Welcome to USA the richest country in the world

Batbat

No right to free medical care, lets see how many billions are they spending on invading other countries?, I guess they would rather spend their riches on Bombs, then their own people

http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/07/18/MNGUG7NA1M1.DTL

When Barry Kushner got into a car accident last year that fractured his arm and left him unconscious, he didn't realize his bad break was just beginning.

About four months shy of the Medicare-eligible age of 65 and without health insurance, Kushner underwent head trauma evaluation and surgery to repair his arm at Marin General Hospital, where he spent about 38 hours.

Later, his head was fine, his arm was healing, and he got the bill: $72, 000 and change for hospital and physician fees. Today the Greenbrae resident realizes he should have had insurance, but he says he thought he had coverage through the Veterans Administration. What most upsets him, though, is the fact that if an insurance company or the government had paid for the care, they would have been charged a fraction of the amount he was billed for.

"It would take me until I was dead and reborn and dead again to pay it off," he said.

In the convoluted world of hospital billing, the amount an institution charges varies depending on a person's insurance status and has little to do with the underlying costs of delivering care.

Health insurers negotiate with hospitals for large-volume, discounted fees on behalf of their customers, which are primarily employers. Government programs pay fixed or contracted rates. Individuals like Kushner -- who are uninsured, don't qualify for government aid and don't have the clout to negotiate prices -- are essentially the only ones who get hit with the retail rate.

Uninsured or self-paying patients pay on average two to four times what hospitals collect from insurers and managed-care plans, said Dr. Gerald Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins University.

The hospital industry has also come under fire for its collection tactics, which include placing liens on the homes of people who fail to pay their bills, garnisheeing wages, filing lawsuits against patients, and sending their accounts to collections agencies.

Anderson said hospitals and their collections agencies often lack humanity in dealing with patients. "They are way too aggressive, and they have not thought of the consequences on the people who are getting care," he said.

For his part, Kushner is indignant.

"If you are either unemployed, uninsured or poor -- the people who need it the most -- they charge you 10 times as much. They try to make up their costs for the loss leaders by gouging the people who can't afford it," Kushner said.

Hospital administrators say they are already squeezed by insurers, low reimbursement rates from Medicaid, and the high cost of treating the growing number of uninsured people who can't afford to pay for care. They acknowledge that there is little relationship between what treatment costs, what hospitals charge, and what they actually receive in payment.

"Nobody in this industry would say this makes sense, but it is the system we have until someone comes up with a better system," said Jan Emerson, spokeswoman for the California Healthcare Association, which represents hospitals.

Hospitals, in general, are able to collect about 50 percent of their standard fees from all their different payers, said Steven Rousso, senior vice president of Healthcare Financial Solutions, a hospital financial consulting firm based in Oakland.

Managed care companies can either negotiate a discount off the hospital's charges or agree to contracted prices based on specific services. Rousso said that amount could be as little as 10 percent or up to about 80 percent of the hospital's full sticker price, depending on what the insurer and the hospital are able to negotiate.

More than half a typical hospital's revenue comes from government sources such as Medicare and Medi-Cal. Based on the patient's diagnosis, Medicare pays a fixed rate, which can be more or less than the cost of providing that care depending on length of stay and hospital's overhead. Medi-Cal, which covers low-income people who meet certain eligibility requirements, pays a contractual rate, which varies by hospital but typically accounts for 30 to 40 percent of inpatient charges and less for outpatient services.

Left out of the system is the uninsured patient who does not qualify for Medi-Cal or Medicare.

"People with no insurance go to the hospital emergency room. That's our national health care system," Rousso said. "The insurance system works well, except for those 40 million people who don't have it."

More than 43 million Americans, or 15.2 percent of the population, do not have health insurance, according to 2002 Census Bureau data. That number increased 6 percent from 2001. California, largely because of its size, has more uninsured people than any other state with about 6.4 million people, or 18.2 percent of the state population, lacking coverage.

The uninsured are not a cash cow for the hospital industry. Hospitals typically collect about 3 percent of their total revenue from uninsured patients. But with the number of uninsured growing because of high premiums, job losses and other factors, medical debt is becoming a growing problem both statewide and nationally.

In a Commonwealth Fund survey released last month, 41 percent of respondents younger than 65 said they had medical bill problems in the past year or were paying off accrued medical debt.

