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don't have enough energy and time to read the article, but do have enough energy and time to type up an indignant response to the article I didn't read
Stay uninformed. Your call. Enjoy.
I'm not sure why you think a guy whose father died from an entirely preventable cause -- sanitation -- has some informative insight on our system of health care.
So, I've read the article and I'm no better informed. I could have said that in one short blurb. In fact, I identified and agreed with most of his observations -- about 20 or 30 years ago.
Sanitation in hospitals is horrible because of lazy, overpaid, union workers that cannot be fired. And post-surgical blood clots are caused by bed-ridden patients not receiving adequate physical therapy, after surgery. Therapists, while not as unionized as hospital sanitation workers, do have unions and it would be interesting to see if the incidence of post-op thrombosis is more or less prevalent in union vs. non-union hospitals.
I've spent quite a bit of time in hospitals, over the years, and just in the past couple of months (don't get hopeful, I wasn't sick), and the therapy for my family, post-op, was fantastic. They came in and had my family members on their feet within hours of surgery (which is only possible due to advances in surgical procedures and technology) and, as a result, my family member were able to recover and leave the hospital in days.
And, during their stays, every staff member having direct contact with the patient used the sanitation station before entering the room. The only person I noted that just came in and did their business were the janitors.
I'd be willing to bet the New York hospital, where his father died, also has a lazy, overpaid, staff of union therapists who allow patients to lie motionless too long and develop blood clots.
Finally, he talks about how it costs over a half million dollars yet, his mother was only billed less than a thousand (I think it should have been nothing since they killed her husband) and he acknowledges Medicare ate a portion of the rest while the bulk probably went unpaid. Except for the $992, seems like a pretty good deal for a week in ICU.
Other than being killed by completely preventable causes that could have been discussed and resolved in about two paragraphs, the rest of his article discusses perceived problems that had nothing to do with his father's death.
I will agree to being peeved about the lack of information technology but, not at hospitals, at the ing doctor's office. Every time I go to the doctor or optometrist, I have to fill out a multi-page form that asks for all the same information they already have on file.
I don't know if that's causing any deaths but, it is aggravating -- particularly at the beginning of each insurance year when you have to do the 15-pager. It's like they've never heard of databases.
But, at the three hospitals I've had an opportunity to visit this month all three had networked computers in the patient's rooms and the patient wore a bar-coded bracelet that was scanned every time they did a procedure, administered medicine, or discontinued a therapy.
I wonder what the concomitant infection and pulmonary embolism death rate is at those three hospitals.
One other thing. While deep vein thrombosis (the major cause of fatal pulmonary embolisms) are mostly preventable, they're not completely preventable and when you throw a clot that blocks a major pulmonary vein, chances of survival are slim to none -- even if it occurs on the operating table. Sometimes, those are just the breaks.
The hospitals will never discipline the doctors. They compete voraciously for the doctors to do their procedures at their hospitals because of the huge amounts of cash generated. Piss the doctor off and he can switch hospitals overnight. They are never gonna tell the doctor to wash his hands for fear of insulting him.
A beautiful, healthy, athletic lady I know and used to snow ski with tweaked an ACL and went in for a routine orthroscopic surgery. She got an infection in her leg at the hospital and ended up losing her leg at the hip. Hospitals are ing dangerous places.
It's all the Union workers' fault, exclusively because they are unionized.
-- Yours in Slander, Yoni
(non-unionized) hospital management and directors have no role in defining/enforcing hospital procedures, because bad-faith UNIONs always block best practices?? GMAFB
lol union boogeyman gonn kill u.
You should've told this guy after his father died, that way he wouldn't have to spend months determining a way to fix our healthcare.
Nice to know that we can fix our health care system by (a) eliminating unions and (b) staying lucky.
Surprisingly enough, that's the solution to 99% of the problems conservatives see in the world.
You could certainly reduce concomitant infections and post-operative thrombosis if you eliminated unions and brought in a staff who knew their continued employment was based on merit and competence.
yoni, just quit making up. It's embarrassing to read.
Actually thus far it has proven to be impossible. Hospital borne infections are a problem in every healthcare system in the world.
I think the first step to having an effective American healthcare model is to actually have a model.
What basic model would work best in the US?
Or should we stick with the let's try a little of everything approach?There are about 200 countries on our planet, and each country devises its own set of arrangements for meeting the three basic goals of a health care system: keeping people healthy, treating the sick, and protecting families against financial ruin from medical bills.
But we don't have to study 200 different systems to get a picture of how other countries manage health care. For all the local variations, health care systems tend to follow general patterns. There are four basic systems:
The Beveridge Model
Named after William Beveridge, the daring social reformer who designed Britain's National Health Service. In this system, health care is provided and financed by the government through tax payments, just like the police force or the public library.
Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. In Britain, you never get a doctor bill. These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge.
Countries using the Beveridge plan or variations on it include its birthplace Great Britain, Spain, most of Scandinavia and New Zealand. Hong Kong still has its own Beveridge-style health care, because the populace simply refused to give it up when the Chinese took over that former British colony in 1997. Cuba represents the extreme application of the Beveridge approach; it is probably the world's purest example of total government control.
The Bismarck Model
Named for the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 19th century. Despite its European heritage, this system of providing health care would look fairly familiar to Americans. It uses an insurance system -- the insurers are called "sickness funds" -- usually financed jointly by employers and employees through payroll deduction.
