December 26, 2009 4:11 pm at 4:11 pm #591012PosterMember
There is so much talk about the new health care system that Obama is proposing. No one bothers to explain exactly what it is. Could anyone in simple english explain exactly what the health care bill includes and how it will effect us.December 26, 2009 11:24 pm at 11:24 pm #671504
basically it will force people to buy healthcare or face a penalty, it will ease the requirements for medicaid and it will force insurance companies to lower their standardsDecember 27, 2009 2:44 am at 2:44 am #671505
I would have no problem with this healthcare bill, as long as the President and entire Congress would also have to utilize it for their own families. If it’s good enough for us, it should be good enough for them.December 27, 2009 9:59 am at 9:59 am #671506PosterMember
1) what will happen to insurance companies like Oxford?
2) The insurnce that e/o must buy is govt. insurance?
3) what about the pple that were never paying for insurance and were on Americhoice etc.
4)Will the price for this insurance be the same for e/o? will there be diff classes? How about a co-pay?
5) what are the advantages? disadvantages?December 27, 2009 11:14 am at 11:14 am #671507
I can’t answer all your questions, but I do know a (very) little.
The insurance that people must buy is not government insurance. There was an option for people 55 and older to buy Medicare, but that provision was deleted.
Currently, the proposed fine for people not buying insurance is $750/year. For most people that is cheaper than buying insurance. So for a young, healthy person, it pays not to buy insurance and pay the fine instead.
If that uninsured person gets sick, he can then buy insurance, and since the insurance companies are not allowed to turn anybody away for pre-existing conditions, he’s guaranteed to get insurance.
Since the insurance companies are going to be insuring a lot more people, many of whom have pre-existing conditions, the premiums for everybody are going to go up.
I know this just barely scratches the surface of the 2000+ page bill the Senate just passed, but I hope it helps.December 27, 2009 5:58 pm at 5:58 pm #671508
The above description makes it sound as if the bill was authored and passed into law by the elders of Chelm.
Not altogether inaccurate.
The only ones who will benefit from this in the end are just those parties whom the socialist regime in the US wanted to sock it to – namely the insurance companies. They will come up with new bare bones policies that will cover so little so that in essence their profit is guaranteed as they will turn down most claims on those policies. And of course the crowd parodied on a certain blog will benefit as well because marbeh b’regulations, marbeh b’opportunities for fraud.
I am tempted to go back to the US and get into the business of providing these new policies. I’d sell them for $600 a year and make sure that the most they ever pay out is about $400 per year which is not hard at all – all I would have to do is set them up with a 30% copay and concentrate my sales efforts on immigrant small businessmen such as independent grocers, shoemakers, and barbers and others who are not very sophisticated.
The prospect of ending up in a certain place after whatever age koreis is does, however, dissuade me from wanting to profit from this ill advised new legislation. After all, I do not really relish spending time with Barack Hussein Obama for eternity.December 27, 2009 6:19 pm at 6:19 pm #671509
essentially this bill is a waste of the country’s time. the last time we had a deregulation like this was with the mortgages and we all know how THAT turned out. obama has done nothing for a year, and he wanted SOMETHING he could call his own. basically he proposed a bill which was gutted completely. every aspect of the original bill is gone. all thats left is a couple of amendments and the actual entry…thats it! plus if anyone needs proof its bogus…look at how it was pushed through and how much senate protocol was broken in the process!December 28, 2009 1:45 am at 1:45 am #671510
This bill does not change much for anyone except people who can’t get health insurance because of pre-existing conditions — but that is millions of Americans. Never again will insurance companies be able to deny coverage because of a pre-existing condtion. Never again will insurance companies be able to cancel your policy just when you most need it. It is impossible to overstate the impact of these changes on those affected; many lives will be saved. For this reason alone this bill deserves our support despite the fact that it solves none of the many other problems of America’s health care system.December 28, 2009 2:39 am at 2:39 am #671511justin2Member
The bill itself doesn’t change much, but the insurance companies will raise the price of insurance as a result of the bill.December 28, 2009 3:16 am at 3:16 am #671512
Charliehall, it’s not to see that that you still stick to your guns in supporting the health care bil. However you still have failed to address the many problems of the bill including but not limited to end-of life care and health rationing.
It is critical to that one realizes that this bill potentialy opens the door to severe halachic issues many involving issues of Pikuach Nefesh.December 28, 2009 5:00 am at 5:00 am #671513
The bill really doesn’t change much regarding end of life care. Most persons for whom such decisions must be made are currently covered by Medicare and this will not change.