Health Access, a coalition of California community and labor groups, and the Service Employees International Union found that since 2002, almost 150 patients had been sued in San Francisco Superior Court by one hospital chain for not paying their bills.

The issue has caught the attention of state lawmakers and the federal government. In California, two bills -- one written by Assemblywoman Wilma Chan, D-Oakland, and another by state Sen. Deborah Ortiz, D-Sacramento -- would limit how much hospitals charge to low- and some middle-income uninsured people.

Federal lawmakers also have been looking into the issue. The House Energy and Commerce committee has been hearing testimony about the issue and requested 20 major hospital networks, including Tenet Healthcare Corp., Sutter Health and Catholic Healthcare West, provide a subcommittee with detailed information about their billing practices.

The San Francisco law firm of Lieff, Cabraser, Heimann and Bernstein, known for filing class-action lawsuits, sued Sutter Health hospital network in federal court on June 30 over its prices. The Scruggs Law Firm, which is based in Oxford, Miss., has spearheaded a nationwide effort against not-for-profit hospitals networks that has led to lawsuit filings against 27 not-for-profit hospitals in 15 states since June 17.

The San Francisco suit, for which the plaintiffs are seeking class-action status, was filed on behalf of Duane Darr, 48, an uninsured Berkeley man who was taken in May to Alta Bates Summit Medical Center in Berkeley, a Sutter hospital, after a fall. He was discharged the same day after incurring a $4, 600 bill for blood tests, a hip X-ray, medication and an electrocardiogram.

"He (Darr) represents the typical uninsured person who goes into the emergency room and is hit with a bill that is what we believe is grossly excessive," said Kelly Dermody, a partner with Lieff Cabraser.

According to the lawsuit, Sutter spent 0.6 percent of its revenue on charity care in 2002 while the statewide average for private hospitals is 1 percent. Critics argue that because Sutter is nonprofit and exempt from certain taxes, it is obligated to provide more care to indigent people. Sutter officials dispute the union groups' claims about the chain's level of charity care.

Sutter spokesman Bill Gleeson said the $109 million spent by his organization doesn't include what the system spends on community clinics, patient education and other services. "There are such broad inconsistencies in what hospitals report (as charity care) that coming up with a percentage is problematic," he said.

Meanwhile, the tactics hospitals sometimes use to collect bills has drawn mounting criticism. California has strong consumer laws that bar the most egregious collection practices, such as seizing a patient's sole residence. But consumer advocates say residents are still aggressively harassed by collections agencies and hauled into court because of their bills.

Responding to criticism, hospitals are re-examining billing policies and reining in collection practices.

seamus

It's a side-effect of the American super-capitalist culture. Hospitals are run as businesses, not as the healthcare institutions that they should be.

The very fact that hospitals negotiate cheaper fees with insurance companies - so patients using that insurance company will attend that hospitals - demonstrates the supermarket-style competitive nature of the American health system. One hospital's gain is another hospital's loss, it's ridiculous. Hospitals, like schools, and other institutions, should never have to compete. Or at least, one institution's gain, should never mean another's loss.

Batbat

its a sick culture, what happens whan you get old?, you get sick, sell your house?, so much money there yet they just dont care about their own people, such a shame

Hairy Homer

Ooh. You'd better hope that Fianna Fail (unsuccessful) council candidate Barbara Foley isn't reading this. Otherwise she'll tout on you to the Department of Homeland Security for being anti-American and a godamm terrorist.

See yesterday's Sunday Tribune, (or pay for its ridulously overpriced e-mail subscription service) for details.

Meh

Originally posted by Batbat
No right to free medical care, lets see how many billions are they spending on invading other countries?, I guess they would rather spend their riches on Bombs, then their own people

You know, I hate to introduce some hard facts into this thread, but the US spends more per capita on healthcare than any other country in the OECD. Even their per-capita public healthcare spending is more than that of most European countries, including Ireland. Whatever's wrong with the US healthcare system (and it does seem to have a lot of problems), it isn't a shortage of money that's the problem. More statistics available here

Batbat

Ooh. You'd better hope that Fianna Fail (unsuccessful) council candidate Barbara Foley isn't reading this. Otherwise she'll tout on you to the Department of Homeland Security for being anti-American and a godamm terrorist.

See yesterday's Sunday Tribune, (or pay for its ridulously overpriced e-mail subscription service) for details.

