What is the hole in our health care system that needs fixing?

I hear there are millions of working americans and their families that have no health insurance..due to employers not offering it.....which sounds like a very bad situation. But I also often hear that everyone in this country has access to free health care if they need it. I also know that in politics people will exaggerate things to make their case so they can have their way. Which is it, are millions of americans not getting health care? Are millions of elderly gettting healthcare but its not really adequate, and their prescriptions unaffordable? Is health care too expensive? Maybe we dont have a problem at all as others say.. Which is it? If your positions is that everyone has access to good free preventative health and dental care, then please be kind enough to explain how it works...does it vary from state to state? Are some states not providing adequate free health care for those who need it? So many questions....but I think you get the idea, please give good information

What is the hole in our health care system that needs fixing?
WOW, get ready for a can of worms.





No, everyone does not have access to free health care if they need it. There are Emergency Rooms for health emergencies if you don't have health insurance. They have to treat you for life threatening emergencies by law. If you go to the ER with strep throat because you don't have any insurance, they might hem and haw but they'll still treat you. If you have a chronic condition, they'll do the least possible for you to get you out of the ER. Hospitals have clinics based on a sliding scale for those who don't have insurance, you often have to wait a long time for appointments. The doctors in the clinic are often overworked, or newly trained. Again, people with chronic conditions do not get the best treatment possible, and frequently, even if they work hard or worked hard all their lives, are treated like dirt because they dont' have insurance. Quality care is not available for those who do not have insurance. Preventive care is non existant, the working poor often to not have enough money to spare for preventive care.





The elderly have medicare which gets cut further year after year, leaving many people to have to choose between buying medication or groceries. If the elderly don't eat well, they are prone to strokes or heart attacks. Often they have to live with other relatives to make ends meet.





I feel that the problem is the insurance and pharmaceutical companies lobbyists. They have far too much power. People say they don't want the gov't in our health care, well, it already is because of the power we have allowed them to have. We also have third party insurance which is through our employers...why do we need that? Why can't we get affordable health insurance on our own, like car insurance? Employer insurance came about during WW2 to attract workers to the unions. It's an outdated way of handling insurance, we need to look at that as well.





A really good book on this subject is "Uninsured in American-Life and Death in the Land of Opportunity" by Susan Starr Stared that really covers this problem in depth and shows that it's not a problem of the poor but crosses many cultures and classes. Great question, a star for you!





EDIT- thank YOU, Bert T for the compliment, I always enjoy your answers and you did it again this time. Let's hope we get somewhere with the new administration.
Reply:There is no hole in the system since there are hardly any uninsured in America. When lobbyists count the number of uninsured they are including the estimated 32 million undocumented foreigners in the U.S.. ( 32 million is the most accurate estimate.) There are hundreds of billions of dollars to be made off of the government by providing free health care to everyone.





Also, don't look to other countries for answers. Canada sends their patients to America when they need diagnostic PET scans (http://www.bio.davidson.edu/courses/geno... ), 64 slice CT scans (http://www.winchesterimaging.com/images/... , http://www.medgadget.com/archives/img/RS... , http://www.radiologyregional.com/imagesf... , http://bgh.kaleidahealth.org/images/64Sl... ), etc.. Those same scanners are available at HMO hospitals all across the U.S.. For some reason, they are not widely available in Canada.





Canadian cancer survivor: "There’s no question that going to the United States saved my life"


Colorectal Cancer Association of Canada - CCAC


http://www.ccac-accc.ca/news.php?id=53


"In Canada the average wait for procedures such as neurosurgery is more than four months; for cancer radiation treatment, over two months. The average wait for treatment after consulting a specialist for coronary bypass clocks in at up to 52 weeks, with four to 12 weeks for angioplasty. That’s the reality in our backlogged public health system, according to a recent survey by The Fraser Institute, a think tank based in Vancouver. In the United States, you can often be on an operating table within a week or two of referral to a surgeon."





Canadian government:


"Four years ago when Suzanne Aucoin was diagnosed with colorectal cancer, she had to travel every week to the United States to buy life-saving cancer drugs " Medical Tourism Boosted by Long Wait Times - Embassy - Newspaper


http://www.embassymag.ca/html/index.php?...
Reply:Greed.





Some states like Illinois offers some help for the uninsured. I live in Ohio. We basically have nothing for someone in my position. I am a 26 y/o male, I have a full time job, but my company is small and does not offer health insurance and I cannot afford my own policy.