The bill will improve things somewhat for those who are not insured. Currently, if you don’t have insurance, you don’t get end of life care — or any other kind of care other than emergency stabilization, which simply means that you are fixed up just well enough so that you won’t die that night. There are no halachic issues that the bill makes worse.December 28, 2009 5:03 am at 5:03 am #671514
The insurance companies are already raising prices because costs continue to soar. And you are correct that the Senate bill contains no real attempt to control costs: No serious review of coverages, and no public option to serve as a standard of coverage. It was mostly the right wingers who forced these things to be pulled from the measure, because cost control means denial of coverage and the right wingers scream “rationing” or “death panel” anytime there is any attempt to control costs. It is disingenuous to complain about high costs but then to turn around and to oppose the exact things that would control costs.December 28, 2009 5:43 am at 5:43 am #671515
And there are still Jews who think Obama is the best thing since sliced bread. What a joke! How are we allowing our congress to vote for this?December 28, 2009 5:43 am at 5:43 am #671516
Most persons for whom such decisions must be made are currently covered by Medicare and this will not change.
Hard to believe that it won’t change, since the government has already said that they are cutting quite a bit of Medicare coverage.December 28, 2009 6:04 am at 6:04 am #671517
congress doesnt give a wooden nickel about us and neither does the senate. their functions are to serve the people and yet, although EVERY opinion poll is showing that the people dont want the bill…they are still passing it! they care about pandering to obama because the only way he will be reelected is if they can show soem of his “accomplishments” on the campaign trail in 2012December 28, 2009 6:38 am at 6:38 am #671518
Hopefully this bill will help trounce the leftists in the 2010 elections.
However, I fear that the Bart Simpson, Britney Spears leisure society that the US has become will vote for physically attractive candidates who deliver good sound bites again just as they did in the US.
As for the death panel, there was a great article in the NYT about a hospital that saves everyone until they can do no more. What was revealed about the attitudes of some doctors and cost cutters shows that the “malchus shel chessed” of old is in danger of disintegrating very quickly into a morally deficient socialist state if the damage of 2008 is not reversed ASAP.
Of course for those on the left who think tzedek means taking from someone who works hard all his life, and often gives others the opportunity to work and support themselves as well, and giving to those who never even make an attempt at working, the new Americhke is just what the doctor ordered.December 28, 2009 8:46 am at 8:46 am #671519
just as they did in the US = should read just as they did in 2008.December 28, 2009 12:33 pm at 12:33 pm #671520
When Purim came along in Chelm, it was very hard to find real aniyim because most of the townsfolk had money. Finally, Gimpel der Yold found a real, live ani living in the next town.
The rov of Chelm, Rav Kapoyer, said: “Gimpel, make sure that guy stays poor or we won’t have any aniyim for matnois le’evyoinim next year! Let’s bring him to Chelm, build him a mud hut, give him a job shoveling the streets with a teaspoon and we’ll pay him four kopeks a month! Then when Purim comes along we’ll give him a few copper crowns!”
This is the way of the left. They need to keep as many people on the bottom and dependent upon them for money, housing and makework jobs as possible – or they won’t have people to vote for them in the next election.
EDITEDDecember 28, 2009 3:39 pm at 3:39 pm #671521
CharleieHall are you serious?
Practically every country that has “socialized medicine” does prctice rationing this is a fact not an opinion. The end-of-life issues that rise up in countries such as England are frequent and troublesome ask any English Posek who deals with such issues.
When one bears in mind that many of those who are running the medical agenda for the Democrats have spoken openly about rationing car (i.e Tom Daschle’s book) it takes an incredible amount of willing denial to not realize the dangers of placing matters of Pikauach Nefesh in the hands of those whose very belief in G-d is questionable.December 28, 2009 4:06 pm at 4:06 pm #671522justin2Member
charliehall:December 28, 2009 4:51 pm at 4:51 pm #671523squeakParticipant
Joseph – Healthcare rationing goes on all the time, even now, in the US. You just may not realize it. Think about organ donation – there’s rationing. Think about what it takes to get a top doctor ($$$) – there’s rationing (the top docs only see those who can pay top rates, everyone else has to see second-rate or lower). The only thing that will change in terms of rationing is HOW the rationing will be meted out. Currently, it is based on a “bakery line number” in the case of organs, and $$$ for everything else.
