What a Texas town can teach us about health care

[Winstonm]

I do not know what is covered(rationed) and what is not covered under the Denmark plan

 

Unfortunately, I can tell you how health-care is rationed in the U.S. It is much like the rationing of justice - it is reserved only to those wealthy enough to be able to afford it.

 

 

The health care industry in Canada is, from both financial and cultural perspectives, huge. The amount of money spent every year in Canada on health care takes up a significant and growing percentage of public spending

 

The U.S. spends more than the rest of the world combined on defense spending - there is negative economic reward for military Keynesianism after the first few years of defense spending. Dissolve empire and universal health-care becomes easily affordable.

[Lobowolf]

Unfortunately, I can tell you how health-care is rationed in the U.S. It is much like the rationing of justice - it is reserved only to those wealthy enough to be able to afford it.

Wealth much more typically helps people avoid justice, not get it. The vast majority of criminal defendants did what they're believed to have done.

[mike777]

I do not know if my suggested plan is best but I do claim it will be the fastest.

 

On Monday the Congress will announce that starting July 4th 2009 everyone is covered under medicare. You do not need to fill out any forms to be accepted.

 

 

http://www.medicare.gov/

 

 

Summary of Medicare benefits, rights and protections, and answers to the most frequently asked questions about Medicare. (128 pages)

 

 

http://www.medicare.gov/Library/PDFNavigat...Pub&PubID=10050

[helene_t]

In any case there will be an ongoing and never ending political debate on the definition of what basic health care coverage means. I expect massive numbers of special interest groups to spring up and lobby and contribute money to our politicians for their favorite definition.

Yeah, this is kinda true.

 

Not sure how to avoid it, though.

 

For instance I have read media reports that say the top tax bracket in Denmark is 60% and the VAT is 25% but I do not know if this is accurate.

True as well but since Danish tax finance the health care system, you should compare those figures to tax plus basic health insurance in other countries. In the Netherlands I paid less tax but was forced to buy a particular health insurance, so that was just tax with another name. Here in UK an NHS contribution is deducted from my salary, conveniently it isn't called tax.

 

Even so, the Danish taxes are quite high, but the health care system is cheap, and especially the administrative overhead is small compared to countries where health care is financed by insurance companies.

[blackshoe]

If the government takes your money, and that taking is not a direct payment for a specific service rendered, it's a tax. If the government requires that you spend your money on some particular thing, it's a tax. Most taxes, whether or not they're called taxes, ought to be eliminated.

[PassedOut]

Most taxes, whether or not they're called taxes, ought to be eliminated.

Wouldn't it be prudent first to eliminate unwarranted expenditures?

[blackshoe]

First, or concurrently, sure.

[PassedOut]

According to Politico, the US congress looks likely to pass a bipartisan health reform bill this year: Barack Obama's health plan takes shape.

 

POLITICO (Washington) -- If Congress were to take a vote on a health reform bill today, Democrats and Republicans would find a surprising level of agreement — so much so that the broad outlines of a consensus plan already are taking shape.

 

Sick or healthy, rich or poor, all Americans would be guaranteed access to health insurance.

 

In fact, they'd probably be required to purchase it — perhaps through mandates in the law that would include stiff tax penalties for anyone who tried to opt out.

 

Newly created insurance marketplaces would make finding a plan as easy as shopping for cheap airfare. People could keep their coverage, even if they switched jobs. And they might be able to choose between private insurers and a government-backed plan.

 

But here's the catch — none of this would come free, with the wealthiest Americans likely to face higher taxes to help pay for coverage for all.

Getting the insurance coverage issues straightened out will address one part of the problem. It might be tougher to establish cost-effective, high-quality care everywhere.

[luke warm]

philosophically, would you be opposed to mandates at the federal level?

[PassedOut]

philosophically, would you be opposed to mandates at the federal level?

I don't have an overarching philosophical position on that. Guess it depends on the specific mandates, the objectives of the mandates, the alternatives to the mandates, and how well the mandates solve the problems we face.

[Winstonm]

I predict that the health-care debate will mimic the global warming debate in that there will be all sorts of distortions of truth based on agenda.

[Lobowolf]

I predict that the health-care debate will mimic the global warming debate in that there will be all sorts of distortions of truth based on agenda.

Way to go out on that limb, Winston!

[helene_t]

In Denmark, at least when I was young, lots of people had a strong ideological preference for government-paid health care, even to the point of arguing that private clinics (not paid by the government) were anti-social because they remove the upper class' motive to support good general health care. I never understood that kind of reasoning. An ideological preference for private health care is just as alien to me. IMHO the only thing that should matter is that patients/taxpayers get the best possible value for money.