Im not anti american, I just think the american administration should take care of their sick people, they should provide a state health care system, anything is better then having hospitals checking your credit card balance before they will treat you (this is true), I also disagree with bush foreign policy but I am not anti american

Hairy Homer

Originally posted by Batbat
Im not anti american, ...I... disagree with bush foreign policy but I am not anti american

Look Bubba. You don't decide whether you're anti-American. The 'authorities' do.

According to a newspaper report, Ms Foley reacted to a constituent who wrote to her outlining some negative aspects of the 'American Experience' to which she had referred favourably in her campaign literature, by reporting him to the US authorities as a potential terrorist!!!!

Bet he'll have a whale of a time if he ever wants to visit his rellies in Boston.

Careful what you say and to whom you say it.

Hey, bet that sounds familiar in Russian. Or Korean. Or Chinese.....

PS Fair play to the good burghers of Malahide for NOT electing Ms Foley.

Batbat

Ms Foley is a fking moron,, nuf said

shotamoose

Originally posted by Meh
Whatever's wrong with the US healthcare system (and it does seem to have a lot of problems), it isn't a shortage of money that's the problem. More statistics available here

Indeed, it seems to be more of a problem of wasting vast amounts of money. There's an interesting graph here comparing the amount of health spending per capita and the ratio of public to private spending. As the website author says, "Basically it shows that the United States has (a) much less public involvement in healthcare than the other countries and (b) much higher healthcare costs."

Based on this fairly crude comparison, the US system seems to deliver not much bang for a lot of bucks, especially when you consider that so many people are without health insurance and get into the kinds of problems described by Batbat. I'd suggest moving to a more socialised health system, but that's probably because I'm just another freedom-hating anti-American.

Hobbes

Originally posted by Meh
You know, I hate to introduce some hard facts into this thread, but the US spends more per capita on healthcare than any other country in the OECD. Even their per-capita public healthcare spending is more than that of most European countries, including Ireland. Whatever's wrong with the US healthcare system (and it does seem to have a lot of problems), it isn't a shortage of money that's the problem. More statistics available here

They make a profit from what they put in. I busted my elbow when I was in the US. For a crummy bandage and X-Rays it cost me over $700. Oh and that was 5 hours waiting for a 2 minute consoltation from a doctor while being in extreme pain (and I had insurance)

They also have this great system of double billing. They bill the insurance company, but then also bill you as well. Sure if you accidently pay them you get your money back but not for a long time.

Batbat

They make a profit from what they put in. I busted my elbow when I was in the US. For a crummy bandage and X-Rays it cost me over $700. Oh and that was 5 hours waiting for a 2 minute consoltation from a doctor while being in extreme pain (and I had insurance)

Theyre whole system is fcuked, I lived there for a couple of years, many people only worked in later years because of medical insurence, its a terrible place if your poor or middle classed, the medical bills are insane

Meh

Originally posted by shotamoose
"Basically it shows that the United States has (a) much less public involvement in healthcare than the other countries..."

I don't think this is supported by the OECD statistics I linked above. The US spends more per-capita on public healthcare than Canada, Sweden, Germany, France (and of course Ireland). Whatever's wrong with the US system, it's not a lack of public money, it seems to be more waste and misdirection of funds.

Batbat

Meh they do spend lots of cash on medical but its a big mess at the moment with insane medical charges, the whole system needs to change

shotamoose

Originally posted by Meh
I don't think this is supported by the OECD statistics I linked above.

Well the chart is based on OECD statistics. As I said it compares the ratio of public to private spending, so the author was saying that the USA had proportionately much less public involvement in healthcare than the other countries.

Whatever's wrong with the US system, it's not a lack of public money, it seems to be more waste and misdirection of funds.

Yep. And European countries seem to get better value for their public money, perhaps because their health systems are organised differently, e.g more socialised.

AngelofFire

I believe that proper healthcare should be a right for everybody not just a commodittee for the wealthy.The film John Q exposes a lot of the inadequacies of Americas health system.

TomF

I hope no one has hurt himself patting himself on the back that we are better at health care delivery than the USA! My son broke his leg about 6 years ago and we drove him to University Hospital in Cork City where we waited for 10 hours for him to be seen. The casualty section was overwhelmed with heart attack and limb injuries and staffed only by junior doctors who had been at work since 7 am (it was midnight then).

