Nationalized medicine is a bad plan

Obama is generating quite a stir with his reform ideas. I'm all for reform. Especially around the way insurance is adversarial to the providers when it comes to payment. But putting the government bureaucrats in charge of making rules for administering healthcare is such a wrong move. I'm not happy with how government continues to grow and grow. It is an organization that is best served by growing itself through more promises to constituents which leads to more control - and more cost.

There are very few governmental activities that achieve their objective more efficiently because they are government. Stories of $400 hammers just make my blood boil. Washington isn't accountable. Politicians are self-serving. Spending is increasingly about cutting deals with other lawmakers to "get my district some money". That's how the game is played.

Does anyone want healthcare run with these motivations and by these people? Look what they have done to Medicaid, Medicare, and Social Security. Is that efficiency? Is that fairness? Is that the right thing to do. I think not.

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What's your opinion?

Thanks for your comments. I'm curious about how you formed your opinions of government involvement. Are you a Medicare beneficiary or member of another plan? Industry professional? Or concerned citizen?

I am going to preface my response with the fact that I am an advocate for universal coverage and am not convinced that a government option is a bad idea.

I agree with your concerns about the growth of the US government, wasteful spending and need for accountability. I am not wild about new taxes either regardless of who pays. However, in terms of Medicare I don't believe the program has been mismanaged. I believe the lack of funding is simply that there are more people entitled to the benefits than people contributing to the funding. And unfortunately, the problem will get worse as more boomers retire.

As it stands now, the new government health plan option would be only one option made available to the uninsured. The issue with a government option is that private insurance plans are threatened. They're concerned that they can't compete because most government plans are able to negotiate (or establish) lower rates with healthcare providers than commercial payers. Additionally, the government plan would have less need for profit which in theory price commercial insurers out of the market.

The other big issue is quality or rationing. However, if you think about the systems that we have now the doctors and other healthcare professionals that care for Medicare beneficiaries also provide care to the commercial patients. I don't think that would change under the Obama plan.

What might change are the services paid for by the plan which people commonly refer to as rationing. For those that have had to use their existing plans they might not think that's new either. Most plans offered today have limits on benefits. For the most part plan benefits are determined by the age of the patient population, medical necessity and safety. However, insurers also price the plans based on the service covered under the plan. The more you pay the more you get. For the most part that probably won't change either. The goal of the Obama plan is to give all people access to basic care. Let's hope we don't loose site of that.

Does anyone else have an opinion, experience or stats to share?

Government-run healthcare is a slippery slope

I appreciate your thoughts Shannon. Some of your points are very valid. There are no easy answers when we are talking about the largest part of the GDP of the world's largest economy. I'm glad you agree about the growth of government and wasteful spending.

I am not a beneficiary of Medicare (not yet), but I have worked on several projects involving healthcare adjudication systems. My experience with government and health proved to me time and again that the bureaucracy is beyond ridiculous...it is maddening. I see no way that letting government bureaucrats control all of healthcare will improve the cost-effectiveness or quality.

We could debate the efficacy of socialized medicine, but I wouldn't trade the U.S. system for Canada's. I participated in a roundtable of about 30 of Colorado's top medical community about 4 years ago where I learned that the percentage of Canadian specialist physicians remaining above the border for more than 10 years after med school has dropped below 20%. Socialized medicine does increase coverage, but in my humble opinion it must decrease the quality.

I like my commercial coverage. I would like to keep it.

The Canadians actually might be ahead...

I grew up in Canada and have such a hard time understanding why people fear the system so much. The Canadian system is actually part government (base level of care) and part private (supplemental benefits for drugs, dental and eye care etc.). I was fortunate to have base and supplemental coverage which meant I didn't pay for doctor visits, drugs, hospital stays or anything else. I actually had several hospital stays during my childhood that would have likely bankrupted my parents if we had no coverage or limited coverage as some do here.

I am not saying that it is the best system but there are elements of it that we should be adopting in this country. However, the fragmentation will make it harder to do so in the US.

For example Canada has purchased the Amalga system from Microsoft. The software integrates medical data from all systems used to deliver healthcare. It is then reported thru another system called Health Vault so that the data is accessible to healthcare providers and patients across the country. Think about the power of that. If you move, the providers in your new city or province for that matter will be able to access your records on demand. It'll reduce the number of repeat tests, limit adverse drug interactions and empower doctors with the information they need to keep you healthy. I heard Dr. Bill Crounse from Microsoft talk about how Canada is using the system and then he said with a laugh "I have to say that the Canadian system is ahead of the US".

I can't even tell you how excited I was to hear about what Canada was doing and that other countries were following their lead. There may be a day when healthcare providers worldwide will be able to access our medical records. Personally I am hoping that it will be with my thumb print so that if I am ever injured and lying unconscious in some ER in a far off land, the providers there will know who I am and how to best treat me. There are currently only a few healthcare systems in the US implementing Amalga and Health Vault. Many large providers are implementing systems that tie the patient to their provider network. It works if you as the patient never have a need to see someone outside that network. It wouldn't work for me because I travel for work and pleasure.

Hopefully by automating the system and squeezing out the unneccessary spending Canada will be able to continue providing care for their citizens and retain the professionals and specialists needed to provide it. However, I don't know whether or not pay is the only reason doctors leave Canada. I would be interested in learning more.

I am against rationing healthcare

No matter what the politicians promise, I am convinced that putting government in control of healthcare will certainly lead to rationing. It already has through indirect forms of denying coverage for certain procedures or medicines by the government-administered Medicare and Medicaid programs.

See what doctors are saying about their real-world experience

I am against socialism in all forms. Healthcare run by the government is a disaster for hard-working Americans like me.

Rationing?

What is rationing? If you're willing to pay for the services you want and consume there will never be rationing. The trouble is that everyone wants the latest and greatest care but no one wants to pay or can pay for it. Providers are the ones that often foot the bill. Even when patients accept financial responsibility at time of service they often fail to pay. Most healthcare providers can't afford to do that anymore.

I think "rationing" is partly a function of helping people make informed decisions about the kind of care they absolutely need. In every aspect of life there is a difference between need and want. We all have to make choices. I don't think that will ever be taken away in relation to healthcare but like everything else in life choices come with costs. If you're willing to pay you can have anything you want.

There is an interesting article in FierceHealthcare about a Colorodo town that offers an HMO plan to residents that is similar to the "socialized medicine" programs being debated and studied by the Obama team. It seems to be working.

Health Care Reform - Check the Facts

The San Francisco Chronicle published a list of resources for those interested in checking the facts about healthcare reform:

1. Anneberg Public Policy Center - www.factcheck.org

2. The Congressional Budget Office offers information on healthcare reform

3. The Henry J. Kaiser Family Foundation wich offers a tool to compare healthcare reform proposals - healthreform.kff.org

4. The Pulitzer-Prize winning project of the St. Petersburg Times - www.politifact.com

5. The White House - www.whitehouse.gov/realitycheck

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