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What does "underinsured" mean in the US?

Quite the personal experience Brandon- thanks for sharing.

The other ridiculous thing to consider is the absurd about of paper shovelling and administrative overhead the US system requires. Talk about bureaucracies!

AoD
 
I see it as bureaucrats without medical licenses practicing medicine.

Yeah...that's made me wonder. How exactly does somebody without medical training decide what procedure is or is not necessary? For all their criticisms about bureaucrats deciding treatments in Canada, its mostly doctors (and usually the person's physician themselves) that decide what care is to be provided.
 
Canadians need to understand its not just better from an access standpoint, health outcomes are simply much better and the technology you find in Canada is top notch. And there are many high tech research centres across Canada that are very much doing a good job relative to the population.


It's a huge problem with medicine that the general public equates better technology with better medicine. Technology is great, but only if used properly, otherwise it's pretty much pointless. Interestingly enough a lot of research that occurs in Canada is more centered on the long-term usage of known drugs, or even of medical processes. One such example is the amazing research put out by the University of Ottawa which creates clinical decision rules like the 'Ottawa ankle rule' which determines when best to use x-rays for sprained ankles. The point of such research is to REDUCE the need for technology and invasive procedures by finding the optimal use of technology.

This contrasts with the oft quoted American statistics of 'the top 5 American research centers put out more research than any other country in the world', which unfortunately heavily skews towards new technology, but not necessarily better healthcare.

Canadian standards tend to be higher, like the expectation that a family or individual needs a family practitioner. You would be amazed at the attitude difference, because most Americans don't see the need for a family practitioner. All these 'problems' of the Canadian system are problems I'd love America to have. Different problems for a different people, I suppose.

Surprizingly there are about as many family doctors in the USA as there are in Canada. Considering there's 10x the amount of people in the USA this is HUGE. The big problem is that people feel in general that they know more about healthcare than doctors. The internet is the worst culprit in this, in that people truly believe that they can direct their own healthcare better than a professional who went to 10 years of school with very high standards and whose job every day is to provide healthcare.

While I don't argue that a lot of times doctors may miss things or may downplay a symptom, the fact that the US medical system is so much more 'consumer driven' is a cost contributor. People who know nothing but demand and receive unnecessary MRIs or full body scans. People who pay $2000 for an annual physical when really they aren't even in any risk group that would justify all these tests. People who demand orthopedic surgeries for problems which could be more easily or even better treated conservatively and end up getting what they want because they pay.

Even if people didn't end up getting these services, by going directly to specialists or by shopping around to multiple specialists, they end up costing the entire system (whether medicaid or the private insurance system) a ton of money.

All this adds up, and if the American system required family doctors to refer first, a lot of this would be mitigated because family doctors are uniquely situated to address a lot of these issues. A lot of times people come in demanding something, and really all they need is reassurance, but hey if they were paying you a ton of money for a relatively benign but useless test (i.e. MRI) you may do it for them.
 
Here's a prime example of how those who are against universal healthcare in the USA tend to just outright lie to scare people:

(From senate minority leader Mitch McConnell)
http://mcconnell.senate.gov/print_record.cfm?id=314075

===================
Americans Want Real Reform
from the Office of Senator Mitch McConnell

Monday, June 8, 2009

‘What Americans want is for health care to be affordable and accessible. What some in Washington are offering instead is a plan to take away the care that people already have, care that the vast majority of them are perfectly satisfied with, and to replace it with a system in which care and treatment will be either delayed or denied’

WASHINGTON, D.C. - U.S. Senate Republican Leader Mitch McConnell made the following remarks on the Senate floor Monday regarding the importance of getting it right on health care reform:

“When it comes to health care, Americans are looking to Washington for real reform. Americans are rightly frustrated with the ever-increasing cost of health care and many are concerned about losing the care they have. Americans also believe that in a nation as prosperous as ours, no one should go without the health care they need. All of us agree that reform is necessary, that we must do something to address the concerns Americans have on this issue. The only question is: What kind of reform will we deliver?

