USA's Health Care vs Universal Health Care

[Maxgain]

Seems the US insurance companies have way too much power. They should be fighting for contracts to cover healthcare which is determined by the government. As part of this what is covered and prices should be set.

In Ireland Insurance will cover every medically necessary (ie not cosmetic) procedure. The goverment covers all medicine costs and prices are negotiated with companies. If meds are too dear they wont be licensed or approved for government schemes and thus no one uses them. In the UK the gov covers it all and they ensure the minimum price is paid.

Firehawk I believe you are wrong to think everyone should go private. MAny insurance companies have negotiated down drug prices and procedure costs with hospitals and pharma. Often the private patient paying out of his own pocket will be charged more.
Think of it as a discount for buying in bulk.

[LiftGirl]

Originally Posted by Maxgain

IThe goverment covers all medicine costs and prices are negotiated with companies. If meds are too dear they wont be licensed or approved for government schemes and thus no one uses them. In the UK the gov covers it all and they ensure the minimum price is paid.

So no one will be able to use a good medicine (maybe the best one for their treatment) if it's too expensive? What if the government decided my asthma medicine was too expensive and should no longer be covered? I'd be in trouble!

What if a great new treatment came out that worked even better, but no one could get it because it was too expensive?

If the government insures the minimum price is paid, then pharmaceutical companies are not encouraged to discover new drugs, because they won't be able to profit much from the millions they spend researching and creating a new drug.

[Maxgain]

Originally Posted by LiftGirl

So no one will be able to use a good medicine (maybe the best one for their treatment) if it's too expensive? What if the government decided my asthma medicine was too expensive and should no longer be covered? I'd be in trouble!

What if a great new treatment came out that worked even better, but no one could get it because it was too expensive?

If the government insures the minimum price is paid, then pharmaceutical companies are not encouraged to discover new drugs, because they won't be able to profit much from the millions they spend researching and creating a new drug.

No that is not true.

A cost benefit analysis is carried out. Practically all drugs types care covered once there is a proven need for them and there is no suitable alternative on the market.

Dearer drugs are bought directly from wholesalers by the government. Pharmacies are not allowed charge a mark up and this reduces cost.

At the end of the day economics has to come into it a cost/benefit analysis.

The health servise has a budget. It seems harsh to apply numbers to health but that is the way it must be.

WIll they pay for a medication or if they feel there is an adequate alternative is it not better to open more beds invest in equipment, staff etc. Thats great we all have the medicines but what now as exists in Ireland public health servise we can no longer afford to keep wards open hire consultants etc.

[Firehawk]

Alot of times in the US, health insurances will not cover a real drug over it's generic if there are generics available BECUASE they are far cheaper. Even if a doctor says "i want you taking the original drug (damn i can't think of the word right now for the original drug lol), the insurance often says no and you are forced to use a generic version. And alot of times, the generic versions are not as effective, or you find that things are added to it (obviously based on patent you can't reproduce the exact same thing) which can cause worse side effects.

So yes, insurance does have a major impact on how you are treated. I had to go for a stress test and was not notified (i guess it's my fault that I assumed) that the coverage had changed. Well i ended up getting all kinds of bills, and saw alot of negotiating done by a 3rd party between the doctor's billing agency and the insurance company. So this stuff definitely goes on. I even got a bill to cover the leftover costs because the insurance told me "well we have a set payment and the doctor charged you what we consider to be an unreasonable amount so we pass the rest of the cost on to the consumer". I said, well your premiums every paycheck are unreasonable, can I just pay what I think is suitable and pass the rest on to you?"

Ridiculous.

[LiftGirl]

Originally Posted by Firehawk

Alot of times in the US, health insurances will not cover a real drug over it's generic if there are generics available BECUASE they are far cheaper. Even if a doctor says "i want you taking the original drug (damn i can't think of the word right now for the original drug lol), the insurance often says no and you are forced to use a generic version. And alot of times, the generic versions are not as effective, or you find that things are added to it (obviously based on patent you can't reproduce the exact same thing) which can cause worse side effects.

First of all, a generic cannot be produced until the patent on the brand name (original) drug runs out. Secondly, generics must be proven to be effective just like regular drugs, through the FDA, and they are not allowed to change the active ingredients. They may change some of the inactive ingredients if they can show it won't effect the medicine.

My insurance is better than most. Luckily it will cover a generic for $10/month, the brand for $20/month and a non-formulary (not on their list) drug for $40/month. Of course I have to pay the brand name charge even if there's no generic available, but I can hardly complain.

Most insurance companies have a specific hospital in your area that they contract certain rates with. As long as you stick with them, you shouldn't get stuck with charges over the usual and customary. Of course, you have to research your health plan to find out which hospitals they have contracts with. There's probably a phone number you can call to talk to a rep who can tell you which hospitals they have contracts with.

[Maxgain]

Bump on what liftgirl says on definition of generic. They are the exact same and doctors are to be encouraged to prescribe them.

