the public option inevitably becomes "government run",we'll only have one choice...

Some of that "expense" is multi million dollar CEO salaries.

The private bean counters have more factors to consider in their counting.

What makes you think you won't be able to read what the public option covers?

John Smith
08-11-2009, 09:13 AM
People get screwed by insurance companies all the time --- both government run and private.

If you didn't know this already, you're not equipped to have this discussion.
I'm having a lot of trouble thinking of a time when Medicare screwed my mom.

John Smith
08-11-2009, 09:14 AM
I believe the "public option" will set a standard of basic health insurance coverage that the private insurers will either have to match or else charge less.

On a side note: I thought it was hilarious during the presidential election campaign when John McCain declared he was all for U.S. seniors purchasing lower-cost medications through Canadian pharmacies! He wants Americans to benefit from Canada's single-payer system. But he wants no part of a public health insurance option here. Precious.
Good point.

Keith Wilson
08-11-2009, 09:16 AM
We all know private insurance has an adversarial and sometimes abusive relationship with patients. Nature of the beast. Why don't we just come up with a reasonable "patient's bill of rights", improved means based subsidies and then just get the hell out of the way? Modern health care is expensive. You can't have cheap, fast and good, you gotta choose two out of three.Yeah? Once again, every other civilized country covers everybody, gets equal or better results, and does it for around 55% of what the US spends . One dollar in three spent on heath care in the US goes to "administrative expenses". "Getting the hell out of the way" has gotten us into the mess we're in right now.

Art Read
08-11-2009, 09:21 AM
"...covers everybody, gets equal or better results, and does it for around 55%..."

That's two out of three. (And those who are forced onto waiting lists might quibble with the "better" part...)

Tom Montgomery
08-11-2009, 09:24 AM
"...covers everybody, gets equal or better results, and does it for around 55%..."

That's two out of three. (And those who are forced onto waiting lists might quibble with the "better" part...)

Have you been paying no attention to the Canadian, British and European Forumites who have posted on this subject?

Keith Wilson
08-11-2009, 09:26 AM
I was not speaking only of Canada. In the UK, for example, one can purchase private insurance to reduce wait times if you don't want to use the NHS. But I am not so dedicated to defending the inviolable privileges of wealth that waiting lists for non-critical care offend me.

Brian Palmer
08-11-2009, 09:26 AM
http://www.cancer.gov/clinicaltrials/results/lung-and-erlotinib0604

Clinical trial of the drug in question. Extended life by an average of 2 months. Annual cost in 2005 was about $35,000 (according to a NY Times article).

Brian

Art Read
08-11-2009, 09:32 AM
"Have you been paying no attention to the Canadian, British and European Forumites who have posted on this subject?."

______________________________________________

Yes. And many more who are not on this forum. There seems to me as much disagreement amongst them as there is amongst ourselves. If one were to judge solely by this forum, the discussion would be over!:D

Tom Montgomery
08-11-2009, 09:33 AM
I agree, Norman.

Tom Montgomery
08-11-2009, 09:37 AM
One of my best friends, Anna L., a 37 year old pharmacist, has a chronic cardiac problem that can be life threatening. She routinely has to wait as long as five weeks to see her cardiologist. Explain to me again about having to wait for care in single-payer systems?

Art Read
08-11-2009, 09:44 AM
"I was not speaking only of Canada. In the UK, for example, one can purchase private insurance to reduce wait times if you don't want to use the NHS. But I am not so dedicated to defending the inviolable privileges of wealth that waiting lists for non-critical care offend me."

__________________________________________________

That's just the problem. The standard of prompt, quality care that "most" here now enjoy would become just another "privilege" of the "filthy rich" under the nationalized universal care that I believe is the progressive element of our nation's ultimate goal. Our society can care for the least amongst us without depriving the rest of their own free choice.

Keith Wilson
08-11-2009, 09:44 AM
There seems to me as much disagreement amongst them as there is amongst ourselves. There is not. In no other country is there any significant political sentiment for keeping government out of health care, nor any for adopting anything even vaguely resembling the US system.
The standard of prompt, quality care that "most" here now enjoy would become just another "privilege" of the "filthy rich" under the nationalized universal care . . Nonsense. This is not the case in other countries; why should it be here? First, may I remind you that the chance of a Canadian-style system here in the foreseeable future is essentially zero. Second, ask the Canadians. While their system is by no means perfect, they are by and large quite satisfied with it. And if they spent 18% of GDP instead of 10%, their wait times would be milliseconds.

We spend about 1.8 times what all the other wealthy countries spend on heath care. Our results are no better. Any of us under 65 can lose our insurance at any time. And you're worried about having to wait for knee surgery?? I don't think that's really the issue; the issue is ideology; you'd rather put up with inefficiency and injustice than compromise your faith in the inevitable virtue of the free market, even when all the evidence is to the contrary.

And please - I getting very, very tired of the conservatives here whining about how the forum is unanimously against them. This is both childish and obviously false.

SamSam
08-11-2009, 09:48 AM
Yes, but I can READ a private health insurers policy BEFORE I sign on the dotted line. If I choose to pay less for a plan that is less inclusive than others, at least I know that going in.
Most people don't get a choice on who the insurance company is or it's policies, it comes with the job. It is too expensive to reject what the company offers and buy your own.

Even then, a large portion of 'covered' people don't use it as other than a sort of catastrophic insurance, as they can't afford to get over the hump of the deductible. And then if you lose your job and can't afford the insurance, you have no coverage.

Health insurance and health care might not be the same thing.

Milo Christensen
08-11-2009, 10:08 AM
. . . Health insurance and health care might not be the same thing.

Give that man a kewpie doll. Notice that the Democrats have recently shifted the term in use from health care reform to health insurance reform. They can't beat 'em, so they'll do what they have to do to be able to claim victory, they'll join 'em. The private insurance companies will get millions of new customers.

The status quo will be maintained and expanded. Expanded benefits will be legislated and cost control will be talked about. Nothing will be done to contain cost in any significant way. Health care costs will still double in 7 - 10 years.

Nationalized health care is dead.

Art Read
08-11-2009, 10:11 AM
"We spend about 1.8 times what all the other wealthy countries spend on heath care. Our results are no better."

_____________________________________________


http://i.telegraph.co.uk/telegraph/multimedia/archive/00643/news-graphics-2007-_643378a.gif

Art Read
08-11-2009, 10:14 AM
From the Daily Telegraph:

UK cancer survival rate lowest in Europe

By Nicole Martin
Published: 12:01AM BST 21 Aug 2007

Cancer survival rates in Britain are among the lowest in Europe, according to the most comprehensive analysis of the issue yet produced.

Half are unaware of lifestyle link to cancer
Thousands wait years for breast cancer results
Cancer figures 'outdated'
Half of women survive cancer
Scrap NHS targets to save lives, say Conservatives
Roy Castle charity attacks Scottish ministers over lung cancer care
England is on a par with Poland despite the NHS spending three times more on health care.

Survival rates are based on the number of patients who are alive five years after diagnosis and researchers found that, for women, England was the fifth worst in a league of 22 countries. Scotland came bottom. Cancer experts blamed late diagnosis and long waiting lists.

In total, 52.7pc of women survived for five years after being diagnosed between 2000 and 2002. Only Ireland, Northern Ireland, Scotland, the Czech Republic and Poland did worse. Just 44.8pc of men survived, putting England in the bottom seven countries.

The team, writing in The Lancet Oncology, found that Britain's survival rates for the most common cancers - colorectal, lung, breast and prostate - were substantially behind those in Western Europe. In England, the proportion of women with breast cancer who were alive five years after diagnosis was 77.8pc. Scotland (77.3pc) and Ireland (76.2pc) had a lower rate.

