Wednesday, April 11, 2007

Finally! Someone is talking about it

16 comments:

A single mom said...

She will never get away with it...socialist

Healthcare is not a right - it is a benefit offered in the free market by employeers

lillith said...

It is a good thing that England, Germany, Japan, Canada, and pretty much every other first world country doesn't agree with you. When you tap into your Medicare you can call yourself a Socialist too! Welcome Comrade.

A single mom said...

Having lived in the UK for a year I can attest to the horrors of the National Healthcare system – like waiting 90 days to see your obgyn.

Later on, when I was a visiting professor in Canada, the Canadian system was even worse, because the government regulates the cost of healthcare Canadian physicians are fleeing Canada to come to the US (35% of the physicians at the University of Utah Healthcare system are Canadian).

While I was teaching in Canada I got pregnant, every physician I called in the Toronto area was refusing to take patients because they were full up. I finally found a nurse practioner who would see me, in 3 weeks.

The Canadian and UK systems of health are broken because physicians are fleeing those countries for higher paying jobs in the US – as a result there are fewer physicians per capita in those countries resulting in longer waits – people have died waiting to see a dr.

If we go to national health and take the profit out of healthcare, the same thing will happen here…and it will be people like you are responsible for the deaths of people under socialized healthcare.

lillith said...

Single Mom,

First off, I have private insurance and it takes a year to see my Ob/Gyn. Why? There is a shortage here and in other countries. That is directly related to malpractice insurance. It has zip to do with socialized medicine.

Second, I keep hearing about these physician's fleeing to the U.S. whenever someone is arguing against univsersal health care, but have never actually seen proof of this. I am sorry, but I don't take a blogger's say so (or a talk radio show hosts) as proof.

Third, are you sure you wanted to say this "and it will be people like you are responsible for the deaths of people under socialized healthcare."

I, personally, will be responsible for their deaths? Lady, I work in a program where I take calls everyday from people who can not afford (or their insurance will not cover) an essential screening for a treatable cancer. Even if they are having symptoms, they are SOL. Instead they will end up in our ERs when the pain is so bad, they can not stand it anymore. We will end up subsidizing their care one way or another.

People are already dying for lack of health insurance. Nearly 12% of Utahns are uninsured and that doesn't count the thousands upon thousands that are underinsured by wonderful companies like Walmart.

I hope you plan to decline your Medicare and don't give me the argument that you paid for it, so you should get it. With universal health coverage, they pay for it too! Medicare is about as socialist a policy as there is one.

A single mom said...

I will decline medicare becuase I will have private insurance when I retire.

a single mom said...

I can tell you about the supply and demand of dr's and that hospitals have no problems hiring foreign doctors - dr's who are fleeing socizlized systems in health care, I can give an example as one who is a faculty member at the U school of Medicine - I’m currently negotiating to hire an another physician for my clinic, U.S. med school grads tend to gravitate to large urban areas (Salt Lake is not one of them) – so, I am in the process of hiring a young Dr from Germany – fluent inn English, excellent qualifications, under state medical system in Germany he would start at only 100K plus the exorbitant tax rate that Germans carry – he is thrilled to come to the US where I can start him at 150K, he’ll be at 300 within a few yrs and will pay lower taxes.

For foreign dr’s the US is paradise as far as earnings go.

I feel bad I can only start him at 100…at IHC I could offer him maybe 135 plus bonuses.

Take the profit out of medicine – you take the quality out of medicine

Since you don't believe blogs- here is anrticle that may wake you up.


Recent studies suggest the United States health care system will soon experience a shortage of doctors and medical professionals. This is leading to increased efforts to attract foreign doctors and medical students to the United States. John Featherly narrates.


Experts say several states have or will soon experience shortages of physicians in a variety of specialties, including cardiology, radiology, surgery and pediatrics.

Dr. Susan Wolfsthal, the director of the University of Maryland's Residency Program, says the United States needs more doctors in all specialties. "There are some parts of the United States where there are many, many physicians and it is very easy for patients to have access to clinical care. And then there are other areas of the United States where there is less and there might be only one physician for many thousands of patients."

This shortage is putting pressure on American medical schools to increase enrollment and on the U.S. government to allow more foreign doctors into the country.

U.S. Congressman Rob Simmons says the United States needs these foreign nationals. "We have people who come to the United States to provide nursing care and medical care and gosh knows we need all the help we can get."

Educators, including Wolfsthal, say foreign students can gain valuable experience and knowledge studying in the United States and working in U.S. hospitals. "You get the same exposure, you get the same opportunity to see whether this is something you are interested in and they also get to see you in action."

