DIYbanter - View Single Post - CFLs vs LEDs vs incandescents: round 1,538

Pete C.

wrote:

On Thu, 27 Aug 2009 12:16:13 -0500, "HeyBub"
wrote:

Pete C. wrote:
wrote:

..

Our health care system works well, 86% of our ~350M population has
health insurance and of the remaining 14% a good number have it
available, but choose not to take it.

Or maybe can't afford it.

No, it's been documented that in that uninsured 14% there are a good
number of mostly young and healthy folks who choose to take the gamble
and use the funds that would be their contribution to health insurance
coverage for other purposes. It would be good if those other purposes
were a down payment on a house or something else good, but most of the
time it's for something silly like a new car or ipod. Either way, it's
their life and their right to take that risk.

They end up with poor healthcare
(the emergency room)

So you're saying that the emergency room, the same emergency room that
handles those with health insurance, provides substandard care?

and we all end up paying for their care which is
delivered at a much higher cost than normal care and since they don't
get preventative care, they are less healthy and therfor cost even
more while recieveing less care.

Well, this applies to the portion of that 14% who do not have health
insurance available, difficult to quantify, but perhaps it's 8% or so of
the total population. This is where the system needs refinement, not
reform, to better target preventative care at those 8% who do not have
access to health insurance.

That is the way compition has worked in this non-free,
non-competitive market.

...

You make some good points. I would argue for LESSER controls on insurance
companies - let the market decide.

As it is now, individual states mandate all manner of restrictions on
insurance companies....

I would agree that current regulations need major revisions.

I would like to take the profit motive out of the system as
much as possible.

For example no doctor should recieve any benefit from sending
a paticent for a test, or procedure. They should be isolated from the
profit of MRI's and perscriptions etc.

As an example: I have a back problem. When it comes up I need
help now.

In the US I end up in the emergency room. There they start
with my insurance card, I see three or for people, all taking
information over the first 20 minutes or so that I am there. I
finally see the doctor and each time, the send me to get one of those
fancy X-ray test that cost a ton. Each time I am taking up a room in
the emergency area of the hospital. Each time they come back with the
same conclusion, and prescribe several perscriptions.

In the UK I get to the emergency room, talk to the lady behind
the desk and I am asked to wait. I was infromed that they knew what
the problem was, but they needed to find a doctor free to write the
prescription. Doctor came we talked while he examined me and within
15 minutes of arriving, I was on a stretcher in the hallway waiting
for the drugs to take effect. I was out of there in less time than it
took to finish the text in the US. Yea, I did not have a private
room, and I was not on an IV and I did not get more X-rays and I had
no bill to pay, nor did they even care that myUS insurance covered me
there.

Let's see, US more time more test and more cost to me and my
insurance company vs faster care, less X-Ray exposure and less than
thirty minutes total vs two to three hourse in the US.

Why in the world would you want the public medical service
when you can get much more expensive care in the US. Of course I can
see where a lot of our commerical medical industry might want to keep
things as they are.

You bring up two basic issues he

The first is the efficiency of records access in the UK public health
system, vs. the US. In the US, unless you are going to see your regular
doctor, the people treating you won't know didly about your past medical
history. This is one of the reasons for the longer wait time and
additional test.

They have been trying to streamline medical records in the US, but keep
running into the privacy issue (we have more privacy rights in the US
generally). I think they will eventually settle on some form of
standardized medical ID card to keep in your wallet with a chip
containing your records.

A standardized chip card with records would ensure they are in your
custody, not some central server subject to hacking, and can be provided
to any medical personnel treating you for the duration needed. In the
case you don't have the card with you, it's no worse than it is today,
so no disaster, just a bit less efficiency.

The second issue is that doctors in the US are currently incentivised to
order extra tests for a number of reasons. They get additional payment
for ordering those tests, and with insurance companies paying rather
low, they try to get as much as they can by ordering more tests. The
next incentive for extra tests is for protection from the insanely
litigious US population, who will sue for the tiniest error and those
extra tests help to cover the doctors posterior. And of course the third
reason for those extra tests was covered above, lack of access to
previous medical records which leads to redundant testing.

Again, all this points to a need to refine the US system, not "reform"
it by ripping it out and starting over.