Coronavirus.

[MacInWin]

Sorry you feel that way, John. Schweb's Lounge is the one place where controversial items can be discussed. I didn't see any back biting, just a discussion of the pros and cons of nationalized medicine. You like it. I don't. You said it worked, and your pockets were untouched. "Worked" is, I guess, a personal observation. Waiting a long time for medical care is, for me, not "working." Presently at the NHS, from the article I cited at the BBC:

The figures show:
4.42 million patients on the waiting list at the end of September, the highest number ever
84.8% of them waiting under 18 weeks - below the 92% target and the worst performance since the target was introduced, in 2012
76.9% of cancer patients starting treatment within 62 days - below the 85% target
83.6% of A&E patients admitted or transferred within four hours in October - below the 95% target and the worst performance since the target started was introduced, in 2004

If that is, for you, a working system, that's fine. For me, having 16% of A&S (emergency room) patients waiting longer than 4 hours is criminal. If the patient is there as an emergency, they should be seen immediately, not parked for 4+ hours.

In my own experience, when I arrived at the Emergency Room of my local hospital I was seen within 10 minutes, had a CAT scan in about 20 minutes and was admitted within an hour. And it cost me nothing because I have Medicare and a supplemental insurance policy. To me, that is what is meant by "works."

 

[Lifeisabeach]

In my own experience, when I arrived at the Emergency Room of my local hospital I was seen within 10 minutes, had a CAT scan in about 20 minutes and was admitted within an hour. And it cost me nothing because I have Medicare and a supplemental insurance policy. To me, that is what is meant by "works."

You can't take your singular, limited anecdotal experience and claim this is the standard of care here. I can personally assure you that your experience is not universal across every hospital in the USA. Some days are better than others, some places are better than others, and even the time of day can matter, but having worked in the industry for well over 20 years in a handful of facilities including level 1 trauma centers, 4 hour waits in the ER waiting room are NOT uncommon right here in the US of A.

 

[Cr00zng]

This is one of the things I'm on the fence on. While I agree with this in principle, I also believe the federal government is incapable of running the healthcare system responsibly. But something is going to have to give, and this current crisis is going to be the breaking point. Rural hospitals in particular have been slowly closing over the past decade because they can't afford to stay open, and this will push many of the remaining ones over the edge. When this is all over, I guarantee you the healthcare system and climate will be irrevocably changed and the people of this country need to come to terms with the fact that we need to do what it takes to make sure it is sustainable for the future.

Medicare, rather CMS, does not actually run much by itself; from treatment to claim processing, private companies do pretty much all aspects of the operation. Its main purpose is to convert regulation changes to operational changes for the private companies. This is why switching from commercial insurance to Medicare is not really noticeable for most people. Other than the substantial monthly premium cost decrease that is.

It is the Congress with its constant regulation changes and budget cuts for CMS that affects the care that retired people receive.

I am not certain, that I would agree that the US healthcare system “will be irrevocably changed”. It certainly should change, but it is unlikely. Health care companies making too much profit from healthcare. Just the major health insurance companies, BCBS and UHC, transfer about $5B per year to Wall St., in the form of dividend. Their perennial $30 stock price prior to ACA, or Obama Care, is in the $250 range. They can afford lobbying the Congress to preserve the status-quo.

Consolidation of hospitals in both, the rural and urban areas, has been ongoing for at least couple of decades for different reasons. In rural areas, the cost of having a hospital outpaced the generated income. In urban areas, the number of hospitals decreased by either merging, or outright purchasing. In both cases, the number of hospital beds available for the area decreased substantially and so did the number of ER departments. The limited availability under normal circumstances was close to the breaking point and crashed with the Corona pandemic.

 

[Cr00zng]

You can't take your singular, limited anecdotal experience and claim this is the standard of care here. I can personally assure you that your experience is not universal across every hospital in the USA. Some days are better than others, some places are better than others, and even the time of day can matter, but having worked in the industry for well over 20 years in a handful of facilities including level 1 trauma centers, 4 hour waits in the ER waiting room are NOT uncommon right here in the US of A.

I do hope that you’ll be safe during this pandemic, wish you the best...

