Healthcare

Alaska having a good debate about Single Payer

 
Oddly enough, Republicans use this sort of thing as an excuse to scrap Obamacare and go back to the old system.
 
Raoul said:
Oddly enough, Republicans use this sort of thing as an excuse to scrap Obamacare and go back to the old system.
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Obamacare is terribly flawed because its mainly used by people on lower incomes. The premiums are not competitive and when they do get hit with copays the burden is disproportionate to their incomes. An expansion of Medicaid is the best solution.

langster said:
But that doesn't happen! We have experts with absolute knowledge of the system and who say it doesn't.
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And what exactly do you think happened here?

If the premiums are just for her she has poor insurance, probably Obamacare. Typical premiums for individuals are between $50-$150 per pay check from what I have seen, so $100-$300 a month. Its fairly typical to pay around 10% copay.

Its very common for an ER visit to be billed at $20k. Most insurance companies have negotiated rates that dramatically reduce that billed amount. When I went to ER in 2015 the billed amount was $21k but the negotiated rate was $2,500.

What happened here is she has poor insurance with high premiums and crappy negotiated rates. If her income is low the premiums and copay are a real burden. Which is exactly why Medicaid needs extending to cover the uninsured and Obamacare needs flushing.
 
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Mike Schatner said:
Obamacare is terribly flawed because its mainly used by people on lower incomes. The premiums are not competitive and when they do get hit with copays the burden is disproportionate to their incomes. An expansion of Medicaid is the best solution.



And what exactly do you think happened here?

If the premiums are just for her she has poor insurance, probably Obamacare. Typical premiums for individuals are between $50-$150 per pay check from what I have seen, so $100-$300 a month. Its fairly typical to pay around 10% copay.

Its very common for an ER visit to be billed at $20k. Most insurance companies have negotiated rates that dramatically reduce that billed amount. When I went to ER in 2015 the billed amount was $21k but the negotiated rate was $2,500.

What happened here is she has poor insurance with high premiums and crappy negotiated rates. If her income is low the premiums and copay are a real burden. Which is exactly why Medicaid needs extending to cover the uninsured and Obamacare needs flushing.
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That is scary - I have no idea how I got away with this but back in 1999 I went to NYC for the first time for St Patricks day - got full drunk and ended up knocking myself out by falling on my face - big gash on head. Ambulence took me to hospital - got stiches, etc. and was there for about 4 hours. As I left the hospital somebody asked me to complete a form which I did and put my home address, etc. in it - also a nurse gave me a tetnus injection on the way out. I never received a bill and nothing came of it. Like I said I have no idea how I managed that as I don't think I had insurance or anything.
 
balaks said:
That is scary - I have no idea how I got away with this but back in 1999 I went to NYC for the first time for St Patricks day - got full drunk and ended up knocking myself out by falling on my face - big gash on head. Ambulence took me to hospital - got stiches, etc. and was there for about 4 hours. As I left the hospital somebody asked me to complete a form which I did and put my home address, etc. in it - also a nurse gave me a tetnus injection on the way out. I never received a bill and nothing came of it. Like I said I have no idea how I managed that as I don't think I had insurance or anything.
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ERs in the US have to treat everyone regardless of insurance or income. Their billing departments will nearly always try and recover money if they can though. You may have just slipped through the cracks so to speak.

My aging father had a medical emergency in the US last summer. He had to go to ER and was admitted for a week. My Mum was freaked out by the paper work and having to pay a $600 deposit in the ER. They actually had travel insurance and everything was covered but the experience was a little much for my Mum. She felt a little better when the insurance settled everything and they actually ended up with $1,050 surplus because the policy paid a $150 stipend for each day in hospital.
 
Mike Schatner said:
Common sense prevails.

That is one of the high benefits of social media these days. When you have an issue with a company that you can't get resolved call them out of Twitter, works every time.
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What’s going on CNN got to do with tweeting about it?

Also, she still has to pay for the portion of the surgery that the insurance won’t cover.

Common sense has no place in that.
 
Carolina Red said:
What’s going on CNN got to do with tweeting about it?

Also, she still has to pay for the portion of the surgery that the insurance won’t cover.

Common sense has no place in that.
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I think she started on social media and CNN picked the story up. She might not have a lot to pay depending on her policy. I am with UHC on one of their most popular plans in Florida and my maximum out of pocket is $2,500.
 
I just read up on this case. UHC initially declined the treatment because the medical notes had the wrong diagnoses. She had holes in her liver caused by surgery to remove colon cancer. The poor woman fought cancer, had her liver damaged in the process then clerical errors caused a world of grief. With only 30% of people waiting for a liver actually getting a transplant each year she still has an uncertain future.

UHC actually approved the treatment on May 7th long before CNN were involved.
 
Mike Schatner said:
Life expectancy is impacted by many things, not just healthcare. The US has a lot of diet and obesity issues which impact peoples health significantly.
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Which makes Denmark very worrying. Not that I'll have a word said against bacon, any facts presented on the subject will be fake news as far as I'm concerned.
 
Eboue said:
Diet and obesity issues are healthcare.
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Not as it relates to healthcare expenditure they are not. There are many factors which contribute to life expectancy and to tie expenditure to life expectancy is a visual like that can be somewhat misleading. Someone already eluded to gun deaths in the US but drug related and car deaths are also significantly higher than other countries.

BTW - Love that graph. Spent a good portion of the last decade in reporting and BI and I can appreciate a good visual.
 
