Is it true that Universal/National HealthCare leads to HealthCare Rationing ?

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Is it true that Universal/National HealthCare leads to HealthCare Rationing ?

liberalprogressivedemocrat's picture
liberalprogress...
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Apr. 20, 2010 7:28 pm

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Every medical system has "rationing". Can't provide more Dr. appointments than you have Dr.'s to take them.

Can't provide more surgeries than you have operating rooms and surgeons.

We ration according to finances...and have a lot of empty hospital beds that probably need to be utilized..

In our financial rationing system...a lot of the beds are empty.

Retired Monk - "Ideology is a disease"

polycarp2
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Jul. 31, 2007 4:01 pm

Polycarp is exactly right.

There was a good article in the NY Times about this issue.

Why We Must Ration Health Care.

reed9's picture
reed9
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Apr. 8, 2010 11:26 am

The BBC had a story about diabetes, and the problems with patients not coming back to the doctor thus increasing amputations and death. This was especially true for people with type 2 diabetes. Then I thought of myself, currently recovering from a pulmonary embolism. My first regular doctor was at the age of 59, when I needed Viagra. At 63, I have a whole new set of doctors, but I still won't wait more than 45 minutes from my appointment time. After 45 minutes I get my deductible refunded and tell the receptionist I'll make a new appointment.

The healthcare reforms will probably make the wait longer, which will eliminate me from demand. I suspect that has alot to do with the diabetes treatment problems in GB, which is infact a way of rationing.

wmstoll's picture
wmstoll
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May. 12, 2010 1:31 pm

Youd probably do better with the Japanese Universal Care system. The documentary on Frontline showed an average waiting time of 5 minutes... in a next day appointment.

Retired Monk - "Ideology is a disease".

polycarp2
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Jul. 31, 2007 4:01 pm

The excessive costs and many varied forms of denials to Health Care is the relevant concern. Countries who provide National / Universal Health Care simply do not allow money / the exchange of money to be their God. These countries morally and ethically are the good shepherds of their people. Taxes are the result of citizens / non-citizens using money. Therefore, when taxes are paid in this country it becomes the sole property of city, state, and federal government. Here, the governments behave as if they have no responsibility or love for the welfare of its people. Medicare and Social Security are not gifts from the government. It is paid by you into a fund. The rules of this fund continually change in the hope of your death, before you can receive your payments. A lump sum or the opportunity to borrow from it is out of the question. Companies and others can borrow this money for a Farthing on the dollar. This issue is too important to be wasted on Crystal Balling or speculation.

GreenMule's picture
GreenMule
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May. 9, 2010 5:30 pm

When the profit motive is taken away and the value of healthcare services is more accurately accounted by outcomes, the "rationing" loses its scary implications and becomes a client centered process of "best care."

Managing the processes of death and dying instead of pretending that heroic measures are "best care" is part of our growing up to the idea that it is not about "staying alive." It is about keeping on as long as it is good, and it is about being honest about the pain and suffering of recovery as well as the passion to stay alive. It is not a choice that can be dictated, and that brings us to the issue of "rationing."

If I am denied a procedure I am ready to endure and have invested my hopes of real life for my future in, I want a review. But, if I am facing an ordeal that will rob me of the time I have left to spend with those I love in some human condition, I want the best advice and not a CYA financial decision from my doctors.

The dreaded "death panels" were client-centered counseling procedures in an area of critical emotional and psychological stress. Helping people face their own mortality and find their own best practice is how rationing ought to be done. But, if we are reduced to bureaucratic impersonalization, who wants to argue for the horribly expensive end of life spending of "heroic measures?"

Send me to hospice and let me be compost.

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DRC
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Jul. 31, 2007 4:01 pm

When my aunt reached the end of life, nothing could be done. Every bodily system/organ just began shutting down...worn out.. Heart, lungs, pancreas, liver, kidneys, adrenal glands, etc. She was pushing 100. The only thing left was hospice. It was extremely beneficial.

Compost is a slow process, DRC. First your body is turned into bacteria poop...and your body will be around in one form or another as long as the universe continues to expand, contract and start the whole process all over again...forever. The first new form is bacteria poop.

