SiCKO by Michael Moore

[Epinephrine]

You have to admit Epi that the father of Canadian medicare Thomas Douglas probably didn't envision the government paying for every scrapped knee or bad cold in the country. I believe the idea was to ensure that no Canadian would be denied the right to receive treatment for SERIOUS ailments or injuries. I'm sure many people have done studies on the yearly costs of unnecessary doctors visits or minor procedures and I'm sure it's immense. What every goverment should do is increase funding for preventive health care measures like chiropractors, psychologists and whatever the hell it takes to make people stop smoking, eat healthy and exercise. Instead the Ontario goverment decides to cut those areas and my kids (well someone's kids) are going to be paying for it via higher taxes in 30 years.

What I was trying to say was about insurance, and insurance pools where a small percentage of abuses can drive the costs upward, and the situation where people rely on insurance instead of family, friends, smaller social circles.

Eric, I think your view of this and to Eph's view on this is an extremely simplistic view of medicine. It's true that a lot of people see the doctor for 'small' things, which don't really qualify as a problem. But the fact is, the vast majority of spending on health care is for the big things. Primary care (for things like colds and so on) really isn't that much of the health care budget and doesn't even take that much time for doctors. In fact, a recent study in the Canadian Medical Association Journal, found that the extra time spent in the ER by emergency doctors dealing with minor problems was insignificant. As well, these people did not contribute much to the problem of not enough space in the ER or ER wait times.

From a medical perspective, I can say that sometimes those colds and headaches and stomach aches can actually be something extremely significant, and thus people who feel they need health care should feel FREE to get health care because a lot of the time it is serious.

But really, the fact is, the bigger problems (heart attacks, dementia, broken hips, etc) FAR outweigh the utilization of health care resources in comparison. When a single day in the ICU can cost up to $1000/day, or when cancer drugs can cost $20,000 for one treatment, the price of seeing people with colds is pretty insignificant.

The biggest problems with health care spending in fact are the 'new' and 'novel' therapies. Because they are usually extremely expensive (because of technology and because of drug patents), they can drive up the costs of health care exponentially, while providing relatively minor benefits to all of society. The question is, should we stop paying for expensive cancer drugs, when older drugs work almost as well (but may kill a person a month earlier)? They're going to die anyway right? But then what exactly is the point of having insurance that you are PAYING for (and conversely what does it say about a society in a public system) if you aren't going to use this system to actually help those in real need with the best available methods?

The other huge part of health care is the continuing care for seniors. With the senior population increasing thanks to the baby boomer generation and increased life expectancy, we are having both older and sicker people. These people can be kept alive LONGER and SICKER than ever before. The costs for a full-time staff to look after these people is huge, and they also take up a lot of space in hospitals and other long-term care facilities. MOST people who utilize health care are actually over 60 years old. Those under 60 and over 1 years old really don't use much healthcare at all in comparison, with the group between 5-50 using the least, even if you count risky behaviours and crappy lifestyles.

Yes some of these older people have ate fast food, some of them have also smoked. But the vast majority of them are living longer on average than people a generation earlier did thanks to medical advancements and other social advancements. Should we now abandon these people and deny them health care? I guess being old is not a good reason to see a doctor right, I mean they're close to death anyway right?

I say all of this from experience, and I can say that blaming higher costs simply on 'stupid people who don't wear bike helmets' or 'hypochondriacs seeing the doctor for no reason' or whatever you want to blame is pretty silly indeed.

The true culprit behind higher costs are the rising cost of senior care, and the rising costs of new therapies (for SERIOUS diseases) which cost exponentially more for marginal benefits, but which the public demands. Oh and of course, private insurance companies out to make a buck.