Rates for lung cancer in England were poor, with only 8.4pc of patients surviving - half the rate for Iceland (16.8pc). Only Scotland (8.2pc) and Malta (4.6pc) did worse.
Fewer women in England lived for five years after being diagnosed with cervical cancer (58.6pc) despite a national screening programme. This compared to 70.6pc in Iceland. Dr Franco Berrino, who led the study at the National Cancer Institute in Milan, said cancer care was improving in countries that recorded low survival figures. He added: "If all countries attained the mean survival (57pc) of Norway, Sweden and Finland, about 12pc fewer deaths would occur in the five years after diagnosis."
His co-researcher, Prof Ian Kunkler from the Western General Hospital in Edinburgh, said waiting lists for radiotherapy were partly to blame.
"Although there has been a substantial investment in radiotherapy facilities, there is still a shortfall," he said.
"We have good evidence that survival for lung cancer has been compromised by long waiting lists for radiotherapy treatment."
A second article, which looked at 2.7 million patients diagnosed between 1995 and 1999, found that countries that spent the most on health per capita per year had better survival rates.
Britain was the exception. Despite spending up to 1,500 on health per person per year, it recorded similar survival rates for Hodgkin's disease and lung cancer as Poland, which spends a third of that amount.
An accompanying editorial said the figures showed that the NHS Cancer Plan, published in 2000, was not working.
"Survival in England has only increased at a similar rate to other European countries and has not caught up with the absolute values seen elsewhere," it said.
Prof Richard Sullivan at Cancer Research UK said: "Cancer is still not being diagnosed early enough in all cases."

Keith Wilson
08-11-2009, 10:15 AM
Doesn't do us much good in longevity, does it? Still, I will readily admit health care in the US is normally very good - IF you have good insurance. Our problems are that it's extremely inefficient, and that it's very unevenly distributed; we have 50 million people without any insurance at all.

http://www.project.org/images/graphs/Life_Expectancy_1.jpg

http://www.mchb.hrsa.gov/chusa07/hstat/hsi/images/207iim.gif

Peter Malcolm Jardine
08-11-2009, 10:18 AM
"Would she have got the drugs under a insurance scheme that didn't have euthanasia?"

Actually, the "greedy, evil, capitalistic" drug company GAVE her the drugs... But that's a pretty good question. Why is it that nobody seems to be advocating reasonable standard of care guidelines that ANY provider must adhere to instead of the abortion of a plan they are currently proposing? I think we all can agree on consumer protections against pre-existing conditions, non-portability and recision. Throw in tort reform and improved income based subsidies and I think we'd have a plan!

Papers, let me see your papers. Now... you will appear in front of the death panel:D:D

High C
08-11-2009, 10:21 AM
...Why don't you address the actual proposals for health care reform in THIS country, instead of trying to distract with tales of other systems that we're not planning to adopt?

Uhh, maybe because Keith has made hundreds of posts talking about everybody else's systems as if they were somehow relevant to our issue???

Perhaps you should be consistent and chastise Keith.

Keith Wilson
08-11-2009, 10:23 AM
They are relevant. You keep arguing that it's impossible for greater government involvement to improve the US heath care system. I keep showing you that every system with greater government involvement (and not just in English-speaking countries) is both cheaper and more equitable than ours.

Art Read
08-11-2009, 10:26 AM
"Doesn't do us much good in longevity, does it?"

____________________________________________

Factor in homicide rates, traffic fatalities per capita and obesity levels and then we'll talk....

Tom Montgomery
08-11-2009, 10:32 AM
I, for one, am proud that the U.S. infant mortality rate ranks up there just ahead of the Faroe Islands and right behind Cuba. Now excuse me while I take a break to lunch on some freedom fries.

Art Read
08-11-2009, 10:38 AM
"...its the health plan the determines whats covered not our right to die law!"

My point EXACTLY! Read my posts. I have no problem with your right to die law. I support it. My problem is with the panel that decided this women was not worth a few months of cancer treatment. Had SHE chosen to forgo treatment and seek a physician's assistance with an end of life solution, I would honor her decision.

That, unfortunately, was NOT the case. She wanted to continue treatment as long as hope existed and the STATE refused both her and her doctor's wishes.

Keith Wilson
08-11-2009, 10:39 AM
OK, I give in - we need 50 million people without heath insurance to enjoy the sublime benefits of our current system. Poor bastards; but it's for the greater good. Got to have winners and losers, right? We may pay 1.8X more than the other civilized countries, but hey, you get what you pay for, right? And 1/3 for "administrative expenses", well, that's a good thing too. Those insurance company executives spend a lot of money, and it trickles down, right? And it keeps a lot of folks employed pushing paper at insurance companies and hospitals, and what about all those lobbyists? They'd be out of work if we changed things. It's all necessary so we can enjoy the blessings of freedom. :rolleyes:

Art Read
08-11-2009, 10:45 AM
"Mr. Read take you religious, conservative, lon maybon, republican bible thumping opinion. fold it up till its all sharp corners and shove it up you Ass till your brain is clean."

_____________________________________

Don't make assumptions. The only adjective from your delightful list above that might fit me is conservative. And that only on some topics. I suspect that those who know me here will back me up when I emphatically state the rest are just silly.

('Cept, perhaps, "lon maybon". Not familiar with THAT one!)

Milo Christensen
08-11-2009, 10:45 AM
to you folks not in oregon.

dont even touch this subject! we fought for our right to die law for 20 years. we have managed it since it was first put in the first time. if you dont knopw the record you dont know jack.

Mr. Read take you religious, conservative, lon maybon, republican bible thumping opinion. fold it up till its all sharp corners and shove it up you Ass till your brain is clean.

And for the fu****G record the ditzy bi*** is on the oregon health plan. and its the health plan the determines whats covered not our right to die law!

STAY THE F*** OUT OF OUR STATE POLITICS IF YOU DO NOT LIVE HERE!!!!

Insofar as Oregon is one of the few states to have legalized assisted suicide, thereby making it a legally valid medical option, and that the state run health insurance program has therefore made it an option when refusing to cover treatment for terminal illness, that this particular case, the patient zero, as it were, has a significant bearing on the national debate?

High C
08-11-2009, 10:47 AM
State's rights? Did someone mention state's rights?

Art Read
08-11-2009, 11:10 AM
"If your private insuror were shown to have denied the same benefit, would you be willing to see your premium, and everyone else's premium, raised to cover the costs?"

__________________________________________________ _____

Yes. To a point. What I believe is that it ought to work more like car insurance. You HAVE to have at least catastrophic care coverage. Everybody. (Like automobile liability) What your deductible is and what range of services you wish to pay for should be up to you. NOT the government. Tort reform that discourages frivolous "lottery drawing" lawsuits and encourages "cover your ass" medicine should be enacted. Insurance should be portable from job to job and across state lines. The worst abuses of the industry, (pre-existing conditions, etc...) should regulated against UNIFORMLY! Improved, means based subsidies for low income patients should be implemented. (Medicare+?)

Yes. It will cost more. Any "real" reform will by definition if it is not to sacrifice quality. But it will still provide state of the art medical care to the greatest amount of people, encourage innovation and provide the highest level of individual choice to patients possible.

I believe the real question here is one of distribution. (or re-distribution, as the case may be.) Some look at health care as a "right". All should have equal access even if it means NONE can have "the very best". Others believe that healthcare, like any other service is a commodity. You get what you pay for. I believe the truth lies somewhere in the middle. We cannot as a moral society simply abandon the disadvantaged to their fates. Neither can we deny the free market the opportunity to raise everybody's standard of care with profit driven innovation and competition. That healthcare poses a greater burden on the least wealthy amongst us is unavoidable unless one is willing to coerce both the providers and their wealthy recipients to surrender the rights to the fruits of their own labor and their property. Nobody should be denied needed care based upon ability to pay, but all should pay a reasonable share to the extent of their ability. Only when we all "own" our own healthcare decisions will we behave in our own, and our collective, best interests.