Some think i raise a stink in this form. They haven't seen anything yet! Bacteria poop really stinks. I'd probably prefer the form that comes after that.

Retired Monk - "Ideology is a disease"

polycarp2
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Jul. 31, 2007 4:01 pm
Quote liberalprogressivedemocrat:

Is it true that Universal/National HealthCare leads to HealthCare Rationing ?

It can. But it doesn't necessarily.

What occurs is that one government intervention leads to unintended but predictable consequences, to the economically enlightened, which predictably lead to the next government intervention.

First, there is the AMA which restricts the number of doctors who are admitted to medical schools. The restriction of the supply of doctors raises medical costs and the wages of doctors.

Also, there are various regulations which impose restrictions on the ability of medical insurance companies to discriminate against bad risks and also forces them to cover certain bad risk groups. This of course leads to higher insurance premiums.

So, overall medical costs in the States rise over time. More healthy ppl drop out of insuring themselves because the premiums they pay do not reflect their actual risk of poor health. This drives up premiums even higher.

Next, insurance is made compulsory. After this, costs skyrocket. Then the government introduces price controls. Then there are shortages. Then there is rationing. Then there is politicization of illnesses. U get treatment id u have politically correct disease. U die if you have politically incorrect disease.

So, there are still a few interventions to go before you get to rationing.

Austro-Libertarian's picture
Austro-Libertarian
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Apr. 10, 2010 7:31 am

Is it true that Universal/National HealthCare leads to HealthCare Rationing ?--liberalprogress

I think that question is wrongly put when you consider how medicine in America is practiced today, anyway. There's 'universal access' to medical care in America right now if from no where else, the emergency room. And, legally, everyone has always had the right to get the medical treatment needed at the time they present whether they can pay or not. If you don't acknowledge and/or 'adjust' that point, you never will be able to address how you propose to finance it rationally. Otherwise, we'll have exactly what we have now, a system more based on government covering the most costly as the private industry manipulates it for profit--and a few (like my brother's wife) 'falling in the cracks' that face bankruptcy for care that others may be able to get at little to no cost to them--right here in America now....

So, first off, we actually need to shit or get off the pot. Should medicine be universally accessible to all and, if so, how is that to be rationally financed? Or, should medicine only be directly accessible to those that pay what's charged? If that's the case, you need to figure out what to do with those that present to the emergency room expecting treatment of any sorts that don't pay.....

Don't let the trees prevent you from seeing the forest....

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Kerry
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Jul. 31, 2007 4:01 pm

" U get treatment id u have politically correct disease. U die if you have politically incorrect disease."

what is a politically correct disease.

I agree with PC2 we ration health care according to finances.

shalwechat's picture
shalwechat
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Jul. 31, 2007 4:01 pm
Quote shalwechat:

" U get treatment id u have politically correct disease. U die if you have politically incorrect disease."

what is a politically correct disease.

I agree with PC2 we ration health care according to finances.

A few examples:

A politically correct disease would be aids. You will get priority treatment if you have aids. If you smoke and get lung cancer, you should die.

Austro-Libertarian's picture
Austro-Libertarian
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Apr. 10, 2010 7:31 am
Quote Austro-Libertarian:
Quote shalwechat:

" U get treatment id u have politically correct disease. U die if you have politically incorrect disease."

what is a politically correct disease.

I agree with PC2 we ration health care according to finances.

A few examples:

A politically correct disease would be aids. You will get priority treatment if you have aids. If you smoke and get lung cancer, you should die.

Why do you think that? I'm a "to the core" lib and I don't see the difference. Both are horrible ways to die. Where in any private health insurance provider or government policy does it say that AIDS is more morally correct to fight on a patient-by-patient basis than the treatment of terminal lung cancer? The truth is not that it is a matter of morals. It's a matter of money, as usual with these blood suckers. These days, people found to have HIV almost always have a better chance of long term survival (if they take care of themselves) than those diagnosed with lung cancer, whether the cause is smoking, argon gas, or just some genetic anomaly. And several years worth of anti-retroviral drug treatment still costs less than a single lung cancer related surgery that might get the patient at most four or five months of further agony before his (or her) preordained demise.

