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| So you think universal health care is good for America huh?
Posted: 7/6/2008 6:45:35 PM | Stephano writes:
It's easy to say, hey, let's get rid of the evil insurance companies, screw the middleman.... if you dont work for an insurance company, at least... but that's someone having a bright idea and saying screw those folks who insured our lives and paid our hospital bills for the past 50 years or so, we dont need you now, so.....get lost!
By and far, virtually every one of those people are directly involved in, or very aware that their employer makes its money via murder by spreadsheet:
Health Insurer to Be Charged With Teen's Murder
Dec. 21, 2007
The family of a California teenager who died awaiting a liver transplant said they would sue the insurer whom they blame for their daughter's death.
Nataline Sarkisyan, a 17-year-old from Glendale, Calif., died Thursday just a few hours after her insurer, Cigna HealthCare, approved a procedure it had previously described as "too experimental."
Attorney Mark Geragos said that Cigna "maliciously killed her" and that he hopes to press murder or manslaughter charges against Cigna HealthCare for the death of Sarkisyan....
"They took my daughter away from me," said Nataline's father, Krikor, who appeared at a news conference with his 21-year-old son, Bedros.
Cigna appears to have reversed its decision to deny the transplant after about 150 teenagers and nurses protested outside its Glendale office Thursday. "Protestors are here, the war is here," Hilda Sarkisyan, the girl's mother, told the group hours before her daughter's death. "We have a war here."
The Sarkisyan family claims that Cigna first agreed to the liver transplant surgery and had secured a match weeks ago. After the teen, who was battling leukemia, received a bone marrow transplant from her brother, however, she suffered a lung infection, and the insurer backed away from what it felt had become too risky a procedure.
"They're the ones who caused this. They're the one that told us to go there, and they would pay for the transplant," Hilda Sarkisyan said.
Geri Jenkins of the California Nurses Association said the Sarkisyans had insurance, and medical providers felt comfortable performing the medical procedure. In that situation, the the insurer should defer to medical experts, she said.
"They have insurance, and there's no reason that the doctors' judgment should be overrided by a bean counter sitting there in an insurance office," Jenkins said.
Doctors at the UCLA Medical Center actually signed a letter urging Cigna to review its decision. Nataline Sarkisyan was sedated into a coma to stabilize her as the family filed appeals in the case.
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| So you think universal health care is good for America huh?
Posted: 7/7/2008 7:04:44 AM | The Natalie case brings up large ethical considerations.
The first is how many procedures are you going to perform on an end stage cancer patient who has little or no chance of survival.
The second is, in a health care system with finite dollars, how much money should you spend on an end stage cancer patient, when the money (and organ in some cases) could be better used on someone else?
The facts of the situation were that Natalie was in a coma and in multiple organ failure. Had she been my relative, I wouldn't put her through more pain and suffering. I'm in the unenviable position to know what I would have done given I've been put in this position several times, including with both of my husbands.
I doubt that any country with universal health care would have given a comotose patient a transplant. She certainly would not have had a transplant in Canada.
Regardless of money, I think CIGNA made the proper decision and shouldn't have reversed its decision (which not made in time anyway). | |
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| So you think universal health care is good for America huh?
Posted: 7/7/2008 11:19:37 AM | flyonthewall, I see your points, but apparantly the coma was induced while they waited, she wasnt comatose directly due to the condition.
I dont know the hospital's or the family's circumstances or what I would have done were it my daughter. I dont know the prognosis, either, did the hospital being "comfortable" doing the op mean a good prognosis or ........? If the prognosis was good, I'd have tried to strike a deal with the hospital, mortgage my home, etc. to save her .........
Doesnt the hospital have any liability in this case? Could she have gone on public insurance?
lots of questions. | |
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| So you think universal health care is good for America huh?
Posted: 7/7/2008 11:28:59 AM | I think any time these private health insurance slimebuckets kill someone through denial of care, their CEO's and top bananas should be tried for murder. It's murder to kill someone in the name of the almighty dollar!! | |
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| So you think universal health care is good for America huh?
Posted: 7/7/2008 12:30:25 PM | Stefano --
A lot of details of this case aren't known because there is ongoing litigation. None of the parties are willing or able to talk about it.