R’ Itzik – the case that you describe with insurance companies offering bare-bones policies that just cover government requirements is nearly prophetic. I say ‘nearly’ only because it has already happened. If you are interested in seeing a case-in-point, look no farther than the state of Massachusetts. Start with when the state required every employer to provide health insurance to all employees, and follow the story to where insurance companies cut their coverages to the minimum requirement, to where those bare bones policies now dominate the insurance market to the point where policies with rich benefits almost do not exist in that state. This state is a microcosm of the US after this clause of the Healthcare Reform is passed.December 28, 2009 4:59 pm at 4:59 pm #671524JosephParticipant
squeak – Why did you address your comment to me?December 28, 2009 5:08 pm at 5:08 pm #671525
Helping over thirty million Americans without insurance, most of whom are uninsurable, is a good thing. As I keep repeating, arguments over rationing are irrelevant to all of them when they can’t get any kind of coverage at all. That is why we should all support the bill.
We have rationing now. Private insurers deny coverage all the time. And don’t even think about applying for insurance if you have a pre-existing condition. If that isn’t “rationing” I don’t know what is. For pikuach nefesh we need to get those 30 million Americans covered!
And you have no sympathy for someone who has worked all his life, loses his job at age 58, and gets sick? To tell this person he must die because he can’t pay for medical treatment or medicines is morally deficient!!! This bill is the closest we have come to helping folks like this in the 97 years since Theodore Roosevelt first proposed national health insurance. It is high time we do this.
The Medicare cuts are for home care which is only supposed to be covered by Medicare under very limited circumstances. The cuts are to eliminate the fraud. It is possible for any elderly American to buy supplemental coverage to cover home care, and poor elderly Americans have it covered under Medicaid.December 28, 2009 5:11 pm at 5:11 pm #671526
Bare bones policies with high deductables were a Republican alternative that was rejected by the House of Representatives. The plan would have overridden state mandates and would have continued to allow insurers to reject people with pre-existing conditions. The Senate Republicans were too embarassed to bring it up for discussion.December 28, 2009 5:26 pm at 5:26 pm #671527
Helping over thirty million Americans without insurance, most of whom are uninsurable, is a good thing.
charliehall: What about all the millions of Americans whose taxes (not to mention insurance premiums) are going to go up to cover this? Shouldn’t we care about them, too?December 28, 2009 5:48 pm at 5:48 pm #671528richthefurrydocMember
Being the Jewish doctor of our group, I found myself seeing what happens with people who are so sick that they cannot be with their families on their premier holiday, as I have done nearly every year since 1976. Medicare keeps the hospital an me solvent. There is a question of whether the medicare beneficiaries benefit from my of the stuff guys like me ask labs and pharmacies to do on their behalf but those people pretty much gets what the doctor requests, except for outpatient expensive prescriptions.
At the other extreme are people like I consulted upon this morning who at age 32 has a chronic progressive disease not doing well despite some rather expensive intervention. Despite his skill as a computer programmer, which has afforded him some decent positions with major companies, he cannot maintain employment, he is uninsurable by any actuarial standard in America. Eventually medicare disability will provide for his needs but a whole lot of the care that many of us give him out of necessity will not be compensated. That would not be the case if he lived in Eretz Yisrael or north or our national border.
The political arguments in America are well known. The application of halacha to what is a national blight remains very unclear. I think people are obligated to seek medical care when sick so any disincentive to this runs contrary to my understanding of the principles of shmerat ha-guf. When Israel debated its health care reforms in the 1990’s the expected communal outcome dominated the discussion. Here it seems to be what’s good for me when perhaps the Jewish approach should be more appropriately what is good for us.December 28, 2009 6:04 pm at 6:04 pm #671529
And you have no sympathy for someone who has worked all his life, loses his job at age 58, and gets sick? To tell this person he must die because he can’t pay for medical treatment or medicines is morally deficient!!!
Community assistance (something that seems to exist only in the Torah world and perhaps among lehavdil the Mormons and Amish).
Then again, I voted with my feet in 1992. I am happy to be living in a model Jewish community that is located in a flat tax, free enterprise system (even with the rampant corruption). Because of the lack of incentives for private enterprise to care for the poor and ill as our community does here, people will fall through your Federal safety net no matter what. Here, we (and another minority group) know to expect nothing from the government so we help each other. In the US, even bnei Torah know that the Federal keren hachessed is always there and they often find it best not to work in order to avail themselves of its services, leading to all kinds of ugliness.
