[DavidEvan]

A little scenario:
A man drives his family out for a meal but they have an accident. Two of them need hospital and Intensive care for three months. His wife goes into labour and the 24 week old baby than needs ECMO and Intensive care for the next year. The man's brother has a heart attack and needs an immediate bypass. His father, whilst receiving treatment is coincidentally found to have a tumour needing many scans, investigations, operations, chemo and radiotherapy. He himself is faced with a broken back, artificial limbs, and all the ancillary services necessary for the rest of his life.
All this is free, they live in the uk.

[pyritechips]

Do I think my country "owes" this too me, no.

Bruce, I have never disagred with you before but I must agree with Oldie on this.

You country grows rich, supposedly, because you have a low tax, low public service policy. The one aspect of the American system that angers me, as so vehemently promoted by such groups as the Cato Institute, is that a person's health, his very well-being, should be subordinate to the concept of free-enterprise/profit. Until America eliminates this disgusting obsession with greed it will always have a situation where the supposedly richest nation on Earth is more than willing to use the good spirits, intentions and efforts of wonderful people like Bruce, and when they suddenly do not meet some social "norm" dispose of them.

Any nation that treats its own people so callously may be rich monetarily but they are poor of spirit.

Bruce: my home is your home. I would rather see you move up here, take rooms in my house and apply for healthcare here at less than $100 a month for a couple then jeopardise your health and rely on hope and good wishes to get through to your sixty-sixth birthday.

[oldie]

Originally Posted by DavidEvan

A little scenario:
A man drives his family out for a meal but they have an accident. Two of them need hospital and Intensive care for three months. His wife goes into labour and the 24 week old baby than needs ECMO and Intensive care for the next year. The man's brother has a heart attack and needs an immediate bypass. His father, whilst receiving treatment is coincidentally found to have a tumour needing many scans, investigations, operations, chemo and radiotherapy. He himself is faced with a broken back, artificial limbs, and all the ancillary services necessary for the rest of his life.
All this is free, they live in the uk.

Hi David and welcome to TSGs - Wowee what an intro Much of it perfectly true of course, but again wow - come join the debate - please !!! but any chance of a more revealing profile perhaps old chappie

Oldie

[eggplant43]

Guess my saying I don't feel entitled touched some nerves. I don't know how the US will eventually solve this problem, but feel it will have to be fairly soon. Theoretically, the people are the government, and in their collective wisdom have chosen to keep medicine fully capitalistic. That simply doesn't work with increased population size, population aging, and much longer lifespans, but many continue to beat the same drum despite the major disconnect this now represents.

There are actually good arguments that this system actually costs more in the long run. Hopefully, once we retrieve our government back in November we can all work together to resolve this festuring wound (Iknow, I know, intended).

Jim, I appreciate your offer, and feel the love, but I understand it is cold, and snows there. Oldie, on the other hand lives in the Mediterranean, and I'm hoping for a better offer

Seriously, I understand that Canada will not let us older folks have residency there because of the medical issue. If I'm wrong, please let me know.

[Fidelista]

Originally Posted By FIDELISTA
"We Americans have to change our attitudes about "older Americans"--- they are useless!. I am waving a tiny flag as I speak!."

Kindly elaborate for Oldie please

Regards - Oldie-----------------------------------------------------------------------------------------------------------------------------------------------------
Hello my friend, I was being sarcastic when speaking of waving a little flag. perhaps it was inappropiate. My meaning was that here in U.S. the people who are considered Neo-Con conservates view themselves as true patriots--some say super patriots {waving flags}, and appear to me to have little concern for the plight of the old and working poor.
People like myself , who want public support and reform of the system are considered whining liberal traitors LOL!!
Of course the statement was meant in humor, but by personal obsevation somewhat true. What I am saying is a generalization, I am sure not all conservatives think alike.
Also I believe that honestly and truly, not all of it comes from greed. I am sure that some really believe that the best way to help the old/poor/ middle class,----is to not help them at all. Avoid all socialism---healthy economy--and in the end---people will be better off. Old {long} story. Good to hear from you oldie.

[pyritechips]

Seriously, I understand that Canada will not let us older folks have residency there because of the medical issue. If I'm wrong, please let me know.

And Japanese soldiers were told during the second world war that if the Americans captured them they would be skinned and eaten!
On the other hand, if you get an offer from Oldie, care to make it for three? I'm kind of sick of the snow too!