[onoway]

I got this in my email...not sure exactly how this works in Canada, but much the same, I would think. Also many pharmacies here charge anywhere from $7 up just to count pills from a big bottle and put them into a little bottle. It isn't as though they are making any of these things.

Another question which is totally aside from anything below, is how many drugs have major side effects which cause different and further problems...such as Celebrex helping with arthritis pain but vastly increasing the chances of a heart attack. Not exactly cost effective therapy in my book.

Anyway, I thought this was interesting. I haven't edited it. And I haven't checked to see if the person named actually exists :( Quote:

 

Make sure you read all the way past the list of the drugs.The woman that signed below is a Budget Analyst out of federal Washington, DC offices.

 

Did you ever wonder how much it costs a drug company for the active ingredient in prescription medications? Some people think it must cost a lot, since many drugs sell for more than $2.00 per tablet. We did a search of offshore chemical synthesizers that supply the active ingredients found in drugs approved by the FDA. As we have revealed in past issues of Life Extension a significant percentage of drugs sold in the United States contain active ingredients made in other countries. In our independent investigation of how much profit drug companies really make, we obtained the actual price of active ingredients used in some of the most popular drugs sold in America.

 

 

 

Celebrex:100 mg

Consumer price (100 tablets): $130.27

Cost of general active ingredients: $0.60

Percent markup: 21,712%

 

 

Claritin:10 mg

Consumer Price (100 tablets): $215.17

Cost of general active ingredients: $0.71

Percent markup: 30,306%

 

 

Keflex:250 mg

Consumer Price (100 tablets): $157.39

Cost of general active ingredients: $1.88

Percent markup: 8,372%

 

 

Lipitor:20 mg

Consumer Price (100 tablets): $272.37

Cost of general active ingredients: $5.80

Percent markup: 4,696%

 

 

Norvasc:10 mg

Consumer price (100 tablets): $188.29

Cost of general active ingredients: $0.14

Percent markup: 134,493%

 

 

Paxil:20 mg

Consumer price (100 tablets): $220.27

Cost of general active ingredients: $7.60

Percent markup: 2,898%

 

 

Prevacid:30 mg

Consumer price (100 tablets): $44.77

Cost of general active ingredients: $1.01

Percent markup: 34,136%

 

 

Prilosec: 20 mg

Consumer price (100 tablets): $360.97

Cost of general active ingredients $0.52

Percent markup: 69,417%

 

 

Prozac:20 mg

Consumer price (100 tablets) : $247.47

Cost of general active ingredients: $0.11

Percent markup: 224,973%

 

 

Tenormin:50 mg

Consumer price (100 tablets): $104.47

Cost of general active ingredients: $0.13

Percent markup: 80,362%

 

 

Vasotec:10 mg

Consumer price (100 tablets): $102.37

Cost of general active ingredients: $0.20

Percent markup: 51,185%

 

 

Xanax:1 mg

Consumer price (100 tablets) : $136.79

Cost of general active ingredients: $0.024

Percent markup: 569,958%

 

 

Zestril:20 mg

Consumer price (100 tablets) $89.89

Cost of general active ingredients $3.20

Percent markup: 2,809%

 

 

Zithromax:600 mg

Consumer price (100 tablets): $1,482.19

Cost of general active ingredients: $18.78

Percent markup: 7,892%

 

 

Zocor:40 mg

Consumer price (100 tablets): $350.27

Cost of general active ingredients: $8.63

Percent markup: 4,059%

 

Zoloft:50 mg

Consumer price: $206.87

Cost of general active ingredients: $1.75

Percent markup: 11,821%

 

 

Since the cost of prescription drugs is so outrageous, I thought everyone should know about this.�

It pays to shop around! This helps to solve the mystery as to why they can afford to put a Walgreen's on every corner. On Monday night, Steve Wilson, an investigative reporter for Channel 7 News in� Detroit �, did a story on generic drug prices gouging by pharmacies. He found in his investigation that some of these generic drugs were marked up as much as 3,000% or more. So often we blame the drug companies for the high cost of drugs, and usually rightfully so. But in this case, the fault clearly lies with the pharmacies themselves. For example if you had to buy a prescription drug, and bought the name brand, you might pay $100 for 100 pills.

The pharmacist might tell you that if you get the generic equivalent, they would only cost $80, making you think you are saving $20. What the pharmacist is not telling you is that those 100 generic pills may have only cost him $10!

 

At the end of the report, one of the anchors asked Mr. Wilson whether or not there were any pharmacies that did not adhere to this practice, and he said that Costco consistently charged little over their cost for the generic drugs.

 

 

I went to the Costco site, where you can look up any drug, and get its online price. It says that the in-store prices are consistent with the online prices. I was appalled. Just to give you one example from my own experience I had to use the drug Compazine which helps prevent nausea in chemo patients.

