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American Healthcare debate... (Read 16209 times)
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Re: American Healthcare debate...
Reply #100 - Sep 21st, 2009 at 9:07am
 
Bob P wrote on Sep 21st, 2009 at 8:26am:
Rather than subsidising the insurance companies by forcing everyone to have insurance and taxing the hard working successful to pay the premiums for the less ....., I'd like to see a breakdown of the skyrocketing costs so I could make a knowledgable decision on what can be done to reduce them (I bet not one of the Congress yahoos knows what that breakdown of costs is, much less what is in the bill that is supposed to fix it).


Good point, no one seems to talk about the breakdown.

How can we make good long range decisions without clearly defining the problem?

Marc
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Re: American Healthcare debate...
Reply #101 - Sep 21st, 2009 at 9:12am
 
Marc wrote on Sep 21st, 2009 at 9:07am:
How can we make good long range decisions without clearly defining the problem?

This is the very definition of politics.
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Re: American Healthcare debate...
Reply #102 - Sep 21st, 2009 at 10:06am
 
No public service is run on the basis of "costs". A public service is run on the basis of pre-determined budgets.

The breakdown of costs you want is I think, a red herring. It is not impossible to forecast the costs of running a health delivery scheme based on projections. A consultative process that includes all stakeholders will help arrive at the cost of such a service. Lets not forget, however, that the "cost" is not the correct starting point.  The correct starting point is the amount of money people would be prepared to spend on a monthly basis.  That in turn would determine the budget available per capita which in turn would determine the state-by-state, city-by-city, town-by-town, allocation.

It is down to setting fair prices and fair standards of treatment where profitability is still possible and encouraged, but profiteering and waste is brought under control.

If you consider a public service style socialised healthcare system as the "backbone" of American healthcare, entrepreneurs and insurance companies etc. can then apply their minds to enhancing the healthcare infrastructure by nurturing the backbone and creating new products and opportunities that work alongside the system.
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Re: American Healthcare debate...
Reply #103 - Sep 21st, 2009 at 10:23am
 
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Lets not forget, however, that the "cost" is not the correct starting point.  The correct starting point is the amount of money people would be prepared to spend on a monthly basis.

That's what the last car salesman I encountered tried to convince me of. I told him different. I said that I know what this car cost his dealership, therefore I want him to tell me how much profit he needs to make on it (because I am a reasonable man). I also tell him that it needs to be his best offer because I'm headed down the road to ask the same question of his competitors.
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Re: American Healthcare debate...
Reply #104 - Sep 21st, 2009 at 10:50am
 
deltadarlin wrote on Sep 21st, 2009 at 8:59am:
Can someone from the UK tell me more about the following article?  Is this *standard* procedure?

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Such a sad, tragic story. I Feel so sorry for the mother and wish she'd had a different outcome. I am afraid, I think the little baby would have died anyway, but the medical staff should have at least TRIED to save it.

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Getting back to reality, however, whilst the story is tragic, it is the product of medical guidelines, not a the National Health Service.   The guidelines were created by the INDEPENDENT Nuffield Council on Bioethics, not the British government and not the National Health Service.  As is  often the case, it is quite likely that other countries including the United States would have similar guidelines thanks to the sharing of knowledge between our doctors, professors, universities and other spheres of Academia.  What certainly does NOT happen, is an accountant sits down and says "babies below 22 weeks must die."

I noted too that there are lots of American media organisations incorrectly/disingenuously laying the blame for this tragedy at the door of the UK's NHS. My 5 minutes' very easy research has shown that to be patently unture.  The only conclusion I can reach therefore, is that much of the objections to a national healthcare scheme are based on similar scaremongering by a partisan media, creating untruthful reports.



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Re: American Healthcare debate...
Reply #105 - Sep 21st, 2009 at 10:57am
 
Brew wrote on Sep 21st, 2009 at 10:23am:
Quote:
Lets not forget, however, that the "cost" is not the correct starting point.  The correct starting point is the amount of money people would be prepared to spend on a monthly basis.

