No offense was intended. I just assumed and I hope you will accept my apology for any distress caused by my honest mistake.

I agree the concept of everyone having health insurance is great. Provided the quality of coverage remains the same, there is no problem.

What I am trying to tell you is that socializing healthcare will damage the overall quality so badly that you will hurt many more people than you help.

Its not a linear extrapolation. If fewer people become doctors, then fewer people are diagnosed with conditions such as COPD or diabetics in an early stage when the treatment is less intrusive and less costly. Also, if the doctors are required to crank them out like an assembly line due to government reimbursement schedules, then you still have the same problem. If a nurse or physical therapist goes under the same socialized scenario, then training and education for the patients goes way down. That means compliance with treatment goes way down and more people become sick.

I work in the healthcare field and know a lot of doctors, nurses and physical therapists personally. I assure you a LOT would leave the medical profession and a LOT would alter their service in a way to maximize income even if it led to a lesser quality of care for the patients. The people who are looking for doctors and other medical professionals to be some alturistic saints who care nothing for money are out of touch with reality. They are coin operated just like rest of us.

Instead of turning this into a class war or following the same failed linear extrapolation that everyone else uses, why don't we look for more efficient ways to work within the current system. There are so many constructive ways to improve what we have that its crazy to not try this route first.

If a company, hospital or doctor's office has less of a financial interest in keeping you compliant with the doctor's orders, then you will have fewer patients who are compliant and this will lead to more unnecissary medical costs down the road.

Its called being penny wise and pound foolish.

I don't think that would happen at all, very few people don't follow doctors orders.

So what your saying if they don't need to keep customers in to make a profit the'll stop trying? The same could be said about the police. If they don't have to catch a crook twice as fast as the nearest competitor the'll stop trying.

Exactly. As long as there is a competent government in place i don't think it would would be much of a problem.

2 questions. Why would fewer people become doctors? Why would the government put in place a reimbursement schedule?



No doubt you could you make the current system for efficient but it will never be a fair system.

I won't depute that the rich without doubt get a better health service in the U.S. but you are focusing on the wrong point. The not so well of will have to for a incredible long time to get treated. Some who simply can't afford it will wait for a infinite time. Balance the rich and poor and the waiting times balance out with Canada. The only difference being the that everyone has to wait the same amount of time there instead of those with money getting health care far quicker than anyone else.

__________________
What's this i hear bed? Word has it you and Pam are sleeping together.

You said, "I don't think that would happen at all, very few people don't follow doctors orders."

What do you base this opinion on? I work in the healthcare field. I know many doctors, many nurses who work in private practices and hospitals, respiratory therapists, physical therapists and diabetic educators. I can say with total assurance that more than 50% of the diabetic patients in my region are noncompliant and probably an equal number are undiagnosed. The ones who do not treat thier illness because they do not go to the doctor to get check ups are just as much of a problem as the ones who are diagnosed but do not comply. Nationally, noncompliance estimates for diabetics in the USA are between 30-50% and undiagnosed diabetics is a little north of 30%. Personally, I think these estimates are low.

COPD patients are just as bad. My friends who are respiratory therapists talk to me often about noncompliant COPD patients. They do not take their medication as prescribed and do not use their O2 concentrators as prescribed. These people go in and out of the hospitals so much they are nicknamed "frequent fliers". For my area, I esimate 20-25% are seriously noncompliant and another 25-30% are mildly noncompliant.

Once again, I am basing my opinion of first hand accounts of doctors, nurses, respiratory therapists, diabetic educators, ADA statistics and CDC statistics. If you have better data, then please feel free to share it with me.

You said, "So what your saying if they don't need to keep customers in to make a profit the'll stop trying?"

Thats not really what I said. For some people, healthcare is a calling and these shinning examples will probably weather any storm. For most, however, its an occupation. Its a way to pay bills and provide for their families. When you impair the profit motive, you will lose enough of these to cripple healthcare. In the USA, we are already sitting on a time bomb. In 10 years, its estimated that 85% of the nurses in the USA will retire. Imagine whats going to happen if doctors and hospitals cannot afford to pay them a salary equivalent to what they could earn today?

You said, "The same could be said about the police. If they don't have to catch a crook twice as fast as the nearest competitor the'll stop trying."

Once again, this is not what I said. This is an example to explain either what you thought I said or what my comments made you feel. Anyway, it reminds me of something I did hear from one of my friends who was a respiratory therapist in a local hospital. She said the hospital had her covering the work load that should have been spread over 3 nurses because of budget constraints and that was a big part of the reason she left the hospital. When funds are cut short, then the front line healtcare professionals will be the ones to pay with longer hours, less pay and the stress of trying to do too much. What do you honestly think that will do to the workforce? People with other options will leave and the patients will suffer.

"Exactly. As long as there is a competent government in place i don't think it would would be much of a problem."

I work with healthcare providers and deal with Medicare (a very big government agency) and I can tell you the idea of a competent government is nice. Actually its very sweet but also very unrealistic. Your proposal to put this under a government beurocracy will take the wheels right off the system and endanger the lives of millions of people, because government competence on the level you propose is pure fantasy. I am more likely to see a unicorn than to see the type of government beaurocracy you suggest. The person who leads us to such a change in healthcare will be responsible for more deaths than anyone short of Hitler and Stalin whether its their intention to do so or not.