At one time, I had a personal health insurance policy through SummaCare, a local hospital/health insurance provider. It cost me about $96 dollars per month. That's a little more than what I would cost an employer on a group plan. To make a long story short, individual plans suck. The insurance company knows that I am not backed by any government regulations because I'm not on a group plan, so they gave a crap about me. They would constantly deny my doctors visits knowing I couldn't do anything except pay the bill...





..which brings me to my next point. My doctor was nothing more than a disguised con-artist. He knew every way to bilk money from my insurance company. He knew what tests they probably would and wouldn't cover, and took every test he knew he would get paid on. Well, he didn't know I wasn't on a group plan. Every test I was given was denied, and an hour at the doctors office turned into a $659 bill in my mailbox. I had to fight and fight with them to pay it. It took 7 months, and they paid $580 and I still had to pay the rest. I canceled the policy thereafter.





When I stepped back to look at everything, I saw a money hungry machine whose primary focus wasn't to help people..it was to make money.. a lot of it.
Reply:A star fro me.











You can get free care but it is a long drawn out process.


And sometimes the care is minimal and many times even though Drs Take the Hipocratic oath - they do not do their best for the "Freebies people"





Every state has programs offering free care but you must file endless forms and that for most indigents is the problem.





On the most part they are the least educated and illiterate of our society and the least able to do such tasks





Medicare sucks and needs to be reformed and so does the SS system -- most poeple get under $1200.00 per month to live on - that is nearly impossible.....





But what do I know I am just a Bird





My nest mate and I are on SS and she just had a hip replaced, it costs us $990.00 for the two day stay in the hospital and the home care --- that is not bad. She gets her meds for $2.15 each from AARP. We live off of $1700.00 per month ( we got screwed by my companys pension plan ) we were living off my excellent salary of over $4500.00 per month - that is a culture shock )
Reply:Government doesn't have the balls to clean up the insurance industry.





edit:


Or the pharmaceutical industry.
Reply:Get more unions an make the compines pay 90% an you pay 10 an better pay these people have been makeing money hand over fist since reagan an the dumb *** bushes wake up get the unions rolling an you will see a more productive us an stop shipping the jobs to mexico an over seas
Reply:Doctors over-charging patients for treatment. Doctors not willing to accept whatever the health insurance is willing to cover. Those who have health insurance still have to pay for medical services simply because some doctors who treat a patient say in the emergency room are tier 2 of some insurance companies.





All doctors should accept whatever the health insurance covers for treatment as well as no one should be denied treatment.
Reply:There are MANY answers to that…





Mistakes on behalf of providers submitting and insurances processing claims costs A LOT of money,





Frivolous lawsuits instigated by people like Democratic presidential candidate John Edwards drives medical costs up.





People who never pay for ER visits drive up the cost for those of us who do. These are typically inner city poor (being poor is THEIR fault %26amp; no-one else’s), illegal aliens etc.





Bassackwards socialist governmental programs that pay very little to providers so, they have to recoup by charging those who can afford health insurance even more which causes the insurance company to charge more for premiums and the cycle continues.





Basically… except for the first answer liberalism is to blame.
Reply:Everybody's a "working family......"





Out of supposedly 47 million "Americans" 20 million are illegal immigrants, many of the rest are the children of same. As with minimum wage earners there are students, ex-cons and the like, and then on the other end it's possible that the Bill Gateses and Oprah Winfreys of the world, and the next strata under them, self-insure. And keep in mind ALL of these people get free emergency care.





You can whittle it down to probably about 15-18 million actual "Americans without health insurance" if you exclude these groups, and that's 5% of the population.....





There is no "decline in American healthcare availability" just like there is no "increase in American poverty" - - we just keep importing poor people who legally cannot get health insurance.





Pink "do the least possible" - - - right, they'll solve the present problem - - what do you expect, get your fever back to normal, get the infection under control and THEN a lapdance?
Reply:The decline in health care availability can be traced to the Medicare program. The more involved that the Federal and State governments have gotten in health care, the bigger the problem has gotten.





Since the 1960's, the constant tinkering with health care and health insurance by the government has increased the cost drastically for everyone.





If you understand that Medicare only pays about 50% of what doctors and hospitals charge, you begin to see that not only has that forced the health care providers to DOUBLE their prices in order to get paid what they need, but it has doubled the cost for those who are covered by insurance too. In addition, when Medicare pays half and big groups pay 75% of what the hospital charges, that has to be made up elsewhere. That has driven the cost for health insurance through the roof.