That's what the last car salesman I encountered tried to convince me of. I told him different. I said that I know what this car cost his dealership, therefore I want him to tell me how much profit he needs to make on it (because I am a reasonable man). I also tell him that it needs to be his best offer because I'm headed down the road to ask the same question of his competitors.


Brew, I think we're on the same page here: The costs have to be derived from what people are prepared to pay, not from what the health providers claim their service costs.
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loopy
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Re: American Healthcare debate...
Reply #106 - Sep 21st, 2009 at 11:18am
 
Right... so when I ask how much that procedure costs, I'm going to hear "How much you got, boy?"

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Re: American Healthcare debate...
Reply #107 - Sep 21st, 2009 at 12:36pm
 
Loopy wrote on Sep 21st, 2009 at 11:18am:
Right... so when I ask how much that procedure costs, I'm going to hear "How much you got, boy?"


No. There needs to be consensus from the people that they are prepared to contribute X% of their income each month. This will determine the amount available and from there (obviously with a good deal of bargaining and concessions by all stakeholders) budgets can be set. 

There is nothing quite as inefficient as a business/organisation whose expenditure is not moderated by a budget. Budgeting and allocating funds would help ensure that all Americans receive value for money.
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Re: American Healthcare debate...
Reply #108 - Sep 21st, 2009 at 3:07pm
 
While on this topic and things that piss us off, how about the fact that when US citizens turn 65 and go on Social Security we have
NO CHOICE
but to go on medicare.  Not only do we have to take that coverage, we have to pay for it again!!!!!  We have paid for it our entire working lives.  And as if that is not enough, it is in our best interest to get an additional policy, which we have to pay for, to cover what Medicare does not cover. 

Now wouldn't it be better to do what is proposed with the new health care bill and, as they are saying, if you like what you have you can keep it.  I think that seniors should be given the same option. My husband and I  pay through the nose for our health insurance and that is through the State Retirement System.  Our general coverage is pretty good but when it comes to surgery????? not so much.  Right now I need extensive surgery on my foot.  But, the co-pays to the doc, surgery center, etc., etc., etc, that have to be paid in advance, make it impossible for me to have the surgery.  So----now----I will probably end up with a much worse condition and who knows what I will have to have done. 

So, for me, I might like to think about a national plan, or at least something that limits the co-pays when you are already paying out your ass for coverage.

Just venting, sorry everyone.

Louise
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Re: American Healthcare debate...
Reply #109 - Sep 21st, 2009 at 3:27pm
 
Oh, I left out one thing in my "rant".  Adam, my son, and CH sufferer, is a very hard working individual.  His employer does not provide health insurance, or even offer it at a reduced rate.  So-----he has none.  He works hard, but does not make a ton of money.  Some weeks we scrape by to get him O2, but that is one thing he will never be without.  We may not have anything else, but he will have that.  So, yes that is another reason that I would be willing to look at a nationally [b][i]OFFERED[b][i] plan.

All, working, tax paying US citizens are paying for all, non-working, non-tax paying citizens by way of Medicade.  Perhaps Adam should shove his dignity and personal committments in a drawer and become dependent on the Medicare system.  I hear that they are well taken care of.  It would save him $150 everytime he sees the doctor, not to mention the medical testing and the O2.  Therefore, he rarely sees the doc.  I am fortunate enough that I have a raport with her and she will generally listen to Adam via me and let him try what he wants to try.  But it shouldn't have to be like that.

Sorry if I offended anyone.  I get very territorial when it comes to my children.

Love y'all anyway
Louise
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Re: American Healthcare debate...
Reply #110 - Sep 21st, 2009 at 3:27pm
 
Sounds like " from each according to his ability, to each according to his need."

That sounds to me like the excrement from a large bovine creature. 

