Are you a 1-Percenter?

[jonzr]

It's just a big 'ol cluster f*ck. 

[SCacalaki]

It's tough.  And so there is the model story that you have of your own experience that suggests things aren't currently working.

I've seen M'care in action and it isn't something to model.  M'caid takes forever to obtain eligibility for.  And patients suffer during this waiting period, as they are unable to obtain the care they need.

msdmnr mentioned the cons of quality-based pay.  And I think he's correct and it piggy-backs onto physicians' fear of lawsuits from high-risk cases.  Plenty of stories of OBs turning away women with high-risk pregnancies.
Alas, I think every payor is moving to a quality-based pay system.  So that's where we're headed.

My guess is that there is an answer, but not a perfect answer.  Some people will still not get the care they need.  Some will continue to pay more for care than others.  Physicians will choose other fields, reduce hours/availability, or follow the boutique care system (already prevelant in many areas).  The number of hospitals will be reduced as funding becomes even more scarce. 

[jonzr]

I'm appreciative of all the input but now less hopeful than in my relative greater ignorance.  Sigh.

[Finnegans Wake]

Well, I don't think anyone sees Medicare as the optimal model.  I don't know what the proposed Obama model is, since it appears he's having Congress do the heavy lifting.  All I know is, I think the system in place currently should be scrapped in toto.  And that's from someone with damned good insurance, co-pays, etc.  I think we can do better, more patient- and physician-friendly, more economically sound, etc., but I think we're slouching towards halfassdom.

I know this is all over the place, but one more thing.  One reason we aren't seeing the benefit of increased cost of care in life expectancy or however you want to measure it is that we are battling against an ever-worsening lifestyle.  We eat more, eat worse food, and exercise less than most other countries.  I think the fact that we're in the ballpark with those nations is a testament to a pretty good health care system.  We live longer than previous generations despite a less healthy lifestyle.  Why?  Better health care.

I know I've been on this soapbox for quite a while, but if you get a chance, see Food, Inc.  It's a nice summation of my basic polemic on the American industrialized food system.  DVD out in November. 



Msdmnr, what is your current job, if I may ask?

[Finnegans Wake]

Love the charts at this site...

Single payer is not at the table in this discussion, and is not the same as the proposed public option...

[jonzr]

Love the charts at this site...

Single payer is not at the table in this discussion, and is not the same as the proposed public option...

There you go, highest cost system, 37th in quality.  I'm expecting our sens and reps to act in a bipartisan manner, for the good of the people instead of their own (or party) interest, for once, and deliver a system that's a reasonable top 10 and do it for LESS MONEY THAN WE'RE SPENDING NOW.  Why less?  Because there's already too much waste.  Streamline the system, cut out the greed at the administrative level and BAM!

We need American Healthcare 2.0 sooner than later.

[msdmnr2002]

Msdmnr, what is your current job, if I may ask?

Teaching college full time now.  Anatomy and physiology mainly.

[Finnegans Wake]

Msdmnr, what is your current job, if I may ask?

Teaching college full time now.  Anatomy and physiology mainly.

I'm hoping you don't get the amount of Engrish that Pens does...

BTW, when I die, I'll have 'em send you my liver.  Great for show and tell.

[msdmnr2002]

BTW, when I die, I'll have 'em send you my liver.  Great for show and tell.

Cool, we've got a pig liver in the freezer.  It'll be a good lab to compare.

Hopefully the pig liver hasn't been pickled with Nyquiltinis.

[Gnutella]

If government health care reform passes, put Pittsburgh right back on the "dying cities" list.

Besides, if the federal government can't even execute "cash for clunkers" properly, then why the hell would we want them playing around with a chunk of our gross national product?