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drew013
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Jul. 31, 2007 4:01 pm

I was being sarcastic. I don't think anyone derserves to die. But smokers are generally hated. And there is alot non-profit organizations and government funded research into aids. So, when there is eventually government rationing, there will be a politicization of which illnesses recieve preferential treatment, and who will have to wait a long time for treatment and probably die waiting for it.

Austro-Libertarian's picture
Austro-Libertarian
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Apr. 10, 2010 7:31 am

The problem with the concept of 'rationing' is that there is always rationing. The idea that it is government that is doing it (and, not, for instance, the insurance industry--or even medicine, itself) isn't as consistent with the historical evidence in American medicine. While government in the United States does cover for many of the most costly treatments now (most major trauma and burns, most cardiac, stroke, and cancer patients, many pregnancies and childhood illnesses, all prisoners), there is one place where government actually took over the field from private industry--kidney dialysis. And, before government took over, insurance companies were keeping out the elderly and the diabetic with the idea that kidney dialysis would do little good or, in the diabetic issue, be complicated by recurrent infections and the sort. When government took over (now over 30 years ago), and since there was now a 'paying source' for the elderly and the diabetic, they started getting dialyzed and did as well as anyone else.

For those who think that the private industry doesn't 'ration', I would ask what the private industry does to those that don't pay--and is that (of not offering the medicine to those that don't or won't pay), itself, not a form of rationing? Again, we need to prevent the trees from letting us see the forest....

Awhile back, I quoted an article from the Huffington Post from one of the physicians, Dean Ornish, that has had a diet program to improve heart disease just get cleared to be covered by Medicare. A point Dean Ornish made in that article was that the manner of reimbursement directs the method of medical care--and he is absolutely right about that. Now, how to determine the best method of medical care with that will be the challenge--and in today's monetarily top-heavy programs based as much on what's the most profitable as much as anything of most effectiveness (coupled with some people's mind that the most profitable IS always the most effective), if we ever develope a rational system of financing medical care, that's going to be a hard one to differentiate--and statistics can always be manipulated....

Kerry's picture
Kerry
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Jul. 31, 2007 4:01 pm

In a governmental health care system, costs result in and necessitate political decision-making. From what I have heard and read, Congress, i.e., the Republicans, mostly, is allowing the reimbursement rates to doctors under Medicare to be lowered. According to Easter Seals, there could be cutbacks to Medicaid if Congress does not act to provide more funding. Fewer doctors may participate in these programs if payments are decreased.

Canada and Britain are two countries with single-payer systems which have been mentioned as having waiting lists for certain procedures which are not considered to be urgent or life-threatening. A patient can receive the needed service, but may have to be be placed on a waiting list for tests or operations which can be put off for a while without harm to the patient. The health care system in Canada apparently receives a high approval rating in surveys. The system in Britain has its critics regarding substandard care at some hospitals. Some conservative commentators will claim that countries with single-payer have an "unsustainable" health care system. I don't think there is any movement in Canada, Britain, France, or anywhere else to change their systems and become less fair and more expensive, like ours. It would be interesting to hear more of what citizens in other advanced industrialized countries think of their respective health care systems, and what the political discussions have been in recent years on health care.

If we had more physicians in America talking about the need for health care for all citizens, it would have been more difficult for others who are academically unqualified to understand health and medicine to have made their points against univeral coverage.

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Robindell
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Jul. 31, 2007 4:01 pm

From Robindell's post:

....From what I have heard and read, Congress, i.e., the Republicans, mostly, is allowing the reimbursement rates to doctors under Medicare to be lowered. According to Easter Seals, there could be cutbacks to Medicaid if Congress does not act to provide more funding. Fewer doctors may participate in these programs if payments are decreased.

