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Started By
Message
re: Why can't the US have univeral healtcare with the current budget?
Posted on 10/3/23 at 9:16 am to AgSGT
Posted on 10/3/23 at 9:16 am to AgSGT
quote:
I worked upstairs from y'all for about a decade in the PSSG and worked with your office quite often. Usually Eric was my counterpart in your office. I'm in Missouri now but small world to bump into you online
Small world indeed. Did work in there with Sean and Charlie on testosterone, nursing home stuff, and a little bit of stuff on telehealth. I knew things were going to go bad when Klobuchar came. And they did.
1
Posted on 10/3/23 at 9:16 am to RaoulDuke504
In theory, we could take all the money we pay private companies/insurance companies / doctors / etc for medical care, give it all to the government, and they can spend it on universal healthcare, and it would not cost us any more money.
It's not a money issue.
The real issue is, the only system in America that has less efficency and more wasted money and bloat, then the US healthcare system, is the US government.
The US has proven time and again it cannot run major systems. Heck, look at the VA hospital system. It is terrible.
In the scandanavian countries where universal healthcare works well, they also have an effective government. We have no such thing.
It's not a money issue.
The real issue is, the only system in America that has less efficency and more wasted money and bloat, then the US healthcare system, is the US government.
The US has proven time and again it cannot run major systems. Heck, look at the VA hospital system. It is terrible.
In the scandanavian countries where universal healthcare works well, they also have an effective government. We have no such thing.
Posted on 10/3/23 at 9:19 am to POTUS2024
I left in 2019, IT never understood how to work with a geospatial program and we never received the amount of support we needed, especially after Care in the Community was instituted requiring dang near daily runs for drive time and distance. I did quite a bit with telehealth as well when Walmart and other locations were offering up booths to allow highly rural Vets telehealth closer to home. Got fed up with it though, tired of the cramped college town, now I'm out in the Ozarks of Missouri working for USGS
Posted on 10/3/23 at 9:20 am to RaoulDuke504
Look at how our government handles things like border security or welfare and ask yourself if you want them handling your healthcare!
Posted on 10/3/23 at 9:24 am to AgSGT
quote:
Universal Care would be great for those living in urban and suburban communities but for the rural and highly rural communities they'd be paying into a system that they don't have the same accessibility to. It would be like forcing highly rural voters to fund subways in a large city they don't live in.
This reminds me of a problem that is happening in St. Bernard Parish right now.
The parish is both very suburban in areas (Arabi through Violet) and very rural in other areas (everything down the road). There are no municipalities in the parish, everything is parish run.
There are two fire districts - district 1 and district 2, and they pay roughly the same in property tax rates. District 1 is the suburbs, district 2 is the rural areas. They are managed as one department.
Property values are much lower in District 2, and the population is much more spread out. Due to budget cuts a few years ago, a couple of fire stations were closed in District 2. Now, residents of district 2 have much longer response times than District 1.
District 2 says this is BS because "we pay the same taxes". District says you may pay the same rates, but because you have a much smaller spread out population, you aren't paying the same total, so to give you more coverage means less coverage for the suburban areas.
And both groups have a point. The reality is, we need two different systems, one to deal with the exact issues in each district.
Posted on 10/3/23 at 9:25 am to 4cubbies
quote:No. No. I know it sounds crazy, but Medicare heavily influences facility care and billing, across the board. Not just for the >65 group.
How old do you have to be to qualify for Medicare? 65?
Medicare mandated visual analog pain scales tied pain scores to reimbursement. That set hospital-wide behavior. JCAHO followed suit on visual-analog pain-tracking, and directed it to be incorporated as a component of medical performance improvement (QA/QI) programs.
Posted on 10/3/23 at 9:31 am to LSUFanHouston
quote:
And both groups have a point. The reality is, we need two different systems, one to deal with the exact issues in each district.
Agreed, there is no one size fits all approach that will work in the US, the VA is a perfect example of the weakness of the failures of a one size fits all approach. Many on here may be surprised to know that the VA actually rates pretty highly with the enrollees, but those numbers are skewed by over half our Vets live in urban areas, for those folks its a good system. But the satisfaction rates fall the further you get out into the country and drive time and accessibility comes into play. Contrary to the urban enrollees, care satisfaction is far lower for our highly rural enrollees which if I remember right accounted for around 800k enrollees. I went from 10 min from the VA along with their partners at UF to being out in the sticks of Missouri. I have to deal with the VA as it relates to burn pit exposure, but because of my rurality, I try to use my insurance to go to clinics closer to home. The hour and half to the regional center in Columbia is a pain
Posted on 10/3/23 at 9:33 am to NC_Tigah
quote:
That is/was CMS, not the AMA. It's a common misconception. The AMA actually opposed cutting MD numbers. The AMA is the CPT culprit though.