Keith Wilson
08-11-2009, 11:18 AM
Yes. It will cost more. Any "real" reform will by definition if it is not to sacrifice quality. Not to be tedious, but the experience of 20+ other countries shows us very clearly this does not have to be the case.

pcford
08-11-2009, 11:38 AM
There you go again, killing grannies.

Art Read
08-11-2009, 11:44 AM
"It sounds to me like you pretty much support all of the principles of the bill being debated in Congress right now."

________________________________________

Where I disagree with the current proposal is the extent to which government mandates what EVERY, private plan must include in order to be "eligible", the still bandied about "government option", lack of meaningful tort reform and union benefit tax exemption. That's just off the top of my head....

George Jung
08-11-2009, 01:28 PM
Had a new drug rep in this AM, and he was ready to discuss the health care plan, apparently believing I was a kindred spirit. He left, a bit deflated, I'm afraid. I used all the talking points I've learned here; he never had a chance!

BTW, he has a lot of questions, so I took the liberty of giving him contact information of some of our forum experts.

Happy hunting!

George Jung
08-11-2009, 06:37 PM
Apparently I'm not 'special' like your Dr. friends, Norman - I received a small amount of samples, but we've never housed a large amount of 'meds as stocking stuffers', and the number of reps/amount of samples is drying up rapidly, I suspect anticipating Obamacare.

That's okay with me. As I've told most of 'em - I didn't go into medicine to be a social worker (though a big part of my job is just that), nor do I want to be a pharmacist. The amount of 'free' samples is determined, to some extent, by your prescribing habits. You (or your friends, in this instance) prescribe lots of branded drugs - your cupboards will runneth over. Write generics - not so much.

peb
08-11-2009, 08:11 PM
Yep, point granted; they screwed up. But bean-counters overruling doctors' decisions is by no at all exclusive to government heath insurance; it's precisely what we have all the time right now. .

BS. I have had more expereice dealing with insurance companies lately than I would wish on anyone. When they don't pay for something, it is because it is not in your policy or you are beyond your limit. Private insurance companies do not make decisions based on the line of reasoning presented in this video.

Keith Wilson
08-11-2009, 09:51 PM
Private insurance companies do not make decisions based on the line of reasoning presented in this video.No, they don't. They use other lines of reasoning which are just as bad - like "Oh, you didn't mention on the application you saw a dermatologist for acne, so we're cancelling your policy now that you need cancer treatment" (really happened) (http://www.cnn.com/2009/POLITICS/06/16/health.care.hearing/). The people in Oregon were following policy as well, probably policy which was set down clearly in advance.

George Jung
08-11-2009, 10:57 PM
It's like checking out that elephant, fellow blind men - everyone has a different experience and take. Take the sum, and you've a better picture.

I'm so tired having to do battle with insurance companies ('benefits' departments - an oxymoron if ever there was one), filling out pre-auth papers, or worse, having my nurse on the phone for an hour trying to get pre-auth for a drug other than 'first tier'. I've resorted to sendng a stock letter (if they're foolish enough to give me a fax number) stating it's obvious they're trying to practice medicine without a license; I'm documenting, in the patients chart, their directives; they can assume care of the patient. You won't see people backpeddle faster than this bunch when the responsibility sits squarely on their shoulders. (Sometimes) works like a charm.

Keith Wilson
08-11-2009, 11:08 PM
George, I'd be really interested in your rough estimate of what percentage of your time is spent dealing with insurance companies:trying to get paid for work you've done, authorization for something you think needs doing, all of the bureaucratic messing around. What percentage of the time of eveyone in your office combined? How does that compare with the amount of time you spend actually practicing medicine?

Joe (SoCal)
08-12-2009, 06:55 AM
Just to illustrate how silly this health care debate has been, consider the following, from politicalirony.com:

Damn Norman that was good.

Why are the right wing nuts so afraid?

Rigadog
08-12-2009, 07:12 AM
Of course you realize that the 50 million that lack health insurance have displeased God in some way. The lack of coverage is proof. This is just the way it works. If you are worthy & righteous, the blessings will be evident, bestowed aplenty from on high.

High C
08-12-2009, 07:56 AM
Of course you realize that the 50 million that lack health insurance have displeased God in some way....

20 million of those CHOSE to enter this country illegally but get counted anyway to inflate the number

10 million of them are people who could afford health insurance but instead CHOOSE to spend their money in other ways, but get counted anyway to inflate the number

5 million are only uninsured for a brief period between jobs and have COBRA protection, but get counted anyway to inflate the number

5 million ARE insured through medicaid but have CHOSEN not to use it and get counted anyway to inflate the number

It sounds to me like you have a problem with CHOICE....and are contributing to inflation. :p

Joe (SoCal)
08-12-2009, 08:10 AM
20 million of those CHOSE to enter this country illegally but get counted anyway to inflate the number

RWNJ use this taking point all the time way to tie in immigration & health care. But if they are illegal how do you get such an accurate round number like 20 ??



10 million of them are people who could afford health insurance but instead CHOOSE to spend their money in other ways, but get counted anyway to inflate the number

THERE ARE 10 MILLION people who CAN afford health insurance but instead CHOOSE to spend their money in other ways ??? ARE YOU FRIGGEN NUTS ??? Please show me that stat. 10 Million IMMORTAL people choose not to have insurance cause they would rather spend their money on super hero costumes. :rolleyes:



5 million are only uninsured for a brief period between jobs and have COBRA protection, but get counted anyway to inflate the number

Hey conservative nut job have you ever had to PAY COBRA ??? Ya wanna talk about inflation - yea COBRA is a GREAT system :rolleyes:




5 million ARE insured through medicaid but have CHOSEN not to use it and get counted anyway to inflate the number


Link please ?



It sounds to me like you have a problem with CHOICE....and are contributing to inflation.

I'm pro choice .... are you ?;)

peb
08-12-2009, 08:10 AM
No, they don't. They use other lines of reasoning which are just as bad - like "Oh, you didn't mention on the application you saw a dermatologist for acne, so we're cancelling your policy now that you need cancer treatment" (really happened) (http://www.cnn.com/2009/POLITICS/06/16/health.care.hearing/). The people in Oregon were following policy as well, probably policy which was set down clearly in advance.

What is is, a policy that says "if the state decides a person is worth it, the state will only provide suicide help?". Sounds like a great deal.

Also, there is a big difference between, "you are not covered due to lying" and an arbitrary decision like this. An insurance oversite board coould be used to provide an independent appeals path for the unfair decisions (such as your example). By definition, this is impossible with a state run plan. Kind of like trying to file a lawsuit against the government, you can only do so if they say it is ok.

peb
08-12-2009, 08:19 AM
One other note in the "defense" of our admittedly broken healthcare system. The video was a bit misleading at the end. They pointed out that the pharmecutical company is providing the Tarceva drug for free and this is extremely rare. That is not true. The drug company that makes tarceva will provide the drug to anyone who has an income of below $100,000. Now, that is not that great of a deal, because obviously someone making $110,000/year cannot afford a 50K/year drug. But it is much more than the video implies.

peb
08-12-2009, 08:27 AM
RWNJ use this taking point all the time way to tie in immigration & health care. But if they are illegal how do you get such an accurate round number like 20 ??



THERE ARE 10 MILLION people who CAN afford health insurance but instead CHOOSE to spend their money in other ways ??? ARE YOU FRIGGEN NUTS ??? Please show me that stat. 10 Million IMMORTAL people choose not to have insurance cause they would rather spend their money on super hero costumes. :rolleyes:



Hey conservative nut job have you ever had to PAY COBRA ??? Ya wanna talk about inflation - yea COBRA is a GREAT system :rolleyes:



I am almost positive of HighC statistics is correct. It is tough to trust libs with the solution when they deny facts. Of course, when Pelosi and crew start justifying the 17 million that will be without insurace 10 years from now on their plan, they then start pulling out these same type of statistics!!! Yes, I saw it on MSNBC. They broke the 17million down in almost the same categories as high c.