JMHO
Jerry
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Re: American Healthcare debate...
Reply #111 - Sep 21st, 2009 at 5:00pm
 
Louise Barham wrote on Sep 21st, 2009 at 3:27pm:
Oh, I left out one thing in my "rant".  Adam, my son, and CH sufferer, is a very hard working individual.  His employer does not provide health insurance, or even offer it at a reduced rate.  So-----he has none.  He works hard, but does not make a ton of money.  Some weeks we scrape by to get him O2, but that is one thing he will never be without.  We may not have anything else, but he will have that.  So, yes that is another reason that I would be willing to look at a nationally [b][i]OFFERED[b][i] plan.

All, working, tax paying US citizens are paying for all, non-working, non-tax paying citizens by way of Medicade.  Perhaps Adam should shove his dignity and personal committments in a drawer and become dependent on the Medicare system.  I hear that they are well taken care of.  It would save him $150 everytime he sees the doctor, not to mention the medical testing and the O2.  Therefore, he rarely sees the doc.  I am fortunate enough that I have a raport with her and she will generally listen to Adam via me and let him try what he wants to try.  But it shouldn't have to be like that.

Sorry if I offended anyone.  I get very territorial when it comes to my children.

Love y'all anyway
Louise


Spoken like a true Mother... that's one thing I can say for sure... I totally agree with you 101%

LadyLuv

Although I don't want to offend any one either, but if the shoe fit... so be it
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Re: American Healthcare debate...
Reply #112 - Sep 21st, 2009 at 5:30pm
 
Bob P wrote on Sep 21st, 2009 at 8:26am:
Rather than subsidising the insurance companies by forcing everyone to have insurance and taxing the hard working successful to pay the premiums for the less ....., I'd like to see a breakdown of the skyrocketing costs so I could make a knowledgable decision on what can be done to reduce them (I bet not one of the Congress yahoos knows what that breakdown of costs is, much less what is in the bill that is supposed to fix it).

Smiley Nicely put Bob!
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Re: American Healthcare debate...
Reply #113 - Sep 21st, 2009 at 6:30pm
 
Quote:
There is nothing quite as inefficient as a business/organisation whose expenditure is not moderated by a budget. Budgeting and allocating funds would help ensure that all Americans receive value for money.


Wait a minute, I thought you were arguing *for* the government option.

Since when has our government operated on a budget?  Why do you think a large percentage of us are SCARED to death of yet another government run money pit?  Jesus wept...
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Re: American Healthcare debate...
Reply #114 - Sep 21st, 2009 at 7:10pm
 
One of the things rarely reported is that doctors are not legally required to accept Medicare, or Medicaid, for that matter. My twerp neurologist accepts Medicare, which I have, but recently stopped accepting Medicaid because he says it doesn't  reimburse quickly enough to his liking. Something twisted there but I will give the guy a break as he charges $63 for a visit which is probably a third of most neurologists.

One of the biggest problems for us is our "fee for service" system. It's a recipe for runaway costs that are hard to imagine. Most, GOP and Democrats say that this has to stop. Don't hold your breath though.

Charlie

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Re: American Healthcare debate...
Reply #115 - Sep 21st, 2009 at 9:25pm
 
Charlie wrote on Sep 21st, 2009 at 7:10pm:
One of the things rarely reported is that doctors are not legally required to accept Medicare, or Medicaid, for that matter. My twerp neurologist accepts Medicare, which I have, but recently stopped accepting Medicaid because he says it doesn't  reimburse quickly enough to his liking. Something twisted there but I will give the guy a break as he charges $63 for a visit which is probably a third of most neurologists.

One of the biggest problems for us is our "fee for service" system. It's a recipe for runaway costs that are hard to imagine. Most, GOP and Democrats say that this has to stop. Don't hold your breath though.

Charlie




Charlie:

This is a point that my dad and I have discussed a few times the problem is two fold one on the Medical "Business" side of things and the other on the Ins. "Business" side of things both are in the Business of Making money.   In the mean time people who can't afford it or are on non accepted forms of medical aid, insurance, savings plan or what ever other option you can think of are left out in the cold.