 

I used the generic equivalent, which cost $54.99 for 60 pills at CVS. I checked the price at Costco, and I could have bought 100 pills for $19.89. For 145 of my pain pills, I paid $72.57. I could have got 150 at Costco for $28.08.

 

I would like to mention, that although Costco is a 'membership' type store, you do NOT have to be a member to buy prescriptions there as it is a federally regulated substance. You just tell them at the door that you wish to use the pharmacy, and they will let you in.

 

I am asking each of you to please help me by copying this letter, and passing it into your own e-mail, and send it to everyone you know with an e-mail address.

 

Sharon L. Davis

Budget�Analyst

U.S. �Department of Commerce

Room 6839

Office Ph: �202-48...

Office Fax: 202-482-5480

E-mail Address:sdavis@doc.gov

(end of quote)

[blackshoe]

I smell a rat. For one thing, this "analyst" doesn't take into account the cost of R&D. How else are the drug companies to recoup those costs?

[mike777]

I always wondered how a bridge pro like hamman makes so much money playing bridge. I checked and bridge cards cost only a buck or two. The mark up is huge.

 

btw the UK health care plan simply will not pay for drugs that are not cost effective.

If a cancer drug in general only increases a life span for a few years and costs too much, payment is refused. One solution may be to have the government take over the pharmaceutical industry and fix this problem.

[mike777]

I smell a rat. For one thing, this "analyst" doesn't take into account the cost of R&D. How else are the drug companies to recoup those costs?

Well another cost is the fact that many of these companies are for profit companies and investors who put money into these companies demand not only their money back but more...lots more. As Winston pointed out this is a constant problem in trying to run health care.

 

"At which point we reach the Canadian model, which I understand works quite nicely.

 

Personally, I think it is both ludicrous and ridiculous to discuss heath-care within a structure based on capitalism - capitalism is antipathy to health-care. The idea of capitalism is to allocate resources to the most profitable areas - hence, when we find capitalism mixed with health-care we find what we should expect, and that is resources allocated to preventative medicine and the young and healthy.

 

If you are one who is most in need of help - the sick and the elderly - good luck, because the Invisible Hand of capitalism is going to shoot you the finger. "

 

 

If we go to a health care system where we stop trying to recoup all costs that may change things around. That is why a health care plan where we do not worry about how much it costs or where the money comes from is so powerful.

[y66]

Update: From Atul Gawande's May 11, 2015 New Yorker article titled Overkill. An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?:

 

The medical system had done what it so often does: performed tests, unnecessarily, to reveal problems that aren’t quite problems to then be fixed, unnecessarily, at great expense and no little risk. Meanwhile, we avoid taking adequate care of the biggest problems that people face—problems like diabetes, high blood pressure, or any number of less technologically intensive conditions. An entire health-care system has been devoted to this game. Yet we’re finally seeing evidence that the system can change—even in the most expensive places for health care in the country.

[PassedOut]

Update: From Atul Gawande's May 11, 2015 New Yorker article titled Overkill. An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?:

Great article! Thanks.

[Winstonm]

Great article! Thanks.

 

I once met an American physician who lived and practiced in Canada. He said he preferred working in Canada because the physicians were in charge of the care that was received, including testing.

[kenberg]

I decided to delete my post.

[PassedOut]

I decided to delete my post.

Unfortunately, if doctors (and others, too) are rewarded for what is, in effect, incompetence, you'll get quite a bit of incompetence. When that happens, it looks to me like a systemic problem.

[kenberg]

Fir those curious about the response to my deleted post, I mentioned, among other things, that if a surgeon intended to remove a lump and somehow removed something else, this seemed to me to be more a caase of incompetence than of a failed system. I removed it because I of course do not know the details of the case.

[PassedOut]

Fir those curious about the response to my deleted post, I mentioned, among other things, that if a surgeon intended to remove a lump and somehow removed something else, this seemed to me to be more a caase of incompetence than of a failed system. I removed it because I of course do not know the details of the case.

That (and some of the other cases, too) look from this distance as incompetence to me as well. My opinion is that rewarding competence tends to reduce incompetence in general.

[kenberg]

That (and some of the other cases, too) look from this distance as incompetence to me as well. My opinion is that rewarding competence tends to reduce incompetence in general.

 

Rewarding competence? A rash idea.

Yes, I agree.

 

I have had mostly good health but I am aging so issues arise. Different people go at this differently. One guy I know approaches every appointment with his doctor as an opportunity for debate. At the other extreme I know people who really seem oblivious to the fact that some doctors are better at their profession than are others. Once we accept that ultimately we are all responsible for ourselves these decisions get at least a little easier.