BTW, Cobra has an important thing going for it. After leaving your employer you have 30 days to retroactively be insured through the system. What this means is that someone who quits a job on Friday and starts a job two weeks later, does not have to pay a dime. If they get sick or have an accident, they can sign pu for the coverage. So, althrough technically they were without coverage and counted as part of the uninsured, from a practical standpoint they should not have been counted.

Tom Montgomery
08-12-2009, 08:27 AM
I'm so tired having to do battle with insurance companies ('benefits' departments - an oxymoron if ever there was one), filling out pre-auth papers, or worse, having my nurse on the phone for an hour trying to get pre-auth for a drug other than 'first tier'. I've resorted to sendng a stock letter (if they're foolish enough to give me a fax number) stating it's obvious they're trying to practice medicine without a license; I'm documenting, in the patients chart, their directives; they can assume care of the patient. You won't see people backpeddle faster than this bunch when the responsibility sits squarely on their shoulders. (Sometimes) works like a charm.

This is the same story I hear from my friends in the healthcare profession: an M.D. and a couple of nurses and pharmacists. One of my R.N. friends worked for Humana for a while and so has experienced this issue from both sides. NONE OF THEM is happy about the current health insurance situation.

Keith Wilson
08-12-2009, 08:32 AM
What is is, a policy that says "if the state decides a person isn't worth it, the state will only provide suicide help?"No, a policy that says when someone has end-stage cancer, they're not going to spend a pile of money on a drug that will only extend the person's life by a month or two, if at all. The state of Oregon could, if they wished, change the policy and raise taxes to compensate. It's equivalent to an insurance company saying, "Sorry you've reached your lifetime limit; not one more penny for you; rest in peace." or, "Sorry, we consider that drug "experimental; we won't pay." or, "Sorry, that's one's not on the list of approved drugs, we won't pay." Not the same reasoning, but no better.
I am almost positive of HighC statistics is correct.In that case, please provide a reference. I presume the 62% of bankruptcies due to medical expenses is also correct?

High C
08-12-2009, 08:35 AM
.....
Hey conservative nut job have you ever had to PAY COBRA ??? Ya wanna talk about inflation - yea COBRA is a GREAT system :rolleyes:


I'm not sure why I'd bother responding to such a rude little jerk as you, but maybe you'll learn something today.

COBRA provides an astonishing FREE benefit to those who are between jobs. Did you know that you can elect to start COBRA coverage, or not, any time within 60 days, plus a 14 day election period, after you lose that job? And that you can do it even AFTER you get sick or have a major medical need? No, of course you didn't, but you shot off your uninformed mouth anyway.

This amounts to being able to get insurance AFTER the barn catches fire. You can do it only if you need it. If you don't need it, there's NO COST. If you do need it, you pay the premiums and collect a hell of a lot more in payouts.

This is an incredible FREE benefit for anyone who is between jobs.

As for the outrageous cost of COBRA premiums....guess what? Those are the same premiums you'd been paying all along. SURPRISE! Most people have no clue how much of their income is being spent behind their backs on low deductible health insurance.

Didja learn anything today? I didn't think so.

peb
08-12-2009, 08:39 AM
My last post for the day. I will repeat, the only plan proposed that makes sense to me so far is the Wyden-Bennett Plan. It tackles the underlying problems of our system, namely that competition does now work among private insurers at this time to keep costs down and to provide good service. The so called government option (which will only be an option at the employer level) will not magically creat competition that will do any good at all.

http://www.npr.org/templates/story/story.php?storyId=106979677

I also believe this plan could achieve bi-partisan support, execpt for the extreme left who insist on a government option for idealogical reasons. Of couse, it is that group, led by Pelosi, who will keep it from seeing the light of day.

But, it seems like big business would be on board, since it gets them out of the healthcare businesss.
It seems like the moderate dems should be on board since it provides a better path to universal coverage than HR 3200.
It seems like reps would be on board since it is done with tax credits and increases competition in more of a free market fashion.
It is possible that existing insurance companies would not be supportive since it upsets their business model quite radically. On the other hand, it leaves them in business.

My last post for the day. See ya.

Keith Wilson
08-12-2009, 08:41 AM
Most people have no clue how much of their income is being spent behind their backs on low deductible health insurance.NO other country uses high-deductible health insurance as a way to control costs. It seem an excellent way to encourage poorer people to avoid treatment until things are bad enough to get expensive.

Joe (SoCal)
08-12-2009, 08:49 AM
I'm not sure why I'd bother responding to such a rude little jerk as you, but maybe you'll learn something today.

Did ya find the WMD's you KNEW where in Iraq ?
Did ya find the dead body of OBL you KNEW was dead?
Did ya find out about that South American tourist shot in the London subway that you blasted Ian for and you KNEW was really a terrist ?

Sometimes you never learn fat man



As for the outrageous cost of COBRA premiums....guess what? Those are the same premiums you'd been paying all along. SURPRISE! Most people have no clue how much of their income is being spent behind their backs on low deductible health insurance.

Didja learn anything today? I didn't think so.

Ya mean the same OVER INFLATED GOUGING PRICE that you get to pay for FREE when you lost your job and dont know how you are going to pay for sh!te but cobra wants $1,200 per month ? Is that the same FREE program your talking about ???

Didja learn anything today fatman ?

Edited to add: <Slap> Nice Job Tag teaming Norman :D

Keith Wilson
08-12-2009, 08:50 AM
Peb, I think the Wyden-Bennett plan would be a great improvement over what we have now, and I would certainly support it if it came to a vote. It's not my first choice, but it certainly has merit.

High C
08-12-2009, 09:24 AM
Sheeesh... talk about misinformation. There is NOTHING 'free' about COBRA. You PAY for it.....

Another classic Norman Bernstein knee jerk response! You still aren't reading slowly enough to grasp the material being presented. Now take a breath and try to COMPREHEND the written word. Maybe after recess it'll come to you.

I knew Joe had no chance of understanding this, and it seems that I have overestimated you again, silly me. Given the lack of basic economic understanding you display here on a daily basis, I shouldn't have bothered. All you saw and understood was the word "free" and you popped another blood vessel.

Think of it this way, if you're capable of rational thought at all, have you ever made a claim on your homeowner's insurance? Most people have not. Did you pay premiums all those years? If the rules of COBRA applied to homeowner's, you could've had that coverage for 74 days while you were between policies and paid NOTHING unless the house burned down, at which time you'd pay a measly premium or two and collect six figures to rebuild the house. You only have to pay if you make a claim during the first 74 days. If you need it beyond that period, yes, you do have to catch up and pay all the premiums. But for someone who is going through a brief interruption of insurance between jobs, it's a FREE Godsend.

Get it yet?

I've used COBRA in this way twice. Between jobs, no health insurance, no premiums to pay, but I had COBRA in my back pocket, ready to activate RETROACTIVELY if it was needed. I could have simply caught up on the premiums and that gigantic hospital bill would've been covered. That cost NOTHING.

Get it yet?

Pugwash
08-12-2009, 10:07 AM
National surveys show that the primary reason people are uninsured is the high cost of health insurance coverage.2
Economists have found that rising health care costs correlate to drops in health insurance coverage.8
A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. The study noted that 68 percent of those who filed for bankruptcy had health insurance. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses.9 Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.
A new survey shows that more than 25 percent said that housing problems resulted from medical debt, including the inability to make rent or mortgage payments and the development of bad credit ratings.10
About 1.5 million families lose their homes to foreclosure every year due to unaffordable medical costs. 11
A survey of Iowa consumers found that in order to cope with rising health insurance costs, 86 percent said they had cut back on how much they could save, and 44 percent said that they have cut back on food and heating expenses.12
Retiring elderly couples will need $250,000 in savings just to pay for the most basic medical coverage.13 Many experts believe that this figure is conservative and that $300,000 may be a more realistic number.
According to a recent report, the United States has $480 billion in excess spending each year in comparison to Western European nations that have universal health insurance coverage. The costs are mainly associated with excess administrative costs and poorer quality of care.14
The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.14


http://www.nchc.org/facts/cost.shtml

High C
08-12-2009, 10:43 AM
....and we've got yet another bilge participant who thinks the world revolves around them, thier own personal circumstances....