[Eric is God]

I realize that the majority of health care costs in the coming years will go towards seniors and no I don't feel it's right to cut off their coverage in any area Epi. But you know me and you should know that waste and inefficientcies bug the hell out of me. I don't make doctor's appointments for things I know my doctor can't do anything about and when I have to sit in the waiting room for an hour just to get a new perscription it bugs the heck out of me. This may not be true across the country but the one thing that does bug me about the elderly is they take too long to do everything, including visit the doctor. I can't tell you how many times my doctor has had to apologize for being behind because one of her elderly patients either wouldn't stop talking or came in for no good reason. If cutting down on unnecessary visits and denying coverage to people who start smoking now saves us only 2-3% on the country's health care budget, that is a huge amount of money that can be put towards preventive care or any number of programs.

[PH]

God this thread sucks.

Most multi-page threads in this section of the forums do.

[Epinephrine]

I realize that the majority of health care costs in the coming years will go towards seniors and no I don't feel it's right to cut off their coverage in any area Epi. But you know me and you should know that waste and inefficientcies bug the hell out of me. I don't make doctor's appointments for things I know my doctor can't do anything about and when I have to sit in the waiting room for an hour just to get a new perscription it bugs the heck out of me. This may not be true across the country but the one thing that does bug me about the elderly is they take too long to do everything, including visit the doctor. I can't tell you how many times my doctor has had to apologize for being behind because one of her elderly patients either wouldn't stop talking or came in for no good reason. If cutting down on unnecessary visits and denying coverage to people who start smoking now saves us only 2-3% on the country's health care budget, that is a huge amount of money that can be put towards preventive care or any number of programs.

C'mon Eric, efficiency isn't everything. Old people take longer at the grocery store too to get their change. Maybe we should ban them from there too, to save 1-2 more minutes each time we go to the grocery store, that could save millions if spread across the country. <_<

[Eric is God]

C'mon Eric, efficiency isn't everything. Old people take longer at the grocery store too to get their change. Maybe we should ban them from there too, to save 1-2 more minutes each time we go to the grocery store, that could save millions if spread across the country. <_<

I didn't say we should ban them from anything, but how about charging people for unnecessary visits. Obviously there are no easy solutions to health care problems just like there are no easy answers for education problems or traffic problems, but that doesn't mean I won't get really annoyed tomorrow morning when I hit 9 out of 12 lights red on my way to work even though it happens every day :P

Actually when I see someone cut another driver off on the highway I often calculate how much total time the 80 drivers behind him lost by having to break and I do the same thing at grocery stores when some old chinese woman decides to fish around in her purse for 2 minutes so she can pay in change. Yes that's how messed up my brain is but fortunately I found a job where that kind of mindset is reaping huge benefits.

[Epinephrine]

I didn't say we should ban them from anything, but how about charging people for unnecessary visits. Obviously there are no easy solutions to health care problems just like there are no easy answers for education problems or traffic problems, but that doesn't mean I won't get really annoyed tomorrow morning when I hit 9 out of 12 lights red on my way to work even though it happens every day :P

While charging for 'unnecessary' visits sounds good initially, you really are not considering the greater health implications. Most serious problems start off as minor problems. Even things like cancer usually are first noticed as very minor complaints. If people don't go to the doctor for minor things because of the cost factor, then by the time they go, if it is actually serious, it may be too late to help them. Generally people will not go to the doctor for no reason, becasue generally people dont like going to the doctor and have better things to do. I think the current way is fine.

There is FAR more money to be saved by things like better control of hospital infections, tighter control of allowing elderly (but not really sick) people to linger in valuable hospital beds for too long because their family doesn't want to pay for long-term care homes, and things like more negociating with drug companies and so on.

[Eric is God]

While charging for 'unnecessary' visits sounds good initially, you really are not considering the greater health implications. Most serious problems start off as minor problems. Even things like cancer usually are first noticed as very minor complaints. If people don't go to the doctor for minor things because of the cost factor, then by the time they go, if it is actually serious, it may be too late to help them. Generally people will not go to the doctor for no reason, becasue generally people dont like going to the doctor and have better things to do. I think the current way is fine.

There is FAR more money to be saved by things like better control of hospital infections, tighter control of allowing elderly (but not really sick) people to linger in valuable hospital beds for too long because their family doesn't want to pay for long-term care homes, and things like more negociating with drug companies and so on.