“Will we deliver a so-called reform that destroys what people like about the care they have? Or will we deliver a reform that preserves what’s good even as we solve the problems that all of us acknowledge and want to address?

“Unfortunately, some of the proposals that have been coming out of Washington in recent weeks are giving Americans reason to be concerned. Americans have witnessed the government take over banks, insurance companies, and major parts of the auto industry. They’re concerned about the consequences. Now they’re concerned about a government takeover of health care — and for good reason.

“What Americans want is for health care to be affordable and accessible. What some in Washington are offering instead is a plan to take away the care that people already have, care that the vast majority of them are perfectly satisfied with, and to replace it with a system in which care and treatment will be either delayed or denied.

“Last week, I offered some examples of real people in Britain and Canada who were denied urgent medical treatment or necessary drugs under the kind of government-run system that those two countries have and that many in Washington would now like to impose on Americans, whether the American people like it or not. This afternoon, I’d like to describe how government-run health care systems like the one in Canada not only deny, but also delay care for weeks, months and even years.

“By focusing on just one hospital in one city in Canada — Kingston General, in the city of Kingston, Ontario — we can get a glimpse of the effect that government-run health care has on everyday Canadians, and the long waits they routinely endure for necessary care.

“Now, I have no doubt that the politicians in Canada never intended for the people of that country to see their health care denied or delayed. I’m sure the intention was to make health care even more accessible and affordable than it was. But as we’ve seen so many times in our own country, government solutions have a tendency to create barriers instead of bridges. The unintended consequence becomes the norm. That’s what happened in Canada. And Americans are concerned it will happen here too.

“A medium-sized city of about 115,000, Kingston, Ontario, has about the same number of residents as Lansing, Michigan, to its South. But while it’s not uncommon for Americans to receive medical treatment within days of a serious diagnosis, at Kingston General Hospital, wait times can be staggering.

“Take hip replacement surgery, for example. A couple years ago, the wait time for hip replacement surgery at Kingston General was almost two years. Well, a lot of people were understandably unhappy with the fact that they had to wait more than a year and a half between the time a doctor said they needed a new hip and the surgery to get it. So the government worked to shorten the wait. Today, the average wait time for the same surgery at the same hospital is about 196 days. Apparently in Canada, the prospect of waiting six months for hip surgery is considered progress.

“That’s hip replacement surgery. What about knee replacements? Well, at Kingston General, the average wait time is 340 days, or almost a year from the moment that the doctor says you need a new knee. How about brain cancer? In Ontario, the target wait time for brain cancer surgery is nearly three months; same for breast cancer and prostate cancer. And for cardiac bypass surgery, patients in Ontario are told they may have to wait six months for a surgery that Americans can often get right away.

“The patients at Kingston General Hospital in Kingston, Ontario, have been understandably unhappy with all the waiting they have to do. Fran Tooley was one of them.

“Two years ago, Fran herniated three disks in her back, and was told that it would be at least a year before she could consult a neurosurgeon about her injury, which had left her in constant pain and unable to sit or stand for more than a half-hour at a time.

“According to a story in the Kingston Whig-Standard, Fran’s doctor referred her to a neurosurgeon after an MRI scan showed the herniated disks were affecting the nerves in her legs. The story went on to say that patients in Ontario can be forced to wait for up to two years, and sometimes even longer, for tests, appointments with specialists, or even urgent surgery.

“Americans don’t want to end up like Fran Tooley. They like being able to get the care they need, when they need it. They don’t want to be forced to give up their private health plans or be pushed onto a government plan that threatens their choices and the quality of their care. They don’t want to wait years for surgery that their doctors say they need right away. And they don’t want to be told they’re too old for surgery or that a drug they need is too expensive. But all of these things could be headed our way.