[oldie]

FIDELISTA - Thanks for the clarification. but never apologise for humor, or wit or whatever

Britain is in the same (sinking) boat as the US regarding this threads issue. Lord only knows what the next decade will bring

My wife and I are extremely fortunate to have taken early retirement to sunnier climes. But even more fortunate to be accepted into a community where ones elders are the most respected amongst that community. Some say it's the Church. Others say it's old fashioned this or that, but whatever it is it works

Catch you later - Oldie

[eggplant43]

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May 1, 2004

Mistakes Reported in Drug-Cost Comparisons

By ROBERT PEAR

WASHINGTON, April 30 — A new Medicare Web site comparing prescription drug prices is full of inaccurate, erroneous information, sponsors of drug discount cards said on Friday, just hours after the site was unveiled by the Bush administration.

Tommy G. Thompson, the secretary of health and human services, had said the Web site would shine a light on some of the biggest secrets in the health care industry, allowing Medicare beneficiaries to penetrate the mysteries of drug pricing.

But companies offering the cards said the government and its contractor had posted inaccurate data.

"In some cases, the numbers may be too low, but in many cases, the numbers are too high," said Craig L. Fuller, president of the National Association of Chain Drug Stores, which has joined Express Scripts in offering a drug discount card to Medicare beneficiaries.

Mr. Fuller said the posted prices did not reflect all the rebates and discounts available to Medicare recipients.

Stephen E. Littlejohn, vice president of Express Scripts, said: "Our price for a 30-day supply of Vioxx, an arthritis drug, is listed as $159.32 when it should have been listed as $85.93. Celebrex was listed as $121.55. It should have been $84.78. Premarin was listed as $47.43. It should have been $30.71."

Other card sponsors voiced similar complaints. The inaccuracies add to the confusion surrounding the discount cards and the new law.

Representative Bill Thomas, the California Republican who is chief architect of the law, said Friday that its success was imperiled by a steady drumbeat of Democratic criticism likely to discourage elderly people from signing up for discount cards and drug benefits.

"Democrats hope this law will fail," said Mr. Thomas, the chairman of the Ways and Means Committee. Democrats, he said, should allow the law to work "before they gleefully announce it's a failure," and he asked, "Are seniors pawns in this battle for Democrats to recapture power?"

Drug card sponsors are eager for the law to work well, but they were annoyed to see inaccurate data posted on the official Medicare Web site.

"We went onto the site to check like everybody else, and we noticed that some of the price information was not correct or was missing," said Jennifer Leone, a spokeswoman for Medco Health Solutions, which is offering a discount card under the name Preferred Prescriptions.

Laurie L. Meyer, a spokeswoman for Walgreens, said, "About half our prices are inaccurate, on the high side."

Mr. Littlejohn said: "The Web site may be comparing prices that are not comparable. One drug may have hundreds of prices, depending on the dosage, strength, quantity, package size and other factors. We submitted 60,000 prices for products covered by our card."

Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, rejected criticism of data on the agency's Web site. "We stand by our prices," Dr. McClellan said. "I do believe the prices are accurate."

He said some confusion may result from the fact that pharmacies receive the same drugs in bottles of 500 or 1,000 tablets, in small blister packs and in other containers. Prices typically vary with the package size, he said.

To have a lower price listed on the Web site, Dr. McClellan said, drug card sponsors must guarantee that consumers can get that price at retail pharmacies. Before signing up for a card, he said, beneficiaries should probably wait a few days or weeks, to see if prices are reduced.

Medicare beneficiaries can sign up for cards starting Monday and can use the cards from June of this year until January 2006, when Medicare's new drug benefit begins.

Democratic senators said on Friday that beneficiaries should be allowed to bail out of a discount card program and switch to a different one within 30 days after they first enroll. With the information currently available, they said, it is virtually impossible to choose the best card.

The concerns were expressed in a letter sent to Mr. Thompson by the Senate minority leader, Tom Daschle of South Dakota, and 11 other Democrats.

President Bush and Congressional Republicans had hoped to receive political credit for the Medicare law. But from the moment it was signed on Dec. 8, Democrats, led by Senator Edward M. Kennedy of Massachusetts, have denounced it, saying it provides more help to drug companies and insurance companies than to the elderly.

In a 90-minute meeting with journalists on Friday, Mr. Thomas vented his frustration. "This is now the law of the land," he said. "Why don't we try to get as many people as possible under the parameters of the law, instead of continuing to fight this fight?"