Well, when I was a private practitioner going solo, I didn't get paid much by Medicare and I certainly didn't get paid much by Medicaid at the time (and that was about 25 years ago). You have to watch out for what they are really trying to say. While that does prevent many doctors from taking on those patients in their clinics (and that's through clinics that actually practice in areas like suburbs where they might have a choice on who they treat--I practiced in a rural area and I was going to see those patients one way or the other), because of the legal requirements of ER's and privilege requirements for staff physicians in hospitals, that doesn't mean that there is no access to care. There is. And, the problem is that ER care as a primary care alternative is the most expensive. But, what gets paid in ER is NOT each physician per se--that goes through an ER corporation. I am suspicious that this is just some more smoke screening for government to support the ER's--and corporations. Just like the American financial industries, American medicine seems more geared towards 'paying off corporations' than 'paying off private practitioners'--and doing so more for the stockholders than for the American public. And, I work with ER corporations--with my form of training, it's the best I can do to make money with what I have.

Watch out for how this is 'explained'--and, again, don't let the trees prevent you from seeing the forest....

Canada and Britain are two countries with single-payer systems which have been mentioned as having waiting lists for certain procedures which are not considered to be urgent or life-threatening.

My wife is Canadian so my in-laws are Canadian. I don't know about Austro-Libertarian (who I believe is also Canadian) but my in-laws have already told me that they wouldn't trade their system for the American system ever. Unlike how it has been promoted, they have never been on 'waiting lists' and they are quite satisfied with their health care program. My wife's mother died of cancer years ago. Unlike my brother who with his wife had to worry how to pay for it all, my wife's family just had to worry how to manage their grief. They never got a bill.

Actually, years ago, we were informed that the Canadian health care system was of the 'gate-keeper type'--meaning that primary care physicians through access to specialty consults (when needed) could determine the best course of care for each patient. And, compared to the American system, that system paid their primary care physicians more and their specialists less. However, since many in the United States appear to want to go directly to the specialist they believe that they need, I'm not sure how well that would work here. As I've said, my in-laws don't seem to have a problem with it.....

Kerry's picture
Kerry
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Jul. 31, 2007 4:01 pm
Is it true that Universal/National HealthCare leads to HealthCare Rationing ?

Health care is already rationed under the for-profit system. You get what your carrier says you get and are left to your own devices for things not covered. This is the same as it would be for universal/national health care, so the question's kind of irrelevant as it is true for both situations.

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jeffbiss
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Jul. 31, 2007 4:01 pm

The difference being with universal health care the so-called rationing is spread amongst everyone. Where as the for profit system, those with the most ability to pay get the most.

I think national health care is great. Having experienced both systems, its much better for society as a whole to have an equal system for everyone.

meljomur's picture
meljomur
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Jul. 31, 2007 4:01 pm
Quote meljomur:

The difference being with universal health care the so-called rationing is spread amongst everyone. Where as the for profit system, those with the most ability to pay get the most.

I think national health care is great. Having experienced both systems, its much better for society as a whole to have an equal system for everyone.

You are one of the lucky few who actually know the difference between the American system and the European system. Most Americans are so ignorant that they think their system is superior. It's like a prisoner who is happy getting paid for stamping out license plates.

Providing everyone equal healthcare is a great step in the right direction, but it is only a drop in the bucket. Eventually we need to get to the point where we have an equal food system, and housing, clothing, iPod, university, transportation, etc. They're all rationed right now, just by profit extraction, an immoral way to ration. The moral way to ration is equally among all citizens of the Nation.


Jacques Roux's picture
Jacques Roux
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Jun. 20, 2010 3:33 pm
Quote liberalprogressivedemocrat:

Is it true that Universal/National HealthCare leads to HealthCare Rationing?

No. Next question, please.

kwikfix
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Apr. 9, 2010 1:51 pm

Rationing is just another word for allocation. It's said that the market mechanism, i.e, the [expletive deleted] Invisible Hand, 'calculates' the most efficient possible allocation of finite resources. I'm inclined to believe this doctrine, even though it's not to my liking. That being said, it is necessary to ask 'efficient according to what criteria?' The market is one-dollar-one-vote. Market-based medicine means those with much money and those with little money both get more bang for the buck, but of course those with much money get more medicine. Efficiency is not the be-all and end-all. It's a question of, what kind of world do you want to live in? A world in which people are expendable, while lethal to the economically marginalized, should be unpalatable to all but the most callous, even among people of means.