After his treatment and eventual release a week or so later, we had to return several times for X-rays and evaluation by a consultant doctor. I remember one day sitting in the waiting room of the X-ray department next to an old lady in a wheel chair. She said she was there for heart problems, and that her bed in the hospital was next to a broken window and the rain had been coming in and soaking her. The nurses had to rig some kind of sheet across the window to protect her from the rain.

If this is free Irish care, please fly me to the USA and throw me on the mercy of their system! I probably wouldn't wait any longer for care there than here.

We have BUPA insurance, because it is cheaper than VHI and we routinely get billed by the hospital/clinic/doctor at the same time that the insurance gets a bill. We generally have to pay the bills as they arrive because BUPA doesn't settle the claims for expenses except at the end of the year.

shotamoose

Originally posted by TomF
I probably wouldn't wait any longer for care there than here.

So you're not sure but you're still outraged that people would even make the comparison?

bonkey

Originally posted by TomF
I hope no one has hurt himself patting himself on the back that we are better at health care delivery than the USA!

God no. I'd look at a nation which has a functional health-care system in order to make a comparison.

However, the fact that the Irish system is sh1te can be contributed at least partly to the fact that as a small country we dont enjoy economy of scale, and also partly to the fact that its been woefully neglected for so long because we simply couldn't afford more. (I do accept that when we've had the money, we've made a dogs dinner out of making good use of it, though).

Whats the US' excuse?

jc

Champ

However, the fact that the Irish system is sh1te can be contributed at least partly to the fact that as a small country we dont enjoy economy of scale, and also partly to the fact that its been woefully neglected for so long because we simply couldn't afford more. (I do accept that when we've had the money, we've made a dogs dinner out of making good use of it, though).

Well it's at least acceptable. Okay granted i got rescheduled 3 times with the end result that i couldn't get treated for a head injury until it was 3 months past; but once they got to see me they did everything they could and were very professional and kind; even though they were under pressure. It also didn't cause me to go broke; and i don't consider myself rich or even close to it.

Captain Trips

Well the US seems like a thirld-world country at times:

1. Health Care: great if you are in the top 0.1% and can afford it, otherwise you'll pay between $300-500 a month for VHI equivalent care for a family.

2. Education: same again, a priveleged aristocracy get top choice of schools with $50,000/year fees, everyone else has to make do with inadequate and underfunded public schooling. This is right from Primary level (e.g., you will and can only attend the local designated Elementary School PS 143.....and papers please citizen...*cough*) unless of course you can cough up some cash

3. Military: Around publicly listed 3.1% GDP on military. This does not include Homeland Security, CIA, etc., .

4. Finance/Money: the loan system and credit system will hold you on $2 overdrawn 10 years later and mark you down for it. The federal government itself has been overspending for 30 years so it's no surprise what Big Brother does Little Brother follows...

5. Crime. ONe of the highest per capita prison populations in the world. Currently around 5-6 million of the population are or have been in prison.

Check www.msn.com and go to the stock quote search. Type CXW and check out the 400% profit since January 2001 (esp. that spike just after Sept 11 '01). It is the Corrections Corporation of America, a private prison corporation.


WHile at one stage I used to envy the US it is a decidedly primitive place from a civilisation point of view.

ionapaul

Originally posted by Captain Trips

2. Education: same again, a priveleged aristocracy get top choice of schools with $50,000/year fees, everyone else has to make do with inadequate and underfunded public schooling. This is right from Primary level (e.g., you will and can only attend the local designated Elementary School PS 143.....and papers please citizen...*cough*) unless of course you can cough up some cash

However, many of the public universities over there are excellent, in my opinion superior to our best universities here - they still cost $10,000 or so per year, but up to 50% of students can avail of financial aid, everyone can avail of cheap loans. You can make such a large salary coming out of college that repaying the college loan shouldn't be such a problem.
I don't think that their school system is at a third-world level - certainly their primary and secondary systems are not as good as those in Europe or East Asia, but their third-level system contain many of the world's top universities. I used to believe the old bullcrap that 'an American degree isn't worth the paper it is written on' until I spent some time in college there and could compare our third-level institutions (and students) to theirs.

TomF

If a person in the U.S. pays $300-$400 a month for VHI-comparable insurance, and as it is a fact that I pay the equivalent of $250 a month for BUPA insurance for a family of six, I don't see too much cost difference between the two countries. Especially when here there is such a lack of equipment and facilities that you are actually paying a very large penalty by paying for medical care and not getting it. It is just like the enormous taxes we pay for car licensing and petrol: we pay for good roads, and careful policing of those roads but we get narrow lanes, potholes and drunks, scofflaw speeders and mad overtakers ruling those roads.