"For the Democrats to be successful," Mr. Thomas said, "they've got to scare people into not getting into the program. So they tell people that it isn't worth anything."

[eggplant43]

May 5, 2004

Study Finds Widespread Problem of Inadequate Health Care

By LAWRENCE K. ALTMAN

Americans get substandard care for their ailments about half the time, even if they live near a major teaching hospital, the first comprehensive study of health care provided in metropolitan areas has found.

The inadequate treatment leads to "thousands of needless deaths each year," said Dr. Elizabeth A. McGlynn, a researcher at the RAND Corporation and an author of the study, being published today in the journal Health Affairs.

Only a fundamental redesign of the health system will improve the situation, Dr. McGlynn said, adding, "It's a tremendous cultural shift we're asking for."

The study's conclusions were based chiefly on a review of the medical records of nearly 7,000 people in 12 metropolitan areas, including Newark, Miami and Orange County, Calif. On average, the authors found, patients received substandard care, as defined by leading medical groups, 50 percent to 60 percent of the time. There was little variation among the metropolitan areas, randomly selected from 60 with populations of at least 200,000. The areas included cities and their suburbs.

Dr. McGlynn said the study's definitions of adequate care were developed not only from the recommendations published by specialty medical groups but also from four panels of doctors who practiced in a variety of settings. The recommendations reflected what was considered standard at the time the care in the study was delivered, from 1996 to 2000.

The team used the standards to measure average care for adults in an entire community, not the care delivered by specific hospitals, health care plans or doctors. The study did not make comparisons with earlier years or other countries.

"Quality in most areas of care was uniformly poor," said the authors of the study, which was financed by the Robert Wood Johnson Foundation. And Dr. McGlynn added that for the $1.4 trillion a year the United States spends on health care, it was getting "fairly dismal results."

In a telephone interview with reporters, she noted that doctors and hospitals were paid the same whether they provided "very good care or not-so-good care."

Dr. Donald J. Palmisano, president of the American Medical Association, said yesterday that "there is room for improvement" in medical care and that his organization had taken steps so that new recommendations and innovations are quickly communicated to all physicians.

"The main challenge is quick retrieval of pertinent information," Dr. Palmisano said in an interview from a meeting on improving patient safety he was attending in Boston.

Although other researchers have concluded that American health care falls far short of its potential, their studies have not been as broadly based as the new one.

To assess the level of care in the 12 communities, the authors received permission from the patients who participated to scour their medical records for the two preceding years. The authors recorded information concerning 439 steps involved in the care of 30 acute and chronic medical conditions like high blood pressure, immunizations, heart failure, diabetes, broken hips and alcoholism.

For diabetes, the steps included measurements of blood pressure, blood sugar, cholesterol and examination of the feet and eyes. The steps were intended to measure control of the disease and its complications.

Quality of care for some chronic diseases was variable. High blood pressure ranked among the best while diabetes care ranked lowest in most communities, the authors said. Preventive care for sexually transmitted diseases, AIDS and substance abuse ranked lower than screening for high blood pressure and offering immunizations.

Saying that information about quality should be presented locally so officials could tailor action to community needs, the authors urged greater collaboration among communities to improve monitoring of health care.

As models, the authors cited efforts that 43 medical groups and hospitals in Minnesota were making to develop uniform practice guidelines for all health plans in the state. The authors also said monitoring and public reporting of heart bypass surgery in New York State had led to a decline in deaths from the procedure.

The authors also called on research agencies to conduct studies involving larger numbers of communities. They said it would require a study of more than 100 metropolitan areas to draw more definitive conclusions about the effects of the structure of health care systems and finances. (Besides Newark, Miami and Orange County, the areas studied were Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Phoenix; Seattle; and Syracuse.)

[izme]

Originally Posted by eggplant43

Theoretically, the people are the government,

it is the truth and the most important fact of our nation!
too many people do not realize this point, we can change anything in america, but choose to act like submissive lambs

Our own government is capitalizing on this! They know how to fix it but chose to take payoffs ect.
We need to totally change all areas of health care, and put caps on lawsuits ect.

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[eggplant43]

--------------------------------------------------------------------------------

May 12, 2004

73 Options for Medicare Plan Fuel Chaos, Not Prescriptions

By JOHN LELAND

When Mildred Fruhling and her husband lost their prescription drug coverage in 2001, they suddenly faced drug bills of $7,000 a year. Mrs. Fruhling, now 76, began scrambling to find discounts on the Internet, by mail order, from Canada and through free samples from her doctors.