My recent experience with ER, anecdotally confirms your four hours waiting time. The visit included lab test and CAT scan, about a dozen of people seen me. Comparing my ER visits with commercial insurance, where the waiting time was around two hours, but these visits were 10-15 years ego. It seems to me that nowadays, the type of insurance one has would not really matter and all type of insurances will have the same wait time.

I think the limited number of ER available in the area is the major factor in determining the waiting time. That, and EMS brings people to the ER that receives priority.

 

[Cr00zng]

Sorry you feel that way, John. Schweb's Lounge is the one place where controversial items can be discussed. I didn't see any back biting, just a discussion of the pros and cons of nationalized medicine. You like it. I don't. You said it worked, and your pockets were untouched. "Worked" is, I guess, a personal observation. Waiting a long time for medical care is, for me, not "working." Presently at the NHS, from the article I cited at the BBC:If that is, for you, a working system, that's fine. For me, having 16% of A&S (emergency room) patients waiting longer than 4 hours is criminal. If the patient is there as an emergency, they should be seen immediately, not parked for 4+ hours.

In my own experience, when I arrived at the Emergency Room of my local hospital I was seen within 10 minutes, had a CAT scan in about 20 minutes and was admitted within an hour. And it cost me nothing because I have Medicare and a supplemental insurance policy. To me, that is what is meant by "works."

I agree with Lifeisabeach, the four hours waiting time is pretty standard in most urban areas. The waiting time does depend on the patient condition, ALS (Advanced Life Support) receive priority over BLS (Basic Life Support) condition. The chances are that your condition had been deemed ALS and you received priority.

Your supplemental policy pays for copays, mine does not. That was by choice based on my health condition and utilization of the supplemental policy. With that said, I agree, Medicare with the supplemental insurance policy works and an awesome option for retired people. They should stay away from most of the Medicare Advantage plans, that I call Medicare Disadvantage plans, and keep the traditional Medicare plan.

 

[lclev]

I am currently looking to go on Medicare. I will hit the big 65 in June and if one more robocall comes in trying to sell me a supplemental insurance plan or a Medicare advantage plan.....

Anyway, I will be signing up under my husband. I have basically two choices - Medicare plus a BCBS supplemental that includes prescriptions or an Aetna Medicare advantage plan. My husband is already on Medicare and he has the Medicare plus the BCBS supplemental.

We did try Aetna’s plan for him for about two months and changed back. He had to pay more in deductibles and for some reason they had all these wellness visits they pushed on him plus it seemed like they were always micromanaging his healthcare which we soon realized was to keep their costs down. It took us 60 days to figure out it was not going to work and to switch back to regular Medicare. (We had a 90 day window.).

So I will be soon making the change to Medicare plus the BCBS supplimental too. His medical costs are way less than mine are on the regular insurance as he has little to no copays which is not so for me on my current regular insurance plan.

As for which is better: NHS versus what we currently have here in the U.S. - well truthfully isn’t it all in what you get use to?

I use to feel healthcare was not a right but when I was growing up a doctor made house calls and it was at most $25 for the call and meds. You could go have a baby and it cost $2000 for the hospital if you did not choose to have the child at home with the local midwife. Now times have changed and the costs of any health treatment is astronomical. Nothing our government has done has helped. The ACA did not solve anything and in fact, made things worse.

Bottom line - I do not believe the government is capable of running univeral healthcare but I do beleve we need some sort of health system for everyone. How that gets done is the big question and a huge problem.

Lisa

 

[IWT]

I think this is a matter best left to the individual countries.

The UK and USA are so different. We (UK) are a tiny island. It's not difficult to set up a National Health Service; although National is slightly ambiguous in that Scotland and Wales have a huge say over how that service is organised (especially Scotland). Not sure about Northern Ireland and how its run.

We have our successes and our failures. Lots of things are way short of perfect, but there are delightful success stories too. Services are not evenly distributed. We often refer to such as a Post Code (Zip) lottery. Some areas offering this service (eg certain cancer drugs; IVF) others not so.

You guys in the USA have 50 States (hope I got that right). You have Local admin, State admin and Federal admin; not too mention 320 million to serve, as against our 65 million.

What I'm suggesting is that we are comparing oranges with apples.