We are really people living in glass house throwing stones.

Gizzard

I hope no one has hurt himself patting himself on the back that we are better at health care delivery than the USA! My son broke his leg about 6 years ago and we drove him to University Hospital in Cork City where we waited for 10 hours for him to be seen. The casualty section was overwhelmed with heart attack and limb injuries and staffed only by junior doctors who had been at work since 7 am (it was midnight then).

After his treatment and eventual release a week or so later, we had to return several times for X-rays and evaluation by a consultant doctor. I remember one day sitting in the waiting room of the X-ray department next to an old lady in a wheel chair. She said she was there for heart problems, and that her bed in the hospital was next to a broken window and the rain had been coming in and soaking her. The nurses had to rig some kind of sheet across the window to protect her from the rain.

If this is free Irish care, please fly me to the USA and throw me on the mercy of their system! I probably wouldn't wait any longer for care there than here.

We have BUPA insurance, because it is cheaper than VHI and we routinely get billed by the hospital/clinic/doctor at the same time that the insurance gets a bill. We generally have to pay the bills as they arrive because BUPA doesn't settle the claims for expenses except at the end of the year

yes its true irish health care is not the best and there are long wainting sometimes to be seen to, but the difference is in USA you dont get treatment at all if you dont have the cash, Ill take the wait any day over that heartless mentality

michaelanthony

Some ambulances in the US will search a casualty at the scene of an accident for proof of health insurance. If they don't find any, they will leave the victim for the next ambulance that comes along to take care of.

seamus

Originally posted by TomF
We are really people living in glass house throwing stones.

I think most people's point is that in Ireland they don't save your life only to ruin the rest of it by putting you under more debt than you can possibly handle.

Reminds me of a son of my parent's friends, who was attacked on a college campus, and luckily was only metres from the college hospital. Radical surgery saved his life (removed part of his skull, to allow his brain to swell without killing him). It turns out that his VHI insurance only covered him for €50,000 of medical expenses, Within a month, the bill had risen to nearly €1,500,000. What kind of sense does that make? Did they give him an option - "Would you prefer to be saved, or in debt to us for more money than you'll probably make in your entire life?". Now, the choice is obvious, but it boggles the mind. One should never be billed for having their life saved (although I would make an exception for Darwinian examples). What price compassion?

bonkey

Originally posted by TomF
We are really people living in glass house throwing stones.

Tom...here's a hint.

America is supposedly the richest nation in the world. We are not.

America has a population of >200 million, allowing significant economy of scale.
We do not.

There is no excuse for a nation like the US not to outshine us in every socially-relevant field - healthcare, education...you name it. In fact, they should outshine not only us, but effectively everyone else, everywhere, at everything.

And they don't.

Arguably, our education system is superior. Sure, as ionapaul just argued, if you're able to pay, the US system may be superior. (I say "may" because what your criteria are will determine whether we're better or not. If you want a small number of "the best of the best" educated as well as possible, the US system is superior. If you want a better overall standard of education, ours - I believe - comes out on top).

If you're among the whatever-percent-it-is who can get cheap loans, then the US system may still be better.

But if you're one of the people who cant' get a loan, or someone who takes a loan and doesn't get a job (which ionapaul seems to completely ignore the possibility of) then thats just yur tough crap, really isn't it. But don't worry - the proponents of the US system will tell you that you're only poor and unsuccessful because you want to be.

jc

ionapaul

All college students can get loans - the fact that you are in college ensures (in the federal institution's eye) that you will be able to repay the loan after graduation. Financial aid is widespread in the third level system there - a friend who went to Harvard assured me that about 50% of students there were on differing levels of financial aid. Plus you would never be denied a loan if you were accepted to Harvard - you would never look long for a high paying job in the States with that name on your CV!

You don't have to repay your loans while you are unemployed.

Like I've said, I've spent time in college both in Ireland and in the States, and in my experience their system has unjustly gotten a bad reputation. The average American student, in my opinion, is worked and works far harder in college than the average Irish student. This view could be biased by the particular college I went to over there, who knows.

