Let's blame the doctors when we are asked to pay a co-pay and we say we don't have it and front desk wants to add a charge for having to send out a statement. It doesn't matter that we are fully aware that we are supposed to pay it. Let's just get mad. I mean we would never think to go anywhere else and not pay but no matter let's blame the doctors.
Let's blame the doctors when we have to sit in a waiting room full of hacking, nose blowing, throat snorkling patients blowing their fetid breath all over our personal space. How dare he/she take an extra few minutes to answer and comfort the patient in the exam room. Never mind he may be delivering devastating news. Hell! Let's just sit there and moan and groan about having had to sit in the waiting room and the doctor is at least 20 minutes late. Of course he/she had better take the time when our time comes even if it means taking an additional 15 minutes over the alloted time. If he doesn't- well let's blame the doctors for not taking the time to comfort and talk to us.
Let's blame the doctors when we cannot get an appointment for the same day. Even if we do not call and give a 24 hour cancellation notice as requested. Even if we do not bother to call if we are going to be late. Even if we set up a new patient appointment and don't bother to show and an hour of the doctor's time is wasted.
Let's blame the doctors and not the insurance companies for the rising cost of health care. Let's blame the doctors for the copays, the deductibles and out-of-pockets. Let's blame the doctors for not knowing our benefits.
Even though doctors take huge discount on all charges and the write off is ridiculous. Even though he/she may have monumental student loans from college and medical school to pay off. Even though doctors go to school for a very long time, even though doctors are expected to be perfect and not make mistakes, even though insurance companies don't pay them as they should and make their billing office beg for payment of even the most smallest service provided, even though doctors have to take discounts, writeoffs, put up with patients that are abusive,use their services like a free clinic, even though doctors have mortages to pay, rent to pay, staff to pay, benefits to pay, malpractice insurance to pay, even though their hold our very lives in their hands let's just blame the damn doctors!
Wednesday, May 13, 2009
Monday, May 4, 2009
Free Medical Care -Is that the Answer?
The idea of having free health care sounds good actually but is it? Is it a good idea for the government to shoulder the cost of our health care? I mean we pay taxes don’t we? What is the definition of socialized health care? Some say the literal meaning is confined to systems in which the government operates health care facilities and employs health care professionals. According to Wikipedia “The term is often used in the U.S. to evoke negative sentiment toward public control of the health care system by associating it with socialism, which has negative connotations in American political culture. As such its usage is controversial”
Let’s explore how socialized medicine works in another country. Canada's health care is funded and delivered through a publicly-funded health care system, with most services provided by private entities. Under the terms of the Canada Health Act, the publicly funded insurance plans are required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces/territories as to the extent to which such costs as outpatient prescription drugs, physical therapy, long-term care, home care, dental care and even ambulance services are covered.
Considerable attention has been focused on two issues: wait times and health human resources. There is also a debate about the appropriate 'public-private mix' for both financing and delivering services. Canada has a federally sponsored, publicly funded Medicare system, with most services provided by the private sector. Each province may opt out, though none currently do. Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate. Most family doctors receive a fee per visit.
These rates are negotiated between the provincial governments and the province's medical associations, usually on an annual basis. A physician cannot charge a fee for a service that is higher than the negotiated rate — even to patients who are not covered by the publicly funded system — unless the physician opts out of billing the publicly funded system altogether. Pharmaceutical costs are set at a global median by government price controls. Other areas of health care, such as dentistry and optometry, are wholly private.
The various levels of government pay for about 70% of Canadians' health care, although this number has decreased somewhat in recent years. The British North America Act did not give either the federal or provincial governments responsibility for health care, as it was then a minor concern. The Act did give the provinces responsibility for regulating hospitals, and the provinces claimed that their general responsibility for local and private matters encompassed health care.
The federal government felt that the health of the population fell under the Peace, Order, and Good Government part of its responsibilities. This led to several decades of debate over jurisdictions that were not resolved until the 1930s. Eventually the JCPC decided that the administration and delivery of health care was a provincial concern, but that the federal government also had the responsibility of protecting the health and well-being of the population.
Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers. There are also large private entities that can buy priority access to medical services in Canada, such as WCB in BC.
