Comments on: Fixing health care Thu, 21 Jul 2016 07:57:19 +0000 hourly 1 By: NS Fri, 29 May 2009 12:18:23 +0000 I agree, single-payer system is likely the only way to properly/fairly fund health care. Its painfully obvious that business interests have trumped public interest. Of note in particular is way in which R&D is funded, and executed; leading to high expectations of returns/profits in this traders market environment. The next highly advertised drug is a killer app all too often, has led to distrust and noncompliance issues.

A strong, viable public health system that provides BASIC care would lessen the strains on hospitals, ERs, etc. Provision of basic care would decrease costs. Those who enter health care as a vocation rewards were reduced that couldn’t be measured in digits while stresses increased.

Currently, people distrust the medical system and rightfully so. You’ve seen as I have “health fads” come and go based on fuzzy research with large ad campaigns. The relationship between physician/nurse and patient disrupted by those self-interested creating the incentives of individuals to self-diagnose and treat.

Unrealistic goals and profit motivations in directives of the health benefits of particular foods, OTC remedies, etc that change, not limited to FDA and NIH incentives, have all contributed to this distrust. Under the current “guidance” of what constitute an overweight individuals and “unhealthy” even the Governor of California would be ‘classified’ as overweight and not healthy. We have more than one health crisis, one might ask why asthma has reached epidemic proportions among otherwise healthy children/adults not exposed to smoking!!

A hybrid system which allows public health to deliver basic/chronic care and highly reformed insurance industry with oversight to supply more extensive/private care beyond that. Clinics are no fun but do work if given the oxygen/funding. That public health system has a record of eradicating Polio and managing TB outbreaks some 50-60 years ago. Public health systems are a first line of defense in communicable disease and provision of data/vaccinations, common chronic disease monitoring, etc. Stripping out incentives and funding of research for profit-motivated expectations is mandatory, as it direct marketing of Rx mediations. Its time public interest, patient interest becomes the focus of health care reform.

No system will be perfect, every system will have those who abuse it. However, the abuses in this current system is highly lopsided and enabled to the negative in sane/responsible patient care. Finally, it isn’t efficient to further burden health care providers to include a degree in economics to exist and provide care or spend valuable time negotiating standard care for their patient vs what an insurance company will agree to pay.

HR676 written in 2007 with broad bipartisan support provides the best chance of success including est.annual $300B savings just merely by standardization of billing alone. It is disappointing the current Administration has ignored it.

By: john krempen Thu, 28 May 2009 22:01:09 +0000 Yes–healthcare is a major problem–I have been a physician 30 years and still am in a quanry regarding what to do–problem–lobbyists and special intersts hold sway over the all haealth care decisions–I trained in US, Canada and Australia and know the pros and cons of all the systems.–Of course, I could scream at my patients who are obese, smoke, drink and use illegal drugs and tell me it is their right to do so—after all the government has “to take care of me” However, let us ger real and come up with a solution.
First, I see the one payer insurance as the only solution overall-if it has to be funded by a special “Health tax (value added tax)–so be it. I am also a MBA and have studied revenues and costs in every major system–it is the only way to cover all–including all 40 million uninsured. As regarding Insurance companies(Also have Insurance license)—too much waste in commisssions and payments to executives to save money at any cost–Yes there has to be some controls and limits to care–yes, there has to be some agency that is responsible for making decisions on care and costs. We must control drug companies who in US pass on 90% of research to US and little to rest of world. It will take all of us to realize that a complete overall is necessary or a total collapse will occur–yes, I know of physicians and hospitals who overcharge–and ER that go crazy on simple cuts–and they have to be controlled–Yes, I know of illlegal aliens who use the ER as a first aid clinic and care little about the expense–Socialized medicine as in Canada will not work–it was a terrible experience for me–believe me they do control costs -but at a terrible price–death of patients. Dr. Morici’s plan is a start–but does not go far enough–and the plitical consequences of special interests will scream like banshees–with all looking out for their own intersts–not the interests of the American public–I do hope that eventually politics could be removed from this decision-but I doubt it–remember–“one can not feast on champagne on beer prices”

John Krempen, MD, MBA

By: LR Thu, 28 May 2009 19:54:17 +0000 As far as the general health of Americans – it all starts in childhood. Eating and exercise habits are formed when we are young. We need more physical education time for our kids in grades K-8. It should be daily, not just twice a week like it is in so many of our schools. Physical activity is critical to the health of our children. I imagine that the rate of ADHD and ADD would also decrease as a result. Another thing we need to do in our schools is provide healthy food in the cafeteria, not the starch laden offerings that we currently serve our future generation. Fresh vegetables are cheap, so why don’t we feed them to our kids? Moreover, healthy kids = smart kids. We need universal health care with caps on the prices drug companies can charge, PLUS health reform in our schools if we want to compete in the global economy.