I should say I prefer our system of state-supported universities and very small yearly fees. I do think the average Irish person is better educated than the average American - but I simply don't believe that the average Irish college grad is any better educated than their American counterpart.

the_syco

Originally posted by shotamoose
Indeed, it seems to be more of a problem of wasting vast amounts of money. There's an interesting graph here comparing the amount of health spending per capita and the ratio of public to private spending. As the website author says, "Basically it shows that the United States has (a) much less public involvement in healthcare than the other countries and (b) much higher healthcare costs."

Taken from that, there's a quote;

As near as I can tell, France has a better healthcare system than the United States on practically every measure, and does it at half the cost.

Except the French don't really care about old people. Nearly 12,000 died last year, and it wasn't untill afterwards that the French did anything. Also, Ireland, which is on the bottom of the graph, has entire state-of-the-art wings of hostipals, unused.
At least in the US, they use everything they have.

Originally posted by shotamoose
Well the chart is based on OECD statistics. As I said it compares the ratio of public to private spending, so the author was saying that the USA had proportionately much less public involvement in healthcare than the other countries.

Ireland has a small amount of people in the counrty. An even smaller amount have enough money to spend on private healthcare.
The ratio may seem high, as there'd be less people that could spend extra cash on a private healthcare, versus those who could.

America has a lot of people. Due to the amount of major cities, there would be a high density of people who would be able to spend money.
The ratio may seem low, if alot of the people could afford to buy healthcare, versus's those that couldn't.

This would mean, that America may seem to spend less, in a ratio, but still spend more than its EU conterparts.

Originally posted by shotamoose
Yep. And European countries seem to get better value for their public money, perhaps because their health systems are organised differently, e.g more socialised.

And also as the doctors charge less. And that they charge less, as the doctors insurance is less. And insurance is less, as less people sue their doctors for stuff than the US.
A few sue the doctors alot. To get around this, the insurance companies hike up their cost. And so on. Already, in some hostipals in Ireland, doctors have to make alot of money, just to pay off the insurance.

Originally posted by TomF
I hope no one has hurt himself patting himself on the back that we are better at health care delivery than the USA! My son broke his leg about 6 years ago and we drove him to University Hospital in Cork City where we waited for 10 hours for him to be seen. The casualty section was overwhelmed with heart attack and limb injuries and staffed only by junior doctors who had been at work since 7 am (it was midnight then).

In a few months, junior doctors won't be allowed to work that late, under EU law, that has already been passed (Ireland hasn't complied with it yet). Once this happens, alot of the 24 hour services may not be able to be acted upon with full staff.

Originally posted by michaelanthony
Some ambulances in the US will search a casualty at the scene of an accident for proof of health insurance. If they don't find any, they will leave the victim for the next ambulance that comes along to take care of.

If you get to the A&E (in Dublin, Ireland), aren't you meant to pay a small fee, for the ambulance, or something?

Hobbes

Originally posted by the_syco

In a few months, junior doctors won't be allowed to work that late, under EU law, that has already been passed (Ireland hasn't complied with it yet). Once this happens, alot of the 24 hour services may not be able to be acted upon with full staff.

AFAIR Doctors are exempt from that law. Or is there a new one?

sceptre

Originally posted by TomF
If a person in the U.S. pays $300-$400 a month for VHI-comparable insurance

I may be blind but where did that figure come from?

Captain Trips

Originally posted by Hobbes
AFAIR Doctors are exempt from that law. Or is there a new one?

The exemption happened around 10 years ago by petition of the Irish government at the time. There have been several extensions as it stands....and AUgust 1st is the final final look-we-really-mean-it deadline.

Irish doctors were excluded from the EWTD *specifically* when it included almost every other work category over 10 or 12 years ago, AFIAK.

The problem is of course that it's not like there are loads of people ready to take up the other 50 hours that won't be worked any more, so things will either a) grind to a halt or b) it will go back to pre-1997 style when legally doctors could not be paid for over 65 hours a week (and from 50-65 it has *half* rate, not a typo), but would do 100 anyway because that was just needed. Off Topic.


Regarding the US: I find it hard to believe that it isn't a thrid world country. Regarding Harvard (someone mentioned it), in the mid-1990s aroudn 3% of Harvard MBA grads were without jobs on graduation, last year it was 15% (I am quoting an Economist article from May or June).

A lot of talk of patriotism for fellow Americans but they will happily let the impoverished die off, let the racially underserved communities suffer poor schooling and education, racial segregation on a wide scale (take the Long Island Rail Road from Penn STation to the south shore, pass through white town, Irish town, black town, black town, rich town, jew town.....etc., ). E.g., Lynbrook/Brooklyn, Wantagh, etc., Jamaica, etc., .