However, UCLA regularly does transplants without payment, and in any event, certainly would have done one without insurance. There is an interesting article in Forbes Magazine about this:
http://www.forbes.com/2008/01/08/sarkisyan-cancer-insurance-biz-healthcare-cz_dw_0107cigna.html
Further, Cigna had NOTHING to do with the denial of service. It agreed to pay for the transplant out of corporate funds, because the plan the employer selected specifically excluded transplants. If you buy a policy that excludes various illnesses, then you can't be upset when that policy won't reimburse you if you happen to get that illness or need the specified treatment.
One comment to the article, mentioned this:
There are some important fact left out of this article as well as the news story. The plan this patient's father had with his employer was an ASO plan, also known as self funded. That means that the company he worked for funded a bank account for CIGNA to pay claims from, and they made the selection of which benefits to cover and which to exclude. Transplants were excluded under this plan. In the end CIGNA is not the one who made the decision to agree to pay for the transplant. The father's employer did. The insurance company can't release this information due to HIPAA regulations. Do the research for yourself, and place the blame where it belongs.
The fact remains that regardless of how insurance is administered: whether it's through a single-payer plan, a group health plan, whether it's public or private -- there will be limits on the coverage in order to maintain the viability of the program.
If you're reading the papers at all at the moment, you realize that our Medicare/Medicaid program is collapsing before our eyes, with a recent reduction in physician payments of over 10 percent. Doctors are closing their offices to Medicare patients, refusing to take on new patients, and older people are suffering. Every country that participated in World War II has a booming population of aging individuals, and not enough younger generation to support services to them. Such is the problem with our Medicare and Social Security programs.
Regardless of how insurance is administered, there will be haves and have nots in health care. We may have money to provide basic health services to an entire population, but we do not have money to provide every conceivable benefit: transplants, cancer treatments, heart surgery, etc.
In all countries with universal care, it is provided for all by limiting the services and making patients wait for needed treatments. People above certain ages, or in poor enough condition just don't get treatment other than palliative care. It's a fact of life.
Canada is being choked by its health care costs, and politicians increase and decrease taxes for the Medicare program depending on the political winds -- just like we do here. In the UK, around 11 percent of the population gets private health insurance, and those who can't afford it get what is pretty substandard care. (I have a lot of friends in the UK)
In fact, in most universal care countries, private insurance is allowed, and bought by the wealthy -- not for elective procedures like plastic surgery, or private rooms, but for essential services that they could get through UHC. Additionally, many extremely wealthy people don't bother with insurance at all. It is cheaper for them to "self-insure" and save themselves the administrative paperwork.
At a time when the US is moving towards a new standard of private hospital rooms (which greatly reduce the infection rate), in many countries (including Canda) the standard of care is a ward room with 4 patients. Investments in other things suffer too. There is less in the way of advanced diagnostic equipment or even things that we take for granted like MRIs and CT scans. This is why the waiting lists for an MRI in Canada are so long -- they are perhaps the worst equipped of all UHC countries.
The majority of those Americans who want UHC aren't willing to accept a lesser standard of care, like their foreign counterparts. They want Cadillac services. We can't even provide them to our existing Medicare and Medicaid patients. What makes you think we can provide what we are not able to provide to a proportion of our population to everyone? | |
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| So you think universal health care is good for America huh?
Posted: 7/7/2008 5:55:25 PM | The thing with socialized medicine is that you will get treatment, the system is not as we think it is. Sure, it has problems. However, their problems are not people dying in the waiting rooms because they can't get care. Most of the countries in the world have socialized medicine, some of the systems are better than others. If socialized medicine is so bad, why is it that the highest ranked medical systems in the world are at the top of the list while we're down at the bottom of the list.
Sure, we have great doctors, great treatments, and great drugs. Only problem is no one can afford it. | |
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| So you think universal health care is good for America huh?
Posted: 7/7/2008 9:23:22 PM | flyonthewell, I had guessed there was more to the story than was told.
As far as the rest of your post, I am jjust not interested in responding. You seem to be very much invested in the American system as it is and seem to think very little of Canada's. So, Hi, Ho, Silver! Be that Lone Ranger........
I have never suggested we imitate Canada, anyway, just that we move to a single payer system and do much more preventive care. | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 7:48:06 AM | ^ ^ ^ ^ Yeah, there is much more to the story. FWIW, the girl was NOT in an induced coma. The coma was the result of the organ failure. Further, the immunosuppressive drugs she would have had to take after a liver transplant are contraindicated for a person who had leukemia. If you are more interested in thsi story the most comprehensive overview I've seen is here:
http://www.psychiatricadministrators.org/journal/Archive/NewsJournalVol8Issue1.pdf
See page 5.