Sonia Yousef, a rheumatology fellow at the University of Maryland, says foreign students should try to have well-rounded experiences before coming to the United States.

"So you should try to do some volunteer work, anyways it’s good, and that looks good on your resume as well. So that is probably the fourth thing, but it is not as important as clinical experience."

Wolfsthal says universities value the diversity international students bring. "When you have international graduates they bring, as someone from another institution would, they bring a different perspective, they have different interests and so they bring that to the program."

Experts and educators say foreign medical students and doctors gain a lot from their time spent in the United states. They say working in American hospitals and studying at universities in the United States gives foreign students and doctors a chance to work with the latest technology and to grow professionally.

Anonymous said...

Single mom,

My sister lives in Scotland. She has had a great experience with socialized medicine.

I also have many friends who live in countries with socialized health care. Not one of those friends that I have discussed socialized health care with would change their situation.

There are pros and cons to any situation, but the free market has left too many of us in Jeopardy.

The time has come for new solutions.

I don't have a problem with anyone making a profit, but greed has taken over the American health care industry.

lillith said...

Single Mom,

I didn't say I didn't believe bloggers, I just said I wasn't going to believe your statements on your say-so.

Examples of your say-so include
"I can tell you..."
"Recent studies suggest...."
"Experts say...."

The only place you quote an actual article or person, the article refers to shortages of physicians in the U.S., not the fleeing of doctors to the U.S. to escape socialized medicine. It is talking about recruiting medical students from other countries in order to fill school shortages. I am surprised that you did not understand this, being on the Medical School Faculty and all?

I don't think healthcare should be about profit. That is my personal opinion.

Infant mortality rates clearly show it isn't about making a profit either.

This recent ranking shows the U.S. at 36 for infant mortality
http://www.geographyiq.com/ranking/ranking_Infant_Mortality_Rate_aall.htm

This ranking from 1998 shows the U.S. at 28
http://www.marchofdimes.com/files/international_rankings_1998.pdf

Looks like we have lost some ground.

Lillith

Old fashioned deomcrat said...

lillith,

let the healhcare professionals deal with healthcare..let advocates sit on the sidelines - they not what they do

P.S.

I own pharmacy stocks..regulating healthcare will hurt the free market

Old Fashioned Democrat who votes said...

you want national health -

Get ready for this:


LONDON (Reuters) - One in 10 patients admitted to National Health Service hospitals in Britain is unintentionally harmed and almost a million safety incidents, more than 2,000 of which were fatal, were recorded last year, according to a report on Thursday.
Such figures were "terrifying enough", the report by parliament's public accounts committee said, but the reality may be worse because of what it called "substantial under-reporting" of serious incidents and deaths in the NHS.

"To top it all, the NHS simply has no idea how many people die each year from patient safety incidents," Edward Leigh, the committee's chairman, said in a statement.

The committee found that some 974,000 patient safety incidents or "near misses", including 2,181 patient deaths, were recorded by the NHS but it stressed that under-reporting was a serious problem.

"(NHS) trusts estimated that on average around 22 percent of incidents and 39 percent of near misses go unreported, and that medication errors and incidents leading to serious harm are the least likely to be reported," the report said.

Leigh said the findings pointed to two "deep-seated failures": that of the NHS to secure accurate information on safety incidents and the failure "on a staggering scale" to learn from experience.

"Around 50 percent of all actual incidents might have been avoided if NHS staff had learned lessons from previous ones," Leigh said.

The report said it may take a decade or more systematically to improve safety in the NHS but that more immediate progress could be made with the introduction of electronic patient records which should reduce accidents caused by misinterpretation of doctors' handwriting.

The committee also criticized the National Patient Safety Agency, which was set up to improve safety across the National Health Service, saying there was a "question mark over the value for money" it offered.

Stephen Thornton, Chief Executive of the Health Foundation, a charity working to improve hospital safety, welcomed the committee's conclusion that more needed to be done but urged the government to provide more support.

"Hospitals need help to make sustainable, on-the-ground improvements and they need that help now," he said.

Old Fashioned Democrat who votes said...

you want national health -

Get ready for this:


LONDON (Reuters) - One in 10 patients admitted to National Health Service hospitals in Britain is unintentionally harmed and almost a million safety incidents, more than 2,000 of which were fatal, were recorded last year, according to a report on Thursday.
Such figures were "terrifying enough", the report by parliament's public accounts committee said, but the reality may be worse because of what it called "substantial under-reporting" of serious incidents and deaths in the NHS.

"To top it all, the NHS simply has no idea how many people die each year from patient safety incidents," Edward Leigh, the committee's chairman, said in a statement.