"It's the only way I can continue to have some ease in my retirement," she said.

Last week, when the federal government rolled out a new discount drug program, Mrs. Fruhling studied her options with the same thoroughness. What she found, she said, was confusion: 73 competing drug discount cards, each providing different savings on different medications, and all subject to change.

"I personally feel I can do better on my own," she said. But she added, "At this point, I don't think anyone can make an evaluation."

Even before they go into effect on June 1, the cards — which are approved by Medicare but offered by various companies and organizations — have been the subject of heated political debate, an AARP advertising campaign about how confusing they are and anxious speculation from those they are supposed to help. Among retirees of different income groups interviewed last week, the initial reaction was incomprehension.

"Even the person who came to explain it to us didn't understand it," said Mary Shen, 77, at the Whittaker Senior Center on Manhattan's Lower East Side. "It's not fair to expect seniors, who have enough difficulties already, to have to figure this out."

Shirley Brauner, 75, pushed a metal walker through the center's lunchroom. "All I've got to say is they confuse the elderly, including me," she said. "I'm furious. They're taking advantage of the seniors. How can the seniors understand it?"

The prescription drug discount cards are a prelude to the Medicare Prescription Drug, Improvement and Modernization Act, which will provide broad drug coverage starting in 2006. The federal government projects that 7.3 million of Medicare's 41 million participants will sign up for the cards.

Those who wish to do so, however, face the daunting task of choosing the right card.

"What it's like is a bunch of confusion," said Katharine Roberts, 77, who said she had not been to a movie in six years, in part because of her drug expenses. "You might find you really need three cards, and you can only choose one."

The cards are a 19-month stopgap measure to provide discounts of 10 percent to 25 percent for Medicare participants who have no other prescription drug coverage. In addition, low-income participants are eligible for subsidies of $600 a year.

The Department of Health and Human Services approved 28 companies or organizations to issue cards; among them are AARP, insurance companies and health maintenance organizations. Cards cost up to $30 a year. Each card provides different discounts on different drugs, and is accepted by different pharmacies. Participants can choose only one.

To help people sort through the options, Medicare and a company called DestinationRx set up a database on its Web site, medicare.gov, that lists the prices charged under various plans for whatever medications a user types in. People can get similar help by telephone at 1-800-MEDICAR. But some providers complained that the prices on the site were inaccurate, and some cards are not listed at all.

For many retirees, it is too much.

"I'm 85, do I have to go through this nonsense?" asked Florence Daniels, a retired engineer who said she received less than $1,000 a month from Social Security, of which she paid $179 a month for supplemental medical insurance. She gets drugs through a New York State program, which provides any prescription for $20 or less. To make ends meet and afford her drugs, she said she bought used clothing and put off buying new glasses. Some of her friends travel by bus to Canada to buy drugs; others do without, she said.

Ms. Daniels did not use the government Web site to compare drug cards, in part because she cannot afford a computer. "I'm trying to absorb all the information, but it's ridiculous," she said. "Not just ridiculous, it's scary. If there was a single card and it was administered by Medicare, and it got the cost of drugs down - wonderful, marvelous. But with these cards, the only thing we know is that we'll have to pay money to other people to administer what we can get and can't get."

The discount program, which is financed largely by the cards' sponsors, reflects the Bush administration's desire to open Medicare to market principles without allowing participants to import drugs from other countries, which many Democrats favored.

Mark B. McClellan, an administrator at the Center for Medicare and Medicaid Services, said the complexity of the plan encouraged competition. "We're seeing more plans offering better benefits," he said, estimating that people will be able to save 15 percent or more using the cards.

But the complexity of choices will keep many people away from the program, said Marilyn Moon, director of health at the American Institutes for Research, a nonprofit research organization in Washington.

Often, the discount provided by the cards is not as good as what people can get from existing state programs, union plans or consumer groups, said Robert M. Hayes, president of the Medicare Rights Center, a nonprofit organization that helps individuals with Medicare problems.

Sydney Bild, 81, a retired doctor in Chicago, compared the discount cards with the prices he paid ordering his drugs by mail from Canada. Dr. Bild pays $4,000 to $5,000 a year for five medications. When he checked the government Web site, he said the best plans were about 50 percent to 60 percent higher than what he was paying.

But Dr. Bild said his main objection to the new plans was that companies could change prices on drugs, or change the drugs covered. Medicare requires plans to cover only one drug in each of 209 common categories. Consumers can change cards only once a year. Committing to a card is "like love - it's a sometime thing," Dr. Bild said. "What if I chose one? They could drop my drugs two weeks later."