....this from the guy who has informed us of every last detail of his and his wife's medical experiences in support of his ideas! :D

High C
08-12-2009, 10:53 AM
The difference, of course, is that I wasn't presuming that my own circumstances apply to everyone, like you and Roberts.

Nor was I, Mister Knee Jerk, I was pointing out a really beneficial feature of COBRA that might help someone save some serious money. But rather than let it go as helpful info being passed along, you had to blow off your big mouth and throw yet another missed punch at me.

Grow up. :rolleyes:

Tom Montgomery
08-12-2009, 10:57 AM
So I guess if I purchase a house, buy homeowners insurance, and my house burns down, my coverage was free since I only had to pay two measly premiums. Lucky me.

Keith Wilson
08-12-2009, 10:58 AM
I was pointing out a really beneficial feature of COBRA that might help someone save some serious money. That particular feature of COBRA allows you to save at most two months of premiums, if you then get other insurance and nothing serious happens in the meantime. That might be "serious money" depending on your circumstances.

High C
08-12-2009, 11:02 AM
That particular feature of COBRA allows you to save at most two months of premiums, if you then get other insurance and nothing serious happens in the meantime. That might be "serious money" depending on your circumstances.

That's exactly what I said. :rolleyes:

Keith Wilson
08-12-2009, 11:04 AM
That's exactly what I said.You were right. You and Norm manage to misunderstand each other in more ways than I imagined possible.

Keith Wilson
08-12-2009, 11:26 AM
OK, calm down, guys . . . HighC, you made a very large claim about the 50 million people without health insurance in the US, without providing any supporting evidence or a link to the source.


20 million of those CHOSE to enter this country illegally but get counted anyway to inflate the number.
10 million of them are people who could afford health insurance but instead CHOOSE to spend their money in other ways, but get counted anyway to inflate the number.
5 million are only uninsured for a brief period between jobs and have COBRA protection, but get counted anyway to inflate the number.
5 million ARE insured through Medicaid but have CHOSEN not to use it and get counted anyway to inflate the number.
Now I presume you didn't figure this out yourself, and got those numbers from somewhere. And as you know, people have been making are a lot a lot of bogus claims in this debate. So how do we know those numbers are accurate? Evidence, please.

Art Read
08-12-2009, 11:30 AM
You DO realize that an "average" is... well.... just that, don't you? I would not be surprised at ALL to learn that 5 million people regularly leave one job and begin another in less than 74 days... Just like I suspect that an equal number remain unemployed FAR longer than your "average" time too...

Robert L E
08-12-2009, 12:09 PM
Doesn't do us much good in longevity, does it? Still, I will readily admit health care in the US is normally very good - IF you have good insurance. Our problems are that it's extremely inefficient, and that it's very unevenly distributed; we have 50 million people without any insurance at all.

http://www.project.org/images/graphs/Life_Expectancy_1.jpg

http://www.mchb.hrsa.gov/chusa07/hstat/hsi/images/207iim.gif

You, like all others, assume that our health care system is to blame. I, on the other hand, blame our social systems and permissive society for our high infant mortality rates in the USA.

Drug addict's and 14 year old's babies are more likely to die young. People like a free and tolerant society but there are consequences. Having government run health care will not keep violent criminals or drug dealers in prison longer. It will not keep people with promiscuous behavior from contracting socialist diseases either.

I am a cancer survivor just seven weeks out from my last chemo treatment and waiting for my hair to start growing good again. I am fortunate to have good health insurance supplied by my employer. This made it so that me paying for and arranging for treatment was nearly hassle free. No waits, doctor and hospital of my choice, and preferred parking too.

I cannot imagine that government run health care will do anything other than damage cancer care in the USA. The rest of the world will do worse too because the PROFIT DRIVEN motives of the evil capitalists will cease to drive the innovations that trickle down to places like the UK. Other fields of medicine will suffer in the same manner.

My own cancer treatment was routine. It was a Large Type, B Cell Lymphoma. Six nasty chemo treatments and it is checkups only from now on (I hope).

What if I did not have insurance (or cash) though? ..... I would have showed up at some hospital, been shunted (told to go) over to the hospital with the public contract, been hassled about payment, but, in the end, treated for my cancer with the same meds and same probable outcome (less the affects of some time delay). I would not have had the ease and speed of service though.

In the USA "without insurance" is not the same as "without health care".

With government supplied health care the things we are good at will sink to international average levels and the things we are poor at will not improve. I'm glad that we are good at cancer and that we were good at it 35 years ago too or my wife would have died before I had the chance to meet her.

I figure that, with government run health care, every one will have the same mediocre level or care that the "non insured" currently have.

Don't try to say that the private option will survive. The current proposals in Congress are designed to kill off private insurance through attrition.

Bob

Joe (SoCal)
08-12-2009, 01:05 PM
Nor was I, Mister Knee Jerk, I was pointing out a really beneficial feature of COBRA that might help someone save some serious money. But rather than let it go as helpful info being passed along, you had to blow off your big mouth and throw yet another missed punch at me.

Grow up. :rolleyes:

So let me get this FREE BS ol HiC is trying to school us on.

So lets say I get laid off from my job I got exactly how many days free that if, possibly, maybe, I get hit by a bus while out beating the pavement to land a new job ??? So now in that golden moment of time I come down with some dreadful disease Im covered for a few weeks between jobs BEFORE the fee kicks in.

And you say you've had this happen to you twice ??? I don't know about you but I got better luck than getting sick at the exact moment between one job & the next.

Here's was REALLY happens - your boss calls you into the office, your let go. You call your wife, she's like OMG. You file for Unemployment. Maybe you got 2 weeks severance. Your healthy thank god, your wife is healthy, your 3 kids are healthy.

OK so now your out of work 2 weeks severance is gone uneployment pays you about 1/5 of what you were making. Now the FREE COBRA bill come due $1,200 family plan. Hmmmmm your getting $400 per week from unemployment you dont have a company paying your health coverage. UH OH little Tommy broke his arm playing on the monkey bars. What are you gonna do ?

That little COBRA window is gone and the reality is you now have a family of 4 with NO health coverage in a very short period of time.

Peter Malcolm Jardine
08-12-2009, 01:06 PM
OK, calm down, guys . . . HighC, you made a very large claim about the 50 million people without health insurance in the US, without providing any supporting evidence or a link to the source.
Now I presume you didn't figure this out yourself, and got those numbers from somewhere. And as you know, people have been making are a lot a lot of bogus claims in this debate. So how do we know those numbers are accurate? Evidence, please.


Imagine HugeC making up stuff, or talking about things he knows nothing about:D

Nanoose
08-12-2009, 01:11 PM
I thought this thread was about assisted suicide in Oregon?

Peter Malcolm Jardine
08-12-2009, 01:13 PM
You, like all others, assume that our health care system is to blame. I, on the other hand, blame our social systems and permissive society for our high infant mortality rates in the USA.

Drug addict's and 14 year old's babies are more likely to die young. People like a free and tolerant society but there are consequences. Having government run health care will not keep violent criminals or drug dealers in prison longer. It will not keep people with promiscuous behavior from contracting socialist diseases either.

