Thoughts on US healthcare moving forward?

“ Wonder how the covid cost will affect Canadian healthcare? - unless the CAN government has plenty of reserve to smooth over the cost?“

We have Provincial health care. It’s different from province to province. Fed govt contributes to each Province.
And so far covid hasn’t been too bad here in BC....yet.
2nd wave is here now and it’s worse than the first.

astroman said...
"We have Provincial health care."

I know. Less greed, but, that can still run out of funds , thus the "reserve $" I mentioned. They will just move fund. That comes from somewhere - your pocket eventually.

Yup - taxes are quite high.
Income tax plus provincial sales tax as well as gst tax. (Gst is federal tax on “goods and services”)

That was crazy. It depends on a spouses healthcare plan, usually its the other way around. That one sure isnt family friendly.

As I remember Obama care also depended on what state you’re in. Some states started out pretty good and then got drastically worse as time went on. Hopefully they learned from that.

Post Edited (astroman) : 11/7/2020 3:15:16 PM (GMT-7)

I’ve been pretty fortunate most my life so I don’t have a good grasp on healthcare costs. I was on my parents plan until my early 20s. I was on a self plan from Aetna for about 80$ a month before Obamacare was implemented. Then I joined the military and obviously you get great coverage as a benefit for serving. It wasn’t until I signed up for Obamacare when the full weight of the cost hit me. I pay 320$ a month for the cheapest plan. I do get some back at tax time.

Yeah that’s a touchy subject. But then again we all take food off our table for certain people that abuse government assistance every day.

The problem in both is we need people Who Are understanding that make the decisions of where to draw the line and that’s what doesn’t happen.

Conventional healthcare testing and methods were applicable to Lyme disease Or any chronic condition should still be covered though.

In my conventional medical testing and basic healthcare that were related to Lyme disease I had to unfortunately never never never mention lyme disease or none of the appointment was covered. if it was an understanding doctor at least then I explain it to them and told them they cannot write lyme in the notes anywhere. That’s just wrong.

My take is that the drs and options in the US are undoubtedly much better than anywhere else, even though for these chronic diseases they're all mostly useless.

The problem is that there is a legitimate failure to control costs in the US. A prime example is the oft-cited anti-venom anecdote. True story, and I cant remember *exact* details, but a guy got stung by a scorpion in Texas, went to the hospital w/ no insurance, got 2 shots of anti-venom, and received a bill for $70k. That same anti-venom costs $100/shot a few miles across the border. Where the breakdown in pricing difference comes from and what goes into those two numbers, there is not a single person out there who knows the answer.

A list of some of the problems that i see:

First off, there is a problem w/ the fact that there is ZERO price transparency. My IVIG was costing me $4900, ad suddenly it jumped up to $6500. No one at the pharmacy could tell me exactly what changed, and from my understanding the price of IVIG hasnt budged. The machine spits it out, was all i was told. When I go to the dr for a broken arm w/o insurance and get a bill for $20k, what went into that price? Where does it come from?

Second, there is no "rational consumer" in the US. You have zero interest to Dr Shop and save costs when insurance is footing the bill. There needs to be a better system,.

Third, there arent enough drs, and a lot of them do it for the wrong reason, because they all want to make $2m/year.

Fourth, the cost of insurance is just way too high, because every one in the US wants to freaking sue each other. Cannot stand that about this country.

Fifth, the rise of the "professional class" and the regulations which support that. Everything has to be done by a Dr making $2m a year, otherwise you risk being sued. How about delegating responsibility to highly trained lab techs. This empowers a greater percentage of the population and reduces costs. Can be extended to other industries like lawyers vs paralegals.

Sixith, and the most frustrating, big pharma. I never used to believe this idea, but the more i research these immunosuppressive drugs, I realize that they are literally in bed w/ the FDA to keep prices high. Dont get me wrong, they do a lot of good, but the cost of these things is insane. Not to mention the fact that the US subsidizes the cost of pharma for a lot of the world.

Seventh, there is just a sort of "inflation" in this industry, and it ties in to my fifth point. Anything tied to the professional classes like higher education, banking, medicine, etc. These are just protected industries that are subsidized by government money, regulation and protections, which by powers that we dont understand, seem to just create pricing mismatches. I dont know how to explain it otherwise.

