Healthcare Education and Q&A Thread

In the Obama Care thread a question came up, and I want to bring it here for clarification, keeping in mind this thread's original goal of information

Specifically, I asked for a model that was based not on a homogeneous population. It seemed clear to me that a diverse population would have more stresses on the healthcare system than a uniform nation like Japan or Norway.

In Saden's response (http://www.thewarpath.net/parking-lot/30288-obama-care-30.html#post568943)he stated


So, I am asking this question:

Does the diversity of a nation make a difference in the field of health care?

Thanks in advance.

I see what you're getting at, certain races and ethnicities deal with varying levels of incidences of different diseases. But all modern nations have to be ready to treat any illness, no matter how prevalent in their society. I don't think certain nations experience a lower level of cost than we do because of this, I think they experience it because their system is set up to encourage a lower level of utilization of healthcare services.

I see what you're getting at, certain races and ethnicities deal with varying levels of incidences of different diseases. But all modern nations have to be ready to treat any illness, no matter how prevalent in their society. I don't think certain nations experience a lower level of cost than we do because of this, I think they experience it because their system is set up to encourage a lower level of utilization of healthcare services.

Ok, I accept this. I was not necessarily thinking cost when I was asking the questions as much as the difficulties in setting up a national healthcare system, if that is the same thing then i will leave it at this.

I see what you're getting at, certain races and ethnicities deal with varying levels of incidences of different diseases. But all modern nations have to be ready to treat any illness, no matter how prevalent in their society. I don't think certain nations experience a lower level of cost than we do because of this, I think they experience it because their system is set up to encourage a lower level of utilization of healthcare services.

Sorry, can you explain walk me through what you mean by the bolded statement?

Saden asserts we can learn something from these systems in revamping the US healthcare system. In your opinion, is that a reasonable assertion?

Also, I am curious. What would the costs involved be in simply expanding Medicaid to cover these 45 Million. In your opinion, would it be more or less than the costs anticipated by Obama's legislation.

Sorry, can you explain walk me through what you mean by the bolded statement?

This post may help. Essentially the influx of covered patients causes a logjam with wait times, and eventually a lot of people decide going to the doctor isn't worth it (unless it's a serious issue). The longer the wait time for appointments, the more you have people deciding that going to the doctor isn't worth it.

http://www.thewarpath.net/parking-lot/30358-healthcare-education-and-q-and-thread-4.html#post566223

Saden asserts we can learn something from these systems in revamping the US healthcare system. In your opinion, is that a reasonable assertion?

Yes there are things they do which would be intelligent moves for us to adopt:

1) Other nations don't allow malpractice awards like the US does. Consequently their physicians don't have to pay $50,000 - $100,000 a year in malpractice premiums like ours do, so their lower physician salaries afford them a nice standard of living.

2) I think one source of major excess expense in the US is our overabundance of the best technology. When you have a government-run healthcare system, the government decides how to allocate expensive technologies in hospitals all throughout the country. They decide how many Gamma Knife machines the country needs, and where to put them. However, American hospitals are in business competing with one another, so they tend to go after the latest technology to remain competitive and attract physicians to direct their patients there. This results in a technology "arms race", and lots of technologies get underutilized. Then of course, naturally hospitals put pressure on physicians to make more use of the equipment, and you end up with expensive procedures and treatments in lieu of tried & true methods that may be much cheaper.

If the government could find a way to allocate the technology and equipment without oversaturating, but without jamming appointment times out for weeks and weeks, then I think we'd be in great shape.

Excellent points. Thank you.

Also, it should be noted that the geography of the United States lends itself to an expensive healthcare system. We're spread out across a lot of square miles.

Conversely, Europe and Japan are tightly packed. When tightly packed, you gain economies of scale by having fewer access points to care. It makes for fewer locations to staff up. However when spread out geographically like the US, you can't just have a number of hospitals in Chicago and then a number of hospitals in St. Louis, you need a number of centers in between to accomodate emergency care.

While building costs wouldn't vary between countries (you'd simply scale the size of the building to the population density in the area), you still have to staff each facility adequately to handle patient needs. The more facilities you have to staff, the more costly it gets.

Also, I am curious. What would the costs involved be in simply expanding Medicaid to cover these 45 Million. In your opinion, would it be more or less than the costs anticipated by Obama's legislation.

It's really tough to say without knowing what the reimbursement to hospitals would be under the government plan. My instinct says covering all 45 million under Medicaid would be cheaper.

However to cover the 45 million you'd have to raise the limit on the income level that qualifies people for Medicaid. In doing so, you'd end up covering a lot more than 45 million people, which would get exceedingly expensive.

But in a vacuum, if you covered the 45 million under Medicaid, I think it would be cheaper for the government. However, as discussed in previous posts in this thread, Medicaid reimbursement to hospitals blows, and commercial insurance companies are asked to pay rates to hospitals high enough to cover the losses on Medicaid patients. Adding Medicaid patients (without boosting Medicaid reimbursement rates) would mean an even greater burden would be placed on commercial insurance companies.

Those of us who are insured through the Blue Crosses of the world would pay even higher premiums to make up for even more horrendous Medicaid reimbursement. So while the federal government saves money by covering the 45 million through Medicaid, the ultimate cost on the citizenship is the same.

That's the thing, no matter how you configure the reimbursement and coverage part of the equation, healthcare costs what it costs. You're just debating over who pays for it, and how much. The only way we can make the system better is by actually attacking the cost of delivering care.

It's really tough to say without knowing what the reimbursement to hospitals would be under the government plan. My instinct says covering all 45 million under Medicaid would be cheaper.

However to cover the 45 million you'd have to raise the limit on the income level that qualifies people for Medicaid. In doing so, you'd end up covering a lot more than 45 million people, which would get exceedingly expensive.

But in a vacuum, if you covered the 45 million under Medicaid, I think it would be cheaper for the government. However, as discussed in previous posts in this thread, Medicaid reimbursement to hospitals blows, and commercial insurance companies are asked to pay rates to hospitals high enough to cover the losses on Medicaid patients. Adding Medicaid patients (without boosting Medicaid reimbursement rates) would mean an even greater burden would be placed on commercial insurance companies.

Those of us who are insured through the Blue Crosses of the world would pay even higher premiums to make up for even more horrendous Medicaid reimbursement. So while the federal government saves money by covering the 45 million through Medicaid, the ultimate cost on the citizenship is the same.

That's the thing, no matter how you configure the reimbursement and coverage part of the equation, healthcare costs what it costs. You're just debating over who pays for it, and how much. The only way we can make the system better is by actually attacking the cost of delivering care.

First, and again, thanks for the info. As, to the bolded part, I wholeheartedly agree.

Why? We already have government hospitals for vets, why not for citizens? I haven't gone over the cliff though I'm sure there are plenty of folks here who would be more than happy to push me over and watch me fall with glee.
Nobody wants to push you off a cliff , you are to entertaining ,,,, oh and too smart :) . Some might enjoy a " boxing match " between you and Joe , but not falling off a cliff .