Talk of patriotism for fellow Americans is all in vain when they seem to care little for there neighbour except to make sure he is waving a flag.

bonkey

Originally posted by the_syco
Except the French don't really care about old people. Nearly 12,000 died last year, and it wasn't untill afterwards that the French did anything.

Not true.

The French health care system was imperfect in responding to a crisis that was unprecedented, admittedly, but the vast majority of the problem was caused by the attitude of the citizens themselves.

It was widely reported in this part of the world (maybe not in Ireland, but here on the mainland for sure) that the biggest contributor to the problem was that people don't look after the elderly etc. in their community/locale, but rather leave it to social services. If you're heading away for a week, there's no need to make sure granda is gonna be fine.....won't social services take care of him.

This attitude, coupled with the weather, coupled with the increase in numbers of people running from the sun, coupled with the unprecedented nature of the crisis, coupled with the overloading of the social services combined together to cause the problem.

To lay that significantly at the feet of the healthcare system isn't much different to blaming the healthcare system for the number of road-deaths or smoking-related deaths.

jc

shotamoose

Originally posted by the_syco
The ratio may seem low, if alot of the people could afford to buy healthcare, versus's those that couldn't.

The reliance on private health insurance is only really justifiable if everyone who wants it can afford it. In America 70 million people have no health insurance and the overwhelming majority say the reason is they can't afford it (source )

TomF

The quoted figures come from a posting by "Captain Trips", cited below. I can't underwrite its accuracy.

<Captain Trips

Registered: Apr 2003

"Well the US seems like a thirld-world country at times:

1. Health Care: great if you are in the top 0.1% and can afford it, otherwise you'll pay between $300-500 a month for VHI equivalent care for a family. ">

If you get to the A&E (in Dublin, Ireland), aren't you meant to pay a small fee, for the ambulance, or something?

You'll get a bill from the Hospital about a week or two later by post, for roughly 50 euro. You'll also get charged separately for Emergency care (another 50 euro or so). Not sure if Bupa/VHI cover this. I just paid to get the bill out of my vision.

chill

Originally posted by Meh
You know, I hate to introduce some hard facts into this thread, but the US spends more per capita on healthcare than any other country in the OECD. Even their per-capita public healthcare spending is more than that of most European countries, including Ireland. Whatever's wrong with the US healthcare system (and it does seem to have a lot of problems), it isn't a shortage of money that's the problem. More statistics available here

Yes ... but the issue is not how much they spend... it is on whom and who gets the benefit. It is the well off that the money is spent on and who spend on themselves. It is the lower middle class, working class and poor who get screwed.

arcadegame2004

I think the introductory thread justifies what I have been saying on the need for compulsory private-health-insurance.

Victor

Originally posted by seamus
The very fact that hospitals negotiate cheaper fees with insurance companies

I don't have a problem with a discount equal to the reduced administration potential that is there for hospitals treating the insured - maybe 10%, but 80% is rediculous.

Originally posted by Meh
More statistics available here

Interesting that we have a lot more nurses per capita and as a nurse / doctor ratio, but we are screaming that we don't have enough nurses (of course the definition nurse varies, but given we have one of the more restrictive definitions, it seems odd).

chabsey

Originally posted by bonkey
It was widely reported in this part of the world (maybe not in Ireland, but here on the mainland for sure)...jc

Mainland? Please explain.

seamus

Originally posted by chabsey
Mainland? Please explain.

Mainland Europe. bonkey lives in Switzerland.

Gizzard

You'll get a bill from the Hospital about a week or two later by post, for roughly 50 euro. You'll also get charged separately for Emergency care (another 50 euro or so). Not sure if Bupa/VHI cover this. I just paid to get the bill out of my vision.

Im USA its 7000 dollars for a single ambulance not 50 euro, I lived there lots of money to be made but a horrible society that does not care for its people

Hairy Homer

Originally posted by arcadegame2004
I think the introductory thread justifies what I have been saying on the need for compulsory private-health-insurance.

So what's the difference between 'compulsory private-health-insurance' and taxation?

In Germany, from memory from my time there as a gastarbeiter one's payslip came with an itemised bill showing where one's tax went. One could see how much krankensteuer (health tax) lohnsteuer (income tax) and kirchensteuer (church tax-it went to the church of whichever religion you claimed to belong to) one paid each month.