The committee found that some 974,000 patient safety incidents or "near misses", including 2,181 patient deaths, were recorded by the NHS but it stressed that under-reporting was a serious problem.

"(NHS) trusts estimated that on average around 22 percent of incidents and 39 percent of near misses go unreported, and that medication errors and incidents leading to serious harm are the least likely to be reported," the report said.

Leigh said the findings pointed to two "deep-seated failures": that of the NHS to secure accurate information on safety incidents and the failure "on a staggering scale" to learn from experience.

"Around 50 percent of all actual incidents might have been avoided if NHS staff had learned lessons from previous ones," Leigh said.

The report said it may take a decade or more systematically to improve safety in the NHS but that more immediate progress could be made with the introduction of electronic patient records which should reduce accidents caused by misinterpretation of doctors' handwriting.

The committee also criticized the National Patient Safety Agency, which was set up to improve safety across the National Health Service, saying there was a "question mark over the value for money" it offered.

Stephen Thornton, Chief Executive of the Health Foundation, a charity working to improve hospital safety, welcomed the committee's conclusion that more needed to be done but urged the government to provide more support.

"Hospitals need help to make sustainable, on-the-ground improvements and they need that help now," he said.

Rob said...

I'm not sure that "socialized medicine" is the cure, but affordable health care for all should be a goal we can all wrap our heads around.

Emily said...

Rob,

I agree with you. I think the free market is a good thing in most cases, but we're living in a situation where the free market has driven the price up so much that most Americans can't afford health insurance or even basic health care.

My opinion is that health care is run by the insurance business and pharmaceutical companies instead of physicians and medical experts. I am grateful that my husband has excellent health insurance through is employment... but before that, we went for 6 years without health coverage, and just prayed that we would all stay healthy. I had little tiny kids at the time and we used county health department services for immunizations, and only went to see the family doctor when it was absolutely necessary. I am grateful that we didn't have more illness than we did. I especially feel for families who do not have health insurance who go through major health catastrophies - cancer or other life threatening illnesses.

I agree that we should not go straight to "socialized medicine" but we need to get creative about how we're going to fix this problem.

To those who feel healthcare is not a "right" - I don't know about that. I don't think it is fair to make people suffer unnecessarily and die prematurely just because they can't afford health insurance. I hope that America is more humane than that.

lillith said...

To the London article poster,

Get this!
IHI estimates that 15 million incidents of patient harm occur in U.S. hospitals each year

The Institute for Healthcare Improvement (IHI) has announced a national campaign to dramatically reduce incidents of medical harm in U.S. hospitals. The 5 Million Lives Campaign will ask hospitals to improve more rapidly than before the care they provide in order to protect patients from five million incidents of medical harm over a 24-month period, ending December 9, 2008. The Campaign was announced by IHI President and CEO Donald Berwick, MD, MPP, speaking at their 18th National Forum, held in December in Orlando. The new Campaign--which will be sponsored principally by America's Blue Cross and Blue Shield health plans--builds upon the success of the 100,000 Lives Campaign, in which 3,100 participating hospitals reduced inpatient deaths by an estimated 122,000 in 18 months through overall improvement in care, including improvement associated with six interventions recommended by the initiative.

The 5 Million Lives Campaign will promote the adoption of 12 improvements in care (detailed below) that can save lives and reduce patient injuries, and it aims to enroll even more hospitals than participated in the previous Campaign.

IHI estimates that 15 million incidents of medical harm occur in U.S. hospitals each year. This estimate of overall national harm is based on IHI's extensive experience in studying injury rates in hospitals, which reveals that between 40 and 50 incidents of harm occur for every 100 hospital admissions. With 37 million admissions in the United States each year, this equates to approximately 15 million harm events annually--or 40,000 incidents of harm in U.S. hospitals every day.

IHI defines "medical harm" as unintended physical injury resulting from or contributed to by medical care (including the absence of indicated medical treatment) that requires additional monitoring, treatment or hospitalization, or results in death. (Please consult www.ihi.org for a detailed definition of medical harm.) The 5 Million Lives Campaign aims to enlist 4,000 hospitals, challenging all to adopt up to 12 of the following interventions--six of which were included in the 100,000 Lives Campaign and six of which are new:

New interventions targeted:

* Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) infection ... by reliably implementing scientifically proven infection control practices throughout the hospital

* Reduce harm from high-alert medications ... starting with a focus on anticoagulants, sedatives, narcotics, and insulin

* Reduce surgical complications ... by reliably implementing the changes in care recommended by the Surgical Care Improvement Project (SCIP)

* Prevent pressure ulcers ... by reliably using science-based guidelines for prevention of this serious and common complication

* Deliver reliable, evidence-based care for congestive heart failure ... to reduce readmissions

* Get Boards on board ... by defining and spreading new and leveraged processes for hospital Boards of Directors, so that they can become far more effective in accelerating the improvement of care

The six interventions from the 100,000 Lives Campaign:

* Deploy Rapid Response Teams ... at the first sign of patient decline--and before a catastrophic cardiac or respiratory event.