And if tax rates go up and/or quality of health care goes down because of this bill (probably won’t happen because the bill is devoid of any real innovation), people will risk Federal koilel (as many do in EY) rather than essentially work their fingers to the bone for the benefit of the left, the bureaucracy that they spawn and their lazy charges.
Then, there will have to be a tax amnesty followed by a complete return to the old America as the founding fathers meant it to be, the “business of America is business” domestic policy and Teddy Roosevelt foreign policy. I’m not holding my breath, though, because just as with Rome, once rot and laziness sets in, it’s all over in a few generations.December 28, 2009 6:11 pm at 6:11 pm #671530gavra_at_workParticipant
Without a subsidized public option, the “actuarial” cost of entering will be too high for anyone to use when they get their condition (as well as anyone else in the individual market, due to the mean costs including those who join sick). The insurance companies will demand full payment up front for the year (even with a “rebate” for high profits, which will only be if there are any after the costs are paid), and the potential insured will not be able to enter without subsidies.
The big deal here is those subsidies, which only shift money from Medicare Advantage(?) and other programs to the new “Medicaid”. Not a bad idea in general, but not really a cost cutting help. Especially since the subsidies go into the pockets of the Insurance Companies.
What we agree would have made a large reduction in costs is tort reform and/or a Federal HC system with salaried doctors (like the VA) to create “fixed” costs, but neither of those are in the interests of the Democrats (or Republicans, for that matter), even if they are in the best interests of the fiscal (and very possibly physical) health of the nation.December 28, 2009 6:15 pm at 6:15 pm #671531
Lower physician incomes any more and there will be no more Jewish doctors.
Already I see an attitude of “Doctor? What kind of job is that for a nice Jewish boy” – from doctors who advise their sons to work on Wall Street or go into software engineering or law.
Worst case scenario? Muslim doctors from hotbeds of fundamentalism replace US trained doctors as India, the former source of doctors, prospers and fewer doctors from India want to deal with the US system. They get an order from their handler to start mistreating infidels on a given day or as a pattern.
It can happen. I saw a machshefa in a veil filling prescriptions in a major chain pharmacy in NJ three weeks before 9-11 when I was visiting family in the US. All she needs to do is to substitute a very similar looking pill for someone’s RX as part of a terror act…it is not as far-fetched as you might imagine.December 28, 2009 6:44 pm at 6:44 pm #671532
I won’t be around again until their new year’s eve at the earliest – that does not mean shtika ke-hodaah. It means that as a believer in the free enterprise system I have to work hard to get where I want to go. While this is fun, it is of course a time waster as not one of us can make much of a difference as far as policy goes.
Either the US goes back to the way it was, or it will become not a magnet for the best and the brightest – but rather a dumping ground for the mediocre who cannot make it at home and therefore choose a place with a safety net – kind of like the UK or Canada or in some cases EY. Already, the best and the brightest in India and China, as well as in this part of the world, can do everything from home. And because Americans no longer demand or produce quality, drecque merchandise from China is flooding US shelves – part and parcel of the easy does it, disposable culture of the US. Add to that drecque ideas like New Age spirituality and vapid multiculturalism that lead to the opposite of self-reliance, and you have Rome at the time of Nero.
2010 and 2012 will be interesting. Will the US go back to being American? Sadly, I doubt it. The problem is not Obama; it is the dumbing down of the nation and the lack of proper moral standards. If Obama turns out to be an aberration like Carter, then so be it. If, as I fear, he represents the new Britney and Oprah America, then Moshiach better come or you better learn Mandarin.December 28, 2009 11:07 pm at 11:07 pm #671533
CharlieHall when I know of countless Jewish organazation that are dedicated to ensuring that not just money but also lack of knowledge never stand in the way aspersons health.
If such organizations do not exist in the secular world then perhaps all those clamoring to destroy the current system should dedicate themselves to starting such organazations for the betterment of mankind?
Regarding current rationing, It is currently not illegal for someone to be provided with proper healthcare even if they are nintey years old it may be expensive bur it is possible. Those of us who have the proper appreciation of life can ensure healthcare is provided for one and all.
If the government takes over health care that will no longer be the case 9ex. England)which is real Pikuach Nefesh.