“Americans want health care reform. But they don’t want reform that forces them onto a government plan and replaces the freedoms and choices they now enjoy with bureaucratic hassles, hours spent on hold, and surgeries and treatments being denied and delayed. They don’t want a remote bureaucrat in Washington making life and death decisions for hem or their loved ones. But if we enact a government-run plan, that’s precisely what Americans can expect.â€
=====================
 
And here's the response from the Chief of Staff of Kingston General Hospital, debunking all the lies from Senator McConnell:

http://journals.democraticunderground.com/RedEarth/1465

===============
Response to the Senator accusing Canada of having "staggering" wait times from Canadian Surgeon
Posted by RedEarth in Editorials & Other Articles
Thu Jun 25th 2009, 04:50 PM
By Dr. David Zelt
The Kingston Whig Standard
6/24/09

Dr. David Zelt, chief of staff and vice-president, medical administration, at Kingston General Hospital, sent the following reply to McConnell.

I am writing with reference to remarks you made in an address this past week to the United States Senate.

As a surgeon and hospital executive in Canada, I am well aware of the debate now taking place in your country over the role of government in making medical services more widely available to the millions of your fellow U. S. citizens who are now without such vital protection.

The purpose of this letter is not to interfere in that debate, although I would be remiss if I did not declare that I am a proud participant in our public healthcare system in Canada and value its ability to guarantee quality and accessible care to all our citizens regardless of their financial circumstances. Is our system perfect? Definitely not. Are costs and ever-increasing demand a challenge? Definitely yes.

I am writing to you at this time to correct and update information that you provided to the U. S. Senate this week about Kingston General Hospital (KGH), where I am chief of staff and vice-president, medical administration. I am confident that you, as someone playing a major role in the current health-care debate in your country, would want to make your arguments based on material that is both correct and current.

You chose our hospital to provide “a glimpse of the effect that government-run health care has on everyday Canadians and the long waits they routinely endure for necessary care.â€

At KGH we are proud of our reputation as a medium-size regional health science centre providing excellence in research, academic and patient care standards. I respectfully submit that the information you supplied to the U. S. Senate is not an accurate or fair “glimpse†of either our institution or our national health-care system.

For example, you state that at KGH wait times can be

“staggering.†This is simply not true. Our average and median wait times exceed provincial targets. Your researchers have taken data and interpreted it incorrectly, with the result that your information is inaccurate.

Your statement to the Senate: “Today, the average wait time for (hip replacement) surgery at KGH is about 196 days.†In fact, our actual average hip replacement wait time is 91 days — less than half of what you stated.

Your statement to the Senate: “What about knee replacements? Well, at Kingston General, the average wait time is 340 days, or almost a year from the moment that the doctor says you need a new knee.†In fact, our average wait time for knee replacements is 109 days.

Your statement to the Senate: “What about brain cancer? In Ontario the target wait time for brain cancer surgery is nearly three months; same for breast cancer and prostate cancer.†These are simply that, targets. In fact, at KGH our average overall wait times for surgical treatment of all forms of cancer is 31 days (16 days for breast cancer, 49 for prostate and eight for neurosurgical cancer).

Your statement to the Senate: “And for cardiac bypass surgery, patients in Ontario are told they may have to wait six months for a surgery that Americans can often get right away.†In fact, the median wait time for cardiac surgery in Ontario is 16 days (32 days at KGH).

In summary, Senator McConnell, in an effort to advance your position opposing public health care, you have maligned a very proud institution whose service to our community dates back some 170 years. The “glimpse†you have provided of our national healthcare system neglects to mention that at its very base is Canadians’ fundamental right to accessible and quality health care regardless of their financial circumstances.

In closing, Senator, I thank you for this opportunity to bring this information to your attention. We have an excellent data collection system at our hospital and I would invite you or a member of your staff to contact me or other officials of this institution for accurate and current information that would be helpful in keeping the American public correctly informed during your important and ongoing debate on health care.
 
Doesn't surprise me, Mitch McConnell isn't the brightest Senator on Capitol Hill and his staffers feed him the same conservative misinformation any right wing think tank can cook up. All he does is regurgitate the information in his own annoying way.

What Mitch doesn't seem to mention is that millions of Americans are denied the right to have a hip replacement altogether and can't even get treatment. No patient is ever denied care in Canada.