You are far more of an expert than I am so I wouldn't assume to have any answers. I just know that there must be many areas where money can be saved without decreasing health care quality and you just named a few.

[Epinephrine]

You are far more of an expert than I am so I wouldn't assume to have any answers. I just know that there must be many areas where money can be saved without decreasing health care quality and you just named a few.

You just need to think about it a bit. About 55% of doctors are specialists.. you don't 'fake' seeing a specialist. No matter how good your insurance, you still have to pay for wart removal (yes even in Ontario) and boob jobs. Then of the 45% of family doctors, maybe 20% of the stuff seen is considered 'routine', but usually not because people are lonely and want to see a doctor, but because they are geniunely worried. True, there are people who really should not be there, but really while extremely annoying, they cost next to nothing to help.

The real problems with the system are systemic. Simply put, our system is designed to handle a much smaller population, and we really have not invested as much as we should in preparing for the baby boom generation getting old. As well, because people are too cheap to pay for higher taxes (face it, with vastly more elderly than before, vastly more treatments than before, we really need a vastly greater percentage of our GDP to be used in health care) we are stuck with doing more for less.

In Kingston General Hospital, there was an entire 1 1/2 floors dedicated to elderly people who didn't need to be in hospital but had no where to go, because either they lived alone or with a spouse unable to take care of them, or because there isn't enough nursing home spaces, or because their family doesn't want them. They weren't actually sick enough to be in hospital, although they had long-term problems. Because of these people, there were always about 10 in-patients waiting in beds in the ER, and those people in turn added to the waiting lists of everyone else outside the ER to get seen by a doctor.

What we need is both more doctors, more hospitals, and more long-term care beds. As well, we need more preventative health programs to drive down costs in the future, but for the time being, it's a problem faced by most Western countries, which is... too many old people, not enough money to help them.

Looking back at 'old ways' where the 'family used to take care of things' as Eph is so fond of, is completely unfeasible. In 1960 for instance, there was NOTHING we could do for a heart attack. You get one, and basically unless you were really lucky... you died. Now, there are a ton of things we can do, and it's all very expensive, and it all requires hospital care. Should we just stop treating heart attacks? Strokes? Cancers? We really can't... and all this costs a lot of money.

We as a society need to make a choice. Is it more important to live longer and healthier lives, or is it more important to fill those lives with material things? How should we spend our money?

Rising health care costs are inevitable, but we should do our part to try and make it better, not by attacking the extremely small percentage who are 'abusing the system' (whatever that means), but by tackling the real problems like how are we going to manage the elderly. Will people give up living on their own to allow their parents to retire with them in their house? Will people use government power to lower profits at drug companies so everyone benefits with cheaper prices? Will we pay for more preventative health programs to lower future costs? Will we continue to fund medical research very well (instead of cutting it like how Bush did recently in the US) or not?

And of course to relate to this thread... will Americans finally give up this completely false idea that their system is the 'best in the world' and it is so because of private health care which cannot possibly be replaced, and go with a much cheaper not for profit system where everyone in the system isn't just trying to make money, rather than save your health?

[Cops]

Who pays for all this health care?

At my company, for the last 3 years, our group insurance agent comes in each year announcing, “good news, your rate is only going up 25% this year”. We cover 95% of each employee’s insurance and 75% of their families insurance. When we absorb these 25% annual increases we do not have a lot of money left over for annual raises. Yet we continue to have people who run to the emergency room for headaches and sore throats while other people do use the insurance responsibly.

So it may be easy to be critical of health care systems, but I see no posts here about who is going to pay for it all.

regardless, if you put money over human life than that's just sad, of course people don't want to pay taxes but in the end it's worth it.

[Zerzera]

There was a time in America when communists got locked away, young people were sent off to die in some foreign country, and old men ruled the white house.
Now look what they've become. Young communists polluting our forum, condemning the old and wise

[Ephemeral]

regardless, if you put money over human life than that's just sad, of course people don't want to pay taxes but in the end it's worth it.