Until both are put into some kind of checks and balances we will continue to be in a vicious cycle.

Which leads us right back to the issue at hand and Gov. involvement which anyway you look at it ISN'T necessarily a Good Idea to fix the problems.

The only viable option that I can see and even it has it's draw backs is to "regulate" the medical and ins. industries with some sort of over site and without making the people pay more than they are now and not making the people get ins (or pay for) gov provided ins. on top of what they are already paying for it. (You know it will be added on top of the deductions on your paycheck that they are already taking out.)(** I am mainly speaking of those of us that do have ins. even though it may be a crappy plan.)

The problem with ins. co.'s is that, if they aren't making money/profit they drop parts of our coverage in order to make a profit.  This shouldn't be allowed to happen, not with Medical coverage at least.

The problem with the medical system is that they are allowed to pick and choose which types of insurance they will accept.  (Frankly I can't see how a Doctor who took the Hippocratic Oath can do this, because in the end he or she is causing harm, when he denies a patient care for these reasons. **One Phrase in Hippocratic oath is "First Do No Harm!") Not to mention the Sky Rocketing costs of medical care, they charge 20$ for 1 freakin tylenol in a hospital for crying out loud, (that was what I was charged for one the last time I was in the hospital which was years ago).

Just my  Smiley again.   Smiley


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Re: American Healthcare debate...
Reply #116 - Sep 22nd, 2009 at 12:14am
 
Charlie,

The reason your Dr quit accepting Medicaid is legitimate.  In Illinois because of the tremendous numbers of illegal aliens using the system Medicaid is bankrupt and unable to pay its bills.  It used to be the providers had to wait 6 months to receive payment at 50% of the billed rate they now have to wait 9 months or longer, and often have to settle for 40%.  I don't know about you, but when you sell something on Ebay can you afford to wait 9 months and then only get a portion of your price?  I couldn't, and neither can the Drs.

Jerry
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Re: American Healthcare debate...
Reply #117 - Sep 22nd, 2009 at 1:50am
 
Buzz, understanding the whole story behind US healthcare is a very complicated thing. To make it a little easier...

In the US Social Security is said to run out of money in a few years, the same for Medicare and Medicaid. Why? Money has and is paid into those systems always, and are separated on our pay statements.

Our inept government does not separate those funds paid in for any of the above. Are we to expect that somehow they will see the light????

For those of us that can see the light and the way our gov is, the biggest problems with health care costs are not being addressed. It's not politically profitable.

Don
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Re: American Healthcare debate...
Reply #118 - Sep 22nd, 2009 at 2:58am
 
Loopy wrote on Sep 21st, 2009 at 6:30pm:
Quote:
There is nothing quite as inefficient as a business/organisation whose expenditure is not moderated by a budget. Budgeting and allocating funds would help ensure that all Americans receive value for money.


Wait a minute, I thought you were arguing *for* the government option.

Since when has our government operated on a budget?  Why do you think a large percentage of us are SCARED to death of yet another government run money pit?  Jesus wept...


You write as though there is no option but to have the same inept, wasteful government practices.  You don't have to accept second best. Think outside the box.

If the money was ring-fenced  and controlled by an organisation made up of all stakeholders including the government, doctors, patients, insurance companies etc you could get value for money.

The one thing that is 100% true is that such a programme is possible.  The only thing that could cause it to fail is the self-interest of certain groups who have had an easy ride, profiteering from patients and their insurers.
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Re: American Healthcare debate...
Reply #119 - Sep 22nd, 2009 at 3:09am
 
JustNotRight wrote on Sep 21st, 2009 at 9:25pm:
Charlie wrote on Sep 21st, 2009 at 7:10pm:
One of the things rarely reported is that doctors are not legally required to accept Medicare, or Medicaid, for that matter. My twerp neurologist accepts Medicare, which I have, but recently stopped accepting Medicaid because he says it doesn't  reimburse quickly enough to his liking. Something twisted there but I will give the guy a break as he charges $63 for a visit which is probably a third of most neurologists.