There are too many endorsements to hospitals from Big Pharma and all hospitals should be made prescribe by ingredient name.

[Firehawk]

Originally Posted by LiftGirl

First of all, a generic cannot be produced until the patent on the brand name (original) drug runs out. Secondly, generics must be proven to be effective just like regular drugs, through the FDA, and they are not allowed to change the active ingredients. They may change some of the inactive ingredients if they can show it won't effect the medicine.

My insurance is better than most. Luckily it will cover a generic for $10/month, the brand for $20/month and a non-formulary (not on their list) drug for $40/month. Of course I have to pay the brand name charge even if there's no generic available, but I can hardly complain.

Most insurance companies have a specific hospital in your area that they contract certain rates with. As long as you stick with them, you shouldn't get stuck with charges over the usual and customary. Of course, you have to research your health plan to find out which hospitals they have contracts with. There's probably a phone number you can call to talk to a rep who can tell you which hospitals they have contracts with.

Yeah? Should I make those calls on a daily basis? Because that seems like how often things change with insurance companies.

My sister and I (almost done with pre-med) had this conversation about generic drugs and she said she was taught that while generics are supposed to be exactly the same and do exactly the same, they often times do not because of things added.

EDIT: And after all this nutrition discussion about the FDA, do you really trust them when it comes to this stuff? I don't. How many discussions have we had around here about aspertame? What more needs to be said?

[Maxgain]

Generics are the same. They have to prove comparable bioavailablity and distribution as the final product. The difference is often psychological.

A huge blight on the health systems is the over prescribing of brands and often it is for misconceived or unethical reasons.

[Your_Crazy]

Heres the deal. Socialized healthcare would be a good idea. However, the US has so many people who don't provide taxes to the government. We are talking hundred of millions of people. This people already use the Emergancy rooms as their personal clinics since the doctors are required by law and the Hypocratic oath to treat them. The US already looses more than a billion dollars a year. Think about if it was socialized. We would be losing more money and have extreme taxes. Much more than Canada would ever think of. The premise is a good idea, just the end result is bad.

[Firehawk]

If my taxes get any more extreme, I'll be selling my house. Just how much more extreme can they possibly get?
I would much rather have a doctor that went into medicine to actually help people rather than a doctor who is doing it for the paycheck.
I'd be curious to see a statistic on the estimated number of people that don't pay taxes in the US vs Canada's, if anyone can find such a thing.

[getaway]

6 hours in emergency? Those politicians love to exaggerate, longest I've been in emergency is 45 minutes and that was with about 20 other people in the room. I believe universal healthcare is the best way to go, not everyone can afford 6,000 for a simple surgery and health insurance companies are constantly trying to weasel their way out for paying for you. The wait may be long, but the wait isnt going to kill you, would you rather wait a few hours, or pay through the nose?

[Firehawk]

This is an honest question.

Could someone explain why the cost is so high for say, a physical? Why when I go see the doctor for 15 minutes of their time, the insurance is billed 470 dollars? Why is the cost so high to begin with?

[Maxgain]

Originally Posted by getaway

6 hours in emergency? Those politicians love to exaggerate, longest I've been in emergency is 45 minutes and that was with about 20 other people in the room. I believe universal healthcare is the best way to go, not everyone can afford 6,000 for a simple surgery and health insurance companies are constantly trying to weasel their way out for paying for you. The wait may be long, but the wait isnt going to kill you, would you rather wait a few hours, or pay through the nose?

Welcome then to days waiting in the Emergency Room and the wait can kill as documented in Ireland.
The cost to switch to universal healthcare wil be astronomical as well as the prats that will go straight there with any whim instead of to a GP so they dont have to pay.

[LiftGirl]

Originally Posted by Maxgain

The cost to switch to universal healthcare wil be astronomical as well as the prats that will go straight there with any whim instead of to a GP so they dont have to pay.

John Stossel did a good 20/20 report on healthcare. He likened free universal healthcare to free grocery insurance. If you had grocery insurance, why would you buy hamburger when you could get steak? You might buy twice as much food as you'll actually eat. Making something free encourages people to overconsume it.

Also, I saw something in the paper. One official here in Illinois says we are overconsuming health care due to poor lifestyles. I think that's something to think about. Treating health problems related to sedentary lifestyles and poor nutrition really burdens the system.

[LiftGirl]

Originally Posted by Firehawk

My sister and I (almost done with pre-med) had this conversation about generic drugs and she said she was taught that while generics are supposed to be exactly the same and do exactly the same, they often times do not because of things added.

That simply isn't true. Generics are only allowed to change the inactive ingredients, not the active ones. Changing the inactive ingredients will not affect the action of the drug.

Brand names cost 3 times or more as much as generics, and if everyone uses brand name drugs when there are generics available because they falsely believe there's a difference, then health care costs are going to increase way beyond what any system of care can pay.