Almost any system can be made to work if (a) it is properly funded and the people are prepared to pay, however the monies are raised - taxes, personal insurance and so on; and (b) there is absolutely no discrimination in the provision of all services - be that on age, gender, location, ethnicity, personal income and all the rest.

I hate to see people falling out over things. Respect for all points of view is essential. And an understanding that no matter what we think, we've actually got very little control over these matters.

Ian

 

[Cr00zng]

@Lisa…
Age is just a number, once you pass the “big 65”, it will not look that big anymore. My definition of old is on a sliding scale; anyone, who is ten years older than me is old…

You probably already know this, but just in case…

You can start Medicare application three month prior to your birth month and you should. With the pandemic roaming around, the chances are that processing your application will take longer than normal. In my experience, the easiest way to apply for Medicare Part B insurance is via the online application at the Social Security Administration (SSA). You will need to create an account, if you have not already, to access the application. The SSA should start your Medicare Part A insurance on the first day of your birth month, no application needed.

People eligible for Medicare better off keeping the traditional Medicare insurance and not opting for Medicare Advantage Plans. While the monthly premium is lower, the deductible, copays, pre-authorization requirements, etc., not only makes it more expensive on the long run, it also has much more restrictions than traditional Medicare.

I am just curious about your statement in post #46, quote:

“I do not believe the government is capable of running universal healthcare…”

CMS runs the Medicare insurance for eligible people, currently about 60million. Most people I talk to about Medicare are like me, they love the cost and coverage it provides. Your husband already has Medicare and you are looking forward to getting yours.

CMS is part of the government. If it can satisfactorily manage health insurance for 60 million people, why should it not be suitable to manage Medicare type of insurance for 330 million people?

 

[Cr00zng]

@Ian…

To my knowledge, the UK’s NHS system provides healthcare for everyone that includes owning and managing operation of provider services, such us doctors, hospitals, etc. In addition, there are commercial health insurance companies with their private provider networks. This is more of an augmenting service to people, who desire private care.

The US Medicare system is different in a sense, that it does not own any provider practices. All of the services provided to Medicare recipients by private practices, doctors, hospitals, etc. This is as close to the UK’s private care as it can be. The Medicare insurance is just like any other commercial insurance in the US, with couple of differences, like nationwide coverage, lower cost for members, less restrictive, etc.

While the commercial health insurance in the US used to be better, than Medicare insurance, that is no longer the case for most people. The premium, deductible and copays for commercial health insurance increased to the point that it can cost upward to $15-20K per year, prior to the insurance company paying for any services. The commercial health insurance is also more restrictive, requires preauthorization for quite a few services, depending on the actual content of the policy.

 

[lclev]

@ Cr00zng

I could not sign up for any part of Medicare online as I have to go on it under my husband. I was a teacher in Ohio for 30 years at the same school system. When I started teaching teachers did not pay into Social Security as we have our own retirement system not run or supported by the state. At that time we also had our own full coverage no cost healthcare. But as healthcare cost went up and premiums increased our retirement system started to walk back just how much they would pay of the premium and what the policy would cover. Then as members became 65 they moved to offering a Medicare supplement plan that members have to pay part of the cost.

When I started teaching retirees had all their healthcare covered by the retirement system. Sometime in the 80’s new hire teachers were required to pay into Medicare. Teachers who did not change employment were grandfathered and not required to pay into Medicare. Since I fall into the exempted category I have never paid Medicare and thus must go on it under my husband.

While I will say Medicare has worked well for my husband, expanding it to include everyone would be a hugely complicated issue. I do wonder if we took all the current money we have workers paying into Medicare and add to that the insurance premiums that people/companies are paying and put it into Medicare would that be enough to make it workable? And would the big insurance companies and the hospitals launch a huge lawsuit/lobby effort to block it. And then there is our congress... that is a whole other mess.

Lisa

 

[badshoehabit]

From my own experience I know that private health care insurance raises costs. In severe pain and anxious, I had a private consultation then a cortisone injection for hip bursitis. When settling the bill, I asked for a discount as I wasn't using insurance. 'That's the discounted price,' was the reply.

I realise the scale of health care in the US is enormous compared with the UK but, given the will, could states be mandated to raise taxes to cover it? The NHS is not free, as in no-one pays, but because of direct taxation it is free at the point of delivery.