You said, "2 questions. Why would fewer people become doctors? Why would the government put in place a reimbursement schedule?"

Actually you answered your own question. The government's implementation of a fee rate schedule will be the reason we have fewer doctors. Whenever the government sets rates, they do it from the standpoint of cost control and ignore good old motivation of the workforce. If you set rates too low, then you lose doctors who do not see the risk/effort vs reward ratio as being favorable anymore.

If you ever created a commission structure for salespeople, then you know the wrong incentive structure can kill the motivation of your workforce and ensure failure for your business.

You said, "No doubt you could you make the current system for efficient but it will never be a fair system."

No system will ever be truely fair. What you have to ask yourself is how can I make the current system more fair and do I have a better realistic alternative.

Turning rich people upside down and shaking all of the money out of their pockets while setting reimbursement schedules so low that you negatively affect the motivation of healthcare providers does not sound like a "fair" proposal to me. Any scenario that retreats from quality of care is going to be opposed by me and the issue of wealth redistribution is repugnant to me when carried to such extremes.

You said, "I won't depute that the rich without doubt get a better health service in the U.S. but you are focusing on the wrong point. The not so well of will have to for a incredible long time to get treated. Some who simply can't afford it will wait for a infinite time. Balance the rich and poor and the waiting times balance out with Canada. The only difference being the that everyone has to wait the same amount of time there instead of those with money getting health care far quicker than anyone else."

I think maybe you are focusing on the wrong point. 40 million Americans are uninsured. That means that approximately 210 million are insured. Since we do not have 210 million rich in America, its safe to say that our excellent healthcare coverage already goes to the rich, the vast majority of the middle class and a decent segment of the poor. The overall quality droped in Canada. According to my Canadian friends, it dropped significantly. So we are going to significantly drop the coverage of 210 milllion Americans so we can extend this lesser quality to 40 million Americans. I don't know about your math skills, but that does not seem to work to me.

Instead of finding another way to redivide the pie as we cope with more extrapolations of a failed model, why don't we look for smarter ways to deal with healthcare like disease management?

NONDEPENDANT INSURANCE
Lowering the cost of Medicare and increasing the benefits to the elderly.
Let our sons and daughters carry the load.
Please read the following.

I would like to express a concern for our elderly population.
The cost of health care and health maintenance for the elderly is on the rise.
For those of us that can work to provide for our own retirement and supply our own health care via purchasing health insurance there is no problem, but not all U.S. citizens can afford the cost of an all encompassing health insurance and prescription drug program. But for those of us that work and supply our health insurance and prescription drug coverage can afford the cost.
Please hear me out.
This is the short version. I work for a municipality and have group health insurance.
My mother and father have worked all their life and are retired they use Medicare and supplemental health insurance. This still falls short. Both my parents receive social security and both have planed for their retirement by investing on their own to help supplement their retirement. With the cost of health and drugs running far ahead of inflation it makes it hard for them receive the care they rightfully deserve.

I have talk to many of my fellow employees and other employees from other walks of life and all agree that if the health insurance companies would let us we would gladly pay 30, 40 percent more for our health insurance and prescription drug insurance if we could list our parents (living with us or not) on our family plans.

Think about it Medicare’s cost and load would drop, the health insurance companies
Margin of income would increase; the health and happiness of our elderly would increase. Social security and Medicare would receive a 30 to 40 percent boost due to the fact that more than two thirds of elderly citizens would by all effect be off of Medicare.
The government could then increase the level of care it provides to the lower level income and retired citizens that may not benefit from having surviving sons or daughters.
To further sweeten the pot all insurance companies that participate will receive a family help tax decrease that would increase their profit margin. The elderly participants would continue to pay into Medicare as they are now, and Medicare would be secondary insurance with the group plan as primary. This is to ensure that if the primary insurance was dropped due to job loss, disability, death, or for any reason the primary insurance holder could no longer contribute the elderly parent would continue to have coverage.


RETIREMENT INSURANCE FOR INDIVIDUALS

I wish insurance companies would do a little creative thinking.
Why not give the workers that participate in applying their right to obtain insurance for themselves the option to buy insurance how for retirement. Example: a 32 year old worker could choose to purchase retirement insurance now by paying higher premiums
on their insurance plan. Much like a standard pension plan the percentage of premium would base the level of coverage when retired. There would be a retirement premium pay level but at a substantially lower cost. An $800.00 a month plan with prescription would be 20% of the work level premium. A cost of $160.00 per month for the retired person.
There are no supplemental plans that I know of that are this low.
The 32 year old would have paid $67,200.00 into the retirement base of the plan at the age of retirement 67 years old.
The $160.00 monthly premium fixed with the $67,200.00 prepaid would equal a $440.00 a month premium payment if the life expectancy after retirement is 20 years (87 years old).
Medicare’s burden would be eliminated for this person.


As you know for both plans not all will live to participate in the plan and see it through to retirement. This would lessen the burden on the insurance provider. The money paid in should roll over into investment for over head and long term participants.