Compulsory private health insurance seems to me like a fig-leaf to cover up the deficiences of ultra-dogmatic Rabid Righties who cannot believe in public services and will not believe that their own philosophy has any shortcomings at all.

ionapaul

Originally posted by Hairy Homer
In Germany, from memory from my time there as a gastarbeiter one's payslip came with an itemised bill showing where one's tax went. One could see how much krankensteuer (health tax) lohnsteuer (income tax) and kirchensteuer (church tax-it went to the church of whichever religion you claimed to belong to) one paid each month.

Great idea! Except for the church tax - what do you do if you are an atheist?

ionapaul

Originally posted by Gizzard
Im USA its 7000 dollars for a single ambulance not 50 euro, I lived there lots of money to be made but a horrible society that does not care for its people

The US health system definitely needs changing (most Americans will agree with you on this) but to say that their society is 'horrible' and doesn't care for its people is going way too far. Of course it has its faults, as many as Irish society has, or any other society you could mention. I'd much rather be marginalised in Europe than in the US, but on the other hand would rather be marginalised in the US than most of the rest of the world - not too many people starve to death in the States, work in slave labour camps, or are disallowed from driving, voting, or owning property because of their religion or gender.

chabsey

Originally posted by seamus
Mainland Europe. bonkey lives in Switzerland.

That's ok....thought he was referring to Britain!

Mighty_Mouse

I lived in America for a little bit and found its consumerism, economic efficiency "bottom dollar" outlook overwhelming.

I'd much rather be marginalised in Europe than in the US, but on the other hand would rather be marginalised in the US than most of the rest of the world

I think that you've kinda hit the nail on the nead here. I suppose I would like to think a society should be partly judged on how it cares for its less-well off. Also I would think marginalisation is a matter of circumstances than choice in most cases.

I must admit I'm quite happy we don't have a privatised health care system from some of the horror stories I've heard from America.

Hairy Homer

Originally posted by ionapaul
Great idea! Except for the church tax - what do you do if you are an atheist?

I think, but I couldn't swear to it, that it got swallowed up by general taxation. ie, if you registered as belonging to one of the major organised religions, a small part of your tax was diverted to them, but if you didn't the gov just took it anyway.

DadaKopf

Originally posted by shotamoose
Indeed, it seems to be more of a problem of wasting vast amounts of money. There's an interesting graph here comparing the amount of health spending per capita and the ratio of public to private spending. As the website author says, "Basically it shows that the United States has (a) much less public involvement in healthcare than the other countries and (b) much higher healthcare costs."

Based on this fairly crude comparison, the US system seems to deliver not much bang for a lot of bucks, especially when you consider that so many people are without health insurance and get into the kinds of problems described by Batbat. I'd suggest moving to a more socialised health system, but that's probably because I'm just another freedom-hating anti-American.

On top of that, if you once again look at the OECD statistics cited above, you'll see that the US is below the OECD average in both practising doctors per 1,000 population (2.4) and practising nurses per 1,000 population (7.9) (Charts 7 and 8 respectively).

Whatever this says about per capita spending, apart from it revealing that medical costs are higher overall, it also indicates a low enough level of healthcare.

For comparison, Ireland's doctors to 1,000 population is also 2.4, but Ireland tops the Nurses list with 15.3 nurses per 1,000 people.

Edit: Uh, Just realised this thread is on its third page! Oh well. The risks of staying away from the internet.

Gizzard

I'd much rather be marginalised in Europe than in the US, but on the other hand would rather be marginalised in the US than most of the rest of the world - not too many people starve to death in the States

Yess well said, however remember 1 in 4 childern born in america are born into poverty, although americans definition of poverty is different to other parts of the world

chill

Originally posted by ionapaul
The US health system definitely needs changing (most Americans will agree with you on this) but to say that their society is 'horrible' and doesn't care for its people is going way too far. Of course it has its faults, as many as Irish society has, or any other society you could mention. I'd much rather be marginalised in Europe than in the US, but on the other hand would rather be marginalised in the US than most of the rest of the world - not too many people starve to death in the States, work in slave labour camps, or are disallowed from driving, voting, or owning property because of their religion or gender.

Wow... there's an enviable endorsement ......!

sceptre

Originally posted by chill
Wow... there's an enviable endorsement ......!

Let's start a pool on how many more posts are needed before someone points out that the US is better than Nazi Germany. Or does the above count?