Companies began soliciting customers for their discount drug cards last week. When the first pamphlets arrived at Beverly Lowy's home in New York City, Ms. Lowy said, she looked at them carefully. She does not have drug coverage and last year spent about $3,000 on prescription drugs. But the more brochures she read, Ms. Lowy said, the less clear things became.

"You really have to be a rocket scientist," Ms. Lowy, 71, said. "It takes time, energy, and you don't even save money. I thought, 'This one is offering this, this one is offering that.' Finally I decided this isn't for me."

At the Leonard Covello Senior Center in East Harlem, the new cards seemed opaque. Ramon Velez, 72, a retired taxi driver, said he had watched AARP advertisements in which people read the dense language of the federal Medicare bill.

"I was laughing at the people in the ads, but it's true," Mr. Velez said. "Everyone's confused."

Mr. Velez receives $763 a month from Social Security, and often skips his psoriasis medication because he cannot afford the $45 co-payment under his Blue Cross/Blue Shield plan. He wondered if the new drug cards could save him money.

"But it's very confusing," he said. "I'd go to the Social Security office to ask about the cards, but I don't think they'd know."

Alejandro Sierra, 67, a retired barber, paced around the center's pool table. Mr. Sierra takes six medications for diabetes and complications from cataracts and colon cancer, and sometimes skips a medication because he cannot afford it.

"I'm interested in the cards," he said. "But I can't figure it out on the computer, because I can't see."

Carlos Lopez, the director of the center, said the cards had so far produced little but anxiety. Mr. Lopez asked participants to bring any applications to him before signing them, and warned them about people selling phony cards.

"They're not nervous, but concerned," he said. "They feel, why now? Why do I suddenly need a card for medications?"

[thedoc46]

hi guys,

I've just been reading this thread. I currently live in England but I am moving over to Florida in two months. I'm 32yrs old and in excellent health. My wife is 27 yrs old and she too is in excellent health. I am a little confused about your health system. So what would happen if I was to have an accident and no health insurance ? Would they leave me for dead ? that seems a bit barbaric.

I guess that won't happen I'll have to pay like everyone else I guess.

A major concern for me is my mother who would like to come and live over in the US near me (her only son) She had previously had cancer and I guess it's fair to say she's what would be considered a high risk.. What are her options ? Would they say sorry we will insure you but if you get cancer tough luck !!!! I just don't know ..

No really what would happen 1.\ if you had a bad accident and no insurance. 2.\ already suffered with an illness and tried to get insured

thanks in advance

[eggplant43]

Welcome to TSG.

If you were in an accident, and uninsured you'd have to pay out of pocket. If you were unable to do so, the hospital could not refuse you emergency treatment (in theory and law) but many play games around this, especially the "better" ones in big cities.

Your mom would probably be able to get "very expensive" insurance, and they might still exclude coverage of the "pre-existing illness". Our older citizens are entitled to Medicare which pays for much of the expense, but could rapidly bankrupt someone if it was a catastrophic illness. Since your mom is not a citizen, she would not qualify for this benefit.

I'm sure there are many "technicalities" of which I'm not aware, but this broadly answers your questions. In this country, the majority of those insured are insured through their job. Employers are finding it increasingly difficult to cover their employees due to rapidly rising fees, with no end in sight.

[eggplant43]

Many of us complain about the inefficiency of the government. Apparently, if you really want to foul things up, you just need to combine the ineficiencies of the government with the inefficiencies of business. Why did no one think to figure out how to make an simple, elegant service delivery system for the elderly such as having each participant fill out a form, and then let them know what their best options would be?


http://www.sltrib.com/2004/May/05232...s/business.asp

[slickoe]

I am new to this thread, and while I am a lefty in most respects, one thing about the health care issue irks me - the notion that health care should be provided at all to every citizen like in the socialized medicine countries. Food is much more important than health care- if you don't get it every day you eventually die - yet noone is calling for socialized food giveaways. Food costs money, and money doesn't grow on trees. Shelter is necessary, but there is no demand for housing on demand from the government. If the majority of citizens don't want to be taxed to help people who earn less than them, there is no reason why they should have to, regarding health care, food, housing, or anything. Yes catastrophes happen. Accidents happen. Life is sad sometimes. But I don't want big government in charge of my food, shelter, or telling me what I can or can't do, nor do I want them making healthcare decisions for me.