As for the quality of care, some of the brightest people went into medicine because it assured them of a comfortable living turning them into another government buracract will ensure they join Wall Street.December 29, 2009 4:36 am at 4:36 am #671534
Taxes and insurance premiums are going up in part because there are so many uninsured Americans getting emergency care. I guarantee you that if you were uninsurable and got sick you would not mind paying higher taxes.
Rabbi Dr. Moshe Tendler has stated that there is a chiyuv on the community to provide health care for all. I have seen no posek disagree. Israel does so with the total support of the religious parties.
Funny you mention COBRA which is a government subsidized mandate, and Medicaid which is a government run insurance program. I thought you didn’t like government programs?
And “Community assistance” simply does not exist. There is no fund that guarantees the medical bills of any Jew who can’t pay. And the cost of creating such would be greater than the cost of every yeshiva in America put together.
And your choice of Teddy Roosevelt is poignant: He endorsed National Health Insurance 97 years ago. (And his foreign policy was not anything like what the founding fathers would have dreamed of.)December 29, 2009 4:49 am at 4:49 am #671535
You are correct that a subsidized public option might have provided some impetus to control costs, but he right wingers killed it. This bill is the best we will get now and will make a world of difference — a life of difference — to thirty million or more. This will indeed be a big boost to the insurance industry but the greedy bastards are fighting even the Senate bill tooth and nail because they want more! Since they have every single Republican Senator in their pocket we have to give them pretty much what they want because several Democrats also want to give them what they want.
Tort reform is a good idea on its merits but it neither expanded access nor reduced costs in Texas where it had the most aggressive implementation. That state has today the worst medical system in the US with the most uninsured people. And salaried physicians has positives, too — my wife is one. She likes getting paid to give the best care whether it is expensive or not.
Currently, about 25% of US medical residents received their medical degrees outside the US. But that has nothing to do with lack of interest in pursuing medical education — in the 2008-2009 cycle, 42,315 persons applied for 17,759 places in medical school. Most of those rejected were quite capable of suceeding academically. But we need thousands more physicians to fill the residency positions. The answer is to create more medical schools, but this takes enormous amounts of money.
I’ve now been teaching medical students for over a decade. If anything, the quality of students has improved along with their enthusiasm. At my medical school, about half the students are Jewish and they are not in it for the money. And frankly, I’m quite happy that those who thought about going to medical school for money are choosing other careers. Let the people with the real dedication to service take the scarce position.December 29, 2009 4:57 am at 4:57 am #671536
“proper moral standards” means taking care of those who are less well off. At least that is what Judaism says. The moral standards of Sedom would leave them to die for lack of health care, which is what is happening now.
Your statement of “government takes over” is false and misleading. And you know better. The Senate bill provides for a massive expansion of private health insurance. You know that.
Regarding “proper health care” for someone who is ninety that is a nontrivial question. We don’t usually recommend aggressive cancer treatment, for example, for someone that old, because the improvement in life expectancy is miniscule even if the treatment is successful.
And as I said before, I don’t want people to go into medicine because it makes a “comfortable living” certain. I want students who are dedicated to serving HaShem and their fellow humans. And I am very proud of my students, almost all of whom fit that description. They will make great doctors!December 29, 2009 5:54 am at 5:54 am #671537mom12Participant
while I could not read thru evey word of the conversation.. I have a few questions for those that are slightly pro.
Why is it that people from all over the world(where they give free insurance) come to America to get medical care?
Why do people in Israel have to be on a waiting list to have surgery two weeks or more, there are prople walking around with catheters for 6 weeks…My brother was in a motorcycle accident and waited in bed for 2 weeks to have surgery.. this is the kind of medicine we are talking about..brought to you by OBAMACARE..
I dont know…if anyone cares its NOT Obama…
Oh not to forget my neighbors elderly mother who went to Israel for grandchilds wedding and was just left to die because at her age who needed the headache..they actually told this to the daughter-they wanted to know why she was trying so hard..
PS I did NOT vote for ObamaDecember 29, 2009 6:25 am at 6:25 am #671538
I hope you’re not a betting man. In the US I am uninsurable. No way would I want to forcibly take money from someone else to pay for my care. (And if you don’t think taxes are taken forcibly, why do those who enforce collections carry guns?)