I do think little of Canada's system because it offers no improvements over ours, nor do other universal health care systems. I think that offering affordable group programs to individuals who do not qualify is the best option -- whether it's through the federal employee program, a state program, or even allowing people to buy into Medicare (for those who are gluttons for punishment, and want to deal with having a hassle finding a doctor).
What I don't want to see is ANY KIND of single payer system where the federal government plays political football with my health care plan -- either by underfunding it (like Medicare), raiding the coffers (like Social Security), or making arbitrary decisions about the treatments I need -- without any ability on my part to buy DIFFERENT insurance or even pay for those treatments out-of-pocket (as in Canada).
However, their problems are not people dying in the waiting rooms because they can't get care.
See my post 213 in this thread. People dying in waiting rooms is WAY more prevalent in our "single payer system" neighbor to the North, than it is in the United States. When your system is stressed to the max, and individuals cannot find private doctors, ERs get overwhelmed. I provided many links to news articles about patients dying in waiting rooms up in Canada. It shouldn't happen anywhere, but it happens up there way more than it does down here -- and I'm NOT talking per capita (hint: Canada has 1/10 the population of the US). | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 8:15:54 AM |
I do think little of Canada's system because it offers no improvements over ours, nor do other universal health care systems.
This is patently false and has been disproven repeatedly. EVERY credible medical expert has declared the American system has failed. Keeping the current system is not on the table that alone indicates that any of the systems offers improvements, there may be trade offs by all offer improvements.
I think that offering affordable group programs to individuals who do not qualify is the best option -- whether it's through the federal employee program, a state program, or even allowing people to buy into Medicare Gee this sounds familiar I remember another former lobbiest with strong ties to the Pharmacutical and insurance industries liking this idea too. Course both of those are exactly where the problem is caused and who would lose the most if universal healthcare was finally adopted here. Not doctors, nurses, hospitals, salaries etc only the Pharma Medical industrials, and Insurance industries who are of course the only real holdouts.
See my post 213 in this thread. People dying in waiting rooms is WAY more prevalent in our "single payer system" neighbor to the North, than it is in the United States.
Actually no its not. It's just underreported in the US. More often then not those who have been dying here in the states are those without insurance and more often then not the extremely poor and not uncommonly the homeless. | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 9:10:18 AM | I am currently getting MassHealth and really like the public health care plan with its comprehensive coverage and very low copayments. Quite frankly, I wish I had the CHOICE to opt out of private insurance and buy into this excellent coverage that gives me a CHOICE of doctors--when I had private coverage, I could not choose the doctor I wanted to use. With this government health care plan I now enjoy, I HAVE a choice and have no issues with fighting for approval. Also if I call with questions I don't have to wait for very long to get an answer. I wish I could buy into this plan once I get back to work fulltime, and KEEP this coverage. It is WAY better than any private plan I've ever had. People should be able to buy into MassHealth or Medicaid and keep the programs fully funded. Even RICH people should be able to buy this kind of coverage, which can avoid medical bankruptcy and pay for itself with the comprehensive nature of this coverage--I can even get glasses at select locations! Try getting that from Blue Cross  Buying into Medicaid would assure full funding and coverage for everyone. I would be MORE than happy to pay a high premium for the low copayments and excellent access to care. At least Obama is considering allowing people to buy into government provided care. I for one don't want any part of private insurance--it's a fracking rip off and NOT WORTH IT!! | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 9:18:23 AM | Picking a single example to justify a cause is nonsense. Who hasn't made mistakes in their lives? Quite a few have made mistakes which killed people (Car accidents come quickly to mind). You can't personalize the issue then turn around and suggest it points to good national policy. There is no end to this downward spiral. Ultimately, you could argue that everyone who dies has a lawsuit against those who let it happen.
A part of national healthcare in Britain is to limit treatment of the elderly. Presumably, the rationale is that they are on their way out anyway, or aren't as economically productive for the country. Is this any less wacky than the desperate battles (and lawsuits) to keep anyone with the remotest spark of life alive at any cost?
How many people could be kept alive and maintained as healthy, productive individuals for the cost of keeping a single, dying person alive for a little while longer? We're happy to destroy the environment, slaughter animals to extinction, yet EVERY human life must be sustained at any cost. Maybe we have a problem with our values and attitudes to life?