One of the biggest problems for us is our "fee for service" system. It's a recipe for runaway costs that are hard to imagine. Most, GOP and Democrats say that this has to stop. Don't hold your breath though.

Charlie




Charlie:

This is a point that my dad and I have discussed a few times the problem is two fold one on the Medical "Business" side of things and the other on the Ins. "Business" side of things both are in the Business of Making money.   In the mean time people who can't afford it or are on non accepted forms of medical aid, insurance, savings plan or what ever other option you can think of are left out in the cold.

Until both are put into some kind of checks and balances we will continue to be in a vicious cycle.

Which leads us right back to the issue at hand and Gov. involvement which anyway you look at it ISN'T necessarily a Good Idea to fix the problems.

The only viable option that I can see and even it has it's draw backs is to "regulate" the medical and ins. industries with some sort of over site and without making the people pay more than they are now and not making the people get ins (or pay for) gov provided ins. on top of what they are already paying for it. (You know it will be added on top of the deductions on your paycheck that they are already taking out.)(** I am mainly speaking of those of us that do have ins. even though it may be a crappy plan.)

The problem with ins. co.'s is that, if they aren't making money/profit they drop parts of our coverage in order to make a profit.  This shouldn't be allowed to happen, not with Medical coverage at least.

The problem with the medical system is that they are allowed to pick and choose which types of insurance they will accept.  (Frankly I can't see how a Doctor who took the Hippocratic Oath can do this, because in the end he or she is causing harm, when he denies a patient care for these reasons. **One Phrase in Hippocratic oath is "First Do No Harm!") Not to mention the Sky Rocketing costs of medical care, they charge 20$ for 1 freakin tylenol in a hospital for crying out loud, (that was what I was charged for one the last time I was in the hospital which was years ago).

Just my  Smiley again.   Smiley




An interesting post, Ginger, thanks.

I think I see a solution here: There needs to be a standard/basic insurance plan that is acceptable across the board. This plan must be offered by all insurers (government subsidised???) and must guarantee a minimal level of treatment. It can form the basis of every one's medical insurance and the insurers can then offer enhancements which patients can purchase.
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Re: American Healthcare debate...
Reply #120 - Sep 22nd, 2009 at 3:18am
 
Skyhawk5 wrote on Sep 22nd, 2009 at 1:50am:
Buzz, understanding the whole story behind US healthcare is a very complicated thing. To make it a little easier...

In the US Social Security is said to run out of money in a few years, the same for Medicare and Medicaid. Why? Money has and is paid into those systems always, and are separated on our pay statements.

Our inept government does not separate those funds paid in for any of the above. Are we to expect that somehow they will see the light????

For those of us that can see the light and the way our gov is, the biggest problems with health care costs are not being addressed. It's not politically profitable.

Don



It is indeed complicated. And therein lies the problem.

What is needed is a simple, single system that everyone understands.  That system needs to be regulated NOT by government but by all stakeholders so that the medical profession can operate profitably, patients can receive the care they NEED etc, etc.

A decent social healthcare plan is possible. Indeed, I think its actually pretty easily possible, but there are many who would like you to believe its would not be so. Why? Because they are having an easy ride right now.

As a country renowned for the imaginative spirit of its people, I know the US could make equitable healthcare part of the American dream.
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Re: American Healthcare debate...
Reply #121 - Sep 22nd, 2009 at 4:19am
 
Skyhawk5 wrote on Sep 22nd, 2009 at 1:50am:
For those of us that can see the light and the way our gov is, the biggest problems with health care costs are not being addressed. It's not politically profitable.


I wouldn't be familiar with an expression of what "politically profitable" means, but there are aspects of what are fundamentally politically unpopular, such as asserting "those of us that can see the light" about gov and costs. 