Also, study a little history. The number of medical schools was limited years ago by the AMA in an effort to keep down the numbers of doctors, thereby eliminating competition for health care dollars.December 29, 2009 6:26 am at 6:26 am #671539
we need to vote our congresspersons out of office. They ran right over us, probably were coerced by the president, but nevertheless are royally squashing those of us who will be forced to pay ever-increasing premiums for ever-decreasing services.December 29, 2009 8:07 am at 8:07 am #671540heimesheyidMember
Is this a done deal, or there is a chance that it will still not go through?December 29, 2009 8:58 am at 8:58 am #671541
no it IS a done deal…the only question is about the details…there are differences in the house and senate versions that have to reconciled…but the bill itself has already been passedDecember 29, 2009 9:21 am at 9:21 am #671542
Is this a done deal, or there is a chance that it will still not go through?
The House passed a bill and the Senate passed a bill. The two bills are similar, but not identical. Now the two bills have to be reconciled into one agreed-upon bill. Then it will go to Obama for his signature.
And, heimesheyid, I don’t want to offend you, but your question shows why the Jewish schools need to have more secular education, especially history and current events.December 29, 2009 2:37 pm at 2:37 pm #671543richthefurrydocMember
To A600 and Charlie:
As I conclude a thirty year tenure as a physician the activity that I do is not nearly as alluring as it once was, and for many of us not sufficiently lucrative to slog away.
My medical school, a Jesuit institution of which I am most proud, does indeed have an increasing fraction of islamic students, something not at all present during my time there in the mid 1970’s. The Internal Medicine Residency program of my current medical center about halfway between NY and Washington depends on decent students and doctors from various parts of Asia who over time have become valued colleagues. There is nothing wrong with them as physicians, yet it portends a change in what the pool of applicants find attractive. This being my 20th consecutive XMas on call, the Jewish doctors who would constitute an easier minyan than at any of our synagogues that day are notably older. There are more non-Jews who now take their turn in the hospital on what for most people is the most desirable day to be home. There weren’t all that many Islamists or Hindus working with me this weekend. The selection of who takes call seems to reflect a combination of lack of seniority within some groups or volunteers who no longer have children at home in other groups. I do not know the statistics, but I suspect the Jewish dominance in medicine was on the wane.
Recently an old friend from Rockland County where I was raised was admitted to the regional hospital. To satisfy my curiosity, I looked up some of the internal medicine and specialty rosters of physicians, expecting to see a place with Jewish physicians and Catholic nurses. Not so. They have a lot of Asians doing the direct patient care and the obviously Jewish doctors seemed older. I think that trend is likely to continue with less practitioners and fewer scientist among our lantzmen.December 29, 2009 7:58 pm at 7:58 pm #671544
I agree that you should not force others to pay for your care. Relying on public charity rather than health insurance is irresponsible. THAT is why we need this bill — so that you can get insurance if you are uninsurable!
And you are not correct about the AMA limiting numbers of medical schools. That was done after the Flexner report about a century ago that noticed that most medical schools were not fit to train competant physicians. As a result, most were closed down — as they should have been. Today the barriers are not lobbying by physicians but the high cost of starting a medical school. Yet we are still trying to do so; a new osteopathic medical school recently opened in Manhattan and there are currently efforts to start new medical schools in Long Island, in Virginia, in California, and elsewhere.December 29, 2009 8:05 pm at 8:05 pm #671545
You are correct that people come to America for medical care. One reason is that since it is a large country, there is more likely to be a specialist who is expert in a particular rare diseas. But people also go to other countries. The late Sen. Spark Matasunaga went to Canada for cancer treatment even though he could have received free care anywhere in the US. More recently, Americans have been going to Mexico for medical care. One recent study found that a third of residents of El Paso, TX went to Cuidad Juarez, Mexico, directly across the Rio Grande, for medical care but only 5% of Juarez residents went to El Paso! A major reason for the discrepancy was that only 59.6 percent of El Paso residents were insured but that 82.8 percent of Ciudad Juarez residents were insured.
Americans having to go to Mexico for health care because of lack of insurance! We should be embarassed!!!December 29, 2009 9:03 pm at 9:03 pm #671546
With all due respect you left out some facts, It is true that a growing number of Americans go overeas for medical care.
The cost of treatment in America is prohibitive so it is becoming well worth it for insurance companies to pay someones travel expenses to have an operation overseas rather then here.
It is also becoming well worth it for Doctors to operate overseas where they can charge less money and take home more then here.
The cost of doing buisness for a Doctor in the U.S is enormous a typical OBGYN in N>Y must pay out 1 MILLION dollars a year in malpractice insurance!