What Mitch doesn't seem to mention is that most all Americans wait months for knee and hip replacement even if they have insurance and need the surgery, and generally it must go through a lengthy insurance approval process before the doctor gets the chance to say yes to the patient.

The health debate in the US is so convoluted that even the Democrats are afraid to stand strong for a public insurance that guarantees coverage, so let them speak ill of Canada all they want. Its Canada that still has the better health system.

BTW, its ironic that US politicians cannot admit the fact that there are wait lists in the US and pretend everything is done 'right away' when we all know that isn't true.
 
Underinsured in the USA...

Brandon: Good post and topic here! Your rejection notice shows how the for-profit health care system works in the USA-putting money and profit ahead of
preventative care and diagnosis.

EPI: Good posts about Senator McConnell and the GOP's lies about health care and Kingston General Hospital confronting them on the topic.
There is obvious mis-information about Canada's Health Care system being spread by the likes of the GOP and it is good to see them being challenged on it.

The USA may have some of the best health care in the World-if you can AFFORD it! Upwards of 50 Million US residents can't-which in itself is a travesty.

Thoughts from LI MIKE
 
Conservatives For Patient's Rights-a anti-universal care group website...

Everyone: I saw a TV ad for an anti-universal care for the US group called
Conservatives for Patient's Rights - their stand is the typical right-wing thought about the "Government bureaucrat standing between you and your doctor" and the astronomical cost that universal healthcare would cost US taxpayers.

The address is: www.cprights.org/ Brandon and all: Your thoughts...
-Long Island Mike-
 
LOL, my thoughts? Its probably an insurance lobby group. Will have to research how the operation is funded.

And after 5 seconds on google without having finished this post, here is how easy it was to debunk this 'patient group'.

The website says its ran by Rick Scott:

http://www.cprights.org/about.php

http://crooksandliars.com/susie-madrak/once-forced-resign-massive-fraud-case

Rick Scott is a former HCA (Healthcare Corporation of America) executive (the company based in Nashville originally created by former Senate Majority Leader Bill Frist's father - Thomas Frist Sr.) and Scott was found guilty of defrauding and overbilling Medicare in the billions.

So basically the guy running all these anti-universal health care ads is a convicted felon (well, his actions at HCA were found to be a fraud), charged with billing the public Medicare system too much so he can make large profits for his for-profit hospital chain.

Its easy to debunk these hacks. A felon shouldn't be allowed to run a national ad campaign, in my opinion.
 
former CIGNA exec wendell potter interviewed by bill moyers. he says michael moore's sicko hit the nail on the head, among many other things:
BILL MOYERS: Why is public insurance, a public option, so fiercely opposed by the industry?

WENDELL POTTER: The industry doesn't want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don't want any more competition period. They certainly don't want it from a government plan that might be operating more efficiently than they are, that they operate. The Medicare program that we have here is a government-run program that has administrative expenses that are like three percent or so.

BILL MOYERS: Compared to the industry's--

WENDELL POTTER: They spend about 20 cents of every premium dollar on overhead, which is administrative expense or profit. So they don't want to compete against a more efficient competitor.

BILL MOYERS: You told Congress that the industry has hijacked our health care system and turned it into a giant ATM for Wall Street. You said, "I saw how they confuse their customers and dump the sick, all so they can satisfy their Wall Street investors." How do they satisfy their Wall Street investors?

WENDELL POTTER: Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.

I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.

For example, if one company's medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that's ridiculous. And it's horrible.

BILL MOYERS: That they're spending more money for medical claims.

WENDELL POTTER: Yeah.

BILL MOYERS: And less money on profits?

WENDELL POTTER: Exactly. And they think that this company has not done a good job of managing medical expenses. It has not denied enough claims. It has not kicked enough people off the rolls. And that's what-- that is what happens, what these companies do, to make sure that they satisfy Wall Street's expectations with the medical loss ratio.

BILL MOYERS: Who is Ron Williams, and why do you use him as the example of what Wall Street expects and wants from the insurance companies?