 

[chscag]

I realise the scale of health care in the US is enormous compared with the UK but, given the will, could states be mandated to raise taxes to cover it? The NHS is not free, as in no-one pays, but because of direct taxation it is free at the point of delivery.

That would be the idea. However, no one knows how much it would cost in individual taxes to maintain a "NHS" type system for 330 Million people scattered throughout 50 states. Both our Medicare and Social Security systems supported by payroll deduction and taxes are in danger of going broke unless changes are made to them.

Politicians mostly admit that changes have to be made in order to maintain those systems in the future. But no politician will run his/her platform based on that. It's known as the "third rail"; in other words, political suicide.

 

[pm-r]

Politicians mostly admit that changes have to be made in order to maintain those systems in the future. But no politician will run his/her platform based on that. It's known as the "third rail"; in other words, political suicide.

Maybe they should take a look at the way that Canada developed and maintains their medical plan, that's good enough for many Americans to even come north to take advantage of it.





- Patrick
======

 

[chscag]

It's not that simple Patrick. But I agree, Canada has a good healthcare system which is for everyone. However, the population of Canada is 37.59 million as of 2019, the population of California is 39.51 million as of 2019. The total population of the US is estimated to be over 330 million in 2019.

Many Americans have gone to Canada to retire or to live after Canadian law regarding property ownership by non citizens was changed. Canada is certainly a great place to live, albeit, a bit too cold for this Texas guy.

 

[Lifeisabeach]

Maybe they should take a look at the way that Canada developed and maintains their medical plan, that's good enough for many Americans to even come north to take advantage of it.

Heck, some people are even going to Mexico for medical and dental now. In fact, some companies are PAYING their employees to have surgeries done down there instead.
To Save Money, American Patients And Surgeons Meet In Cancun | Kaiser Health News

 

[RavingMac]

I will weigh in with my 2 cents worth on the Medicare and Health Insurance thing.
As a 34 year civil servant I share the generally low opinion of bureaucracy and bureaucrats. Thankfully there is a proven solution that would avoid the worst failings of a Medicare only system, and that is to set up a system based on the Federal Health Insurance system (FEHB).
In it the govt would set minimum requirements for plans every year, including coverage for pre-existing conditions etc etc.
It would be tax funded and each adult would receive a voucher that would cover the cost for the median plan and could only be used to purchase coverage. Couples could pool their vouchers and purchase a family plan.
I doubt the overall program cost would be more than we currently pay as a society. Everyone would be covered. And, competition would act to rein in costs.
Would it be perfect? No, but it would work. It already does (and fairly well) for Govt employees.

If this sounds similar to Obamacare. It is, with a few significant changes.
While there isn’t a mandate, there is no reason for anyone to opt out, since there is no required out-of-pocket cost for the insurance.

 

[chscag]

At one time the FEHB was a great choice. I used it extensively while working for the US Govt as a civilian. Several of the plans even included dental care with very low co-pays. But as the years went by, those plans rose in price and began to cover less with higher co-pays. When I retired from Civil Service I used FEHB until I was eligible for Medicare and then dropped it. Since I have both Medicare and Tricare for Life coverage, it isn't worth it to use FEHB. I receive the FEHB booklet every year during open season and look over the plans. If anything, they have gotten more expensive with less coverage and higher co-pays.

It does look like the political climate is moving more toward a national health system. Maybe sometime in the future?

 

[badshoehabit]

It took the trauma of WW2 and the surprise election of a socialist government for the UK to develop the welfare state and the NHS. There are still some Tories - Iain Duncan Smith is voluble on the subject - who believe, as did Churchill, that providing welfare would dissuade people from working.

It's possible this crisis could be the stimulus for radical change in the US, though the actions of some promote individualism to a silly degree (eg mass protests against the stay at home orders).

 

[RadioFlyer]

If you have some time to listen to a review of statistics and information that is hidden in part due to the focus on Covid. Interesting and challenging.

 

[RadioFlyer]

YouTube pulled the video.

Here is a link to the Kern Country TV station with the rational for the decision. I don't agree with YouTube.

YouTube issues statement on removal of controversial video interview with Bakersfield doctors