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  #11  
Old 12-22-2007, 03:27 AM
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Actually the private sector is finally getting the fact that they save money with preventative care in the long run. Does that mean they should spend $250,000 on an experimental surgery with a 1-10 chance of success? I don't think so...

If you want a good look at government health care take a look at the VA. Besides...What makes you think the government can do a better job? Have you seen the corruption, waste and mismanagement that goes on in our government system?

What we need is a system of choice and a society which does not consider MacDonald's and Wendy's a dinner option. Face it Eric...The American society is not very concerned with taking care of themselves. People like yourself on the FAR Left somewhere in the Green Zone (think cannabis) feel the government should be responsible for taking care of everyone.

I for one don't want any part of that scenario. Personal responsibility is the goal we should be striving for and that is pretty much where we are now.
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  #12  
Old 12-22-2007, 03:34 AM
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Quote:
Originally Posted by Eric5273
The problem with HMOs is that they increase their profit by providing as little care as possible.

In the film "Sicko", one of the things shown is an actual recording of a conversation that took place in the Oval Office between Nixon and Ehrlichman in February 1971. Here is a transcript:

Ehrlichman: We have now narrowed down the Vice President's problems on this thing to one issue and that is whether we should include these Health Maintenance Organizations like Edgar Kaiser's Permanente thing

NIXON: Now let me ask you, You know I'm not too keen on any of these damn medical programs.

Ehrlichman: This is a private enterprise one

Nixon: Well, that appeals to me

Ehrlichman: Edgar Kaiser is running this Permanente deal for profit and the reason he can do it...I had Edgar Kaiser come in and talk to me about this and I went into it in some depth...All the incentatives are towards less medical care because the less care they give them, the more money they make

Nixon: Fine

Ehrlichman: and the incentives run the right way

Nixon: Not bad



The following day, Nixon gave a speech where he said the following:

"I am proposing today a new national health strategy, the purpose of this program is simply this, I want America to have the finest health care in the world and I want every American to be able to have that care when he needs it."



Perhaps the incentive should be to provide the best health care possible. I'm no expert, but I'm pretty sure that is what most doctors would do if given the chance. But instead, they must deal with insurance companies who tell then what they can and cannot do, what drugs they can and cannot prescribe, and when they must refuse care to someone.

Come up with a system that has financial rewards for those who provide the best health care, and that is a private system I would support. But so far I have seen no such system anywhere in the world. Only a profit making system which encourages as little care as possible, and a non-profit system.
BTW...The Kaiser system is much different today. They save money on efficiency and preventative care. Keep in mind I work in the Health Care Environment and I've seen the inner workings of the system. There is a lot wrong with the system and most of it has to do with inefficiency, redundancy and sky rocketing malpractice costs.

You can thank the lawyers for a large part of the mess we are experiencing in health care...That said there is a lot of blame to go around.
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  #13  
Old 12-22-2007, 04:58 AM
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Quote:
Originally Posted by MrLabGuy
Have you seen the corruption, waste and mismanagement that goes on in our government system?
The corruption does not originate in the govenrment, it is because of the private industry. The problem is that when you have a government agency regulate private industry (such as the FDA regulating the drug industry), you end up with corruption. It is the nature of the system.

Does it suprise you that the congressman who wrote the Medicaid bill a couple of years ago was later hired to become the president of the pharma lobby at a salary of seven figures per year?

Or does it surprise you when you look at the FDA and find out that most of the people running the FDA are former board members of the companies that they are in charge of regulating?

That would be like hiring former convicts to regulate the prison system.

That is what you get when you mix private industry with government. The solution is to not mix the two. Get rid of the money, because that is what the corruption is all about -- Money. I say that you pay the doctors, nurses and research people very well. But there is no need for profit to enter the equation. Doctors, Nurses and Scientists will do just as well of a job if they are working for a big corporations or if they are working for the government.