I do not understand, we are willing to pay a much larger percentage of the employees health care costs, I would estimate that we are covering more than 90% of other American companies.

"The average employee contribution to company-provided health insurance has increased more than 143 percent since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115 percent during the same period." Source: The National Coalition on Health Care

Our company has sucked up these increases since 1998 and not asked the employees to foot the bill.

[Ephemeral]

Yes, I know it does.

Basic human decency includes making sacrifices for the good of the collective, regardless of how you may personally feel about some of the individuals within the collective.

Nobody deserves to die a slow painful death in a first world country, for lack of healthcare. Not someone who smokes. Not someone who is a drunk. Not even a selfish asshole who only cares about himself.

Basic human decency does indeed include consideration, including consideration of others who might not agree with YOUR opinion. There is no community value in making personal attacks on others in these forums. Selfishness is the only value/reason I can determine.

I do not think that in any post have I stated that anyone deserves to die or deserves not to have health care. I happen to be dealing with a real life example for now, one where a employee's mother is being denied health care and O2 because she refuses to stop smoking. She is on the path to death, the medical industry could provide treatment to extend her life, but they will not. We have stepped in and helped (paying for the medical care and paying for her legal services so she can put her will in place).

My posts in this thread intent was to simply raise questions and present other perspectives.
My personal opinion is the health care, world-wide, is fucked up. The insurance industry is nothing more than capitalized gambling. The drug industry (which I did substantial research on while in college) is nothing more than legalized drug dealers. The drug companies are investing mostly in drugs that keep people alive vs. drugs that cure because they profit more if a person has to buy drugs for the rest of their lives. And the medical industry has stood by and let their once noble profession be turned into a giant cash cow.
Doctors can make much better medical decisions by making house calls. 'Detail men' (drug company salesmen with marketing experience only) making sales calls on doctors, handing out free samples, free brief cases, free vacations to induce doctors to buy more drugs than they know they need is a huge problem. Pitching drugs as the ultimate, 'quick fix' answer to a person's medical problem in the media is something that should be closely questioned.

And yet, yes I do think that we all have responsibility in not abusing insurance, in making sure that we are not asking for others to pay for our own decision. And I do believe that understanding how it gets paid for is important.

[SEAL]

Question: What does an american pay to be 'fully' insured?
(This means personal insurance. Not your house or other material things or vacations or travel-insurance, ect. So no strings attached. Goto the hospital whenever you want, visit the denstist whenever)

I currently pay 150 (201 us dollars) euros per month, which I personally find ridicules. This means, from my salary, 42% to the goverment for tax. From the 58% that i actually get on my bankaccount, I have to pay 150 euros for insurance.

I'm just wondering what alot is in the usa.

[Ephemeral]

Question: What does an american pay to be 'fully' insured?
(This means personal insurance. Not your house or other material things or vacations or travel-insurance, ect. So no strings attached. Goto the hospital whenever you want, visit the denstist whenever)

I currently pay 150 (201 us dollars) euros per month, which I personally find ridicules. This means, from my salary, 42% to the goverment for tax. From the 58% that i actually get on my bankaccount, I have to pay 150 euros for insurance.

I'm just wondering what alot is in the usa.

In the US, the annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $11,500 in 2006. The typical worker contributed nearly $3,000 in 2006, (10 percent more than they did in 2005) (1).

In our company the typical worker (family of four) pays only $1440 annually for a family of four, our company pays the rest.
Note that items such as average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits should also be considered. I can only speak to the plan we currently have and the rates are as follows: $25 deductable for urgent care, $15 deductable for doctor visit and $5 co-pay for meds.


(1) Reference: The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2006 Annual Survey. 26 September 2006

[Vykromond]

Most multi-page threads in this section of the forums do.

I think this thread is actually pretty good. j=t's, Epi's, and Eph's posts have all been interesting.