n8chz's picture
n8chz
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Jul. 31, 2007 4:01 pm

Universal iPods? Want.

monsieurb54's picture
monsieurb54
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Jul. 31, 2007 4:01 pm

Well, now that you are bringing up an old thread, from post #10, I see that I even said this two years ago:

So, first off, we actually need to shit or get off the pot. Should medicine be universally accessible to all and, if so, how is that to be rationally financed? Or, should medicine only be directly accessible to those that pay what's charged? If that's the case, you need to figure out what to do with those that present to the emergency room expecting treatment of any sorts that don't pay.....

Don't let the trees prevent you from seeing the forest....

Kerry's picture
Kerry
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Jul. 31, 2007 4:01 pm

Roux, "Providing everyone equal healthcare is a great step in the right direction, but it is only a drop in the bucket. Eventually we need to get to the point where we have an equal food system, and housing, clothing, iPod, university, transportation, etc. They're all rationed right now, just by profit extraction, an immoral way to ration. The moral way to ration is equally among all citizens of the Nation."

Equal in what way? Red Cross soup kitchens or Delmonico's Steakhouse for everyone? Tents or 30 room mansions for everyone? Goddwill hand-me-downs or Nieman Marcus furs for everyone? Everybody alredy has an iPod... Community college or Harvard or Oxford for everyone? Skateboard or chaffeur driven limos for everyone? Is everyone to have all the luxuries of life or is everyone to live in equal squallor and misery? Utopia doesn't and won't ever exist.

camaroman's picture
camaroman
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May. 9, 2012 11:30 am

Are people ignorant about the rationing that is already practiced by the insurance companies? You'll see rationing if you need some expensive treatment and the insurance company conveniently calls it 'experimental' and won't pay for it. They can stall and if they are lucky, the patient will die. They don't care because they snuck into ERISA that they can't be sued for denying treatment. All they can be forced to do is provide the treatment-so they benefit from stalling and hoping the patient dies.

lovecraft
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May. 8, 2012 12:06 pm

camaroman wrote:Equal in what way? Red Cross soup kitchens or Delmonico's Steakhouse for everyone? Tents or 30 room mansions for everyone? Goddwill hand-me-downs or Nieman Marcus furs for everyone? Everybody alredy has an iPod... Community college or Harvard or Oxford for everyone? Skateboard or chaffeur driven limos for everyone? Is everyone to have all the luxuries of life or is everyone to live in equal squallor and misery? Utopia doesn't and won't ever exist.

poly replies: Probably something more equitable would be dividing the national pie so some get an amount closer to the national productivity.

The U.S. generates $40,000 per year for every man, woman and baby...or $160,000 per year for each family of four.

That wouldn't put everyone in a mansion or put a new Lexus in every garage. It would, however, enable everyone to eat and obtain medical care if the national pie were divided more equally.

Probably asking the min. wage earner to work 120 hours per week to meet the earnings/rent ratios deemed economically viable to meet rent expenses after food, clothing and transportation costs in any county in the U.S. is a bit much.. A basic shelter would be nice....mansion not required.

http://www.census.gov/hhes/www/housing/special-topics/files/who-can-afford.pdf

Probably life-saving surgeries should take precedence over a tummy tuck and the pulling of abcessed teeth should take precedence over a "store bought" smile. Sucn things are "rationed" according to income...not need. The poor man needing a life-saving surgery gets the coffin. The rich one gets his tummy tuck.

A kid in Denver died several years ago from an abcesed tooth. however, dental time was well-spent whitening some teeth .We ration...dole out medical/dental services...according to income rather than the absolute need to sustain life...

Retired Monk - "Ideology is a disease"

polycarp2
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Jul. 31, 2007 4:01 pm

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Should public radio program in the public interest?

NPR is supposed to be our national public radio, but they're barely covering climate issues that are in the public's interest.

Only one month ago, a national New York Times/CBS News poll found that half of all Americans think that global warming is already having a serious impact. Sixty percent of those surveyed even said that protecting our environment should be a priority “even at the risk of curbing economic growth.”

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