> -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Charlie Bell > Sent: Friday, July 13, 2007 7:55 AM > To: Killer Bs Discussion > Subject: Re: U.S. health care > > That assumes you keep providing care the way you do. > > Increase preventative medicine and primary nursing, and you reduce > other healthcare threefold.
How? I'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. While the lack of health insurance for about 15% or so of Americans is a horrid fact that must be addressed, these people do not represent the majority of health care costs. For example, most of the lifetime cost for medical service in the US is accrued after age 65. Everyone over 65 is eligible for Medicare. Under basic Medicare, the co-pay (the out of pocket cost) for a primary physician visit is $5. For most on Social Security and Medicare, this is not a major worry...other factors (an unwillingness to bother a neighbor for a ride is my mother's favorite excuse) are more important. Most of the time, the elderly make an appointment....but when a member of the family living with us this summer became ill, she walked in without an appointment to an urgent care facility, and saw a nurse practitioner within 1.5 hours. So, an inability to afford primary health care is not the most important factor in the cost structure of the US. For the elderly, the cost problem in seeing a physician/nurse is not that they cannot afford $5, but that when they do get sick, the treatment is expensive. My wife has arthritis, and just one of the meds that provides her relief costs about $200/month. My mother is on a number of expensive meds...that are mostly covered by insurance...she has a small co-pay. A major source of cost, in the US, is the legal system. Hospitals are not required to accept every potential patient, but, once a patient is in a hospital, no service can be denied because of cost. If it is, the hospital and the doctors open themselves up to lawsuits that run in the multiple millions. As a result, tens of thousands of dollars are spent prolonging the life of dying people by a few weeks or months. My brother-in-law, a physician, talked about having to code (bring back from clinical death) someone twice a day for a month until the family accepted the fact that he was dying and nothing could be done but prolong the death. In most cases, it takes weeks for the family to come to grips with that, and allow the person to die. There are other factors, like the horrid bureaucracy of paperwork, poor health habits, etc. that contribute to this problem. But, a lack of available primary care medicine is not the critical problem. This has been tested experimentally for the last 15-20 years in the US when HMOs first came out. Primary co-pays were very small (near token), and primary care was encouraged. Indeed, my health insurance paid me $100 to get a physical. Studies of people who had this insurance showed, at most, a modest health gain over those in more traditional plans. Dan M. _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