I am a cancer survivor just seven weeks out from my last chemo treatment and waiting for my hair to start growing good again. I am fortunate to have good health insurance supplied by my employer. This made it so that me paying for and arranging for treatment was nearly hassle free. No waits, doctor and hospital of my choice, and preferred parking too.

I cannot imagine that government run health care will do anything other than damage cancer care in the USA. The rest of the world will do worse too because the PROFIT DRIVEN motives of the evil capitalists will cease to drive the innovations that trickle down to places like the UK. Other fields of medicine will suffer in the same manner.

My own cancer treatment was routine. It was a Large Type, B Cell Lymphoma. Six nasty chemo treatments and it is checkups only from now on (I hope).

What if I did not have insurance (or cash) though? ..... I would have showed up at some hospital, been shunted (told to go) over to the hospital with the public contract, been hassled about payment, but, in the end, treated for my cancer with the same meds and same probable outcome (less the affects of some time delay). I would not have had the ease and speed of service though.

In the USA "without insurance" is not the same as "without health care".

With government supplied health care the things we are good at will sink to international average levels and the things we are poor at will not improve. I'm glad that we are good at cancer and that we were good at it 35 years ago too or my wife would have died before I had the chance to meet her.

I figure that, with government run health care, every one will have the same mediocre level or care that the "non insured" currently have.

Don't try to say that the private option will survive. The current proposals in Congress are designed to kill off private insurance through attrition.

Bob

I would agree that the infant mortality rate is not the best statistic to use when comparing health care systems. It is, however, affected by the number of poor people who have little access to monitored care throughout their pregnancies, or poor nutrition, etc...

The opinion that the private option will not survive can not be substantiated, particularly when the worlds best health care systems are in fact public-private partnerships. Most american debates (and Canadian) seem to be about reinventing the wheel. There are numerous examples of health systems that have used government guidance and intervention to their advantage.


Most of the negative sentiment in the american debate is based on nothing. The facts, supported by health care systems proven to be substantively better than the US in almost every way, are easy to find.

Keith Wilson
08-12-2009, 01:27 PM
http://www.mchb.hrsa.gov/chusa07/hstat/hsi/images/207iim.gif


I, on the other hand, blame our social systems and permissive society for our high infant mortality rates in the USA. "Permissive society"? Look at the chart again. While mothers' bad habits are indeed hard on infants, there is no correlation between "permissive societies" and infant mortality. The best is Singapore, about as far from permissive as one can get in the developed world, but only slightly worse is Sweden. France, Portugal, Italy, Germany, Greece, Switzerland, and Holland have almost identical rates, 60% of the US, despite very different cultures. No, while there are certainly other factors that affect infant mortality besides the heath care system, blaming a "permissive society" cannot survive a cursory look at the the data.

And Robert L E, you neglect to mention the enormous bill with which you would have been presented had you not had good insurance. I haven't been able to find an average cost for treatment of B Cell Lymphoma, but would you have been able to pay it? What would you have done?

Robert L E
08-12-2009, 02:22 PM
You raise good points.... but from what I've read, the biggest contributor to infant mortality is lack of pre-natal care, and uninsured people don't get that.


Also a good point. Your new program will have an army that forcibly goes out and drags women in for pre-natal care?



Other nations have substantial entrepeneurial investment in new health care technological developments. They're not as big as those in the States, because they don't have the same population... proportionally, they have just as much innovation. Those big drug companies that seem to have 'Made in the USA' stamped all over them are buying up foreign biotechs at a record rate... they sure aren't doing it because foreign countries don't innovate.

Also a good point. Explain why other countries don't have the same results cancer outcomes as the USA (with our poor health care system) then. Should they not have better results than the USA? Should not the UK have nearly identical results in cancer as the USA?

The USA is not the rest of the world.



And the costs would have been born by the taxpayers... your care wouldn't have been 'free', by a long shot.

Very true, but it addresses something that I did not say. Never the less, I would have gotten MY free health care at the expense of others. If I had no money in the future utopia, this would change in what way? Would I still not be getting others to pay for my health care?



You were lucky to have good insurance.

I'm glad for both you and your wife.


I'm glad for both of us too. I'm glad for the hundreds of thousands of others too. I'm glad we get USA results and not world class cancer care. Keep in mind that the USA "uninsured" are included in the USA cancer results. The "uninsured" must be getting pretty good cancer care too.


You don't have a basis to say that... and the currently debated bill is NOT 'government-run health care'. Are you 65 yet? Planning to not take advantage of Medicare? THAT is 'government-run health care'.... and millions of senior citizens would hang anyone who tried to take it away from them.


Good point. Most seniors buy supplemental insurance though. They are a good voting block. I suspect they will not like being a part of the ONE system that we are working towards. In ONE system they would be the expensive expendable ones. The ones no longer paying taxes.



Private insurance can only be killed by it's own cost and inefficiency. If it's consistently better, and more economical, then it will survive, handsomely.

If you cannot add members how can you survive? If you are taxed additionally (you will still be required by force of law to pay for the "public" health care) how will it be affordable?



But, more to the point, the most optimistic assessment of the present health care bill, made by the most liberal and progressive person imaginable, is that it's simply a small collection of incremental improvements, most of which are actually supported by conservatives, with a few proposals (like a public option) that is unlikely to make it through.

Characterizing the bill as 'gov't-run health care' is nothing more than fear-mongering.

Very good points. Lets make separate bills on each point so they can be debated of the merits of each and not crammed in a massive pile that is too large to know well enough to accept. I do not accept it on YOUR faith.

Lets start with tort reform and group negotiations for drugs. How about re instituting the rule against advertising drugs directly to consumers? How about making it illegal again for lawyers to advertise for clients. Ambulance chasing used to be illegal.

Bob

Keith Wilson
08-12-2009, 03:04 PM
Sorry ,but the 'negotiations for drugs' thing is hopeless. The deal with the devil that was made between George Bush and Ted Kennedy, in order to establish Medicare Part D, required that the gov't be PROHIBITED from negotiating drug prices.Why the **** can't we change that damned law? It's not merely stupid, but IMHO borderline criminal misuse of public funds.

High C
08-12-2009, 03:14 PM
Why the **** can't we change that damned law? It's not merely stupid, but IMHO borderline criminal misuse of public funds.

Do they ever go back, admit a mistake, and tear up a law? If they haven't yet done it with mandated ethanol, which saves no petroleum and starves third world people, it doesn't seem likely.

Keith Wilson
08-12-2009, 03:22 PM
Do they ever go back, admit a mistake, and tear up a law? Yes.

Art Read
08-13-2009, 07:46 AM
Just one thought... The last time this nation ventured upon a wholesale, top to bottom restructuring of an entire segment of our economy was the Transportation Security Act. Had we "really" debated THAT measure, I can just imagine the proponent's arguments.... "Don't be be silly, we won't be subjecting 'Grandma's' and other non-threatening disabled people to inappropriate, degrading violations of privacy... It will be a seamless, efficient 'improvement' in airport security. We HAVE to act NOW or airplanes will start crashing into buildings every day!" Trust us, we're the government. Only qualified, competent personnel will be implementing these measures..."

How's that worked out for us?

Art Read
08-13-2009, 08:19 AM
"...but on the overall, security WAS improved, was it not?"

_________________________________________________

But how much did TSA really have to do with that? I'd submit that highjacking airplanes has become a "non-starter" for disgruntled individuals of all stripes ever since 9-11. Before that day, the conventional wisdom was keep calm, keep your head down and wait for the hostage negotiation team on the ground. Now, it's "Let's Roll!"

With beefed up cockpit doors and a plane full of passengers with "real" steak knives, I wouldn't want to be the next poor bastard told to "Strike a blow at the Great Satan" from a commercial airliner!

How 'bout we spend some of that money to improve explosives screening instead?

Nanoose
08-13-2009, 08:24 AM
I thought this thread was about assisted suicide in Oregon. :rolleyes:

Art Read
08-13-2009, 08:29 AM
"I thought this thread was about assisted suicide in Oregon."