By: The Real Deal Thu, 28 May 2009 18:28:35 +0000 America is still dominated by a deeply ingrained thinking – government is bad, everything it does is bad. It, the the liberal thinking associated with it, is the source of evil. Conservative America has spent a couple of decades trying to destroy government. They believe free enterprise solves all problems – and so the current health care ‘problem’ (and throw in the economic crisis) must be due to a conspiracy of the liberals to screw them. Much of America would rather die or go bankrupt rather than have the government run health care insurance and control prices and ‘liberty’. There is great satisfaction in dying and win ideologically.

Health care is just one brewing civil war that has inflicted America, marred in irreconcilable differences on just about all fronts. The country federal and most state governments are bankrupt, on the verge of destruction much to the satisfaction to those who entertain neocon thinking. The population is fractured and polarized to the extreme. Maybe it will take a real bloody civil war to clear out the decks.

By: NS Thu, 28 May 2009 10:37:56 +0000 The current trend of blaming the sick for being sick is wrongheaded and indicates the lack of education in basic medicine. What is considered a trendy and faddish “healthy lifestyle” today, maybe found to be a hazard 10 years from now. Out of your control environmental hazards may also ‘trigger’ chronic illness for which lifestyle choices provide zero protection. Do you want your care metered on choices you made with the best information available at the time you made them a decade earlier and judged as deserving of your troubles? Surely you could have done “something” yourself to mitigate it, right? Surely you shouldn’t have used that cellphone so much and should have kept up with the research regarding those EMFs messing with your brain….right?

Most of the comments here point to nutrition and exercise. While this is important in ones overall health picture, it isn’t a panacea against illness. Obesity causes are not all hand to mouth problems; some stem from side-effect of medications that are not optional, some stem from chronic diseases which are not linked to lifestyle choices. In physiology ones knows that the very act of aging is defined by body systems which do not perform optimally. Painful arthritis limits mobility and is determined by DNA, not lifestyle. Hormonal levels change and slow, leading to creeping weight gain no matter how little you put in your mouth because of declining BMRs.

The conversation regarding health care delivery sorely requires HANDS ON PROFESSIONALS, who are EDUCATED. Making pariahs of those who become ill challenges Mean Mr. Karma to exact his revenge on those who make uneducated judgments and speculate about others without experience or education as a guide.

The year over year double-digit increases in health care costs are also related to the market driven-profit driven outcomes. Sole source providers of durable equipment, medications, supplies suffer from near-monopolistic abuses. Ad hoc insurance billing/costs mean there are more billing agents per patient in hospitals than hands-on providers of the care. Without serious reforms in business, tort reform, insurance and a shift to a patient-centric care system vs a profit-centric one, healthy lifestyle choices will not provide the efficiencies or decline in costs that are anticipated. It puts the burden in the wrong places before addressing the more serious and egregious reasons for the unsustainable increasing costs and harsh metering of care.

By: Elaine Thu, 28 May 2009 10:02:10 +0000 While I agree, adults should be more responsible for their health and exercise more, as this would reduce health care costs. However, the cost of other government funded programs such as “Equality Care” (Wyomings’ version of Medicaid) could be greatly reduced if those programs would pay for visits to the local emergency room only if the treatment received is due to an emergency!! As an example, I heard a young single mother talking about how she had to take her child to the emergency room because they feel down and scraped their knee. After getting X-rays and who knows what other unnecessary treatment, at a cost of some $1200, the child was sent home with some anti-biotic ointment and and band-aid. If the mother had simple cleaned the wound and put OTC anti-biotic ointment and a band-aid on it at home, at a cost of less then $5, this blatant waste of taxpayer dollars could have been avoided. Perhaps it should be mandatory that everyone take at least a basic first aid class to qualify for tax payer funded health care programs and any visit to the emergency room which is not an emergency be paid for by the patient or in the case of minors by their parents!

By: Bharati Wed, 27 May 2009 17:02:58 +0000 I remain healthy most of the time with plenty of effort. Do not see why my money or the govt should support those who do not ‘want’ to be healthy. The vast majority may not need medicine, just more common sense! Remove all insurance and give us cheaper clinics and personnel.

By: SG Wed, 27 May 2009 08:06:47 +0000 Why the monstrous sucking up to private insurance companies?
Insurance companies don’t offer a genuine product.

By: C.D. Walker Wed, 27 May 2009 03:16:34 +0000 Anubis-
“I still maintain we must eat healthier foods, exercise more and moderate alcohol consumption.”

Absolutely right, completely agree. But the will of a person must WANT to do those things. Some people like to eat, and overeat, and not exercise. We can not make them. What we can do is help them, encourage them, help them to see the benefits of a healthier lifestyle. Provide the information needed. Get them with a nutritionist, a workout instructor, a program like the ones I see on Dr. Phil and such. But only if they want.

By: Anubis Wed, 27 May 2009 03:07:05 +0000 Perhaps I was not clear C.D.. I believe a single payer system by taxation is the most cost effective way to deliver health care. I would support such a system. While that should make health care available to all citizens I still maintain we must eat healthier foods, exercise more and moderate alcohol consumption. Otherwise the general poor health of Americans will continue to be a drain on our economy. Should our old habits continue it is doubtful we will see significant savings in health care costs if any at all.