You mentioned the VA. The reason the VA has problems is not because of lack of effort from the doctors or other medical staff. The reason is because they are underfunded and lack enough doctors and staff. Instead, they have a shortage of doctors, shortage of facilities (there are long wait lists), and an overall lack of proper funding. It has nothing to do with being government run. The lack of funding is because congress and the president have chosen to cut their budget year after year. The lack of funding is not some oversight or mistake due to lazy government employees.
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  #14  
Old 12-22-2007, 08:32 AM
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Quote:
Originally Posted by Eric5273
The answer is that the insurance companies should not decide themselves what they will and will not cover. There should be laws that decide that. The insurance companies can decide what they will charge for insurance, but there should be clear guildlines as to what they will and will not cover. The problem is that most people are not medical experts, so they don't know what sort of items they will need covered until it's too late and their policy does not cover what they need done.

As for Scottie's husband, is he still alive? Obviously it is terrible that he had to wait, but in the case of this girl, she died while waiting.
So you want the GOVERNMENT to dictate what operations you can and can't have? Man have you ever been sick? A close family member of mine had cancer and was refused a drug, legal in Germany, because the FDA didn't approve of it yet. The drug stopped all symptoms from chemotherapy that cause skin ulcers. Yeah, go government...love to have them involved with their religious methodologies in medicine. You can NOT open that door. A government is not a cure-all for societies problems. I can't figure if you are exceptionally pro-government or full heartedly against it In some cases you want powers taken away, others you want drastically increased....
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  #15  
Old 12-22-2007, 12:14 PM
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Quote:
Originally Posted by Eric5273
The corruption does not originate in the govenrment
No Eric...It originates in Man. If you eliminate all the private industry you will still have corruption. If you eliminate all the money in the world you will still have corruption. Man will continue to use whatever means possible to gain power and win influence.

Next you will want the government to develop a drug which takes the drive out of man so we can all live in peace and harmony.

Your world is frightening.
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  #16  
Old 12-22-2007, 01:45 PM
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Quote:
Originally Posted by Wagner
So you want the GOVERNMENT to dictate what operations you can and can't have?
Yes. We live in a democracy and we elect our leaders, so yes I feel comfortable with our leaders dictating that more than some insurance company who obviously makes more of a profit by providing less care to me -- a sure sign that they will decide on not providing enough care, as was the case with this girl who died.

Obviously someone has to decide, unless you are wealthy enough to pay for your own health care out of pocket and then you can obviously do whatever you want.



Quote:
Originally Posted by Wagner
I can't figure if you are exceptionally pro-government or full heartedly against it In some cases you want powers taken away, others you want drastically increased....
I don't want someone making decisions who benefits financially from making the decision one way or the other. I want someone making the decision who does not have a personal stake in the outcome. It does not matter whether the issue is going to war or deciding on health care. If private industry (i.e. "special interests" as John McCain like to call them) has the ability to influence this person or group of people, then I don't want them making the decision.

If our election system is going to stay the same as it currently is, then it doesn't matter who makes the decision as the government are just puppets of private industry anyway. Whether the insurance company decides or some government body, the outcome will be the same.

We need to reform our democracy and have publicly funded elections, and eliminate the influence that the lobbies have on our elected officials. If we do that, we will eliminate much of the corruption in government, and then I will be comfortable with the government making more decisions.

Until then, you might as well have Haliburton and Lockheed decide when we should go to war, and have Pfizer and Merck decide on what drugs get approved by the FDA, because those companies are making the decisions anyway. Why not just make it more obvious to everyone.
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  #17  
Old 12-22-2007, 03:02 PM
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Quote:
Originally Posted by Wagner
And there is no law requiring a HMO to do a surgery they deem experimental, regardless of success rate.
Quote:
Originally Posted by MrLabGuy
Does that mean they should spend $250,000 on an experimental surgery with a 1-10 chance of success? I don't think so...
You guys got to stop listening to the news media. Who is to decide whether a surgery is experimental? Sure, liver transplant is relatively new compared to lung and heart transplants, but still have been around for years. The doctors themselves said in the released statement that the liver transplant is NOT experimental. Researched have shown that the success rate for liver transplant is between 70% to 95% depending on the hospital that performed the surgery. This was measured on survival rate of 1 year or longer post-operation. Would you take that chance when put in that situation? The fact of the matter is NOT the initial cost of the $250,000 liver transplant procedure, but the associated costs of the aftercares which can run into the millions and the insurance company took this into account on deciding the life and death of an individual. I definitely agree with Eric that it should be left to the doctors to decide in the patient's best interest, NOT some bean counter sitting thousands of miles away running a cost/investment analysis.

