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About that "World's Best Healthcare System" the U.S. is supposed to have...

A project manager for a manufacturing company, she is one year removed from a cardiac arrest and the subsequent physical recovery is being dwarfed by a near-impossible fiscal recovery. She was sent last Sept. 9 to the emergency room at St. Mary's Hospital, which was out of her insurance network, instead of to Meriter Hospital, three blocks away, which was covered by her insurance. It's the difference between a $1,500 maximum out-of-pocket expense and the now-$50,000-plus she's facing in bills.

"I was unconscious when I was taken to the hospital," she said. "Unfortunately, I was taken to the wrong hospital for my insurance.

http://m.channel3000.com/woman-taken-to-wrong-hospital-faces-bankruptcy/29648000
 
A News 3 investigation revealed Rothbauer's situation -- what's called "balance billing," where patients receive the balance between the hospital charge and what insurance companies will cover -- is not unique. While the local insurance companies that represent roughly 80 percent of those who have insurance in our area will offer out-of-network patients in-network rates during emergency room visits, there remains no guarantee they won't face hefty bills on the back end depending on the treatment they receive."My strong suspicion is this happens more frequently than you think," said Meg Gaines, who runs the Center for Patient Partnerships, a consumer health care advocacy group at the University of Wisconsin-Madison Law School. "I mean every time someone goes down, they don't have someone around who knows what their insurance is."


#America
 
#America[/FONT][/COLOR]

In most states (~40), emergency care is covered under "prudent person" laws which basically says insurers need to cover any ER care that is deemed an emergency by a prudent lay person. These are good laws except that its nearly impossible to define what a prudent person is so essentially all care through the ER is covered as in network. This has been the law in NC since 1997.
 
I'll add that as we add more of the research funding load onto private enterprises, especially pharma, you'll see the cost go up to consumers for drugs, and you'll see research funding bottlenecked into only therapeutics/drug development and out of basic research. Not good for patients/health care consumers in the US at all.

This will end up being a huge problem. Sure there is the side of the coin where your taxes are going to fund research which eventually leads to windfall profits for large corporations but the pipeline of how that works is essential and necessary for the advancement of science. Basic research really is the foundation that most new discoveries are based on. It seems like progression of new drugs these days is, basic research and the grunt work to begin the search for answers, a major breakthrough from a lab, collaborations and a big move into this area by multiple people, the formation of start-up companies to explore the idea further and the application of the idea, if successful said company is bought by a large pharmaceutical company which has the means and money to bring the drug through clinical trials and take a hit when its a failure. Without basic research pharmaceutical companies aren't going to waste their time on that aspect and there will be a significant decline in advancement.
 
I almost feel like we could use a biomedical research thread, but BigTree and I would probably be the only ones posting on it.

Anyway, the US funding of health research is stalling as other nations are ramping it up.

I seem to remember posters saying on this thread that'd be a good thing. I tend to disagree.

Tend to disagree? You should vehemently disagree because it will not be a good thing at all. For reasons outlined below, it won't be good for pharma or research or the US population. Everybody loses when we start to stagnate biomedical research funding

This will end up being a huge problem. Sure there is the side of the coin where your taxes are going to fund research which eventually leads to windfall profits for large corporations but the pipeline of how that works is essential and necessary for the advancement of science. Basic research really is the foundation that most new discoveries are based on. It seems like progression of new drugs these days is, basic research and the grunt work to begin the search for answers, a major breakthrough from a lab, collaborations and a big move into this area by multiple people, the formation of start-up companies to explore the idea further and the application of the idea, if successful said company is bought by a large pharmaceutical company which has the means and money to bring the drug through clinical trials and take a hit when its a failure. Without basic research pharmaceutical companies aren't going to waste their time on that aspect and there will be a significant decline in advancement.

This is a succinct and accurate description of the system in place. A system, I might add, that works exceptionally well for driving truly novel discoveries. Pharma companies, like every other for profit corporation, aren't driven by some innate desire to innovate (basic research scientists, now there is a breed of individuals that LOVE LOVE LOVE to be the first person to discover/innovate) unless they view it as profitable. That is why, for quite some time, the brunt of the cost for innovation has fallen on basic scientific researchers supported by public funds. Cutting/restricting public funding will only ensure Pharma continues to dump money into proven tracks of therapy, not start developing completely new ones. Make no mistake, continuing down the current trend of biomedical funding is going to set back medical discoveries by decades if not longer (it already has set it back). And in the end, the average taxpayer is going to see next to no difference in the amount of taxes they pay but people will die from conditions/diseases that could have otherwise been treated.
 
Great posts. There has to be a public role in innovation because the private sector can't stomach the risks associated with making large leaps in knowledge.
 
Good posts. Pharma is doing everything they can to distance themselves from the R&D side. Over the last 8 years, I've watched client after client axe their entire R&D departments...in some cases with no warning. Increasingly my clients are small labs, but many of those are struggling start-ups who can't afford the truly state of the art equipment and materials needed to aggressively pursue their goals. The few who make it invariably get bought, their work and patents sucked up, and the rest sold off for parts...then the cycle starts over.
 
