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The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

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131–140 of 228 posts

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#131

Um don't know where you're working but that isn't how any of the hospitals or ERs here are running. I was into an ER room being treated within 20 minutes only a week ago... and they said they were pretty busy that day. This all reads like complete and utter FUD EDIT: Never mind engagement, I see this is nothing but a SP propaganda thread.

SP?

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#132
post #81

Earlier quoted context omitted.

Can I ask why? Even right wing think tanks agree that medicare for all would save 2 billion a year in healthcare costs at least https://thehill.com/blogs/congress-blog/healthcare/484301-22...

It is simple, calculating, and heartless. When there is a fixed amount of X available, a fair division of X across Y people gives everyone X / Y. When you need more than X / Y, you are screwed (ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO) Since I can afford to buy a lot more than X / Y of healthcare for me…

> ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO

A bad example, given that private cataract surgery is quite affordable in the UK. You could quite easily pay that much in the US even if you had insurance.

https://lp.opticalexpress.co.uk/cataract-v1-0/?cam_id=20230&...

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#133

Earlier quoted context omitted.

It is simple, calculating, and heartless. When there is a fixed amount of X available, a fair division of X across Y people gives everyone X / Y. When you need more than X / Y, you are screwed (ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO) Since I can afford to buy a lot more than X / Y of healthcare for me…

I appreciate your honesty. I completely agree that the current system is excellent for those who can afford it, and queuing-based-on-worth certainly appeals to those with worth. In the US this worth translates into money, which translates into lobbying. You are not marching in the streets because you don't need to. Your money speaks for you. I say this not to patronise you, since you clearly understand this is the ca…

> a system I agree which would be most distressing to someone with 1 careact and lots of spare cash.

It wouldn’t be distressing to someone with lots of spare cash in the UK because they would just get the surgery done privately. There seems to be a common misconception that private healthcare is not available in the UK.

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#134

Earlier quoted context omitted.

The alternative you ask for then, is for people to merely die and suffer in pain while doing so. In the past, that's what we did, because there just was no option for such people. I looked up Ivan Illich, and this essay critiques modern medicine as creating "lifelong patients." That indeed is what has happened, but the alternative is for people to just die. The reality really is I don't really believe anyone ever too…

The alternative could be to tax the fk out of sugar and other parts of our food chain known to cause people to go into the obesity-diabaetes pipeline. Obesity related health problems are BY FAR the most common killer in America today. But we won't do that because it'll make some very rich people upset and it'll reduce individual liberty. We value individual liberty over a healthy population.

haha the other thread said the real culprit is the vegetable oil, not sugar. Twenty years ago it probably would have been fat. Too many things to ban!

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#135

Veteran doc and health services executive here. Three recommendations to improve your overall healthcare experience as a patient. Number one recommendation: spend $$$ on a concierge primary care doc. Depending on your market can be anywhere from $1,500 to $15,000 per year. Why? Concierge doc will help you triage your problems, give you great access, keep you out of the hospital/ER, and help you cut through red tape i…

Undoubtedly all of this is true and an effective set of strategies for people of means to navigate the system. But this is precisely why healthcare reform will never take root in the U.S. There is no vision for public health. As an academic discipline, public health is robust in the U.S.; but there is no traction in the practical realm because the ghosts of Puritanism still inhabit the the sociopolitical structures. The poor apparently deserve their poor health access.

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#136
The real problem in our health care system is private equity trying to profit off of it, not improve healthcare. It is well-documented that whenever the government is billed, the business model is to overcode and pocket 40% of the money. Physicians For a National Plan (PNHP) think the answer is a single payer healthcare system.

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#137

Veteran doc and health services executive here. Three recommendations to improve your overall healthcare experience as a patient. Number one recommendation: spend $$$ on a concierge primary care doc. Depending on your market can be anywhere from $1,500 to $15,000 per year. Why? Concierge doc will help you triage your problems, give you great access, keep you out of the hospital/ER, and help you cut through red tape i…

>Number one recommendation: spend $$$ on a concierge primary care doc. Fuck the country I was born in if this is the solution I need to keep myself healthy in a place I pay more than my fair share of taxes and rent to scumbag landlords just to live. Fuck this world.

Don't blame the rest of the world for your own country's fuck-ups.

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#138

Earlier quoted context omitted.

> By "single payer" do you mean the European model of "socialized" healthcare? Its socialized healthcare. You dont have to put in quotes. It was first advocated by socialists in the First Socialist International at the end of 19th century. It constitutes part of the social democratic program.

The reason I put it in quotes is that at least in France, healthcare is not completely free, and somewhat resembles the US model. Sure, everyone has to pay and gets "free" healthcare, but that's the basic level, barely above "none". If you need dental work, glasses, etc, you better have either cash or a "mutuelle", which is usually tied to your employer (though you can purchase your own above that if you like). Lower…

Procedure cost is a huge factor: AFAICT, it's generally cheaper everywhere than the US, frequently dramatically cheaper, for the same procedure, for out-of-pocket (non-insurance) cost.

Here in Japan, everyone has insurance, either private through their company, or public through the government, and the insurance pays a flat 70% of the cost, and the patient pays the other 30%. But the procedure costs are generally not that high to begin with, so the 30% copay ends up being pretty cheap usually.

Re: The Collapse of U.S. Healthcare – The Perspective of a Primary Care Physician

#140

Earlier quoted context omitted.

In the USA its all about the money. Those "political forces" are not a grassroots movement, people in the street demanding insurance-based healthcare. No, it's well organizes, very well paid, lobbying on behalf of a profit-based health system. A system that generates lots of profits for nice big companies. And make no mistake, they're not going to roll over. And sure, doctors are depressed because they're finally com…

> are not a grassroots movement, people in the street demanding insurance-based healthcare. > No, it's well organizes, very well paid, lobbying on behalf of a profit-based health system. A system that generates lots of profits for nice big companies. I am not a lobbyist or an owner of an insurance company. I am a "person on the street". I do not want single payer.

Lobbyists have been successful convincing you of something in their paymasters interest and not at all in yours.
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