The number one problem is that at the same time you have a large number of people without coverage, you have the government forcing increased benefits down the throat of employers. That raises the cost even more and causes more employers to cut back or eliminate health insurance.





We are getting the cart ahead of the horse in thinking that getting everyone covered will solved the problem. The truth is that unless we get the cost of health care under control, we will not have any chance of increasing the number who are insured.





There are plenty of bad guys behind this problem. It starts with out of control government who lets big medicine and big insurance do what they want and pass the problem on employers. We are very near a complete collapse of our current system as many employers are close to the max of what they can pay to cover employees. Of course that has not happened in industries (or schools or governement) where those costs are just passed on in the form of higher taxes. The cost of health care is what is preventing our schools from having enough to operate....the lions' share of tax dollars to to teacher health care and retirement programs.
Reply:Alright, I work in a hospital in the US so I hope I can answer your question.





The problem isn't a lack of access, there are plenty of doctors and other providers, the problem is cost. So although by law anyone can go to an emergency room and get treatment for their problems, the ER will charge you an outrageous amount for the care provided. A recent visit for strep throat was over 500 USD and no tests were run and no meds given, this was just to look and do a 30 second exam.





The hospitals know that the majority of patients will not pay this, the ones who pay out of pocket are a rarity. The people with insurance will only pay a small portion of the charge and their insurance company will dictate to the hospital how much they will pay.





I know you don't wan't to hear this but yes lawyers are largely to blame for this. insurance rates have skyrocketed over the last 15 years resulting in not only much higher direct medical costs but more unneccesary tests (all very costly) ordered by physicians in order to cover their own liabilities.





Also, it is important to remember that health insurance is simply a way of sharing the cost of medical treaatment among many people, the majority of whom do not use as much as they pay for. Insurance companies are in the business of making money! If they have to pay for frivolous tests, proceedures and lawsuits, they will simply raise the rates of all their subscribers to make up the difference. Have no fear, the insurance companies will not loss out in this situation. I have seen patients cost their insurance companies upwards of a million dollars (the average 25 week preemie baby who has a better than 50/50 chance at survival for instance). How many of these can we, as a society, support?





In a slighty long winded nutshell, that is the problem with health care in the US today.
Reply:1. When a business is "FOR PROFIT", PROFIT is what they are interested in, not cures, not affordable healthcare, not the welfare of their customers. As long as the Healthcare Industry is profit-motivated, having a sick customer base is in their best interest. Therefore, our Healthcare System can NOT be in the business of curing illness or repairing broken organs and limbs. This is why the LAST disease cured in the world was Polio, over 40 years ago. There's no profit in cures.


2. Any employer with more than 12 (or 20 in some states) employees MUST offer some form of Healthcare plan to its employees. The CATCH is, it can be a plan which would cost the employee so much to participate (one such plan I personally saw would cost 115% of the employees' post-tax salary, to cover himself, his wife and 1 child, all nonsmokers and in fine health), no one WILL participate, and the employer still gets to say he has one available. This is why the kids this next 2 or 3 generations coming will have no option than to either go into buisness for themselves, or work for some huge corporation, with so many employees they can offer reasonable co-payments and higher benefits with lower premiums. Or, Nationalize the damn industry and make US anti Monopoly Laws MEAN something again. And of course hospitals and clinics and such are running monopolies. They are the hospital you HAVE to go to; go ahead and switch doctors and you gamble on whether your insurance carrier will honor payments for treatment from them. If they don't it's not THEIR problem, it's YOURS and the hospital or whatever will contact YOU, not the insurance co. for payment.





3. Many other countries have realized many of these trends BEFORE they became facts of life in their countries and this is why their nationalized, NON-PROFIT Health systems cost their GNP about 4 to 7%, (depending on country), while Healthcare costs in the US take up almost 14%, and both Health Insurance Companies and Drug Companies are posting huge profits each quarter, while millions of American citizens have no hope at all of ever finding an employer who can offer a reasonably priced healthcare plan, AS LONG AS THE US HEALTHCARE INDUSTRY IS FOR PROFIT. And just because a family can't afford employer-subsidized health insurance doesn't mean they can just walk into a hospital and demand treatment. First, the hospital ER WILL secure a promise of payment from you, whether you have insurance or not. And there are NO discounts for paying cash anymore either. They don't care, they're GOING to get their money. If you have a mailing address they will assault you DAILY with demands of payment, your credit will suffer for non-payment, etc. If you have a family and a residence, they will NOT consider you indigent and unable to pay.