Before Medicare, health care was affordable. Jus' sayin'.
I'm sure you've got some links supporting this, showing how affordable it was, and what % of the population was covered.
 
Yes I do. I'm sure you have some links showing old people who died because doctors and hospital turned them away before 1965, don't you?
 
Yes I do. I'm sure you have some links showing old people who died because doctors and hospital turned them away before 1965, don't you?

"In other words, in the pre-1965 era, if you had to go to the hospital, the hospital may not have turned you down -- but if you were in the sizable percentage of Americans who had to pay all or much of the costs out of pocket, you’d be paying for your misfortune for years to come."

"In a 1963 survey, patients from the general population were given a list of symptoms and asked whether they had been able to see a physician about them. Among those who reported "pains in the heart," 25 percent said they did not see a physician; for "unexpected bleeding" it was 34 percent; for "shortness of breath," it was 35 percent; for "abdominal pains," it was 31 percent; for "repeated vomiting," it was 40 percent; for "diarrhea for four or five days," it was 38 percent. Meanwhile, comparing the annual rates of hospital admissions per 100 persons suggests that Medicare and Medicaid had a tangible impact on widening access to health care. In 1963, the rate of hospital admissions for patients with private insurance was 15 percent, compared to 9 percent for those without private insurance. By 1970, the rates had equalized at 13 percent each, with the rate for those without private insurance increasing due in part to expanded access through Medicare and Medicaid. "Many people in the U.S. prior to 1965 had very limited access to medical care," said Ronald Andersen, an emeritus professor of health services and sociology at the UCLA School of Public Health who has studied this data since the 1960s and provided the data to us. "This situation improved considerably after the implementation of Medicare and Medicaid."

http://www.politifact.com/truth-o-meter/article/2012/jan/20/was-early-1960s-golden-age-health-care/
 
Ron Paul, based on his experience as a physician before Medicare, made the same point I am making and the Washington Post tried to refute it. Although they tried hard and gave him three pinocchios, even they admitted that they could not refute this assertion.

http://www.washingtonpost.com/blogs/fact-checker/post/ron-pauls-claims-about-life-without-medicare-and-medicaid/2012/01/31/gIQAedy5hQ_blog.html

In trying to refute him, they used a government survey from 1963:

"A later study from the Social Security Administration made similar conclusions, as we learned from PolitiFact. The 1963 Survey of the Aged showed that seniors were paying especially high medical costs because they needed more care and that median costs for elderly couples needing hospital care reached about $7,000 a year in today’s dollars."

Medicare.gov estimates that people on Medicare today in good health spend $6600 per person out of pocket, about the same out of pocket costs as elderly couples needing hospital care did in 1963.

http://www.medicare.gov/find-a-plan/staticpages/medigap-out-of-pocket-costs.aspx?AspxAutoDetectCookieSupport=1

Medicare has fucked up health care for older people far beyond any possible repair.
 
Look no further than the resurgence of measles for evidence that other people's poor health care decisions have consequences for everybody else.
 
Look no further than the resurgence of measles for evidence that other people's poor health care decisions have consequences for everybody else.

Okay then. "We" have a choice: attempt to force others to be vaccinated (which "we" can't do anyway) or vaccinate your own rear end of your own free will so you can stay the fuck alive.
 
Ron Paul, based on his experience as a physician before Medicare, made the same point I am making and the Washington Post tried to refute it. Although they tried hard and gave him three pinocchios, even they admitted that they could not refute this assertion.

http://www.washingtonpost.com/blogs/fact-checker/post/ron-pauls-claims-about-life-without-medicare-and-medicaid/2012/01/31/gIQAedy5hQ_blog.html

In trying to refute him, they used a government survey from 1963:

"A later study from the Social Security Administration made similar conclusions, as we learned from PolitiFact. The 1963 Survey of the Aged showed that seniors were paying especially high medical costs because they needed more care and that median costs for elderly couples needing hospital care reached about $7,000 a year in today’s dollars."

Medicare.gov estimates that people on Medicare today in good health spend $6600 per person out of pocket, about the same out of pocket costs as elderly couples needing hospital care did in 1963.

http://www.medicare.gov/find-a-plan/staticpages/medigap-out-of-pocket-costs.aspx?AspxAutoDetectCookieSupport=1

Medicare has fucked up health care for older people far beyond any possible repair.

Did you read that Washington Post article? They said they couldn't prove a negative, which you can't, not that he was correct.

"A Social Security Administration analysis of the survey said: “Many aged persons never recover from the economic effects of a single hospital episode. Unfortunately, the heaviest burden is likely to fall on those with the least resources,” and “even for the insured there is no present guarantee against dependency in old age caused by catastrophic medical expenses.”

"In terms of Paul’s notion that government benefits provide a perverse incentive for doctors to charge more, that’s not possible with strict price controls in place for Medicare and Medicaid. Theory has it that providers just shift costs to the privately insured rather than absorb them, but Ginsburg said only the most elite hospitals can do that for fear of being dropped by insurers. Most will instead change their production processes to cut costs, he said."
 
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