Mike Schatner said:
Not as it relates to healthcare expenditure they are not. There are many factors which contribute to life expectancy and to tie expenditure to life expectancy is a visual like that can be somewhat misleading. Someone already eluded to gun deaths in the US but drug related and car deaths are also significantly higher than other countries.

BTW - Love that graph. Spent a good portion of the last decade in reporting and BI and I can appreciate a good visual.
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Yes it is michael. A healthcare system can provide for dietary education, eradication of food deserts, subsidizing fresh produce etc.
 
Mike Schatner said:
Not as it relates to healthcare expenditure they are not. There are many factors which contribute to life expectancy and to tie expenditure to life expectancy is a visual like that can be somewhat misleading. Someone already eluded to gun deaths in the US but drug related and car deaths are also significantly higher than other countries.

BTW - Love that graph. Spent a good portion of the last decade in reporting and BI and I can appreciate a good visual.
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So you agree that diet and obesity are health related issues ?
 
Raoul said:
So you agree that diet and obesity are health related issues ?
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They are health related but not not necessarily healthcare expenditure related. People in the UK don't have a better life expectancy because the NHS gives them dietary education. You struggle to get specialist appointments and service in the NHS these days. Life expectancy is higher in the UK for multiple reasons. For starters the US has far more obesity due to several factors including poor diet and races that are more prone to obesity. National life expectancy statistics are impacted by gun violence, gang violence, car related deaths and drug deaths all being significantly higher in the US.

Its not a simply problem that can be thrown on a graph with expenditure, the two statistics have no real correlation. That aside its been universally known for at least two decades the US spends more than other nations on healthcare and also has worse life expectancy and infant mortality.
 
Eboue said:
This is gonna be good
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The graph you posted has two raw statistics from various countries in a veiled attempt to make a correlation between those two statistics. Although it is somewhat interesting the US spends so much on healthcare but lags behind other nations on things like life expectancy and child mortality the issue is much wider than that.

The US has very different demographics which needs factoring in. Motor vehicle deaths are three times higher in the US, drug related deaths are three times higher, the murder rate is close to five times higher. All of those things impact the overall life expectancy but have little to do with healthcare expenditure.
 
Eboue said:
Yes it is michael. A healthcare system can provide for dietary education, eradication of food deserts, subsidizing fresh produce etc.
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Yup. Tons of patients come through my wife’s ICU because of diet/obesity issues. That’s directly related to healthcare expenditures.

And yes, I made a pun there.
 
Eboue said:
that's nice and all but I want to hear about the differences between the races. Obesity, skull sizes, whether or not they buy sushi at 7-11, etc
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Race definitely plays a huge role in national life expectancy between countries. For instance three of the minority racial groups in the UK have higher life expectancy which bumps the national number up. So race definitely impacts national life expectancy numbers.

Carolina Red said:
Yup. Tons of patients come through my wife’s ICU because of diet/obesity issues. That’s directly related to healthcare expenditures.
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Obesity impacts both statistics, life expectancy and the amount of money spent dealing with obesity related health issues.
 
Carolina Red said:
So... healthcare expenditures
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The original point was the US has different demographics that impact the life expectancy numbers, the main one being higher obesity rates.

Life expectancy and healthcare expenditure are not stats you can throw on one graph for multiple countries. BI and analytics are produced to help make strategic decisions. Based on the graph above the decision would be reducing healthcare spend will increase life expectancy in the US. ;)

Strip out the disparity in vehicular deaths, murder rate, drug related deaths and demographics factors and the life expectancy between the UK and US is very similar. At that point you can compare healthcare expenditure more reliably. It also leads to the bigger question of how the US can improve the national like expectancy for all races.
 
http://www.pressdemocrat.com/news/8350350-181/petaluma-man-suspected-of-aiding?artslide=0

David Clement, 65, said his wife, Debra Bales, 52, of Petaluma, grew determined to kill herself after doctors ended her prescriptions to the opioid medication she had been dependent on for nearly two decades.

“She took the other end of the rope and she jumped,” Clement said to the 911 dispatcher. “She just wanted out of her pain. I couldn’t see abandoning her.”

Clement said he married Bales, a longtime friend, about six years ago to get her onto his health care plan through his work as a grocery store department manager. Bales lived with her mother in Petaluma.


Bales had been mostly bedridden for the last decade and had chronic pain since 1999 or 2000 when she underwent surgery for a hysterectomy, Clement said. She experienced daily bouts of debilitating nausea and constipation that lasted hours. For Bales, the thought of going through detox “was just unimaginable,” he said.

But Clement lost his healthcare — and hers — in October when he was going through his own troubles. He had a manic episode and quit his job, a decision he told detectives was “irrational,” costing him his income, health insurance and apartment. He moved into a homeless shelter in San Rafael.

Without private insurance, Bales visited new doctors who had “a new philosophy” about opioid prescriptions and abruptly declined to renew hers, Clement said. Bales took her last dose about a day before she killed herself, he said.

Bales called him about two weeks before she died and said she wanted to drown in the ocean, he said. But their plan fell through. Clement told detectives they realized they were too far from the ocean to walk to and drown. Bales was too weak to walk far, and they didn’t have a car.

Bales then asked him to pierce her heart with a pair of scissors, he said. They decided he would smother her with a pillow instead.

He bought duct tape at a Bodega Bay store to tape shut her nose and mouth. He said he began to smother her with the pillow as he straddled her on the bed, but he stopped the moment she started struggling. They scrapped that plan and took a break. Clement took a nap while Bales watched movies.

“My conscience wouldn’t let me do it,” he told detectives in the recorded interview.
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and now he is going to be tried for manslaughter. this country is hell
 
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