It would seem that we already have in a sense almost the same set up, with a few differences. We have Medicare and we have Medicaid. We have private insurance for those of us who can afford it. Of course we do not have a federal government that feels the health of the population falls under any type of government act or law. Medicare is money given back but paid in by the tax payer and Medicaid is money taken from the tax payers to support those who are not able to afford health insurance on their own, because of a multitude of reasons such as the elderly, disabled, and low-in-come Americans. Medicare coverage consists of two parts. Part A, which is financed largely through Social Security taxes, provides hospitalization insurance. Intended to assist people who need long-term medical treatment, Medicare Part A covers inpatient hospital services, skilled nursing facilities, home health services, and hospice care. Part B, which is financed through premiums paid by those who choose to enroll in the program, provides supplemental insurance to help cover the cost of physician services, outpatient hospital services, and medical equipment and supplies.
Medicaid provides medical assistance to 36 million low-income Americans. It was established through Title XIX of the Social Security Act of 1965 to pay the health care costs for members of society who otherwise could not afford treatment. The program is jointly funded by the federal government and the state governments, but is administered separately by each state within broad federal guidelines. Medicaid recipients include adults, children, and families, as well as elderly, blind, and disabled persons, who have low or no income and receive other forms of public assistance. Medicaid also covers the "medically needy," or those whose income is significantly reduced by large medical expenses. Medicaid covers the full cost of a wide range of medical services, including inpatient and outpatient hospital care, doctor visits, lab tests, X-rays, nursing home and home health care, family planning services, and preventative medicine. A large proportion of the Medicaid population is elderly or disabled, and thus also qualifies for Medicare. In these cases, Medicaid usually pays for Medicare premiums, deductibles, and co-payments, in addition to some non-covered services.
The problem is most insurance is only affordable for those of us who hold jobs, in which the employer pays the greater portion of the premium. Some of us who have pre-existing conditions or major chronic illnesses would not be able to afford insurance unless it is part of an employer benefit package. What about the self employed or the person who works with an employer who does not offer health insurance? What then? Certainly that person does not meet the qualifications of Medicare or Medicaid, and then what does him or she do? Well that person will join others in the system as uninsured. It is not surprising then that the idea of free health care is thus so appealing. But there are downsides to freebies. Here are some to name a few:
There is no incentive to be responsible for one’s health. It’s free I’ll wait until it becomes an issue and then I will go to the doctor who will give me some medicine and make me better.
Doctors and nurses would soon found areas of medicine that are not monopolized by the Federal Government. Then we would have a shortage of health care professionals.
Drug companies would cease to have competition and would soon not have the funds available for research and development of newer and better drugs. Soon only a few pharmaceutical companies would be in business and they would control the drug prices.
Free health care would become not “as good” as that which is paid for with private money and the rich would seek treatment elsewhere. The poor would wait needlessly for and receive substandard care a direct result of a system overburdened and underfunded.
If the government is controlling it then that means the politicians are handling it. And we know how that goes. Soon the lobbyists are pushing bills that benefit the select few who control the pharmaceutical companies and private medical facilities. Now after having said all of that do you really think free medical care is the solution or more of a mess than we already have now. Is there a solution we can all live with?
Information on Canada's Socialized Medical system taken from Wikopedia.
Let’s explore how socialized medicine works in another country. Canada's health care is funded and delivered through a publicly-funded health care system, with most services provided by private entities. Under the terms of the Canada Health Act, the publicly funded insurance plans are required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces/territories as to the extent to which such costs as outpatient prescription drugs, physical therapy, long-term care, home care, dental care and even ambulance services are covered.
Considerable attention has been focused on two issues: wait times and health human resources. There is also a debate about the appropriate 'public-private mix' for both financing and delivering services. Canada has a federally sponsored, publicly funded Medicare system, with most services provided by the private sector. Each province may opt out, though none currently do. Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate. Most family doctors receive a fee per visit.
These rates are negotiated between the provincial governments and the province's medical associations, usually on an annual basis. A physician cannot charge a fee for a service that is higher than the negotiated rate — even to patients who are not covered by the publicly funded system — unless the physician opts out of billing the publicly funded system altogether. Pharmaceutical costs are set at a global median by government price controls. Other areas of health care, such as dentistry and optometry, are wholly private.