WENDELL POTTER: He has, apparently, had a seat at the table of health care discussion. He was recruited by Aetna from WellPoint. Aetna had gone on a buying binge. There's been an enormous amount of consolidation in the health insurance industry over the last several years. Aetna bought a lot of competitors.

It reached 21 million members. And, but what it realized and what investors began to see is that a lot of the businesses that it had bought were not all that profitable. So they were in Aetna was in a pickle. And they saw their stock price starting to plummet. So they brought-- among the things they did was bring Ron Williams in. And Williams, among the first thing he did was order a revamp of the IT system, so that--

BILL MOYERS: The information technology system--

WENDELL POTTER: Exactly, so that the company could determine more about which accounts were not profitable or margining profitable. So with that new system, he was able, and the other executives to identify the accounts that they wanted to get rid of. And over the course of a very few years, they shed eight million members.

BILL MOYERS: Eight million policy holders?

WENDELL POTTER: Eight million people, men, women, and children, yes.

Some of them were shed by intention. Some, I'm sure, probably walked because the-- or left for whatever other reason, but they intentionally had this program to purge these accounts. Eight million fewer people were enrolled in Aetna's plans. Many of them undoubtedly joined the ranks of the uninsured, because their employers had been purged.

BILL MOYERS: So what happened to Aetna's stock?

WENDELL POTTER: Went up. And it has--

BILL MOYERS: And so did Ron's--

WENDELL POTTER: And--

BILL MOYERS: --compensation, right?

WENDELL POTTER: Ron's compensation and his stock on Wall Street.


Watch the Youtube interview

http://youtube.com/watch?v=0-M10jDkmm0

http://youtube.com/watch?v=Mv1FwOCNoZ8

the whole thing is on the PBS site:
http://www.pbs.org/moyers/journal/07102009/watch2.html
 
^ Thanks for that; Moyers is one of the rare pundits who aren't in the whitewashing business.
 
Anthony Weiner stands up in Congress:

anthony weiner introduces bill to kill medicare (republicans don't support it)
http://youtube.com/watch?v=sTh-Yu9RfF0

& single-payer will get an up-or-down vote in the house! will anthony weiner become the american tommy douglas?
Single Payer Gets A Vote (Updated)
July 31, 2009

Anthony Weiner is about to be the new hero of the progressive crowd after getting a promise from Nancy Pelosi to debate — and vote — on a single-payer plan to solve health care reform.

Weiner got that promise after he agreed to withdraw an amendment to essentially create Medicare for the whole nation in the Energy and Commerce Committee health care markup session this evening.

The Brooklyn-Queens Rep. looked a little surprised when Chairman Henry Waxman said Pelosi would allow that vote, and made Waxman repeat the deal to be sure it was clear and on the record.

It’s an especially big deal for advocates of a single health care system — who see it as cheaper and simpler than the complicated measure being drawn up — because they have been complaining that they have not even been able to get an airing of their position.

And having the vote of the floor of the House will force members to declare a position, and bring much more attention to the idea.

Update: Weiner, who high-fived Tammy Baldwin after getting the deal, crows in a quick press release:

“It’s a Better Plan and now it’s on Center Stage,” says Weiner

Washington, DC - Congressman Henry Waxman (D-CA), Chairman of the Energy & Commerce Committee announced today that Speaker Nancy Pelosi has pledged to give Single-Payer an up or down vote when healthcare reform is considered before year’s end.

Congressman Anthony Weiner (D-NY), Co-Chair of the Middle Class Caucus and member of the Energy & Commerce Committee who led the effort with Rep. Tammy Baldwin (D-WI); Rep. Mike Doyle (D-PA); Rep. Elliot Engel (D-NY); Rep. Rep. Bobby Rush (D-IL); Rep. Janice Schakowsky (D-IL); and Rep. Peter Welch (D-VT), released the following statement:

“Single-payer is a better plan and now it is on center stage. Americans have a clear choice. Their Member of Congress will have a simpler, less expensive and smarter bill to choose. I am thrilled that the Speaker is giving us that choice.”​

- Michael McAuliff
http://www.nydailynews.com/blogs/dc/2009/07/single-payer-gets-a-vote.html
 

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