Hence an increasing number of good doctors are choosing to operate overseas and treat American patients there.December 30, 2009 4:50 am at 4:50 am #671547
You are incorrect regarding the cost of malpractice insurance. In four of the five boroughs of NYC an “occurence” policy for an Ob/Gyn costs $163,269/year. In Manhattan the cost is $137,642/year. It took me less than five minutes of internet searching to get those quotes online, from Medical Liability Mutual Insurance Company. That is still high, but it isn’t a million a year or even close to it. I’ve much prefer a system like Canada where (1) it is almost impossible to win a malpractice case against a physician, and (2) there is no need to go to court for medical treatments because it is all covered by the provinicial health insurance!
You are correct about medical tourism, however; the example I gave of El Paso/Juarez is precisely the effect you mention: Texas has more uninsured citizens than any other state so they go to Mexico for care they can afford. (That also shows that tort reform is inadequate to fix the system; Texas has some of the most draconian limits on medical malpractice cases in the US but it continues to have the most dysfunctional health care system.)December 30, 2009 9:47 am at 9:47 am #671548heimesheyidMember
Can anyone validate 2 concerns that I have heard:
1) the top specialists will look elsewhere for work since it wont be worth it for them with this new healthcare plan?
2) Waiting times for specialty doctors will be much longer since the incentive to please will be lost?December 30, 2009 3:02 pm at 3:02 pm #671549
CharlieHall the number quoted by me was the actual number told to me by OBGYn, I would assume one of the differences is there practices (as in most cases) had multiple physicians resulting in increased patient capacity and increased risk btring up the cost.
In addition even if the number you quoted would be correct add rent, workplace insurance, cost of a secratary, physician assistant, and taxes and you can easily see why health care is so expensive.
As to Medical Care, the care that those in Texas recieve in Mexico is unavailible to the vast majority of Mexico citizens they are private not public doctors(this might be one of the reasons why the Mexican population is gradually relocating to the U.S)
As to malpractice why should it be impossible to sue a doctor? If one cannot sue there is nothing to weed out bad Doctors from the system, which is precisley the problem in Canada and other country’s with socilized medicine the amount of “bad doctors” is staggering.
Of course if the Government pays the bills since they write the laws as well they will limit lawsuits (again one of the problems with socilized medicine)
What does make sense is that lawsuits should be capped and there should be protections in place for honest to goodness mistakes that occurred through no fault of the Doctor.December 30, 2009 4:23 pm at 4:23 pm #671550
Either you misunderstood, or the ObGyns are not telling you the truth. Maybe the combined insurance for seven ObGyns was over a million dollars?
The reason that much of the Mexican population is migrating to the US is that free trade has devastated the agricultural sector in Mexico, disappearing millions of jobs. NAFTA was a scam in that it permitted free movement of capital and goods but not labor. The EU is a much better system.
I agree with the need for compensating patients who have been injured through medical errors — recovering actual damages may be a Torah right! But most “malpractice” lawsuits aren’t about errors they are about bad outcomes. And Texas’ experience with capping malpractice awards has shown that it does nothing to fix the system.December 30, 2009 4:29 pm at 4:29 pm #671551
“1) the top specialists will look elsewhere for work since it wont be worth it for them with this new healthcare plan?”
Already we see “top specialists” refusing many insurance plans. The new law will not change that (for better or for worse).
“2) Waiting times for specialty doctors will be much longer since the incentive to please will be lost?”
The waiting times will be reduced from forever to finite if today you are one of the millions of uninsurable Americans. But in any case it isn’t clear that the US needs anywhere near the number of specialty physicians it now has. The New York area has far more specialists than do other parts of the US, but it isn’t any healthier than many of those other areas and health outcomes aren’t any better. Other countries have even fewer specialists yet have better outcomes. For all the common serious chronic diseases, a well trained primary care physician can manage patient care just as well as specialists, who really are needed only when the patient does not respond to standard treatment.
Also, it is not clear that how pleased a patient is with his/her physician has any association with health outcomes.December 30, 2009 7:15 pm at 7:15 pm #671552
Charliehall I have verified the fact that yes the OBGYN’s were telling me the truth.
As for the matter of specialties the reason why so many Doctors go into specialties is because it is much more lucrative (as it should be due to the more intense schooling)
It’sinteresting to note that you completley sidestepped the point I wrote about Mexico that being the medical treatment that tourists recieve there is by and large not availible for the general population, if you want to read over my point in greater detail you are welcometo go back and read my original post.
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