Interesting that no-one seems to have looked at the question of good health as an important economic issue. Keeping a healthy, productive workforce would seem to be an important national goal. Is private enterprise capable of meeting that goal without government intervention? | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 9:23:32 AM | flyonthewall, I hear you loud and clear with not wanting the federal government to play political football with our health plans or raiding it like Social Security or impeding you and I from buying additional coverage. Those certainly are valid issues, particularly when if there is a surplus of funds and they "borrow" a few billion to fund some covert operation in which they hope to incite the next war or something... that would not make me happy.
You did give me the nod to opening up Medicare to the general public in the marketplace. Would if Medicare could be opened up, was able to raise its rates to providers because of all the new premiums being paid into it by the general public, could be offered with very good benefits at a very reasonable premium rate, be seamless in that one could have it from day one working at a job paid by the employer throughout life with Social Security kicking in to pay it as a senior, and maybe a heavy player as the government branded insurance plan but offered in the marketplace along with private ones...........would you feel better?
As Ive indicated earlier, I think that is what will happen.
As far as the rates paid by Medicare and Medicaid, it is wrong when these are cut because they only respond to increases in the cost of care so paying less to providers when the costs are greater is a good way to sabotage the program, but then if we werent being such a superpower and giving half the federal budget to the Pentagon..... | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 10:17:31 AM | I don't care if other people want to opt into Medicare, as long as it's not the only game in town. However, you said that you are interested in a single payer system. A single payer system only allows the government to fund a single insurance payor that it oversees. It is illegal in such systems for people to buy insurance for services that are covered by the single payor system.
So, for example, if you need a heart bypass and the waiting list is 8 months for your "level" of seriousness, you would not be able to 1) buy private insurance for that service, or 2) pay a doctor in-country out of pocket for that service. You could go to a foreign country and pay out-of-pocket, but then people in the US can do that too.
What a single payor system does is take the money that is available for health care, and spread it over the people who need health coverage. If the system doesn't have enough money then hospitals close, equipment becomes old, new technology isn't available, and doctor shortages occur.
If Medicare is opened up, it will be a can of worms. People interested in paying into the system won't want to pay more than seniors pay now. What would be the point if they had to pay as much as they are paying for their current private insurance? Reimbursement rates, even before this recent 10.6 percent cut were still below what physicians get from private insurance companies. People who want to cast their fortunes with government run programs, are just going to have to suffer the consequences. I feel sorry enough for people who HAVE to be on Medicare, but if you elect it I have no sympathy.
but then if we werent being such a superpower and giving half the federal budget to the Pentagon.....
Apparently you have never looked at the US budget. Here's a link to a pie chart:
http://upload.wikimedia.org/wikipedia/en/b/bc/Fy2007spendingbycategory.png
Entitlement programs and mandatory spending programs cost over half of the US budget. The combination of Social Security, Medicare, Medicaid, Schip, unemployment and interest on the national debt is just about 65 percent of the budget. Military spending was 15.1 percent in the year 2007. | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 11:44:28 AM | flyonthewall ...well, I am not an expert in this stuff, to be honest, but I trust Alan Sager, who is a strong advocate of the single payor system and maybe if you Googled him he'd have better answers for you than me.
I dont think we have to take anything off the shelf of anyone else's. I think there are enough smart people out there who know already what works and what doesnt work.
We are ripe for changes, we have to. We cant sustain the kind of cost increases we've had. Why not take from the best and create something new and uniquely American? | |
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| So you think universal health care is good for America huh?
Posted: 7/8/2008 12:35:13 PM |
Entitlement programs and mandatory spending programs cost over half of the US budget. The combination of Social Security, Medicare, Medicaid, Schip, unemployment and interest on the national debt is just about 65 percent of the budget. Military spending was 15.1 percent in the year 2007.
I noticed you included interest on the national dept (8% or 9% depending on whose pie chart you look at) in with other social spending. I wonder if that 15% Military spending does includes dept owned to retired service personal or the "war on terror" spending. Also, the government puts it at 20%. Truth be told, I looked at lots of pie charts and don't think I found two that matched.
This one seemed to be closest, average-wise, for all the charts I looked at and seemed to be the closest to the one provided by the US Government:
http://en.wikipedia.org/wiki/Image:U.S._Federal_Spending_-_FY_2007.png | |
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