There was a report some time ago suggesting there might be a physician surplus and the AMA went full gas to limit everything and that's what happened. The report was wrong and now we have a shortage. CMS absolutely limits resident funding, which is ridiculous. But that was at least partially due to the urging of the AMA.
This blog post discusses this and gives various links regarding this issue. Link to blog post
Posted on 10/3/23 at 9:35 am to LSUFanHouston
quote:More than anything else, those countries don’t spend as much on elderly care. That’s the biggest differentiator. If we want to bring our spending in line with other countries, we are going to have to drastically cut what we spend on seniors.
In the scandanavian countries where universal healthcare works well, they also have an effective government. We have no such thing.
There is ZERO cultural appetite for that in this country.
Posted on 10/3/23 at 9:37 am to AgSGT
quote:
I left in 2019, IT never understood how to work with a geospatial program and we never received the amount of support we needed, especially after Care in the Community was instituted requiring dang near daily runs for drive time and distance. I did quite a bit with telehealth as well when Walmart and other locations were offering up booths to allow highly rural Vets telehealth closer to home. Got fed up with it though, tired of the cramped college town, now I'm out in the Ozarks of Missouri working for USGS
VA IT is really bad. You may remember one of the researchers there needed a specific statistical software program for a very specialized analysis. Got grant money for it and IT refused to buy it. The project was funded but the work was never done.
There was an issue back when there was controversy about testosterone and I was trying to bring attention to it, related to the statistical analysis in a paper. I contacted a journal that offered to entertain the issue as one of its editors is considered one of the top guys in the world n this type of problem. But the manuscript had to be in LaTeX which is free, and I asked IT to install it. The funding for my position expired and I never got that on my computer.
Posted on 10/3/23 at 9:38 am to Taxing Authority
quote:
we are going to have to drastically cut what we spend on seniors.
That isn't happening any time soon with the expected "Silver Wave" about to start hitting the senior care systems
Posted on 10/3/23 at 9:39 am to LSUFanHouston
quote:Good point. One-size-fits-all doesn’t work in a parish, it sure as hell doesn’t work in a country of 350 million.
And both groups have a point. The reality is, we need two different systems, one to deal with the exact issues in each district.
The problem is healthcare is a personal service—not a public good. And government has never been good at delivering personal services to individuals. Our needs, desires, abilities, and goals are too different.
Posted on 10/3/23 at 9:40 am to LSUFanHouston
quote:
In the scandanavian countries where universal healthcare works well, they also have an effective government.
They also have a much more polite and orderly society (Well, Sweden is falling apart) in which people usually pull together. Thats not the case here.
Posted on 10/3/23 at 9:41 am to POTUS2024
quote:Try to link that. I suspect in the process you'll find a different story.
There was a report some time ago suggesting there might be a physician surplus and the AMA went full gas to limit everything and that's what happened.
Posted on 10/3/23 at 9:42 am to POTUS2024
That reminds of my job before the VA, I was working with a company there in Gainesville, 3001 Inc, and we were taking the Navy's utility CAD drawings and bringing them into a GIS which also involved us going to the fields to ground truth our data and collect some other survey data. In the end the idea was that upon completion they'd have the data in a GIS and they could use Trimble GPS Units to check in and out data for public works. By the time we were done, they couldn't plug the units in using a USB without a lot of paperwork. By the time they were finally able to utilize what we'd given them over a year had gone by and the data we collected at that point was obsolete. That was a lot of work for nothing
Posted on 10/3/23 at 9:42 am to AgSGT
quote:Of course not. Image a president campaigning on cutting Medicare. He might get 3… maybe 4… votes?
And both groups have a point. The reality is, we need two different systems, one to deal with the exact issues in each district.
Posted on 10/3/23 at 10:04 am to LSUFanHouston
quote:A couple of years ago we were visiting the Edvard Grieg estate in Norway. Our tour guide was a cute blonde 20-something, working the summer between semesters. She was in a walking boot with a significant limp.
In the scandanavian countries where universal healthcare works well
Long-story short, she had a non-healing foot fracture, and the system had left her in a boot for nearly four months. I cannot tell you how inexcusable that is. She had a f/u appointment scheduled several weeks off with no alternate options.
So this girl, who in the US would have gone to surgery and returned to full function 6-8wks post-injury, in Norway runs a significant chance of lifelong pain, a limp, and perhaps amputation in the event of further complication.
That is how well Scandinavian universal healthcare works.
Posted on 10/3/23 at 11:37 am to RogerTheShrubber
quote:
Whats this "we" shite?
Sorry, forgot a lot of you are bots and aren't actually Americans
Posted on 10/3/23 at 11:39 am to NC_Tigah
No, its just not a good point
Posted on 10/3/23 at 11:41 am to VolSquatch
quote:
Sorry, forgot a lot of you are bots and aren't actually Americans
If you had good insurance, you would not be shilling for shitty government rationed care.
My insurance is amazing.
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