* Deliver reliable, evidence-based care for acute myocardial infarction ... to prevent deaths from heart attack.

* Prevent adverse drug events ... by reconciling patient medications at every transition point in care.

* Prevent central line infections ... by implementing a series of interdependent, scientifically grounded steps.

* Prevent surgical site infections ... by following a series of steps, including reliable, timely administration of correct perioperative antibiotics.

* Prevent ventilator-associated pneumonia ... by implementing a series of interdependent, scientifically grounded steps.

There is no cost for hospitals to join the 5 Million Lives Campaign though there is an obligation to adopt at least one intervention and an expectation of regularly reporting hospital profile and mortality data throughout the Campaign. www.ihi.org

COPYRIGHT 2007 Healthcare Purchasing News
COPYRIGHT 2007 Gale Group

P.S. I am a health professional and I will not sit on the sidelines.

I can trade articles, statistics, and opinions with you all day, but at the end of the day. Americans pay too damned much for healthcare and I don't just mean in dollars. Elderly have to give up food to afford pills. Workers can't afford their share of insurance premiums, so they go without. There is something seriously wrong with how our system is structured. I think a universal health care system is the only solution I can see, because free market is failing our citizens.

A single mom said...

Emily,


I can tell you as a physician the biggest obstacle to affordable healthcare is the federal government.

When you look at payout rates for medicade and Medicare they are so low, that dr’s will drive fees up in other areas. I bet you didn’t know this but you could be sitting a dr’s office with a common cold (for example) – and waiting with you will be four other people with common colds. Two of those people will have health insurance; one is a Medicare patient and the last one has no insurance. Guess what – they all get billed differently, the 2 with insurance will get a reasonable rate because those folks are regular customers, the Medicare patient you bill what the govt gives you and the one without health insurance, you demand cash up front and charge that person a third more than your insured patients because that is where you make your money – this isn’t a big secret – this is a common formula among physicians – oh yes, the poor pay the most.

What is scary to me about the medical market place is how dr’s are turning away medicare patients and the uninsured – at my clinic; if you don’t have insurance you see a nurse practitioner or a resident. If you have Medicare or insurance a physician will see you. What is really scary is that several of my colleagues no longer accept Medicare patients – they believe that the federal government pays too little, so they refer Medicare patients to the residents and only see patients with private insurance. If the federal government paid market rates Medicare and medicade patients would be fine.

Drug companies are not the culprit either (for public disclosure I will admit I do consulting work for 3 drug companies) – companies put a lot of time and effort into the development of drugs…the people who develop these drugs don’t come cheap (MD’s & PhD’s) by the time a drug is developed, it will take up to 5 years for a firm to recoup it’s R&D costs on a drug. – and when the patent expires..poof you go generic and you loose you profit base…I won’t even begin to bore you with the time and money spent in the trial phase.

People need to look at healthcare not as a right – but as commodity – getting the government out of price fixing for certain rates will open more access for all.

Now the question of the uninsured – ways to fund healthcare for those folks would be the following:

1) An federal sin tax of 1% on cigarettes and alcohol
2) A federal sin tax of 1% on all prepared food (ie everything from Burger King to 5 star restraunts)
3) Tighter restrictions on WIC and food stamp recipients as to what they can purchase

These are just a few of my thoughts…people say dr’s overpaid – at the age 42 being in academic medicine I earn only a little over 250K a year – and I primarily treat the poor, If I was in private practice and I could pick and choose my patients, I’d make three times as much.

A sugar house resident said...

Average Utah phyiscan salaries:

Total Annual Compensation (base compensation, incentives and/or production):

Average Median
Anesthesiology $332,216 $300,000
Cardiology—Non-Invasive $300,625 $300,000
Emergency Medicine $246,760 $229,000
Family Practice $148,563 $135,000
Gastroenterology $282,000 $205,000
General Surgery $256,111 $240,000
Hospitalist $177,400 $182,000
Internal Medicine $158,500 $140,000
Neurology $218,867 $200,000
OB/GYN $221,286 $200,000
Oncology $226,875 $225,000
Orthopedic Surgery $319,000 $332,000
Otolaryngology $261,429 $245,000
Pathology $204,698 $156,000
Pediatrics $131,000 $124,000
Psychiatry $182,300 $170,000
Radiology $347,500 $300,000
Urology $320,714 $290,000