1: When you remove the limits on pre-existing conditions, or require certain things to be universally covered for everyone its no longer insurance, its becomes a shared payer system. Words have meaning and you better know what you're asking for when you choose it.

2: There have to be limitations on coverage. Money, medical personnel, training and equipment are not endless resource. With government run single payer system the government decides what's covered, who's covered, and until what age, and under what circumstances you will be treated. Unless you're filthy rich you will have surrendered control over your health care to someone else. Do you know what care is best for you, or maybe some government accountant, or even worse, some bribe taking million politician who doesn't give a rat butt about your heath.

3: Specifically for Lyme, unless you get the general medical world to accept unresolved Lyme and its various co-infections, get the more in depth testing "approved" for payment by whatever insurance or socialized system you're dreaming of, getting pre-existing conditions covered is pointless when they don't recognize the disease.

4: Obama care will be tossed out in the supreme court next year. The legal basis for the fines and mandatory purchase of health insurance we removed from the law. Its on borrowed time and the democrats do not have the votes to re-write the law.

5: RE: "I Wonder how the covid cost will affect Canadian healthcare?" You seem to be assuming every reported case is costing money. Under 20s barely have any symptoms, Under 50s and its often nothing more a few boxes of tissues, some decongestant, and lost income. And a very large percentage people that are dying were already in the
medical system on their way out because of their comorbidities. If anything it will save them money but bumping off end of life patients sooner. Cruel, but factual.

dcd2103 said...
My take is that the drs .........

Absolutely the best post here. Standing ovation if I could type and stand at the same time.

skinny_joe said...
I dont think healthcare will ever cover chronic ailments for the most part that do not have a distinctive positive/negative test for. There are just to many hypochondriacs and too many alternative treatments with no scientific evidence other then so and so did it and it helped.

It sounds heartless but I don't know if chronic ailments should be covered other then something to alleviate discomfort. Is your neighbor worth spending millions to try and get better for a ailment? Would you take food off your table to help them with some unproven treatment? Not easy questions to answer.

I do see my non literate lyme Dr for some things related to lyme.
ie - she writes lab reqs that Dr J wants done. She has filled a few prescriptions as well.
But I don’t expect or ask her to write the abx scripts.
She’s done medical imaging as well.

For the most part though - she doesn’t get involved with my lyme treatment.

Quin said...

Girlie said...
If we can provide free health care here in Canada - I don’t see why you can’t get it in the U.S?

If the free health care was so great, why did you pay to go to a doctor in Washington DC?

Because I wanted to be treated by one of the best llmd’s in the world.
My Dr here isn’t knowledgeable about chronic Lyme.
I did treat here first with a LLND but he could only take me so far.

skinny_joe said...
Ive never understood why anyone calls something "free healthcare" your still paying for it. The cost is just shared.

In the US there are plenty of people with truly "free healthcare" they have a procedure and never pay a dime. Others pick up the cost with increased premiums and increased cost of services. Thats free healthcare.

I’ve heard about cases in the US who end up selling their home to pay for medical bills - ie - heart surgery or cancer treatment.
That’s tragic

As much as I railed against costs, I do believe that profit begets motivation which begets quality. And I do think our system provides better drs and more options.

I'm in touch with a lot of guys from the UK on the autoimmune fb groups. One i've become quite close with. God darn is it tragic. The poor guy has been trying to get treatment for 2y, but he's beholden to the one neurologist he's allowed to see. Each appointment takes months, and they've been pushing it off by continuing to require him to get more tests. "Oh, you'll need a lip biopsy now before we can do anything. Next availibility is 4m from. Ok got that, hm maybe we need autonomic testing." He finally got approved to see some specialist in London, only to have his neuro and the specialist conspire to come up with a reason why he doesnt need IVIG. And there's zero recourse, nothing he can do, cant seek help elsewhere. He literally wants to off himself.

The problem, as I stated above, isnt quality, its cost, which suffers from the lack of transparency. In a typical for-profit system these market inefficiencies get arbed out due to competition, and price drops. Doesnt seem to happen in the us, too much friction.

Post Edited (dcd2103) : 11/9/2020 5:58:29 PM (GMT-7)