________________________________________________


No... It was about a government run health care panel denying a cancer patient expensive chemotherapy because their policy is not to "provide treatment that prolongs life or alters the course of the disease"... The offer to pay for her suicide instead was just salt in the wound.

Nanoose
08-13-2009, 08:39 AM
...It was about a government run health care panel denying a cancer patient expensive chemotherapy because their policy is not to "provide treatment that prolongs life or alters the course of the disease"... The offer to pay for her suicide instead was just salt in the wound.

Thanks, Art. However, it seems the policy is related to 'advanced' cancers, not all cancers, as you indicate above.

Art Read
08-13-2009, 09:00 AM
"That is precisely what the real opponents of health care reform are saying: "Do nothing at all."

__________________________________________________ _____________________________

Norman, you're wrong. I'd LIKE to see real, rational reform of our healthcare policy. I suspect a majority of those who oppose the current plan would agree. What I do NOT want to see is the government approach this in the same manner that they seem to approach every other opportunity for social engineering these days. If you think dissent is loud now, wait 'till the Senate takes up the Cap and Trade bill again!

Put positive, outcome based initiatives and protections in place and get out of the way! I am far less sanguine than most here about the government's ability to micro-manage major components of our economy without bias or partisan agendas. I believe our historical record in that regard supports my concern. I don't think the government is evil or that it has no role in establishing the conditions in which the market operates. I just believe that it is being co opted into a role for which it is neither suited or designed for.

Keith Wilson
08-13-2009, 09:09 AM
One essential point is that demand for health care is functionally infinite - or at least far larger than society can afford. Therefore it is ALWAYS rationed. Right now in the US it is rationed according to wealth, or by what kind of insurance you have. Other countries ration it differently, but it is always rationed.

Currently, an enormous percentage of health care dollars are spent in the last few months of life. It's a peculiarity of the current system that insurance companies can be spectacularly cheap, but when someone is actually dying, the checkbooks magically opens and almost anything goes. Perhaps it's fear of getting sued ("You killed grandpa!") but honestly, spending half a million dollars to extend someone's life three months does not seem to me a good use of resources.

Art Read
08-13-2009, 09:11 AM
"I think the woman in question probably knew the 'score', in terms of what getting the drug was likely to do for her...."

____________________________________________

Listen to what her DOCTOR said in the video again. Please. The panel's decision was based on criteria implemented 15 years earlier when the program was enacted. He maintains that advances in treatment have changed the prognoses. THAT'S what terrifies me about this. Legislation simply can NOT keep pace with the state of the art. Imagine government "procurement" officers choosing your IT systems for you. Oh... Yeah. They do. Look at the IRS. How's THAT worked out?

Keith Wilson
08-13-2009, 09:16 AM
Art, other countries manage to do it effectively; not perfectly, but much more efficiently that the US, and everybody is covered all the time. The US government is not any worse than the government of Canada, or Australia, or Germany, or Denmark. . .

Art Read
08-13-2009, 09:24 AM
Seems to me I just read "Big Pharma" is on board with this after their negations with the White House. What's the budget they just announced for PROMOTING the plan? 150 million?

Nanoose
08-13-2009, 09:30 AM
Do health care providers in the U.S. not say things like, "We are sorry. This is terminal and there is nothing more we can do for you." ?

Art Read
08-13-2009, 09:46 AM
"Don't try to tell me that anyone out there is advocating a better alternative plan."

__________________________________________________ __________________

What do you call the Wyden-Bennett Act?

Bottom line, no solution is going to "save money". I don't believe any real reform can be done with out costing many of us much more. We could certainly have "cheaper" health care, but not without huge sacrifices. Keith's oft repeated dead horse aside, I don't believe that the "solutions" the rest of the industrial world's nations have devised ARE in all respects superior to ours.

We have a wonderful opportunity to examine a whole range of existing systems. Both their advantages and faults. Why can't we use this opportunity to IMPROVE on ALL of them? Isn't that the "American Way"?

I really think that the critical mass HAS been reached in this country to finally "do something". Let's not get so emotionally attached to the "idea" of winning the battle over this particular proposal and actually formulate a solution that recognizes and addresses a broad spectrum of ideas? THAT'S leadership I would admire and stand behind...

Art Read
08-13-2009, 09:56 AM
"I did. Try looking at what the double blind trials for this drug (NOT 15 years old) have shown: an average extention of life expectancy of 2 months."

_____________________________________________

Yeah, averages are a bitch. Going by what the doctor said however, the difference was more along the lines of "quality of life" issues. Staying home, out of the hospital or hospice, pain-free significantly longer. Seems a reasonable aspiration to me.

Keith Wilson
08-13-2009, 10:10 AM
Bottom line, no solution is going to "save money". I don't believe any real reform can be done with out costing many of us much more. We could certainly have "cheaper" health care, but not without huge sacrifices. Keith's oft repeated dead horse aside, I don't believe that the "solutions" the rest of the industrial world's nations have devised ARE in all respects superior to ours. Not in all respects, no; there are always tradeoffs. They do however, deliver results that are in most respects equal or superior, for MUCH less money - and again, everybody is covered, all the time. I may have beaten it to death, but discounting the experience of every other developed country seems to me willful stupidity.

Nanoose
08-13-2009, 10:49 AM
I'm not sure they phrase it that way. more likely, they will say that they don't pay for experimental treatments.

What happens in Canada, for extreme cases like this? Are doctor's prescriptions ever denied on this basis?

I don't know. But I do know we are realistic enough to tell people there's nothing more that can be done when that is the truth, and to follow that with excellent palliative care. Medicine is not a cure all.

I wonder how much of what is offered/happens medically in the U.S. is driven by fear of litigation? I would think a lot. The $$ impact of that has got to be HUGE on the system....malpractice insurance driving up doctor's fees....on and on it must go.

It would seem there are a lot of people with a vested interest in keeping the U.S. system as it is, thank you very much. The change that is needed is overwhelming, and systemic. The resistance will be (is) huge.

Art Read
08-13-2009, 11:06 AM
To be continued here... http://www.woodenboat.com/forum/showthread.php?t=100990

(The "other", bi-partisan bill in question:http://en.wikipedia.org/wiki/Healthy_Americans_Act )

Nanoose
08-13-2009, 11:29 AM
Thanks, Norm.

Art Read
08-13-2009, 11:49 AM
From Forbes: http://www.forbes.com/2008/05/05/physicians-training-prospects-lead-careers-cx_tw_0505doctors.html

Reasons Not To Become A Doctor
Tara Weiss, 05.05.08, 5:30 PM ET

"...Getting sued by a patient is a major concern. Of course, doctors who make fatal mistakes and who are unqualified should be held responsible. But there's evidence that the bulk of lawsuits brought are frivolous. Of all malpractice lawsuits brought to jury trial in 2004, the defendant won 91% of the time. Only 6% of all lawsuits go to trial; those that aren't thrown out are settled. Only 27% of all claims made against doctors result in money awarded to the plaintiff, according to Smarr, president of the trade association for medical malpractice companies.

Regardless, doctors need to defend themselves against the possibility of damages--and that's an extremely expensive proposition. It takes about four-and-a-half years from the start of a lawsuit to the end, and the average cost to the defense in legal fees was $94,284 in 2004, according to the American Medical Association.

Many states are trying to establish laws to protect doctors from baseless suits. Texas went from the state with the most lawsuits filed to the only state that wrote tort reform into its constitution after its citizens voted it into law. Since tort reform was enacted in 2004, the yearly premium doctors pay in Texas for malpractice insurance has dropped by 40%. Now, the most plaintiffs can recoup for emotional damages is $250,000 from doctors and $500,000 from hospitals. Most interestingly, the number of claims filed against doctors has dropped by about half.