Before, you say I'm full of it; my mom just went through the entire liver transplant operation ordeal, so we've done some research on the topic. Luckily for my mom, she was poor enough to have both medi-cal and medi-care, which beared the brunt of most of the bills. The doctors specifically told her to NOT do anything stupid like enrolling into any medical supplemental insurance prior to the transplant knowing that similar fiasco with the insurance company would occured had she enrolled. I know that government run agencies isn't the solution to this complex health issue, but it definitely beats any HMO plans out there at the moment. During my mom's ordeal, never once, did we had to get permission from medi-care or medi-cal to do anything. The doctors need to perform a procedure, we sign the consent, and the procedure gets done. That's it and that's the way it should be with HMOs - get out of the way and just let the doctors do their job. Afterall, there's no time to waste when you're dealing with a life and death situation.

Last edited by dkl; 12-22-2007 at 03:16 PM.
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  #18  
Old 12-22-2007, 03:49 PM
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dkl...Sorry to hear about your mom's ordeal and I'm glad she made it through the surgery. My comment about experimental surgeries was not meant to include liver transplants. It was a general comment about drawing the line somewhere and having health insurance. Little do you know Medi-Care and Medi-Cal also limit services so the fact that you were able to get the procedure was pretty lucky. That does not happen all the time with everyone. It has more to do with government oversight which sometimes allows and sometimes doesn't. Unfortunately it becomes a lucky roll of the dice.

What should happen here is when people come up for open enrollment they should avoid choosing Cigna. If enough people move away from Cigna due to this publicity Cigna will lose money and change their policy. That is how the free market works.
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  #19  
Old 12-22-2007, 03:52 PM
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I didn't focus on "why" they deemed it experimental, that is a whole other issue. And I didn't attempt to answer why. The fact is it was deemed experimental.

Quote:
Originally Posted by dkl
You guys got to stop listening to the news media. Who is to decide whether a surgery is experimental? Sure, liver transplant is relatively new compared to lung and heart transplants, but still have been around for years. The doctors themselves said in the released statement that the liver transplant is NOT experimental. Researched have shown that the success rate for liver transplant is between 70% to 95% depending on the hospital that performed the surgery. This was measured on survival rate of 1 year or longer post-operation. Would you take that chance when put in that situation? The fact of the matter is NOT the initial cost of the $250,000 liver transplant procedure, but the associated costs of the aftercares which can run into the millions and the insurance company took this into account on deciding the life and death of an individual. I definitely agree with Eric that it should be left to the doctors to decide in the patient's best interest, NOT some bean counter sitting thousands of miles away running a cost/investment analysis.

Before, you say I'm full of it; my mom just went through the entire liver transplant operation ordeal, so we've done some research on the topic. Luckily for my mom, she was poor enough to have both medi-cal and medi-care, which beared the brunt of most of the bills. The doctors specifically told her to NOT do anything stupid like enrolling into any medical supplemental insurance prior to the transplant knowing that similar fiasco with the insurance company would occured had she enrolled. I know that government run agencies isn't the solution to this complex health issue, but it definitely beats any HMO plans out there at the moment. During my mom's ordeal, never once, did we had to get permission from medi-care or medi-cal to do anything. The doctors need to perform a procedure, we sign the consent, and the procedure gets done. That's it and that's the way it should be with HMOs - get out of the way and just let the doctors do their job. Afterall, there's no time to waste when you're dealing with a life and death situation.
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