Unlike the U.S. insurance industry, though, Bismarck-type health insurance plans have to cover everybody, and they don't make a profit. Doctors and hospitals tend to be private in Bismarck countries; Japan has more private hospitals than the U.S. Although this is a multi-payer model -- Germany has about 240 different funds -- tight regulation gives government much of the cost-control clout that the single-payer Beveridge Model provides.
The Bismarck model is found in Germany, of course, and France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America.
The National Health Insurance Model
This system has elements of both Beveridge and Bismarck. It uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into. Since there's no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance.
The single payer tends to have considerable market power to negotiate for lower prices; Canada's system, for example, has negotiated such low prices from pharmaceutical companies that Americans have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated.
The classic NHI system is found in Canada, but some newly industrialized countries -- Taiwan and South Korea, for example -- have also adopted the NHI model.
The Out-of-Pocket Model
Only the developed, industrialized countries -- perhaps 40 of the world's 200 countries -- have established health care systems. Most of the nations on the planet are too poor and too disorganized to provide any kind of mass medical care. The basic rule in such countries is that the rich get medical care; the poor stay sick or die.
In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using home-brewed remedies that may or not be effective against disease.
In the poor world, patients can sometimes scratch together enough money to pay a doctor bill; otherwise, they pay in potatoes or goat's milk or child care or whatever else they may have to give. If they have nothing, they don't get medical care.
These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we're Britain or Cuba. For Americans over the age of 65 on Medicare, we're Canada. For working Americans who get insurance on the job, we're Germany.
For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.
The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it's fairer and cheaper, too.
http://www.pbs.org/wgbh/pages/frontl...es/models.html
The “Secret” to International Health Care Cost Control is Always Government Involvement
Either countries directly own the system and pay fixed salaries to doctors, as in the UK; or they are single payer countries where the government is the only insurer paying a set rate for treatments, as in Canada; or the government creates a regulated all-payer system where all insurance companies pay a low fixed price, as in Japan. While the exact mechanisms vary from country to country the simple fact is that every other first world country pays less for health care because their governments regulate the prices. The governments use some system to mandate that people can’t be overcharged for what is seen as a basic necessity.
Yeah, why would anyone call you a hack?
It's not even a ing secret.
The only way to keep costs down in a single-payer health care system is to fix wages and ration the provision of medical care.
In the end, bureaucrats decide on your health care. Not doctors and not you.
I don't see anything wrong with that statement.
Of course you didn't.
on cue:
http://www.nytimes.com/2012/08/07/bu...work.html?_r=1In the summer of 2010, a troubling letter reached the chief ethics officer of the hospital giant HCA, written by a former nurse at one of the company’s hospitals in Florida.
In a follow-up interview, the nurse said a doctor at the Lawnwood Regional Medical Center, in the small coastal city of Fort Pierce, had been performing heart procedures on patients who did not need them, putting their lives at risk.
“It bothered me,” the nurse, C. T. Tomlinson, said in a telephone interview. “I’m a registered nurse. I care about my patients.”
In less than two months, an internal investigation by HCA concluded the nurse was right.
“The allegations related to unnecessary procedures being performed in the cath lab are substantiated,” according to a confidential memo written by a company ethics officer, Stephen Johnson, and reviewed by The New York Times.
Health care is always rationed, one way or another.
Also, I don't see why we can't have a single payor system, and then have private doctors who want to cater to the rich people who want better care, less wait times etc erc
Well, I'd rather have a free market picking winners and losers than the government.
ideological bull
I think the producers who would end up paying for both systems, would have something to say about that.
And, besides, you'd end up right back where you are...with the non-producers demanding the same level of health care the producers are receiving.
No, the only way Obamacare works (and, even then, "works" is a relative term considering the level of care that will be necessary to keep it afloat) is if he can force everyone to use the same system - except for the elite few, of course.
More on the Economics of Single Payer Insurance
The proposed Maryland Health Security Act has put the idea of single payer healthcare back on the table. The Maryland chapter of Physicians for a National Health Care Program has summarized its main features and provides a link to the bill. It proposes to lower health care costs by broadening the pool of the insured, lowering administrative costs, and negotiating for better prices on drugs and medical devices (anyone who has purchased pharmaceuticals outside the US will attest that this make a large difference).
Real News Network has run a series of interviews on this plan. You can view Part 1 for an overview. I thought the second and third segments, on the economics, would be of particular interest to readers. Gerald Friedman of UMass Amherst has done a study of the plan which ascertained that it would produce considerable savings, which he describes in Part 2. Part 3 discusses broader economic ramifications, for instance, that employers in Maryland would enjoy a compe ive advantage relative to other states, and that implementation of the plan would lead to some businesses shifting more of their operations into Maryland, thus increasing the state’s tax base.
http://www.nakedcapitalism.com/2012/...xz73XAGYGES.99
The solution set is not binary. LnGrrrR has made a good point, which I've been trying to make forever. Hybridize the Single Payor model.
Let the Single Payor handle the HMO functions...day to day routine checkups and treatments. The single payor piece will go along way to establishing some serious cost savings as well as increasing the quality of care by simply standardizing the back office processes. Everyone uses the same form. Every form goes into a uniform database. It's a no-brainer.
Then let the insurance companies do what they were designed to do....produce insurance plans that leverage risk across time. Freed of the HMO functions, they should be able to reduce premiums substantially and riding on the standardization from the single payor piece, pick up savings in administrative costs to boot.
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