"The lawyers know the huge damages they were [previously] able to get are [now] limited," says Smarr.

Miami-Dade County, in South Florida, is now the most precarious place for doctors to practice when it comes to lawsuits. In 2007, OB/GYNs paid on average $275,466 annually for malpractice insurance. That number is a slight drop from 2006, when the average cost was $299,000, according to Mike Matray, editor of the newsletter Medical Liability Monitor.

Doctors have to practice defensive medicine, and their insurance rates are so high," says Matray. "But rates are leveling off and coming down right now. However, if history repeats itself, they will go up in a few years. A lot of doctors right now are not encouraging their kids to be doctors."

To support that assertion, a 2007 survey by Merritt, Hawkins indicated that 57% of 1,175 doctors questioned would not recommend the field to their children...."

Art Read
08-13-2009, 11:54 AM
Malpractice Costs Driving Doctors Out

www.suntimes.com

November 11, 2002

BY JIM RITTER HEALTH REPORTER

Soaring malpractice insurance premiums are forcing doctors to scale back their practices, retire early, move to other cities or find new work, physicians groups say.

On the North Shore, an obstetrician-gynecologist who will pay $118,000 in liability insurance next year is studying to obtain a pharmacist license.

"I never thought about doing anything else," said the 43-year-old doctor, who asked not to be named. "Now all I'm thinking about is what else can I do."

In the 12-month period ending last July, liability insurance premiums nationwide increased 24.7 percent for internists, 25 percent for general surgeons and 19.6 percent for obstetrician-gynecologists, the Medical Liability Monitor reports.

In Chicago, annual premiums total about $32,000 for internists, $76,000 for general surgeons and $110,000 for OB-GYNs. By comparison, doctors' average income, after insurance and other expenses, was $160,000 in 1999, the American Medical Association said. One reason rates are so high for OB-GYNs is that doctors get sued after difficult births leave babies with permanent disabilities.

There's anecdotal evidence insurance costs are changing the way doctors practice.

Brain surgeons, for example, may do less brain surgery. According to a survey of 700 neurologists by the American Association of Neurological Surgeons, 43 percent said they are planning to or are considering restricting their practice to get relief from liability premiums as high as $300,000.

Premiums vary widely. General surgeons, for example, pay $66,000 per year in Long Island, N.Y., and $174,000 in Miami. In Las Vegas, more than 75 obstetricians have moved or plan to move to lower-cost cities. And in West Virginia, a shortage of orthopedic surgeons who can afford liability insurance has left the state with only one Level I trauma hospital to treat the most critically injured patients, the AMA's American Medical News reports.

Doctors blame "frivolous" malpractice lawsuits and "jackpot" jury awards. "The dollars that go to pay for legal defense and plaintiffs' attorneys ultimately come from patients," said Dr. John Schneider, president of the Illinois State Medical Society.

But in the last 30 years, jury awards and settlements have gone up no faster than health care costs, a study by Americans for Insurance Reform found.

So far this year, there have been 211 malpractice settlements in Illinois, with an average award of $1.9 million, according to the Jury Verdict Reporter.

Some experts said the insurance industry and the economy are more to blame than trial attorneys and juries. Insurance companies make money by investing premiums in stocks, bonds and other investments. To compensate for the recent drops in stock prices and interest rates, insurance companies are hiking premiums. The same thing happened in the mid-'70s and mid-'80s.

The House has passed a bill that would limit malpractice awards to economic costs such as lost wages and a maximum of $250,000 for pain and suffering. But the bill is expected to die in the Senate.

Copyright The Sun-Times Company

http://www.papillonsartpalace.com/malprDact.htm

Art Read
08-13-2009, 12:43 PM
Ok... Here's another one from 2008. That's two from 2008 and one from 2002. Ask your primary care doctor if he thinks the problem's fixed.

_____________________________________________

Staten Island doctors join rally against insurance rates
by Staten Island Advance
Tuesday March 04, 2008, 5:35 PM


Photo courtesy of Jeff Becker
Surrounded by as sea of white coat-clad physicians, Assemblyman Lou Tobacco speaks during a rally against medical malpractice insurance rates.
Scores of Staten Island doctors put down their stethoscopes this morning to take up posters and banners.

Rising before dawn, the 150 or so borough physicians trekked 170 miles to Albany to join about 1,500 fellow doctors from around the state. Their goal: To rally against what they say are excessive medical malpractice insurance rates.

The move may have paid off.

After hearing from the governor and the state Insurance Department superintendent, there is hope. They say a possible $50,000 surcharge against them may be off the table.

"Most of us are cautiously optimistic that the $50,000 surcharge won't happen," Dr. Ralph K. Messo, president of the Richmond County Medical Society, said today in a telephone interview from Albany. "It turned out to be a positive day. It gives us a glimpse of hope the disaster plan won't happen."

A task force appointed by Gov. Eliot Spitzer was considering such a levy to solve the state's medical malpractice insurance funding woes. By law, doctors can be surcharged to make up deficits to pay medical malpractice claims.

The typical Island obstetrician-gynecologist pays an eye-popping $160,000 to $225,000 in annual malpractice premiums, doctors say.

Dr. Messo said part of the Island contingent rode two buses up to the rally.

Some ralliers carried banners proclaiming, "Enough Is Enough!" while others asked who would deliver babies if obstetricians are forced to close their practices. In a symbolic gesture, many left white lab coats on the steps of the Capitol to show how doctors are leaving the state in droves because of soaring malpractice rates.

"New doctors are choosing not to practice here," said Dr. Messo. "Many areas across the state are facing a shortage of doctors, especially for specialists."

In July, Spitzer created a task force to probe the state's rising medical malpractice costs. The group was formed on the heels of a 14-percent medical malpractice insurance premium spike -- the largest increase in 14 years.

Insurance Superintendent Eric R. Dinallo said then the current crisis was created by the prior administration's appropriation of $691 million of medical malpractice insurance reserve funds for general state expenses. The Medical Malpractice Insurance Plan, the state-regulated, high-risk pool for doctors declined coverage by commercial carriers, is $500 million in debt.

A spokesman for Dinallo said today the task force's report is to be released in the spring. Messo, however, said word is it may come out the next week.

The spokesman, Andrew Mais, could not say whether a potential surcharge is completely off the table.

"We've consistently said the task force is looking to ameliorate the burden of medical malpractice insurance, including the surcharge, on doctors," he said. Assemblyman Lou Tobacco, who met with doctors, said legislators need to pitch in.

The South Shore Republican is sponsoring or co-sponsoring bills to cap certain awards, such as pain and suffering, in medical malpractice cases. He also supports establishing a pilot program of specialized "medical courts" that would use "specially-trained judges" and "objective independent medical expert witnesses" to adjudicate medical, dental and podiatric malpractice cases.

"If we are serious about delivering the best quality care to New Yorkers, then we need to be serious about making certain that doctors remain in New York and practice medicine here," Tobacco said in a statement.

However, some consumer and patient advocates dismiss such proposals as "non-starters."

"We certainly don't think that insurance problems that doctors may be having should be solved on the backs of patients," said Joanne Doroshow, executive director of the Manhattan-based Center for Justice & Democracy.

Ms. Doroshow said tighter regulation of insurance rates, the insurance industry, and of doctors, themselves, are better solutions.

A recent report showed that 4 percent of the state's 80,000 physicians account for 50 percent of medical malpractice payouts, she said.

"The real crisis is that there's far too many preventable medical errors -- errors that kill and injure thousands of New Yorkers each year," Russ Haven, legislative counsel of the New York Public Interest Research Group (NYPIRG) said in a statement. "The best way to reduce medical malpractice payouts in New York is by adopting a laser-like focus on preventing medical errors."

-- Contributed by Frank Donnelly

Rigadog
08-16-2009, 03:16 PM
Just go to the emergency room, Health care is free there right?