The various levels of government pay for about 70% of Canadians' health care, although this number has decreased somewhat in recent years. The British North America Act did not give either the federal or provincial governments responsibility for health care, as it was then a minor concern. The Act did give the provinces responsibility for regulating hospitals, and the provinces claimed that their general responsibility for local and private matters encompassed health care.
The federal government felt that the health of the population fell under the Peace, Order, and Good Government part of its responsibilities. This led to several decades of debate over jurisdictions that were not resolved until the 1930s. Eventually the JCPC decided that the administration and delivery of health care was a provincial concern, but that the federal government also had the responsibility of protecting the health and well-being of the population.
Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers. There are also large private entities that can buy priority access to medical services in Canada, such as WCB in BC.
It would seem that we already have in a sense almost the same set up, with a few differences. We have Medicare and we have Medicaid. We have private insurance for those of us who can afford it. Of course we do not have a federal government that feels the health of the population falls under any type of government act or law. Medicare is money given back but paid in by the tax payer and Medicaid is money taken from the tax payers to support those who are not able to afford health insurance on their own, because of a multitude of reasons such as the elderly, disabled, and low-in-come Americans. Medicare coverage consists of two parts. Part A, which is financed largely through Social Security taxes, provides hospitalization insurance. Intended to assist people who need long-term medical treatment, Medicare Part A covers inpatient hospital services, skilled nursing facilities, home health services, and hospice care. Part B, which is financed through premiums paid by those who choose to enroll in the program, provides supplemental insurance to help cover the cost of physician services, outpatient hospital services, and medical equipment and supplies.
Medicaid provides medical assistance to 36 million low-income Americans. It was established through Title XIX of the Social Security Act of 1965 to pay the health care costs for members of society who otherwise could not afford treatment. The program is jointly funded by the federal government and the state governments, but is administered separately by each state within broad federal guidelines. Medicaid recipients include adults, children, and families, as well as elderly, blind, and disabled persons, who have low or no income and receive other forms of public assistance. Medicaid also covers the "medically needy," or those whose income is significantly reduced by large medical expenses. Medicaid covers the full cost of a wide range of medical services, including inpatient and outpatient hospital care, doctor visits, lab tests, X-rays, nursing home and home health care, family planning services, and preventative medicine. A large proportion of the Medicaid population is elderly or disabled, and thus also qualifies for Medicare. In these cases, Medicaid usually pays for Medicare premiums, deductibles, and co-payments, in addition to some non-covered services.
The problem is most insurance is only affordable for those of us who hold jobs, in which the employer pays the greater portion of the premium. Some of us who have pre-existing conditions or major chronic illnesses would not be able to afford insurance unless it is part of an employer benefit package. What about the self employed or the person who works with an employer who does not offer health insurance? What then? Certainly that person does not meet the qualifications of Medicare or Medicaid, and then what does him or she do? Well that person will join others in the system as uninsured. It is not surprising then that the idea of free health care is thus so appealing. But there are downsides to freebies. Here are some to name a few:
There is no incentive to be responsible for one’s health. It’s free I’ll wait until it becomes an issue and then I will go to the doctor who will give me some medicine and make me better.
Doctors and nurses would soon found areas of medicine that are not monopolized by the Federal Government. Then we would have a shortage of health care professionals.
Drug companies would cease to have competition and would soon not have the funds available for research and development of newer and better drugs. Soon only a few pharmaceutical companies would be in business and they would control the drug prices.
Free health care would become not “as good” as that which is paid for with private money and the rich would seek treatment elsewhere. The poor would wait needlessly for and receive substandard care a direct result of a system overburdened and underfunded.
If the government is controlling it then that means the politicians are handling it. And we know how that goes. Soon the lobbyists are pushing bills that benefit the select few who control the pharmaceutical companies and private medical facilities. Now after having said all of that do you really think free medical care is the solution or more of a mess than we already have now. Is there a solution we can all live with?
Information on Canada's Socialized Medical system taken from Wikopedia.
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