Nonetheless, political entrepreneurship has been shown to be prevalent.

What has seemed inherent to the extent of more than a creeping suspicion in the recent past and been a proven before, private enterprise has shown, perhaps through lobbying now, the ability to extract huge sums from federal operations, a main motivation for paid voice on an issue.  Not FOR anything unless a way can be seen to make gov a device for exploitation. 
  We don't have a Teddy Roosevelt (give'm Hell Harry made a V.P. ticket in part on his popularity contributing here) to represent us in this arena and a basic fear could arise of a continuance and even an acceleration as a result from this kind of legislation. 
  In some areas, it appears companies know how to win bids from gov, but not how to do the work, making extreme waste.  Whose interests are really being looked out for when it may be a clinging impression gov is for public interest?  What is the design in place presently that has been engineered by this political entrepreneurship? 

Suspicion is warranted that any legislation decided may see its way to profit commerce more than individuals.  The track record is subpar to what we might consider efficient business with our money, whereas we seem the investors without input or say in the choices implementing programs.  Democracry being subservient and ignored when money is talking much louder.

Change from the chance of this scenario is a good idea, trusting it will actually happen is in part a problem, but the future of healthcare can seem a luxury item expense.







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Re: American Healthcare debate...
Reply #122 - Sep 22nd, 2009 at 8:19am
 
Tort reform is not on the health-care agenda.
43% of the members of Congress are lawyers.


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Re: American Healthcare debate...
Reply #123 - Sep 22nd, 2009 at 10:16am
 
Well, being the bean counter I am.... Since I went on medicare in March, I figure I'm ahead for the year.... It's costing me about 12% of my SS to have medicare plus a supplement policy, BUT it's the first time in years I've been ABLE to AFFORD to go to the doctor.

My medications (that I HAVE to have) have been costing me over $200 a month - they now cost me about $15 a month (worth the $38 a month I pay for the extra coverage for RX). My doctor can run tests that he needs without me thinking how to pay for them (my supplement covers what medicare doesn't) and I don't pay anything out of pocket.

If medicare is socialized medicine - then I'm all for it. Of course there's some fraud in it - and that needs to be eliminated (checks and balances would cure that), but it's helped a lot of seniors who can't afford to be sick.

That's my opinion and doesn't represent the views of this forum probably.

Hugs BD Kiss
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Re: American Healthcare debate...
Reply #124 - Sep 22nd, 2009 at 11:10am
 
BarbaraD wrote on Sep 22nd, 2009 at 10:16am:
Well, being the bean counter I am.... Since I went on medicare in March, I figure I'm ahead for the year.... It's costing me about 12% of my SS to have medicare plus a supplement policy, BUT it's the first time in years I've been ABLE to AFFORD to go to the doctor.

My medications (that I HAVE to have) have been costing me over $200 a month - they now cost me about $15 a month (worth the $38 a month I pay for the extra coverage for RX). My doctor can run tests that he needs without me thinking how to pay for them (my supplement covers what medicare doesn't) and I don't pay anything out of pocket.

If medicare is socialized medicine - then I'm all for it. Of course there's some fraud in it - and that needs to be eliminated (checks and balances would cure that), but it's helped a lot of seniors who can't afford to be sick.

That's my opinion and doesn't represent the views of this forum probably.

Hugs BD Kiss


Barbara, you have just illustrated the whole point of a socialised healthcare system. Smiley

There are a lot of political (pseudo)reasons why people don't want such a scheme, but so far all of the stumbling blocks I've had explained to me are things that can be overcome.

Healthcare only costs what it does because its been allowed to become hideously expensive. Why? because there is no one to reign in what is charged.  There is no one to put a brake on run-away expenditure, on unnecessary tests, on profiteering.  There is a balance that can be found between the needs of patients and the right of medical practitioners/hospitals etc. to make a profit. It just takes a little imagination and preparedness to make compromises.
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